Identifying the Unique Needs for Clean-Sport Education for Para-Athletes and Athlete-Support Personnel

Background: To date, clean-sport education has not been purposefully designed to address the needs of paraathletes and athlete-support personnel (ASP).To maximize the effectiveness of clean-sport education for these important groups, this study co-created the first set of recommendations for clean-sport education identifying their specific needs.Methods: The Delphi method was used to develop the education recommendations.134 stakeholders representing anti-doping, para-sport, and ASP with relevant expertise were invited to be panel members.In Round 1, the expert panel (n = 66) suggested potential items for clean-sport education delivered to para-athletes and ASP.The findings from Round 1 were then integrated with items from a review of relevant literature, interviews with 41 ASP, and nine focus groups with para-athletes across six countries to form a survey assessing the importance of 28 potential items for inclusion in the recommendations.In Round 2, an expert panel (n = 44; 67.7% response rate) completed this questionnaire.In Round 3, panel members (n = 38; 57.6% response rate) ranked for relative importance the topic areas rated highest in Round 1.Based on these rankings, a draft set of recommendations was created.In Round 4, panel members (n = 29; 43.9% response rate) rated the degree to which they accepted these recommendations and the feasibility of their delivery, as well as identifying possible barriers and facilitators to their implementation.Results: The results of Round 2 and Round 3 were used to create a set of educational recommendations consisting of 18 items for para-athletes and nine items for ASP.In Round 4, the para-athlete recommendations were either fully (n = 18), mostly (n = 8) or partly accepted (n = 1) by the panel, whereas those for ASP were either fully (n = 19), mostly (n = 4) or partly accepted (n = 3).One panel member did not accept the ASP recommendations at all.Conclusions: Para-athletes and ASP have been underserved in the design and delivery of anti-doping and clean sport education.Directly addressing their specific educational needs in relevant policy (e.g., WADA ISE) would help ensure their needs are effectively and consistently addressed in future education delivery.