Introduction: The role of theory in research cannot be over emphasised. Present literature on athlete complementary and alternative medicine (CAM) use poses two problems: in the few studies on CAM use that have utilised theory, the use of theory has been inconsistent or lack validation; in athlete motivational studies, theoretical models focused on the athlete and the sport and not on health-seeking. Many theories exist in the literature to help explain health-seeking behaviour, but the bulk of studies that employ theory focused on the general nonathlete population and mainly applied in the setting of conventional medicine use. Difficulties in using theory for CAM studies include the lack of consistent definition of what CAM and health is; the definitions of CAM and health are also influenced by subculture and context. In the subculture of sports and the context of the athlete population, studies in doping have shown that athlete concept of health differs from the general nonathlete population. Because of the importance of theory and a paucity in the literature of its utilisation in research on athlete CAM use, the current study seek to find the applicability of existing theoretical models when studying athlete CAM use.

Methodology: In-depth interviews using Grounded theory were conducted on a population of elite level swimmers. Various issues were explored: including understanding the athlete perception and personal definition of CAM; motivational factors influencing athlete health-seeking; the role and relationship of health-seeking and sports performance. Results: Existing theoretical models for health from the fields of economics, sociology and psychology did not adequately explain the findings of the study on athlete CAM use. Athlete motivation theories in sport psychology also did not fully explain in athletes matters relating to health, or behaviour when using CAM. Based on the findings of the study, a new theory (threshold and memory) using concepts from immunology, is proposed.

Conclusions: In future studies looking at athlete CAM use, there should be greater emphasis placed on theory. Not only does validated theory have practical implications for academic researchers; social marketers and organisations interested in communicating with athletes on health and CAM issues may also benefit from an evidence-based theoretical foundation. The current study challenges the validity of extrapolating existing theories (used in conventional medicine studies in nonathlete populations) on athlete CAM use, and proposes a more specific theory. This new theory specific to athlete CAM use forms the foundation for subsequent quantitative validation studies.


Published in Full, Peer-reviewed, Athlete, CAM, Theory


Koh, B. (2010). Threshold and memory: A new theoretical model for athlete CAM use. Journal of Science and Medicine in Sport, 12(Supp 2), e110. doi:10.1016/j.jsams.2009.10.226

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Abstracts/Journal of Science and Medicine in Sport 12 (2010) el-e232