Performance Enhancement Drugs: Knowledge, Attitude, And Intended Behavior Among Community Coaches In Hong Kong


The purpose of the study was to elucidate the perceived knowledge, actual knowledge, attitude, and intended behavior of community coaches with respect to performance enhancement drugs (PED). The Theory of Planned Behavior was used as a guiding framework to structure the questionnaire used for data collection. Results of the analyses suggested that community coaches under-estimated their own knowledge about PED. Most respondents are supportive to the anti-doping movement in terms of both attitude and behavior intent. Results of the present study also partially agreed with the Theory of Planned Behavior, perceived knowledge, actual knowledge, and attitude towards PED were found to be significantly related to behavioral intent. Implications of the results were discussed.


The Athlete should not be the only person to be blamed in case of a positive drug test. Numerous studies have pointed out that an athlete’s use of drugs in sport could be attributed to a complex interaction of personal and environmental factors (Nicholson and Agnew, 1989; Tricker, Cook, and McGuire, 1989). Possible contributing environmental factors include attitudes of peer group and parents, accessibility to drugs, and cultural norms and values (Polich, Ellichson, Reuter, and Kahan, 1984; Tricker and Connolly, 1997).

In the coaching literature, coaches are viewed as having a strong influence in regulating athletes’ behavior and attitude (Anshel, 1990; Orlick, 1990). For example, Dieffenbach, Gould, and Moffett (2002) suggested that coaches play crucial roles in influencing quality of coach-athlete relationship, developing achievement goals for the athletes, mentoring athletes’ development and indirectly model the positive skills and characteristics athletes need for success. Therefore, it is argued that coaches could be one of the more important agents in preventing drug use among athletes and should be included in any doping prevention campaigns (Dubin, 1990).

For coaches to function optimally as role models and in assisting young athletes to formulate correct attitudes against doping, they must also possess accurate knowledge and appropriate attitude on doping and drug use. Although coaches can gain information about drug use and drug abuse through various channels, seminars and information packages are the media more favored by Hong Kong community coaches. In Hong Kong, the Sports Federation and Olympic Committee, Hong Kong, China and the Hong Kong Coaching Committee are the major stakeholders to provide such information to community coaches. In order for these agencies to develop appropriately sequenced knowledge, some understanding of the current status of coaches’ knowledge and attitude on drug use and drug abuse is necessary. Therefore, one of the purposes of the present study was to assess the perceived knowledge, actual knowledge, attitude, subjective norms, and behavioral intent related to performance enhancement drug (PED) among Hong Kong community coaches.

In developing this study and in constructing the questionnaire for data collection, the Theory of Planned Behavior (Ajzen and Fishbein, 1988) was used as a guiding framework. According to this theory, a person’s behavior is mainly determined by his/her behavioral intent which, in turn, is influenced by attitude towards the behavior, subjective norms, and perceived behavioral control. As the theory has been successfully used to predict recreational drug use (McMillan and Conner 2003; Orbell, Blair, Sherlock, and Conner, 2001), intentions to use PEDs among collegiate athletes (Allemeier, 1996) and in adolescents (Lucidi, Grano, Leone, Lombardo, and Pesce, 2004), we were confident that it could provide a meaningful structure for the study.



A total of 114 community coaches attending a coach education class during the data collection period were invited to take part voluntarily in the study. The sample is comprised of 93 male and 21 female (Age: 29.3 ± 8.1; mean ± SD). Among the participants, 28% are university graduates, 11% were university students, the remaining 61% are secondary school graduates.


The questionnaire used for data collection was developed by the authors from literature review and consultation with experts working in the area of doping and drug use. The questionnaire is comprised of 61 items. Apart from the demographic section, all other items were designed to elucidate perceived knowledge on PED, actual knowledge about PED, attitude, subjective norms, and behavior intent on drug use in sports. A combination of response types was employed, including likert-type scale and binominal scale. As the possible total scores from items related to perceived knowledge on PED and from items related to actual knowledge about PED differs, the raw score from each category was transformed to allow for parallel comparison. In transforming the scores, the maximum of 100 points was used as the reference.


A summary of means and standard deviations of key constructs examined in this study is presented in Table 1. The score mean for perceived knowledge on PED was 23.7 whereas the score mean for actual knowledge on PED reached 66.1.

Scores on attitude, subjective norm, and intent behaviour were computed in a way that positive scores represent preferred attitude, norm and intentional behavior that support the anti-doping movement. Negative scores, on the other hands, represent the support of the use of doping to take advantage over other athletes. The scores in attitude, subjective norm, and behavioral intent are 1.21 ± 0.91, –0.16 ± 1.01, and 1.37 ± 1.4 respectively. Both attitude and behavioral intent of the Hong Kong community coaches are supportive of the anti-doping movement. However, the score on subjective norm was negative and this suggests that they perceive doping as a problem in the sporting community. Table 2, 3 and 4 show the response pattern of participants to questions on attitude, subjective norm, and behavioral intent, respectively.

In terms of attitude, majority of the respondents agreed (86.2% agreed or highly agreed) that doping is not only a problem in sport but also a social problem. Most respondents did not have strong feeling on whether sanction imposed on doping cases is stringent or not (57.9% have no comment on the issue). The majority disagreed (63.7% disagreed or highly disagreed) that athletes can use drugs to enhance performance if it does not hurt his/her health. Most respondents did not believe (70.1% respondents disagreed or highly disagreed) that refusal to take PEDs equals to refraining from being an elite athlete. Respondents are slightly biased to disagree (43.8% disagreed or highly disagreed and 35.1% had no comment) that scientific research should develop drugs that can pass tests of doping control.

Questions in elucidating subjective norm of the respondents found out that most respondent disagreed (47.4% disagreed or highly disagreed) that most achievement records in sport are related to doping. The majority respondents agreed (73.6% agreed or highly agreed) that doping is a serious problem in international sports. On the other hands, most respondents disagreed (51.8% disagreed or highly disagreed) that doping is a serious problem in Hong Kong sports.

The behaviour intent of the respondents is in general supportive to the anti-doping movement. Most respondents (65.8%) claimed that they would take positive actions against his/her friends or relatives who are on banned substance. The respondents slightly biased towards not working with medical team to produce high quality banned substance (44.3% disagreed or highly disagreed and 41.6 had no comment). The majority of the respondents (62.8%) claimed that they would not find ways to assist his/her friends or relatives to get hold of banned substance.

Table 5 shows the Pearson correlation coefficients among the key constructs of the study. Behavioral intent is significantly correlated to perceived knowledge (r = -.270, p = .004), actual knowledge (r = .304, p = .002), and attitude (r =.335, p = .000) but not to subjective norm (r = .065, p = .493).

Two other significant correlations were identified, namely the correlation between actual knowledge and perceived knowledge (r = -.263, p = .007), and between attitude and actual knowledge (r = .233, p = .018).


According to the Theory of Planned Behavior (Ajzen and Fishbein, 1988), a person’s behavior is mainly determined by his/her behavioral intent which, in turn, is influenced by attitude towards the behavior, subjective norms, and perceived behavioral control. Result of the present study finds partial agreement with the Theory, namely the level of intentions to perform a particular behaviour depends on the individual’s attitude on the behaviour. However, the relationship between subjective norm and behavioral intent was not significant in our study. One of the possible reasons for this discrepancy is that the participants are community coaches who may not perceive themselves as having any significant influence or involvement with the doping problem more commonly found in elite level athletes. The three items used to elucidate information on the subjective norms were biased towards drug use among elite level athletes. Therefore, even though the respondents might have agreed to the presence of doping problem at

the elite level, the items were not sufficiently sensitive to capture their opinions on drug use issues on their day-to-day settings. Further investigation on this issue with refined items would be needed.

The present study also aims at elucidating the Hong Kong community coaches’ current status of knowledge and attitude on PEDs. This group of coaches was found to be relatively supportive to the anti-doping movement according to their attitude (1.21 ± 0.91) and behaviour intent (1.37 ± 1.4) scores. A survey on Norwegian coaches found that coaches have strong and unequivocal attitudes against doping (Figved, 1992). Laure, Thouvenin, and Lecerf (2001) also found that 98.1% of the France coaches consider that they have a role to play to flight against doping. The present respondents’ actual knowledge on PEDs, reached the mean value of 66.1, was fair and yet had rooms for further improvement. This baseline measurement could also be used for monitoring the effectiveness of any intervention programs in the future.

It is interesting to notice that there is a huge discrepancy between the respondents’ perceived knowledge (mean = 23.7) and actual knowledge (mean = 66.1). Participants tend to under-estimate their knowledge in PED and doping control. This conclusion is further supported by the negative correlation between the perceived knowledge and actual knowledge (r = -.263, p = .007). The more knowledgeable they are, the greater their under-estimation. It is possible that the more they know about PED and the doping control system, the more they understand that the problem of drug in sport is more complicated than presented. This implies that any education program designed for the coaches on PEDs could be more effective if it is mandatory. As the individuals with the least knowledge is likely to perceived that they have enough knowledge about the issue.

It is also interesting to note that the low perceived knowledge on doping among coaches was also found in a survey on France coaches. 80.3% of the France coaches consider themselves badly trained in the prevention of doping (Laure, et al., 2001).

Unlike the Hong Kong community coaches, the Norwegian coaches believed that they are well informed about doping (Figved, 1992). This can be due to the fact that the education about PEDs for coaches was more structured and successful in Norway than that in Hong Kong. Furthermore, the difference on cultural background may have lead to the under-estimation of the Hong Kong coaches’ knowledge on PEDs as discussed in the previous paragraph.

Currently, seminars on PEDs are few and infrequent in Hong Kong. A systematic curriculum on doping is also lacking. According to Figved’s study (1992), most coaches believed that seminars, courses, and evening sessions were the best ways of changing attitudes and increasing knowledge. Given the important role of coaches in influencing the direction of fair play in sports and the findings from this study, we suggest the need to develop a systematic and spirally progressive education program on drug use and drug abuse. Furthermore, incentives such as certifications and fee waivers could be developed to encourage coaches to such courses so as to work towards knowledge and attitude development in the area of PED.


  1. Allemeier, M.F. (1996). CIAU athletes’ use and intentions to use performance enhancing drugs: a study utilizing the theory of planned behaviour. Thesis (M.A.) University of British Columbia, Eugene, Ore: Microform Publications Int’l Inst for Sport & Human Performance, University of Oregon.
  2. Anshel, M.H. (1990). Sport psychology: From theory to practice. Gorsuch Scarisbrisk: Scottsdale, AZ.
  3. Ajzen, I. & Fishbein, M. (1988). Understanding attitudes and predicting social behaviour. Englewood Cliffs, NJ: Prentice Hall.
  4. Dieffenbach, K., Gould, D., & Moffett, A. (2002). The coach’s role in developing champions. International Journal of Volleyball Research, 5(1), 30-32.
  5. Dubin, C. (1990). Commission of inquiry into the use of drugs and banned practices intended to increase athletic performance. Ottawa, ON: Canadian Government Publishing Centre, 615.
  6. Figved, S.E. (1992). Drug education programs for coaches and leaders. Science Periodical on Research and Technology in Sport, 12(4), 5-9.
  7. Laure, P., Thouvenin, F., and Lecerf, T. (2001). Attitudes of coaches towards doping. J Sports Med Phy Fit, 41, 132-136.
  8. Lucidi, F., Grano, C., Leone, L., Lombardo, C., & Pesce, C. (2004). Determinants of the intention to use doping substances: An empirical contributions in a sample of Italian adolescents. International Journal of Sport Psychology, 35, 133-148.
  9. McMillan, B. & Conner, M. (2003). Applying an extended version of the theory of planned behavior to illicit drug use among students. Journal of Applied Social Psychology, 33, 1662-1683.
  10. Nicholson, N. & Agnew, M. (1989). Education strategies to reduce drug use in sport. Sports Coach, 13(1), 38-41.
  11. Orbell, S., Blair, C., Sherlock, K., & Conner, M. (2001). The theory of planned behavior and ecstasy use: Roles for habit and perceived control over taking versus obtaining substances. Journal of Applied Social Psychology, 31, 31-47.
  12. Orlick, T. (1990). In pursuit of excellence (2nd ed.). Champaign, IL: Human Kinetics.
  13. Parish, C.A. (1973). An epidemiological survey of drug use among secondary school students in grades eight and eleven in eastern South Dakota. Doctoral dissertation, University of South Dakota.
  14. Polich, J.M., Ellichson, P.L., Reuter, P., & Kahan, J.P. (1984). Strategies for controlling adolescent drug use. The Rand Publication Series, Ca.
  15. Tricker, R. & Connolly, D. (1997). Drugs and the college athlete: An analysis of the attitudes of student athletes at risk. Journal on Drug Education, 26, 275-287.
  16. Tricker, R., Cook, D., & McGuire, R. (1989). Issues related to drug abuse in college athletics: Athletes at risk. Sport Psychologist, 2(1), 155-165.


This study was supported by the Faculty Research Grant of the Hong Kong Baptist University.

Table 1

Table 2

Table 3

Table 4

Table 5