Exploring anti-doping knowledge level: a systematic review among athletes, students, and athlete support personnel in the sports sector

The level of anti-doping knowledge within the sports sector remains an underexplored area of research. Moreover, the methods used to assess this knowledge are not standardized, resulting in a lack of harmonization across studies. This heterogeneity makes it difficult to analyze and compare the level of knowledge among different populations in a consistent manner. The main aim of this study was to systematically review the level of anti-doping knowledge among Athletes, Students, and Athlete Support Personnel in the sports sector. The secondary objective was to identify and evaluate the methodology used to measure the level of knowledge. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used to identify relevant studies. All articles assessing anti-doping knowledge were included, regardless of study design, measurement instruments, or target population. A set of evaluation criteria was developed and used to objectively measure the quality of the included studies. Ninety-three studies were included in the analysis. Twenty-five publications (26.88%) did not clearly report the level of anti-doping knowledge. Across the remaining studies, a wide heterogeneity of instruments and reporting approaches was observed. Using a heuristic and interpretive classification framework to synthesize author-reported descriptors, most studies were heuristically classified as reflecting a predominantly “Low” level of anti-doping knowledge (45.16%), while fewer studies reported “Limited” (8.60%), “Basic” (5.38%), or “Good” (13.98%) knowledge. No study explicitly described an “Extensive” level of anti-doping knowledge. These findings should be interpreted as indicative patterns derived from descriptive synthesis rather than as precise quantitative estimates. Despite methodological heterogeneity, these findings highlight the need to develop standardized and validated assessment tools and to implement structured educational programs to improve anti-doping knowledge across the sport sector. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024513234 , identifier CRD42024513234.