Potential moderators and mediators of intervention effects in a sport-based mental health literacy and resilience program for adolescent men

Engaging young men in mental health promotion initiatives is important given the negative attitudes toward mental health and increased suicide rates, reported by young men. Ahead of the Game (AOTG) is a sport-based, psychoeducational initiative which uses sports as a mental health and resilience promotional medium. This study sought contribute to the literature on the effectiveness of the AOTG program by exploring for whom, and through what mechanisms, the intervention works. A secondary analysis of the AOTG randomized controlled trial was conducted, which comprised a sample of 350 adolescent male sport-playing participants (M = 14.53 years, SD = 1.19 years) and control group of 466 sport participants (M = 14.66 years, SD = 1.39), various mental health related measures were taken at baseline and at approximately 8 weeks follow-up. Moderation analyses were conducted to examine age, socioeconomic status, and baseline measures of mental health as potential moderators of program effects. Mediation analyses were run to explore whether changes in psychological distress and wellbeing were mediated by changes in AOTG’s various primary mental health related outcomes. Results indicated age did not moderate any effects of AOTG. Meanwhile, socioeconomic status and baseline help seeking, implicit beliefs, and psychological distress all showed signs of moderating main effects of AOTG. Mediation analyses revealed that changes in resilience and implicit beliefs partially mediated changes in psychological distress. Further, increased resilience had an indirect effect of on athletes’ wellbeing. The implications and future directions, in light of these findings, are explored. Lay summary: Ahead of the Game was shown to be effective regardless of age and particularly beneficial for those in low socioeconomic, displaying low levels of help seeking, and those with higher psychological distress. Increasing resilience was also shown to be an important pathway for increasing wellbeing and reducing distress.