Improving antidoping education for coaches in Greece: A questionnaire-based study on knowledge gaps and recommendations for enhancement

Background Coaches play a critical role as athlete support personnel in shaping attitudes and behaviors related to clean sport. Despite their influence, evidence suggests that coaches’ antidoping knowledge and operational readiness may be inconsistent, increasing the risk of inadvertent antidoping rule violations. Purpose This study aimed to assess baseline antidoping knowledge, awareness, and perceived ethical influences among coaches in Greece prior to participation in a structured antidoping education program, and to identify priority areas for targeted educational intervention. Methods A cross-sectional questionnaire was administered to 633 coaches from multiple sports disciplines between August 2023 and April 2024. The questionnaire assessed sociodemographic characteristics, awareness of antidoping organizations and rules, knowledge of prohibited substances, Therapeutic Use Exemptions (TUEs), testing procedures, supplement and medication risks, use of digital compliance tools, and ethical pressures related to performance. Descriptive statistics, chi-square tests, and 95% confidence intervals were used. Results While general awareness of antidoping organizations was high, substantial knowledge gaps were identified. Only 25.57% of respondents reported knowledge of the 11 antidoping rule violations, and 78.06% were unfamiliar with TUEs. Awareness and use of digital tools such as Global DRO and ADAMS were limited. Although most coaches rejected the use of unfair means, performance-related pressures emerged as a salient ethical influence. Supplement use was common, despite uncertainty regarding contamination risks. Conclusions The findings reveal important deficits in operational antidoping knowledge among coaches, particularly in areas associated with inadvertent doping risk and regulatory compliance. These results highlight the need for coach-focused education that emphasizes applied competence, ethical decision-making, and digital literacy.