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Purpose: In this study, we tested the effectiveness of a multicomponent sports-based program aimed at promoting early intervention, help seeking, and resilience among a sample of adolescent male sport participants. Methods: The Ahead of the Game program comprised four intervention components and a messaging campaign. Two components targeted mental health literacy, intentions to seek and provide help, and resilience among adolescent boys. A mental health literacy program for parents and a coach education program to assist in the support of athletes' psychological needs were also included. We evaluated the program using a nonrandomized controlled trial matching two regional communities. In total, 350 sport participants (mean, 14.53 yr) were included in an intervention group, whereas 466 (mean, 14.66 yr) received usual practice in a matched control community. One hundred and eighty parents or caregivers and eight coaches also participated in the intervention components. Between-group mean differences on the primary and secondary outcomes were analyzed using linear mixed models, adjusted for clustering at club level, participant age, and socioeconomic status. Results: Significant positive group–time interactions were found for the primary outcomes of depression and anxiety literacy, intentions to seek help from formal sources, confidence to seek mental health information, and resilience. We also found a significant positive group–time interaction for the secondary outcome of well-being. There were no group–time interactions for social distance (stigma), intentions to seek help from informal sources, implicit beliefs about adversity, perceived familial support, or psychological distress. Conclusions: Given the high rates of sport participation worldwide and the increasing focus on mental health in this domain, translation and dissemination of the program may be warranted after replication. [ABSTRACT FROM AUTHOR]

Formative evaluation is critical in maximising the implementation strategies and processes of interventions. It is also critical to both providing contextual explanations for and maximising the success of such interventions. The purpose of this study was to undertake a comprehensive formative evaluation of the implementation process of a multi-component, sports-based mental health program for adolescent males ("Ahead of the Game"). Primary outcomes included program reach, dose, fidelity and cost during initial piloting and two distinct implementation phases. The iterative formative evaluation process provided opportunities to adapt the program and its implementation strategy to optimise reach, dose and fidelity relative to implementation cost. Formative evaluation data showed that the program failed to achieve optimal reach in the initial pilot phase (Phase I), with low doses of the program received by stakeholders, and moderate fidelity. Bottom up implementation strategies improved dose and club ownership during Phase II but resulted in high costs and lower fidelity and was associated with implementation staff retention and management issues. Phase III with more streamlined staffing and club integrated implementation resulted in high reach, dose, fidelity and club ownership and an associated reduction in implementation cost per participant. Conclusion : Formative evaluation succeeded in maximising the Ahead of the Game program engagement over three distinct phases. Results are salient for informing cost-effective implementation strategies for sports-based health promotion. • The cost per a participant differed considerably between implementation models. • The most successful implementation model included a small group of full time, experienced implementation leaders. • Opinion leaders and formally appointed leaders are key to optimising ownership, fidelity and dose of intervention. [ABSTRACT FROM AUTHOR]