Assessing the need to use sport supplements: The mediating role of sports supplement beliefs

Journal article


Yuka Murofushi, Yujiro Kawata, Miyuki Nakamura, Shinji Yamaguchi, Saori Sunamoto, Hanako Fukamachi, Hiroshi Aono, Etsuko Kamihigashi, Yuji Takazawa, Hisashi Naito and Philip Hurst 2023. Assessing the need to use sport supplements: The mediating role of sports supplement beliefs. Performance Enhancement & Health. 12 (1), p. 100269.
AuthorsYuka Murofushi, Yujiro Kawata, Miyuki Nakamura, Shinji Yamaguchi, Saori Sunamoto, Hanako Fukamachi, Hiroshi Aono, Etsuko Kamihigashi, Yuji Takazawa, Hisashi Naito and Philip Hurst
Abstract

Aim: Sports supplement use by athletes can lead to unintentional anti-doping rule violations (ADRVs) due to the contamination of prohibited substances. This phenomenon underscores the need for athletes to reconsider their supplement use, assessing its safety, efficacy, and necessity—a process referred to as ‘reconsideration of supplement use’ in this study. Additionally, ingesting sports supplements may escalate to doping when athletes believe they improve performance, a notion measured by the Sports Supplement Belief Scale (SSBS), which assesses the degree to which athletes expect supplements to enhance their performance. Understanding the factors that may encourage and prevent an athlete from using supplements is crucial. This study explores the mediating influence of the perceived risk of ADRV due to supplements, reconsideration of supplement use, and sports supplement beliefs as factors influencing athletes’ decisions to use supplements as factors influencing athletes' decisions to use supplements.

Methods: In Study 1, a Japanese version of the Sports Supplement Belief Scale (SSBS-J) was created using back-translation. In order to evaluate the reliability and validity of the scale, we utilized data from 356 university athletes, which were divided into two distinct cohorts. A two-step statistical analysis was implemented involving Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The survey included questions about the frequency and number of supplements used. Internal consistency and fit of the SSBS-J were evaluated using EFA and CFA, and the scale’s ability to determine supplement use was assessed using linear regression analysis and t-tests. In Study 2, 525 university athletes (64.6% men, Mage = 18.7 ± 0.7 years) were asked to complete measures related to the perceived risk of committing an ADRV due to supplementation.

Results: The SSBS-J showed high internal consistency (Cronbach’s α = 0.876), a one-factor structure similar to the original version in the EFA, and a good model fit in the CFA, thereby supporting construct validity. Linear regression results indicated that the SSBS-J scores were significantly associated with the frequency and number of supplements used. Significant differences were found between the scores of supplement users (21.51 ± 6.54) and non-users (16.48 ± 6.14) (p < 0.001). Next, discriminant analysis correctly classified 64.7% of supplement users and 61.0% of non-users. In examining the direct effect of ADRV awareness on supplement use, a significant negative path coefficient of -0.44 was observed (p < 0.001). The path coefficients from ADRV awareness to the reconsideration of supplement use and from a reconsideration of supplement use to supplement use through SSBS-J were all significant (p < 0.001), with an indirect effect path coefficient of 0.06.

Conclusions: These findings suggest that ADRV awareness can influence reconsideration of supplement use and subsequently deter supplement use mediated by sport supplement beliefs. These insights emphasize the importance of promoting doping risk awareness, revisiting supplement use, and mitigating sport supplement beliefs to reduce inappropriate or unnecessary supplement use among athletes. From an anti-doping perspective, this insight could be valuable in guiding athlete education regarding supplement use.

KeywordsAnti-doping; Athletes; Anti-doping rule violation; Reconsidering supplement use; Scale development; Sports supplement belief; Sports supplement
Year2023
JournalPerformance Enhancement & Health
Journal citation12 (1), p. 100269
PublisherElsevier
ISSN2211-2669
Official URLhttps://www.sciencedirect.com/science/article/pii/S2211266923000385
Publication dates
Online30 Nov 2023
PrintFeb 2024
Publication process dates
Accepted18 Nov 2023
Deposited20 Nov 2023
Accepted author manuscript
License
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Restricted
Publisher's version
License
Supplemental file
License
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Restricted
Output statusPublished
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Hurst, P., Ring, Christopher and Kavussanu, Maria 2021. Ego orientation is related to doping likelihood via sport supplement use and sport supplement beliefs. European Journal of Sport Science. 22 (11), pp. 1734-1742. https://doi.org/10.1080/17461391.2021.1995509
Targeting personal morality in anti-doping education
Hurst, P. 2021. Targeting personal morality in anti-doping education . HED Matters. 4 (1), pp. 9-12.
A psychological intervention reduces doping likelihood in British and Greek athletes: A cluster randomized controlled trial
Maria Kavussanu, Vassilis Barkoukis, Phil Hurst, Mariya Yukhymenko-Lescroart, Lida Skoufa, Andrea Chirico, Fabio Lucidi and Christopher Ring 2021. A psychological intervention reduces doping likelihood in British and Greek athletes: A cluster randomized controlled trial. Psychology of Sport and Exercise. https://doi.org//10.1016/j.psychsport.2021.102099
Prefrontal cortex oxygenation during endurance performance: A systematic review of functional near-infrared spectroscopy studies.
De Wachter, Jonas, Proost, Matthias, Habay, Jelle, Verstraelen, Matthias, Díaz-García, Jesús, Hurst, Philip, Meeusen, Romain, Van Cutsem, Jeroen and Roelands, B. 2021. Prefrontal cortex oxygenation during endurance performance: A systematic review of functional near-infrared spectroscopy studies. Frontiers in Physiology. 12, p. 761232. https://doi.org/10.3389/fphys.2021.761232
A moral intervention reduces doping likelihood in British and Greek athletes: evidence from a cluster randomized control trial
Kavussanu, M. and Hurst, P. 2020. A moral intervention reduces doping likelihood in British and Greek athletes: evidence from a cluster randomized control trial. Journal of Sport and Exercise Psychology. https://doi.org/10.1123/jsep.2019-0313
Athletes using ergogenic and medical sport supplements report more favourable attitudes to doping than non-users
Hurst, P., Ring, C. and Kavussanu, M. 2020. Athletes using ergogenic and medical sport supplements report more favourable attitudes to doping than non-users. Journal of Science and Medicine in Sport. https://doi.org/10.1016/j.jsams.2020.09.012
The placebo effect in sport: How practitioners can inject words to improve performance
Roelands, B. and Hurst, P. 2020. The placebo effect in sport: How practitioners can inject words to improve performance. International Journal of Sports Physiology and Performance. 15 (6), pp. 765-766. https://doi.org/10.1123/ijspp.2020-0358
Can taste be ergogenic?
Best, R., McDonald, K., Hurst, P. and Pickering, C. 2020. Can taste be ergogenic? European Journal of Nutrition. https://doi.org/10.1007/s00394-020-02274-5
Dual career: balancing success in sport and life
Howland, L., Papadimitriou, A., Minoudis, V. and Hurst, P. 2020. Dual career: balancing success in sport and life. in: Chatziefstathiou, D., Garcia, B. and Seguin, B. (ed.) Routledge Handbook of the Olympic and Paralympic Games Routledge. pp. 1-21
No differences between beetroot juice and placebo on competitive 5-km running performance: A double-blind, placebo-controlled trial
Hurst, P., Saunders, S. and Coleman, D. 2020. No differences between beetroot juice and placebo on competitive 5-km running performance: A double-blind, placebo-controlled trial. International Journal of Sports Nutrition and Exercise Metabolism. 30 (4), pp. 295-300. https://doi.org/10.1123/ijsnem.2020-0034
Who responds to a placebo? Factors associated with response to placebo during a double-blind randomised controlled trial
Hurst, P., Saunders, S. and Coleman, D. 2020. Who responds to a placebo? Factors associated with response to placebo during a double-blind randomised controlled trial. European Journal of Sport Science.
Emailed - Are Nike's Vaporfly trainers the emperor's new shoes?
Hurst, P. 2020. Emailed - Are Nike's Vaporfly trainers the emperor's new shoes? CCCU Expert Comment.
An evaluation of UK Athletics’ Clean Sport Programme in preventing doping in junior elite athletes
Hurst, P., Ring, C and Kavussanu, M. 2020. An evaluation of UK Athletics’ Clean Sport Programme in preventing doping in junior elite athletes. Performance Enhancement & Health. https://doi.org/10.1016/j.peh.2019.100155
An educational placebo effect intervention reduces the likelihood of athletes using performance enhancing drugs
Hurst, P., Foad, A., Coleman, D. and Beedie, C. 2018. An educational placebo effect intervention reduces the likelihood of athletes using performance enhancing drugs.
Psychological mechanisms underlying morality in sport
Hurst, P. 2019. Psychological mechanisms underlying morality in sport.
Fear of failure predicts doping likelihood in competitive athletes
Hurst, P. 2018. Fear of failure predicts doping likelihood in competitive athletes.
Sport supplement use predicts doping attitudes and likelihood via sport supplement beliefs
Hurst, P., Kavussanu, M., Boardley, I. and Ring, C. 2019. Sport supplement use predicts doping attitudes and likelihood via sport supplement beliefs. Journal of Sports Sciences. https://doi.org/10.1080/02640414.2019.1589920
Improved 1000-m running performance and pacing strategy with caffeine and placebo effect: a balanced placebo design study
Hurst, P., Schiphof-Godart, l., Hettinga, F., Roelands, B. and Beedie, C. 2019. Improved 1000-m running performance and pacing strategy with caffeine and placebo effect: a balanced placebo design study. International Journal of Sports Physiology and Performance. 15 (4), pp. 483-488. https://doi.org/10.1123/ijspp.2019-0230
The placebo and nocebo effect on sports performance: a systematic review
Hurst, P., Schiphof-Godart, l., Szabo, A., Raglin, J., Hettinga, F., Roelands, B., Lane, A., Foad, A., Coleman, D. and Beedie, C. 2019. The placebo and nocebo effect on sports performance: a systematic review. European Journal of Sport Science. https://doi.org/10.1080/17461391.2019.1655098
Notes and tips on surveys
Hurst, P. and Bird, S. 2019. Notes and tips on surveys. in: Bird, S. (ed.) Research Methods in Physical Activity and Health London and New York Routledge. pp. 102-108
Questionnaires
Hurst, P. and Bird, S. 2019. Questionnaires. in: Bird, S. (ed.) Research Methods in Physical Activity and Health London and New York Routledge. pp. 93-101
Evaluating the effectiveness of the VIRTUES and HEROES projects: qualitative evidence
Kavussanu, M., King, A., Hurst, P., Skloufa, L. and Barkoukis, V. 2018. Evaluating the effectiveness of the VIRTUES and HEROES projects: qualitative evidence.
Preventing doping in sport: the HEROES project
Kavussanu, M., Hurst, P., Hatzigeorgiadis, A., Elbe, A. and Ring, C. 2018. Preventing doping in sport: the HEROES project.
Preventing doping in sport: the VIRTUES project
Kavussanu, M., Hurst, P., Barkoukis, V., Skoufa, L., King, A. and Ring, C. 2018. Preventing doping in sport: the VIRTUES project.
The effects of moral disengagement on doping likelihood and guilt
Kavussanu, M., Ring, C. and Hurst, P. 2018. The effects of moral disengagement on doping likelihood and guilt.
Social cognitive predictors of doping intentions: a multi-national study
Kavussanu, M., Skoufa, L., Barkoukis, V., Hurst, P., Chirico, A., Lucidi, F. and Ring, C. 2018. Social cognitive predictors of doping intentions: a multi-national study.
Effects of personal and situational factors on self-referenced doping likelihood
Ring, C., Kavussanu, M., Lucidi, S. and Hurst, P. 2018. Effects of personal and situational factors on self-referenced doping likelihood. Psychology of Sport and Exercise. https://doi.org/10.1016/j.psychsport.2018.11.003
The effects of moral disengagement mechanisms on doping likelihood are mediated by guilt and moderated by moral traits
Ring, C. and Hurst, P. 2018. The effects of moral disengagement mechanisms on doping likelihood are mediated by guilt and moderated by moral traits. Psychology of Sport and Exercise. 40, pp. 33-41. https://doi.org/10.1016/j.psychsport.2018.09.001
The placebo and nocebo effect in sport: intentions, attitudes and beliefs towards sport supplements and banned performance enhancing substances
Hurst, P. 2018. The placebo and nocebo effect in sport: intentions, attitudes and beliefs towards sport supplements and banned performance enhancing substances. PhD Thesis Canterbury Christ Church University Faculty of Social and Applied Sciences
Consensus statement on placebo effects in sports and exercise: the need for conceptual clarity, methodological rigour, and the elucidation of neurobiological mechanisms.
Beedie, C., Hurst, P., Coleman, D., Foad, A., Benedetti, F., Cohen, E., Davis, A., Elseworth-Edelsten, C., Flowers, E., Roelands, B., Hettinga, F., Raglin, J., Szabo, A., Camerone, E., Barbiani, D., Lane, A., Lindheimer, J., Schiphof-Godart, l. and Harvey, S. 2018. Consensus statement on placebo effects in sports and exercise: the need for conceptual clarity, methodological rigour, and the elucidation of neurobiological mechanisms. European Journal of Sport Science. https://doi.org/10.1080/17461391.2018.1496144
Could placebos be putting lives at risk?
Hurst, P. and Beedie, C. 2018. Could placebos be putting lives at risk?
Caution, this treatment is a placebo. It might work, but it might not”: why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport
Beedie, C., Whyte, G., Coleman, D., Hurst, P., Cohen, E., Lane, A., Raglin, J. and Foad, A. 2017. Caution, this treatment is a placebo. It might work, but it might not”: why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2017-097747
Is there a role for implicit and explicit information about placebo and nocebo effects in reducing the use of drugs in sport?
Hurst, P., Beedie, C., Coleman, D. and Foad, A. 2017. Is there a role for implicit and explicit information about placebo and nocebo effects in reducing the use of drugs in sport?
Is the intention to use sport supplements a predictor of placebo and nocebo responding among athletes?
Hurst, P., Beedie, C., Coleman, D. and Foad, A. 2017. Is the intention to use sport supplements a predictor of placebo and nocebo responding among athletes?
Athletes intending to use sports supplements are more likely to respond to a placebo
Hurst, P., Foad, A., Coleman, D. and Beedie, C. 2017. Athletes intending to use sports supplements are more likely to respond to a placebo. Medicine & Science in Sports & Exercise (MSSE). https://doi.org/10.1249/MSS.0000000000001297
Development and validation of the sports supplements beliefs scale [Conference paper abstract]
Hurst, P., Foad, A. and Coleman, D. 2015. Development and validation of the sports supplements beliefs scale [Conference paper abstract]. Journal of Sports Sciences. 33 (Sup1), pp. s72-s74. https://doi.org/10.1080/02640414.2015.1110330
Expectations, caffeine and pacing strategy: how positive and negative expectations can influence running performance
Hurst, P. 2014. Expectations, caffeine and pacing strategy: how positive and negative expectations can influence running performance. British Journal of Sports Medicine. 48 (A3). https://doi.org/10.1136/bjsports-2014-094245.8
Expectancy effects on competitive 5 km time-trial performance
Hurst, P. 2013. Expectancy effects on competitive 5 km time-trial performance. British Journal of Sports Medicine. 47 (17). https://doi.org/10.1136/bjsports-2013-093073.15
Reproducibility of outdoor 5 km running time-trial in a competitive environment
Hurst, P. 2013. Reproducibility of outdoor 5 km running time-trial in a competitive environment. British Journal of Sports Medicine. 47 (e4). https://doi.org/10.1136/bjsports-2013-093073.14
Development and validation of the Sports Supplements Beliefs Scale
Hurst, P., Foad, A., Coleman, D. and Beedie, C. 2016. Development and validation of the Sports Supplements Beliefs Scale. Performance Enhancement & Health. https://doi.org/10.1016/j.peh.2016.10.001
Reliability of 5-km running performance in a competitive environment
Hurst, P. and Board, L. 2016. Reliability of 5-km running performance in a competitive environment. Measurement in Physical Education and Exercise Science. https://doi.org/10.1080/1091367X.2016.1233421
Beliefs versus reality, or beliefs as reality? The placebo effect in sport and exercise
Hurst, P., Foad, A. and Beedie, C. 2016. Beliefs versus reality, or beliefs as reality? The placebo effect in sport and exercise. in: Lane, A. (ed.) Sport and Exercise Psychology London Routledge. pp. 325-344
Capitalizing on the placebo component of treatments
Beedie, C., Foad, A. and Hurst, P. 2015. Capitalizing on the placebo component of treatments. Current Sports Medicine Reports (CSMR). 14 (4), pp. 284-287. https://doi.org/10.1249/JSR.0000000000000172
Influence of acute dietary nitrate supplementation over 5 km
Hurst, P., Coleman, D. and Saunders, S. 2015. Influence of acute dietary nitrate supplementation over 5 km. British Journal of Sports Medicine: International Sports Science + Sports Medicine Conference 2015 Abstracts Newcastle Upon Tyne 8–10th September 2015. 49 (Sup. 2), pp. A6-A6. https://doi.org/10.1136/bjsports-2015-095576.17
Placebo and nocebo effects during repeat sprint performance
Hurst, P., Beedie, C., Coleman, D. and Foad, A. 2016. Placebo and nocebo effects during repeat sprint performance.
Knowledge and experience of placebo effects modifies athletes’ intentions to use sport supplements
Hurst, P., Beedie, C., Coleman, D. and Foad, A. 2016. Knowledge and experience of placebo effects modifies athletes’ intentions to use sport supplements.