Understanding and building clean(er) sport together: Community-based participatory research with elite athletes and anti-doping organisations from five European countries

Andrea Petroczi, Andrew Heyes, Sam Thrower, Laura Martinelli, Susan Backhouse, Ian Boardley, The RESPECT Consortium

Research output: Contribution to journalArticlepeer-review


Background: In sport the narrative is changing from anti-doping to clean sport. Yet, our understanding of what ‘clean sport’ means to athletes is notably absent from the literature.

Objectives: Working together with elite athletes and National Anti-Doping Organisations (NADOs), this study explored the meaning and importance of ‘clean sport’ and ‘clean athlete identity’.

Design: For the first time, a community-based participatory research design was employed to explore (a) how elite athletes define clean sport and being a clean athlete; (b) the hopes and challenges associated with clean sport and being a clean athlete; and (c) what can be done in anti-doping to elicit clean sport.

Methods: Five elite athletes in five European countries (Germany, Ireland, Netherlands, Slovenia and UK) were recruited as co-researchers by their respective NADOs, trained for their role as co-researchers and individually interviewed. Seventy-seven elite athletes were then purposefully recruited for 12 athlete-led national focus groups. Finally, the five athlete co-researchers and five athlete participants took part in one 2.5-hour long international focus group.

Results: Reflexive thematic analysis resulted in generating four overarching themes: ‘clean is being true to the self’, ‘clean performance enhancement has multiple meanings’, ‘clean is not a solo act’ and ‘the problems and solutions are systemic’. Collectively, the themes showed that the clean athlete identity is highly idiosyncratic and rooted in upbringing, early experiences, and love of sport. It is also characterised by continued, intrinsically motivated commitment to fundamental values acquired in childhood and morals. Whilst elite athletes value anti-doping efforts, their experiences of disparity and unfairness in doping control undermine their trust in anti-doping and they feel action is needed to address these concerns.

Conclusion: Clean athlete identity is a social endeavour and artefact, which should be reflected in and developed through evidence-informed anti-doping interventions. Raising athletes’ voices via collaboration and participatory research is an enriching experience for athletes and researchers, and a worthwhile endeavour for sport organisations with responsibility for anti-doping. To make anti-doping education personally relevant, the richness of individual interpretation of ‘clean’ for the self (i.e., clean athlete identity) and performance-enhancement is advised to be acknowledged, respected and cultivated

© 2021, Elsevier ltd. The attached document (embargoed until 27/03/2023) is an author produced version of a paper published in Psychology of Sport and Exercise uploaded in accordance with the publisher’s self-archiving policy. The final published version (version of record) is available online at the link. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
Original languageEnglish
Early online date27 Mar 2021
Publication statusPublished - 1 Jul 2021


  • Qualitative
  • Focus groups
  • Values of sport
  • Identity
  • Clean sport
  • Anti-doping
  • Prevention,

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