Sports nutritionists’ perspectives on enablers and barriers to nutritional adherence in high performance sport: A qualitative analysis informed by the COM-B model and theoretical domains framework

Abstract

Athlete adherence to nutritional guidance is critical for optimal health and performance, yet little is known about the barriers and enablers to athletes' dietary behaviours within highperformance sport. To advance understanding, we applied a theoretical lens derived from the Capability, Opportunity, Motivation -Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) to explore the qualitative accounts of sports nutritionists. Five focus groups comprising sports nutritionists working in Olympic and Paralympic sport (n = 14), professional sport (n = 6), or both (n = 6) were undertaken. Thematic analysis was conducted and the interpretations of the findings were guided by COM-B and the TDF. To achieve nutritional adherence, the behavioural analysis identified the need to intervene across all three COM-B components and at least five associated TDF domains (e.g., decision-making processes, reinforcement, social influences, behavioural regulation and environmental context and resource). For the first time, the findings illustrate the complex interplay of the training setting with the capabilities, opportunities, and motivation of the practitioners, athletes and coaches. By applying established behavioural science theories to sports nutrition, the foundations for the development of targeted and multifaceted behavioural interventions addressing athlete dietary adherence in high-performance sport have been laid.

Comparison of barriers and facilitators of MIND diet uptake among adults from Northern Ireland and Italy

“…It has been suggested by similar theoretical models, that 25 participants is the ideal sample size for qualitative research [ 47 ]. Also, similar to other qualitative studies using the COM-B and TDF [ 39 , 40 ], twenty-five NI and 25 Italian participants were recruited onto the study, to take part in either a focus group or an interview.…”

“…BCTs are considered the active component of the intervention designed to change behaviour, such as self-monitoring of behaviour and goal setting. The COM-B model and TDF have been used by several studies to explore barriers and facilitators to behaviour change in sexual health [39], physical activity in obese pregnant women [40] and reducing sugar [41].…”

Cross cultural “behavioural diagnosis” examining the uptake of the MIND diet, using the COM-B model to inform an intervention.

“…According to similar behaviour change theories, the ideal sample size for elicitation studies is 25 [39]. Also, similar to other qualitative studies using the COM-B and TDF [40,41], twenty-five NI and Italian participants were recruited onto the study, to take part in either a focus group or an interview…”

“…To our knowledge, this is the first study investigating adherence to the MIND diet at midlife (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55) years old) in a Mediterranean and non-Mediterranean country. This study addresses this gap in the literature and highlights the perceived barriers and facilitators to adhering to a diet that may promote brain health at midlife and compares those barriers and facilitators to those living in Northern Ireland.…”

Barriers and Enablers to Clean Sport: A Qualitative Meta-Synthesis Informed by the Theoretical Domains Framework and COM-B Model

“…Motivation can be reflective or automatic, and characterises the brain processes that drive behaviour. The COM-B and TDF have been applied to many contexts including those relevant to clean sport, such as nutritional programme adherence (Bentley et al, 2019;Costello et al, 2018), clinical medication adherence (Jackson et al, 2014;Crayton et al, 2018) and therapeutic use exemptions in sport (Allen et al, 2019). Importantly, the COM-B model forms the hub of the Behaviour Change Wheel (BCW) (Michie et al, 2011).…”