A randomized iterative approach to optimizing an online substance use intervention for collegiate athletes

Area of Science:

• Behavioral science
• Public health
• Digital health interventions

Background:

• Collegiate athletes exhibit high rates of drug use, with limited evidence-based interventions available.
• myPlaybook is an online intervention designed to address multiple predictors of drug use in this population, including norms, expectancies, and harm prevention intentions.

Purpose of the Study:

• To optimize existing modules within the myPlaybook intervention through rigorous evaluation and revision.
• To enhance the efficacy of an online tool aimed at reducing drug use among student-athletes.

Main Methods:

• Employed the Multiphase Optimization Strategy (MOST) framework across three sequential randomized factorial trials.
• Recruited and randomized numerous schools and invited first-year and transfer collegiate athletes to participate in surveys and intervention modules.
• Iteratively evaluated and revised intervention modules based on effect sizes (d) for targeted outcomes across trials.

Main Results:

• Initial trials indicated small effect sizes (d < 0.15-0.3), prompting revisions to target proximal outcomes.
• Following revisions, the 'norms' module significantly improved descriptive and injunctive norms (d > 0.35).
• The 'expectancies' module showed a moderate effect on alcohol positive expectancies (d = 0.3), while other modules remained ineffective.

Conclusions:

• Two optimized modules from myPlaybook demonstrated substantial improvements in proximal outcomes relevant to drug use.
• These findings suggest that the refined myPlaybook intervention holds promise for positively impacting drug use behaviors in collegiate athletes.