Objectives The phenomenon of doping is rarely researched in Paralympic sport, especially from the coach perspective. This study responds directly to this gap in research by exploring coaches' doping-related perceptions, knowledge, and opinions of the current anti-doping system in order to inform future interventions specific to disabled elite sport contexts. Method Eleven coaches from Germany (n = 6) and the UK (n = 5) working across physiological (n = 7) and skill-based (n = 4) sport disciplines at an elite level (Paralympic, n = 10 and World Championship, n = 1) took part in semi-structured interviews. Data were analysed using abductive reflexive thematic analysis (Braun & Clarke, 2019a). Findings Four themes were developed to capture the coaches` perspectives. The first represents coaches` perception that doping is an issue in Paralympic sport. The second theme shows that risk factors to dope are typically multiple and intertwined, stemming especially from financial incentives and pressure to win. Theme three captures coaches' opinion of differences in testing and education across countries due to budget, resource, or infrastructure issues. Finally, data showed that coaches prefer to refer responsibility for doping prevention to their national anti-doping organisation, rather than taking on personal responsibility for anti-doping efforts. Conclusions According to the interviewed coaches, doping has the potential to be a big issue in disabled elite sport. The main risk factors of money and pressure to win (earn prize money or funding/sponsorship) are knitted together and can be additionally impacted (negatively) by a nation`s sporting system. These factors should be addressed by thinking both on an individual level (e.g., support dual careers) and a structural/policy level (e.g., aim to have minimum standards to level the global inconsistent anti-doping systems, including anti-doping education/testing). Furthermore, coaches should take their role and be proactively made aware of their responsibility in doping prevention to coach clean and protect their athletes properly.
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