Compliance by Hong Kong’s National Sport Organizations With the World Anti-Doping Program

Abstract

 

The present study aimed to assess current anti-doping efforts among Hong
Kong’s national sport organizations (NSOs), for example
organizations’ readiness to change and to initiate or strengthen
anti-doping measures. The points of view of administrators, coaches,
and committee members were considered. A great majority of NSOs in Hong Kong appeared to be at the
contemplation stage, concerning anti-doping actions. The major
constraints they faced were limited funds and manpower.


The World Anti-Doping Program, developed by the World Anti-Doping
Agency (WADA), is structured in three levels: a World Anti-Doping
Code, international standards, and models of and guidelines for best
practices. WADA officials state that one purpose of the World
Anti-Doping Program and code is “to ensure harmonized, coordinated,
and effective anti-doping programs at the international and national
level with regard to detection, deterrence, and prevention of doping”
(World Anti-Doping Agency, 2003). We would like to suggest that the
program actually can serve two purposes. On the macro level, it can
provide various international federations and national anti-doping
organizations (NADOs) with a framework for developing anti-doping
policies, rules, and regulations. On a micro level, it can guide
national sport organizations (NSOs) in carrying out anti-doping
functions like educational programming and in adopting appropriate
practices to demonstrate compliance with various anti-doping
regulations.
The World Anti-Doping Code has been in place for over 5 years, so the
roles of international federations and NADOs in promoting and
monitoring athletes’ anti-doping behaviors should be clear to sport
organizations and professionals involved in high-level competition
(e.g., World Games, Olympics). Those not involved at that level may
be less familiar with arrangements, for instance coaches and
administrators of NSOs that have not produced athletes qualifying for
high-level competitions. Even NSOs with experience in high-level
competition may have second- or third-tier athletes lacking the
exposure their elite counterparts have had. Given that NSOs play a
significant role in communicating anti-doping information to athletes
and explaining their role in anti-doping regulations, the evaluation
of NSOs’ current practices is important. The present study provided
such an evaluation, using a case-study approach to determine the
extent of Hong Kong NSOs’ compliance with the anti-doping program.
Specifically, we aimed to assess whether Hong Kong’s NSOs were
implementing anti-doping functions, as well as to identify
constraints on their full compliance. Although the study involved
only Hong Kong organizations, knowledge gained should be applicable
in countries with similar anti-doping experience, and the study
should thus prove useful to international federations, NADOs, and
WADA as they direct resources and efforts.
Since to an extent NSOs are organizations whose anti-doping
compliance or noncompliance can be treated as the adoption of one
management practice over another, their anti-doping compliance can be
modeled as organizational change. We therefore reviewed such models
and chose Prochaska’s transtheoretical model (TTM) (Prochaska,
2000) to analyze NSO anti-doping functions. The popular TTM was
originally developed to explain behavioral change in individuals
(Prochaska, Prochaska, & Levesque, 2001).
Central to the TTM are three theoretical constructs related to
change: (a) stages of change, (b) decisional balance, and (c) process
of change. Intentional change—whether by an individual or an
organization—can occur in stages and so can be seen as a series of
movements along a continuum. There are six such movements or stages:
pre-contemplation, contemplation, preparation, action,
maintenance
, and termination. The terminology process
of change,
in contrast, connotes the belief that change is
influenced by both overt and covert activities that comprise
experiential processes and behavioral processes.
Experiential processes characterize the early-stage transition and
include consciousness raising, dramatic relief, environmental
reevaluation, social liberation,
and self-reevaluation.
Behavioral processes characterize later-stage transition and include
stimulus control, helping relationship, counter conditioning,
reinforcement management,
and self-liberation.
In sum, the TTM provides an opportunity to understand the temporal
ordering of events as an established pattern is changed, which is
what we intended to do in terms of the NSOs’ implementation of
anti-doping functions. It also provides opportunity to explore
mechanisms mediating intentional change (e.g., constraints on
implementation of anti-doping functions). An additional rationale for
adopting the model was its prior successful application in an
analysis of family-service agencies (Prochaska, 2000), a study of the
implementation of a system of “time-limited therapy” that has
notable parallels to the implementation of anti-doping functions.

 

Method

 

Design of Questionnaire

The three versions of the self-report instrument used in the present
study were developed with input from three NSOs of different sizes,
whose staffs were invited to participate in face-to-face interviews
with a member of the research team experienced in anti-doping works.
During these interviews, the purpose and procedures of the study were
clarified for the NSOs, and items for inclusion in the questionnaire,
as well as in a structured interview, were identified. NSOs
participating in these preliminary interviews did not participate in
the study itself.

 

Collection of Survey Data

A letter of invitation to participate in the research project and
three copies of the final questionnaire were delivered to each NSO in
Hong Kong (except the three involved in instrument development).
Follow-up telephone calls were made to confirm the organizations’
interest in participating. NSOs that volunteered to participate were
scheduled for interviews with research team members. Completed
questionnaires were collected during or after an interview session.
The three versions of the study questionnaire included one for NSO
administrators, one for NSO coaches, and one for NSO committee
members. All versions included Part 1 and Part 2; the version for
administrators contained an additional three parts. Part 1 of the
questionnaire represented a modification of the Readiness to Change
Questionnaire (RTCQ) (Rollnick, Heather, Gold, & Hall, 1992). The
original RTCQ, designed to study drinking behavior, is a 12-item
questionnaire that assigns excessive drinkers to either the
precontemplation, contemplation, or action stages
(Heather, Gold, & Rollnick, 1991). For the present study, the
modified questionnaire assessed each NSO’s readiness to increase
its anti-doping efforts. Part 2 of the questionnaire was based on the
early interviews with the three NSOs not generating study data. From
these interviews, a list of pros and cons of increased anti-doping
efforts was developed. Part 2 asked respondents to rate the
importance of these pros and cons as influences on the NSO’s
decisions about increasing or not increasing anti-doping work.
Finally, Parts 3, 4, and 5 of the questionnaire were directed to NSO
administrators only and collected information about (a) spending on
anti-doping works, (b) opinions about anti-doping education programs,
and (c) an NSO’s demographic information.


Collection of Interview Data

Two members of the research team conducted structured face-to-face
interviews with representatives of NSOs who were either
administrators, committee members, or senior coaches. All were
familiar with their NSO’s anti-doping works. Standard questions
were posed initially, with a respondent’s answers guiding a series
of appropriate follow-up questions.

 

Results

A total of 62 invitations were sent to NSOs in Hong Kong to
participate in the research project, and 44 NSOs returned completed
questionnaires, a response rate of 71%. Interviews were completed
with 42 NSOs’ representatives, a response rate of 67.7%.

National
Sport Organization Demographics

The participating NSOs’ demographics provide a rough idea of the
scope of Hong Kong’s locally organized sport. Tables 1–4 present
the numbers of athletes, of coaches, and of competitions organized by
or participated in by our respondents. Most of the NSOs had fewer
than 5 full-time and 5 part-time employees. A majority (77.1%) had
fewer than 50 athletes active in international events that were
endorsed by an international federation. Over half of the surveyed
NSOs (60.6%) had 50–200 Level-1 coaches, while about half (57.6%
and 51.5%, respectively) had fewer than 31 Level-2 coaches and fewer
than 6 Level-3 coaches. About half of the NSOs organized fewer than
10 local competitions per year, and 65% organized 0–1 international
event annually. About 63% of the NSOs sent athletes to 1–5
international competitions each year.

 

Table
1

 

Numbers
of Employees at Hong Kong’s National Sport Organizations, With
Percentage of All Surveyed NSOs Having Similar Numbers

 

Full-time Part-time
Count % Count %
0 2 4.8 20 48.8 1–5 28 66.7 20 48.8 >5 12 28.6 1 2.4 Total 42 100 41 100

Table 2

 

Numbers
of Athletes Within Hong Kong’s National Sport Organizations, By
Competitive Event Type, With Percentage of All Surveyed NSOs Having
Similar Numbers

 

100

26

100

International Eventa Other Event
Count % Count %
0–10 7 20.0 1 3.8 11–50 20 57.1 5 19.2 51–100 4 11.4 9 34.6 101–200 3 8.6 2 7.7 > 200 1 2.9 9 34.6 Total 35

 

aFor
purposes of this study, an international event is a competition
endorsed by an appropriate international federation.
Table 3

 

Numbers
of Coaches Within Hong Kong’s National Sport Organizations (By
Level), With Percentage of All Surveyed NSOs Having Similar Numbers

 

 

Level 1 Level 2 Level 3
Count % Count % Count %
0–50 8 24.2 0–10 13 39.4 0 7 21.2
51–100 9 27.3 11–30 6 18.2 1–5 10 30.3
101–200 11 33.3 31–50 3 9.1 6–10 7 21.2
201–300 4 12.1 51–100 5 15.2 11–20 4 12.1
>300 1 3.03 >100 6 18.2 >20 5 15.2
Total 33 100 Total 33 100 Total 33 100

Table 4

 

Annual
Average Number of Competitions Organized By and Participated in By
NSOs, With Percentage of All Surveyed NSOs Having Similar Numbers

 

17

42.5

3–5

13

31.7

Average # of Local
Competitions Organized
Average # of
International Competitions Organized
Average # of
International Competitions
Participated In
Count % Count % Count %
0–5 14 34.1 0 9 22.5 1–2 13 31.7
6–10 10 24.4 1
11–20 8 19.5 2 6 15 6–10 6 14.6 21–30 1 2.4 3 1 2.5 11–20 6 14.6 >30 8 19.5 >3 7 17.5 >20 3 7.3 Total 41 100 Total 40 100 Total 41 100

 

Resources
Used for Anti-Doping Efforts

Our data suggest that Hong Kong’s national sport organizations have
not invested much, either in terms of finances or manpower, in
anti-doping efforts (Table 5). A majority of our respondents—close
to 88%—had expended no funds for anti-doping efforts within the 3
years preceding the study and anticipated no such spending throughout
the current year. Moreover, 80%–90% of the NSOs had neither any
staff members nor honorary consultants assigned to anti-doping work.
Table 5

 

Average
Annual Spending on Anti-Doping Efforts by Hong Kong NSOs, Over 4-Year
Period, in United States Dollars, With Percentage of All Surveyed
NSOs Spending Similar Amounts

 

 

Average Annual
Spending in 3 Years Preceding Study
Anticipated Spending
During Current Year
0 USD 36 (87.8%) 37 (88.1%)
1–1,000 USD 3 (7.3%) 2 (4.8%)
1,001–2,000 USD 1 (2.4%) 2 (4.8%)
> 2,000 USD 1 (2.4%) 1 (2.4%)

Tables 6

 

NSOs’
Staffing for Anti-Doping Efforts, By Paid Status and Position, With
Percentage of All Surveyed NSOs Providing Similar Numbers of Staff

Paid Staff

 

 

Count %
0 35 85.4
1 5 12.2
2 1 2.4

 

Honorary
Consultant from Medical Profession

 

Count %
0 32 80
1 3 7.5 2 2 5 >2 3 7.5

 

Honorary
Consultant from Legal Profession

 

 

Count %
0 36 90
1 2 5
2 2 5

 

Honorary
Consultant from Technical Field (e.g., Doping Control Officer)

 

 

Count %
0 33 82.5
1 2 5
2 3 7.5
>2 2 5

 

Honorary
Consultant (Unspecified)

 

 

Count %
0 38 95
4 1 2.5
6 1 2.5

 

Opinions
About Anti-Doping Education Programs

The NSO respondents were asked their opinions or perceptions
concerning appropriate content for inclusion in anti-doping
educational programs or informational materials (Table 7). The three
most important content areas, according to our respondents, were
“ways to avoid inadvertent doping,” “rights and
responsibilities of athletes in doping control,” and “anti-doping
rules and regulations.”
Table 7

 

NSO
Respondents’ Rank Ordering of Importance of Content Areas in
Anti-Doping Educational Programs, From Most to Least Important

 

Content Score
Mean SD
Ways to avoid inadvertent doping .97 1.09

Rights and responsibilities of athletes in doping control

.95 1.17 Anti-doping rules and regulations .77 1.02 Responsibilities of NSO in doping control .56 .93 Competitive sports and ethics .47 .69 Therapeutic use exemption for prohibited drugs .45 .92 Drug testing procedures .40 .80 Current international anti-doping practices .39 .84 Whereabouts information of athletes .35 .87 Current Hong Kong anti-doping practices .34 .72

As shown in Table 8, the surveyed respondents indicated that the most
suitable medium to deliver anti-doping educational programs was a web
page. Workshops, pamphlets, and video presentations were also
considered suitable modes of delivery.
Table 8

 

NSO
Respondents’ Rank Ordering of Suitability of Anti-Doping
Educational Program Delivery, From Most to Least Suitable

 

Mean SD

 

 

Web page

2.77

2.02

Workshop

2.58

2.12

Pamphlet

2.15

1.79

VCD

2.13

1.73

Other

.35

1.03

 

Surveyed
NSO associates suggested other suitable media for providing
anti-doping education (Table 9), as well.
Table 9
Other Modes of Anti-Doping Education Suggested by Respondents

 

 

Mode Number of
Respondents Making This Suggestion
TV
Commercial/Program
3
Seminar 1
Newspaper Article 1
Commercial Media 1
Exhibition 1

 

Respondents
were asked what they thought would be a suitable time to conduct an
anti-doping workshop; opinions varied from NSO to NSO. As shown in
Table 10, while 45% preferred weekday evenings, other times also had
support (i.e., weekday “office hours,” 30%; weekends, 25%).
Table 10
Anti-Doping Workshop Times Preferred By Respondents

 

 

Frequency %
Monday–Friday
“Office Hours”
12 30
Monday–Friday
Evenings
18 45
Saturday–Sunday 10 25
Total 40 100

 

 

 
Asked if they would recommend that their NSO staff attend a 6–8-hr
anti-doping workshop costing $300 HKD (about $40 U. S.) per
participant, 68.3% of our respondents said yes (Table 11).
Table 11
Number/Percentage of Respondents Who Would/Would Not Recommend NSO
Staff Attendance at 6–8-Hr, 300 HKD Anti-Doping Workshop

 

 

Frequency %
Yes 28 68.3
No 13 31.7
Total 41 100

 

Readiness
for change

Data from the modified RTCQ completed by NSO administrators, coaches,
and committee members are presented in Table 12. A majority of
respondents of all three types were in the contemplation stage (54.5%
of administrators, 51.1% of coaches, and 47.7% of committee members).
Being in the contemplation stage meant actively considering whether
to initiate or strengthen an NSO’s anti-doping effort.
Table 12

 

Indicated
Readiness to Initiate or Strengthen NSO’s Anti-Doping Efforts, In
Terms of RTCQ “Stage,” With Percentage of All Respondents at Same
“Stage”

 

 

Precontemplation Contemplation Action
Administrators 8 (18.2%) 24 (54.5%) 14 (27.3%)
Coaches 8 (17.8%) 23 (51.1%) 14 (31.1%)
Committee Members 10 (22.7%) 21 (47.7%) 13 (29.5%)

Factors in
Decision Making About Anti-Doping Efforts

Administrators, coaches, and committee members were asked to rate the
importance of a list of pros and cons of initiating or strengthening
anti-doping efforts within their NSO (Tables 13 and 14).

 

Table
13

 

NSO
Respondents’ Rank Ordering of Importance of “Pro” Factors in
Anti-Doping Decisions, From Most to Least Important

 

 

Pros Score
Average SD

 

Administrators

 

It will directly or
indirectly improve professional knowledge of the NSO staff.
5.1 1.17

 

It will help us to
avoid being penalized by an international federation.

3.85

1.61

 

 

It will affect the
professional image of the NSO.

3.69

1.49

It will help to
preserve the health of our athletes.

3.17

1.38

There is a need to
comply with the rules and regulations set forth by the
international sporting community.

2.06

1.17

It will help to
maintain fair play.

2.06

1.21

 

 

Coaches

 

It will directly or
indirectly improve professional knowledge of the NSO staff.
4.11 1.41
It will help us to
avoid being penalized by an international federation.
3.93 1.67
It will affect the
professional image of the NSO.
3.7 1.66
There is a need to
comply with the rules and regulations set forth by the
international sporting community.
2.93 1.6
It will help to
preserve the health of our athletes.
2.7 1.6
It will help to
maintain fair play.
2.41 1.54

Committee
members

It will directly or
indirectly improve professional knowledge of the NSO staff.
4.85 1.24
It will help us to
avoid being penalized by an international federation.
4.1 1.62

 

It will affect the
professional image of the NSO.

3.94

 

1.6

It will help to
preserve the health of our athletes.

2.73

1.58

There is a need to
comply with the rules and regulations set forth by the
international sporting community

2.45

1.11

It will help to
maintain fair play.

2.24

1.28

 

 

 

 

Table
14

 

NSO
Respondents’ Rank Ordering of Importance of “Con” Factors in
Anti-Doping Decisions, From Most to Least Important

 

 

Cons Score
Average SD

 

Administrators

 

It will create
unnecessary hassle for our athletes.
4.98 1.23

It will pose additional
financial pressure on our NSO.

3.81

1.46

Anti-doping work is not
essential to the development of our NSO.

3.36

1.55

 

 

Athletes in our sport
do not use prohibited substances to enhance performance.

3.12

1.66

There is a lack of
professional knowledge to implement such works.

3.07

1.51

 

 

There is a lack of
manpower to implement such works.

2.44

1.38

 

 

 

 

Coaches

 

 

It will create
unnecessary hassle for our athletes.
4.56 1.28
Anti-doping work is not
essential to the development of our NSO.
3.78 1.41
It will pose additional
financial pressure on our NSO.
3.6 1.55
Athletes in our sport
do not use prohibited substances to enhance performance.
3.58 1.76
There is a lack of
professional knowledge to implement such works.
3.06 1.63
There is a lack of
manpower to implement such works.
2.76 1.21

 

Committee
Members

 

It will create
unnecessary hassle for our athletes.
4.92 1.41

Anti-doping work is not
essential to the development of our NSO.

3.92

1.68

 

It will pose additional
financial pressure on our NSO.

3.85

Athletes in our sport
do not use prohibited substances to enhance performance.

3.27

1.71

There is a lack of
professional knowledge to implement such works.
3.52

1.69

 

There is a lack of
manpower to implement such works.

2.85

1.66

 

 

 

 

 

 

 

For
the list of “pros” associated with initiating or strengthening an
anti-doping effort, administrators, coaches, and committee members
alike said the three most important considerations were, in
descending order of importance, “It will directly or indirectly
improve professional knowledge of the NSO staff,” “It will help
us to avoid being penalized by an international federation,” and
“It will affect the professional image of the NSO.” Similarly,
for the list of “cons,” they agreed that the most important
consideration was “It will create unnecessary hassle for our
athletes,” and that the second and third most important factors
were “Anti-doping work is not essential to the development of our
NSO” and “It will pose additional financial pressure on our NSO,”
respectively. However, administrators said financial pressure was a
more important consideration than coaches and committee members said
it was, while the latter groups felt more influenced than
administrators did by anti-doping’s perceived nonessential role in
the development of an NSO.

NSOs’
Present and Upcoming Anti-Doping Efforts

The interviews we conducted with representatives of Hong Kong’s
NSOs allowed for collection of information about their current and

upcoming anti-doping activities, including work in education,
capacity building, drug testing, cooperation with international
federations and anti-doping organizations, and policy. Results
obtained are presented in Table 15.

 

Table
15

 

NSOs’
Present and Upcoming Anti-Doping Work, By Activity, With Percentage
of All Surveyed NSOs Pursuing Same

 

Activity Statusa Count %

 

Education

 

To remind athletes
and athlete support personnel that they are bound by the
anti-doping rules
1 7 16.3
2 1 2.3
4 35 81.4

Total

43

100

To distribute
information on doping control from third parties to your athletes
and athlete support personnel

1

14

32.6

2

1

2.3

4

28

65.1

 

 

Total

43

100

 

 

To distribute
information about education programs on doping control to
athletes/coaches/sport administrators

1

18

41.9

4

25

58.1

Total

43

100

 

 

To include
information on doping control in newsletter, web page, or
correspondence with NSO members

 

 

1

30

69.8

2

5

11.6

 

 

4

8

18.6

Total

43

100

 

 

To seek assistance from
relevant parties to organize education or information sessions for
your athletes and athlete support personnel, on matters related to
doping control

1

28

65.1

2

8

18.6

 

 

 

 

3

2

4.7

4

5

11.6

 

 

Total

43

100

To organize educational
talk or seminar for your athletes/coaches/sport administrators on
anti-doping

1

35

81.4

2

5

11.6

4

3

7

 
Total

43

100

 

 

Capacity Building

 

To upgrade the existing
staff on doping issues, through information/education program
1 32 74.4
2 5 11.6
4 6 14

Total

43

100

To train a doping
control officer for your NSO

1

38

88.4

2

3

7

4

2

4.7

 

 

Total

43

100

 

 

 
Drug Testing (and Related Functions)

 

To conduct drug tests
for locally held international event
1 23 53.5
2 4 9.3
4 16 37.2

Total

43

100

To conduct drug
tests for local competition

1

39

90.7

2

1

2.3

4

3

7

 

 

Total

43

100

 

 

 

To conduct
out-of-competition drug tests on your athletes

1

41

95.3

2

1

2.3

4

1

2.3

 

 

Total

43

100

To keep record of all
drug tests conducted on your athletes (for international
competition and out-of-competition)

1

26

60.5

2

3

7

3

1

2.3

 

 

4

13

30.2

Total

43

100

 

 

To regularly update
your international federation(s) and anti-doping organizations on
the drug test record and results of your athletes

1

36

83.7

 

2

1

2.3

 

 

4

6

14

 

Total

43

100

 

 

To collect or
coordinate the whereabouts information of your athletes

1

24
55.8

4

19

44.2

 

 

Total

43

100

 

 

 

 

To regularly update
your international federation(s) and anti-doping organizations on
the whereabouts information of your athletes

1

30

69.8

4

13

30.2

Total

43

100

 

 

To assist athletes in
the application of the therapeutic use exemption (TUE)

1

34

79.1

2

1

2.3

 

 

4

8

18.6

Total

43

100

 

 

To keep records of TUE
for your athletes

1

35

81.4

2

1

2.3

 

 

4

7

16.3

Total

43

100

 

 

To regularly update
your international federation(s) and anti-doping organizations on
the TUE status of your athletes

1

39

90.7

2

1

2.3

 

 

4

3

7

Total

43

100

 
Cooperation
with International Federations and Anti-Doping Organizations

 

To assist international
federation(s) and anti-doping organizations in conducting drug
tests
1 35 81.4
4 8 18.6
Total 43 100

 

 

Policy

 

To discuss doping
issues in meetings of your NSO
1 25 58.1
2 1 2.3
4 17 39.5

Total

43

100

To include a clause
forbidding use of prohibited substances by athletes in the
constitution of your NSO

1

26

60.5

2

5

11.6

4

12

27.9

 

 

Total

43

100

To prepare a procedural
guideline to handle anti-doping duties (If such a guideline
exists, please provide details on the target group and contents.)

1

33

76.7

2

7

16.3

4

3

7

 

 

 

 

Total

43

100

 

 

aA
numeral 1 in this column indicates an NSO does not intend to pursue
the activity in the foreseeable future; a 2 indicates that an NSO is
seriously considering action within 6 months (i.e., in the
foreseeable future); a 3 indicates that an NSO has developed a plan
to act; and a 4 indicates that the NSO has a system in place and
pursues the activity.
In terms of education, most NSOs (81.4%) had reminded their athletes
and athlete support personnel that they are bound by anti-doping
rules. Answers to our follow-up questions suggested that most of the
reminders were sent prior to major competitions. The majority of Hong
Kong NSOs would distribute to relevant persons information on doping
control obtained from third parties (65.1%) and related educational
programs (58.1%). However, only 18.6% of the NSOs had included
anti-doping information in a newsletter, a web page, or
correspondence with its members. To organize educational programs,
with or without assistance from third parties, was uncommon among the
local NSOs. Programs to enhance an NSO staff’s anti-doping
knowledge were also relatively undeveloped. Only 14% of NSOs had
organized educational programs to upgrade such knowledge, and only
4.7% had a trained doping control officer of their own.

On issues of drug testing and related functions, 37.2% of the NSOs
reported they had experience conducting drug tests at locally held
international events. However, only 7% had conducted drug tests for
local competitions and 2.3% had conducted out-of-competition tests on
athletes. It seems that in Hong Kong only athletes competing at the
international level are monitored via drug testing. Athletes in local
competitions have minimal exposure to drug testing.

In terms of record keeping, about 30.2% of NSOs had records of drug
tests conducted on their athletes, but only 14% reported this
information to an international federation (most federations made no
requests for the information). About half of the NSOs (44.2%) had
experience collecting or coordinating whereabouts information for
athletes. Only 30.2 %, however, updated an international federation
regularly about such information (follow-up questions suggested that
international federations did not request regular updates, especially
from NSOs without athletes competing internationally). Only 18.6% of
NSOs had experience applying the therapeutic use exemption with their
athletes; 16.3% kept records on TUE and 7% regularly updated an
international federation concerning athletes’ TUE status.

Only 8% of NSOs had assisted an international federation or
anti-doping agency in conducting drug testing. Responses to follow-up
questions suggested that both in-competition testing and
out-of-competition testing were involved. In terms of policy, 39.5%
of NSOs had discussed doping issues in their meetings. About one
third (27.9%) had included a clause prohibiting the use of specified
substances by athletes affiliated with them. Response to follow-up
questions indicated that most NSOs addressed the issue only
indirectly, asking individuals to refer to rules and regulations set
forth by international federations. Among the respondents, only 7%
had a procedural guideline for handling anti-doping duties.

 

Discussion and Recommendations

The main purpose of the survey was to evaluate the anti-doping
functions of Hong Kong’s NSOs. Data from a questionnaire and
interview suggest that the majority of NSOs in Hong Kong were at the
contemplation stage in terms of the implementation of anti-doping
functions. According to Prochaska’s transtheoretical model,
individuals at the contemplation stage have started to acknowledge a
target behavior, but they may not be ready to make any change
(Prochaska, 2000). Moreover, if pressured about the behavior,
individuals in the contemplation stage can be very resistant to
change. In the case of Hong Kong’s NSOs in the contemplation stage,
educational workshops and realistic support with resources are
essential to moving them to the next stage, which is the action
stage.
Studies of TTM suggest that “stage-matched interventions”
outperform “action-oriented interventions” (Prochaska et al.,
2001); the former can increase the likelihood of progress to the next
stage, action. For organizational change, TTM dictates that
interventions should be individualized and matched to employees’
readiness to change. This would be a necessary consideration during
development of anti-doping workshops’ content.
According to Prochaska et al. (2001), dramatic relief,
self-reevaluation, and thinking about commitment are processes of
changes that should be emphasized with those in the pre-contemplation
and contemplation stages. The Hong Kong NSOs can, then, be moved to
change their anti-doping functions through the use of emotional
arousal components, for example discussion of fears of sanctioning by
an international federation if noncompliance persists, or discussion
of advantages of successfully implementing the anti-doping code. A
reevaluation of the NSO’s strengths and weaknesses pertaining to
implementation can be helpful. NSOs should also be encouraged to
discuss the possibility of implementing anti-doping programs and to
make a commitment to further anti-doping efforts.
The present study found that resources are the major constraint on
implementation of anti-doping functions by the Hong Kong NSOs. To
provide the needed additional funds and manpower most
cost-effectively, a centralized body could be established to
coordinate anti-doping functions, rather than providing funds to
underwrite various NSOs’ individual efforts.
The present study is the first to study the status of anti-doping
efforts among Hong Kong’s national sport organizations. Apart from
investigating what anti-doping functions the NSOs are currently
fulfilling, we also measured their—the administrators’, coaches’,
and committee members’—readiness to change by starting or
strengthening anti-doping efforts. It appears that a majority of NSOs
in Hong Kong are in the contemplation stage of implementing
anti-doping functions and facing the constraints of limited funding
and manpower. These data provide a starting point for the design of
assistance to the NSOs as they initiate or strengthen anti-doping
efforts to comply with the World Anti-Doping Code. Results are likely
relevant, as well, in countries with similar anti-doping experience.
They should thus be of use to international federations, national
anti-doping organizations, and the World Anti-Doping Agency, in terms
of directing effort and resources.
References

Heather, N., Gold, R., & Rollnick, S. (1991). Readiness to
Change Questionnaire: User’s manual.
(Tech. Rep. No. 15).
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Drug and Alcohol Research Centre.

Prochaska, J. M. (2000). A transtheoretical model for assessing
organizational change: A study of family service agencies’ movement
to time-limited therapy. Family in Society, 81, 76–84.

Prochaska, J. M., Prochaska, J. O., & Levesque, D. A. (2001). A
transtheoretical approach to changing organizations. Administration
and Policy in Mental Health
, 28(4), 247–261.

Rollnick, J. O., Heather, N., Gold, R., & Hall, W. (1992).
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use in brief, opportunistic intervention among excessive drinkers.
British Journal of Addiction, 87, 743–754.

World Anti-Doping Agency. (2003). World Anti-Doping Code.
Retrieved August 28, 2006, from http://www.wada-ama.org/en/

Author Note
Lena Fung, Hong Kong Baptist University; Yvonne Yuan, Hong Kong
Sports Institute Limited.
This research was supported by a social science research grant from
the World Anti-Doping Agency.

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