The Role of Athlete Support Personnel in Anti-Doping: A Narrative Review of Contemporary Evidence

Doping remains a major threat to athlete health and sport integrity. Although anti-doping efforts have traditionally focused on athletes, increasing attention has turned to Athlete Support Personnel (ASP) due to their influence on athletes' decisions, behaviors and involvement in anti-doping rule violations. This narrative review aimed to synthesize the existing literature on the role of ASP (including coaches, physicians, pharmacists, sport psychologists, nutritionists, physiotherapists, parents and other family members) in anti-doping, with particular attention to their influence on athletes' knowledge, attitudes, behaviors, education and decision-making related to doping. Coaches, physicians, and pharmacists are among the ASP groups most frequently examined in the literature, although substantial knowledge gaps remain across all groups. Coaches shape motivational climates and ethical norms but often lack adequate understanding of anti-doping regulations and supplement risks. Physicians and pharmacists play key roles in medication management and Therapeutic Use Exemptions procedures, though incomplete regulatory knowledge may contribute to inadvertent violations. Nutritionists are central in preventing supplement-related doping, while research on sport psychologists and physiotherapists remains limited despite their preventive potential. Parents significantly shape athletes' moral development and susceptibility to doping, acting as protective or risk factors depending on family dynamics. Overall, anti-doping education for ASP remains inconsistent. In conclusion, ASP plays an essential yet heterogeneous role in influencing doping-related behaviors. Strengthening role-specific and interdisciplinary anti-doping education, particularly within university programs and professional development, appears critical for enhancing ASP competence and promoting a sustainable culture of clean sport.