A pilot study assessing the preliminary efficacy and acceptability of a mental health promotion e-learning module for sports coaches

ABSTRACT The study aim was to evaluate the preliminary efficacy and acceptability of an e-learning module to increase sports coaches’ mental health literacy and intention to engage in mental health promotion. Thirty-five coaches completed measures at baseline and 1-week follow-up. Mixed methods were used to assess the acceptability of the module, including interviews with 15 coaches. Coaches’ knowledge, confidence and intention to engage in mental health promotion increased at 1-week follow-up. Coaches found the module to be acceptable with the content perceived to be informative, the design visually appealing, and the module realistic to be implemented more broadly within their sport.


Introduction
Mental health difficulties are the leading cause of disability in youth populations, and typically emerge during adolescence with a first onset before the age of eighteen (Castelpietra et al., 2022;Solmi et al., 2022).The occurrence of mental disorders during adolescence is associated with a range of negative consequences and, if left untreated, can have long-lasting effects, for example, lower levels of education attainment and increased risk of unemployment (Clayborne et al., 2019).Globally, there is an increasing trend in the prevalence of mental disorders in youth populations (Moreno-Agostino et al., 2021).In Ireland, depression and anxiety rates are also increasing, with 40% of adolescents self-reporting levels of depression outside the normal range, while 49% of adolescents reported heightened levels of anxiety (Dooley et al., 2019).
While the prevalence of mental disorders has increased in youth populations in recent years, there remain multiple barriers to accessing formal mental health services in most countries (O'Connor et al., 2021).These barriers typically relate to the cost of services, not knowing where to go for help, a shortage of accessible mental health specialists leading to excessive waiting times, and insufficient government funding (Moroz et al., 2020).Given this increasing prevalence of mental disorders in youth and the lack of access to formal mental health services, a complementary approach is required to support youth mental health.One approach is to incorporate mental health promotion into contexts in which youth actively engage in (Rice et al., 2018).Sport is one such context, with many young people participating in sports on a regular basis; for example, in Ireland, 60% of adolescents are involved in community-based sports at least once a week (Woods et al., 2018).Traditionally, health promotion interventions have been delivered in school settings; however, some adolescents have been reluctant to engage in these interventions due to their negative perceptions of the school environment, and thus alternative community settings such as a sports club may be preferable (Patafio et al., 2021).Indeed, there is increasing evidence that sports clubs might be a useful setting in which to engage in youth mental health promotion (Van Hoye et al., 2020).For example, a recent evaluation of the Ahead of The Game program, which used the community sport club setting to promote mental health in adolescent males, has shown it to be a feasible and potentially cost-effective mental health promotion strategy (Eckermann et al., 2021;Vella et al., 2021).
Coaches are the key gatekeeper of the sporting environment, interacting with athletes on a regular basis and supporting their physical and psychosocial development through sport (Walton et al., 2022).Through these interactions, they can build trusting and supportive relationships which can lead athletes to feeling more comfortable to seek support when required (Mazzer et al., 2012).Indeed for some athletes, coaches may be the only trusted adult they can approach to discuss their mental health concerns (Mazzer & Rickwood, 2009;Mirković et al., 2021).Consequently, there is an increasing recognition of how coaches can engage with their athletes on topics such as mental health (Bissett et al., 2020).There is growing evidence to support this view, with parents, athletes and coaches alike suggesting that coaches could engage in mental health promotion as part of their role (Brown et al., 2017;Ferguson et al., 2019;O'Leary et al., 2022;Swann et al., 2018).This could include openly discussing the importance of mental health with their athletes, encouraging help-seeking behavior, and modeling language and behavior to normalize discussions of mental health in the sporting environment (O'Connor et al., 2023).Although engaging in mental health promoting behaviors may increasingly be seen as part of the coach's role, there remains uncertainty as to whether coaches have the mental health literacy to engage in these behaviors with their athletes (Brown et al., 2017;Ferguson et al., 2019).
Mental health literacy is an increasingly studied construct and has traditionally been defined as "an individual's knowledge and beliefs about mental health and how they influence one's intentions to seek support" (Jorm et al., 1997, p. 182).It includes the ability to recognize common mental health disorders, knowledge of risk factors and causes, awareness of treatments and of the formal services available, and attitudes that promote appropriate helpseeking (Jorm et al., 1997).However, more recent definitions have begun to shift from this focus on mental ill-health to a wider definition that incorporates the knowledge and attitudes necessary to benefit mental health (Mansfield et al., 2020).Kutcher et al. (2016, p. 21, 155) outline one such definition that incorporates four components: "(1) Understanding how to obtain and maintain good mental health; (2) understanding mental disorders and their treatments; (3) decreasing stigma related to mental disorders; (4) enhancing help-seeking efficacy (knowing when, where, and how to obtain good mental health care and developing competencies needed for self-care)."The widening of the mental health literacy definition to include skills to promote mental health aligns with the World Health Organization conceptualization of mental health which includes wellbeing, optimal functioning and coping (World Health Organisation, 2018).This shift in focus encourages a mental health promotion approach that supports individuals to develop personal competencies and psychological strengths and to use social resources to benefit their mental health.This approach is complementary rather than in competition with approaches that focus on the prevention of mental disorders (Kobau et al., 2011).
There have been a small number of interventions targeting community coaches' mental health literacy in recent years.These interventions in general show an increase in coaches' knowledge of mental disorders and their intention to help the athletes they work with (Breslin et al., 2022;Sutcliffe et al., 2021).However, in both the cross-sectional and experimental research to date, there has been a focus on the traditional form of mental health literacy (i.e., recognition of mental disorders and associated risk factors), with no measurement of the more positive aspects of mental health literacy (Mansfield et al., 2020).With this shift to view mental health literacy as an asset for health, consideration needs to be given to individuals' knowledge of the factors that promote good mental health and how it can strengthened.Promising research within school settings shows that such a focus on the positive aspects of mental health literacy by school staff can enhance wellbeing in student populations (Bjørnsen et al., 2018).However, this evidence base does not extend to coaches.Consequently, there is a need for research examining what coaches understand about the factors that are important for maintaining good mental health, and how coaches' intention to promote such factors to the athletes they work with can be increased.
There is also a need to consider how interventions might be delivered to coaches.Some intervention studies have encountered considerable challenges with the recruitment and engagement of coaches (Vella et al., 2021).This may be due to the length or delivery mode of such mental health literacy programs which are typically face-to-face.Therefore, how these programs are delivered may need to be reconsidered if they are to reach the widest audience possible and be a realistic and sustainable public health strategy for mental health promotion.One such approach might be to move programs online, with some evidence indicating that online interventions can increase the mental health literacy of adults (Peyton et al., 2022).Indeed, a research study examining an e-learning mental health module for collegiate coaches showed increases in coaches' mental health literacy and their intentions to engage in culture setting communication with respect to mental health after completing the online module (Kroshus et al., 2019).However, to the authors' knowledge, there have been limited e-learning programs targeting the mental health literacy of community sports coaches.
In summary, there is an increasing prevalence of mental disorders in youth populations, with many of this cohort not having access to appropriate services.Sports clubs might be a useful setting in which to engage in youth mental health promotion.However, there remain gaps in the research literature.While there have been a limited number of interventions targeting coaches, these have tended to focus on the recognition of mental disorders and associated risk factors rather than the factors that promote good mental health in young people.Furthermore, these interventions have typically been delivered face-toface which might limit their scalability.Therefore to address these gaps, the aim of this study was to conduct a preliminary evaluation of the efficacy and acceptability of a brief e-learning module to increase coaches' mental health literacy and their intention to engage in youth mental health promotion.The current study assesses a pilot of the One Good Coach™ e-learning module which was developed by Jigsaw, the National Centre for Youth Mental Health in Ireland, who provide therapeutic services and promote youth mental health for those between 12 and 24 years of age.This e-learning model was developed through engagement with key stakeholders in the Irish sporting community.It was chosen for its focus on maintaining good mental health, and if deemed effective and acceptable, its potential scalability due to the reach of Jigsaw, the National Centre for Youth Mental Health in Ireland.The first aim was to examine coaches' knowledge, confidence and intention to engage in mental health promotion, while the second aim was to assess the acceptability of the "One Good Coach" module to coaches.

Participants
Participants were coaches recruited from two sports, a field-based team sport (i.e., rugby), and an individual sport (i.e., swimming).In total, 52 coaches (45% female) agreed to participate in the study and began the baseline surveys.Of these 52 coaches, 35 (67%; 18 coaches from rugby, and 17 coaches from swimming) completed the baseline survey and 1-week follow-up and are included in the study analysis.Seventeen percent of coaches were between 21 and 40 years of age (n = 6), 66% were between 41 and 60 years of age (n = 23), and a further 17% were over 60 years of age (n = 6).Thirty-one percent of coaches were female (n = 11), and 60% (n = 21) had been working youth athletes for at least 10 years.They were engaged in coaching activities for an average of 8.84 hours per week (SD = 9.97).Seventy-one percent of coaches worked only with athletes who were 18 years of age or younger (n = 25), while the other 21% of coaches (n = 10) reported working with a wider age range of athletes, i.e., athletes who ranged in age from 12 to 24 years of age.Fifteen coaches agreed to take part in a follow-up interview to assess the acceptability of the module, with eight coaches from rugby and seven from swimming.Twenty percent of the coaches interviewed were female (n = 3).

Study design, setting and procedure
This was a single-arm, nonrandomized pre-post study with a mixed methods evaluation of the acceptability of the intervention to coaches.This mixed methods approach incorporated an initial quantitative data collection phase followed by a qualitative data collection phase.The study was underpinned by critical realism which incorporates a realist ontology with a constructivist epistemology (Maxwell, 2012).Critical realism allows for the use of different data sources when trying to understand phenomena, and mixed methods research fits within such a philosophy (Ryba et al., 2022).The study took place across two sports in Ireland.Ethical approval was granted by the Research Ethics Committee of Jigsaw, the National Centre for Youth Mental Health and a University's Human Research Ethics Committee (LS-E-20-154).The research team engaged with the national governing bodies of both sports who agreed for an e-mail to be sent on behalf of the research team to a group of coaches in each national governing body inviting them to take part in the study.This e-mail contained a link to the online survey, a study information sheet, an informed consent form and details on how they could access the e-learning module.Survey data collection took place using Qualtrics (Qualtrics, Provo, UT) with the survey taking approximately 15 minutes to complete.Baseline survey data collection took place immediately prior to beginning the e-learning module, and coaches were sent an e-mail one week after completion of the module asking them to complete the survey again.All coaches were also invited to take part in a follow-up interview to discuss the acceptability of the module.These interviews took place over Zoom.

One good coach™ e-learning module
One of the key pillars of Jigsaw's mission is mental health promotion (O'Reilly et al., 2022).As part of this approach, Jigsaw runs workshops for adults who work or volunteer with groups of youth to increase their mental health literacy with a particular focus on understanding how to support young people to maintain good mental health (O'Reilly et al., 2022).The One Good Coach™ workshop grew out of this approach to mental health promotion.The workshop has four overarching learning outcomes for coaches.One, to have an enhanced understanding of mental health (e.g., through discussion of the World Health Organization definition of mental health, and translation of that definition into "everyday language, and a recognition that mental health is not a fixed state).Two, to recognize the importance of their role as One Good Coach™ (e.g., through research findings that highlight the link between a young person having a supportive adult in their life and good mental health, and how sports coaches can be that supportive person for their athletes).Three, to have a greater awareness of how to promote and support youth mental health in their role as coaches (e.g., through the promotion of the "5-a-Day" for mental health concept, and supporting young people by using active listening skills.The "5-a-Day" concept focused on encouraging young people to, connect with others; give support to others, take notice of how they feel; be physically active, and get involved in activities in which they can have a say).Four, to increase their awareness of local mental health supports and how they can be accessed (e.g., through discussion of the supports available within specific regions).The module was initially delivered face-to-face; however, it was transformed into an online offering to provide it to more people.The e-learning module takes approximately 40 minutes to complete.It is tailored to a sporting audience with images of athletes and coaches from different sports throughout the module.During the module, there are short video and audio components explaining various concepts for coaches to engage with (see Table 1).

Mental health knowledge
To assess coaches' understanding of mental health, the Mental Health Knowledge Scale (Dooley et al., 2014) was used.It contains seven statements related to factors important for good mental health (e.g., mental health is a state of emotional wellbeing; mental health is an ability to cope with normal stresses of life).All items were measured on a 5-point Likert scale, ranging from 1 "strongly disagree" to 5 "strongly agree."This measure has been used previously with an adult population in an Irish context and has demonstrated adequate reliability (Dooley et al., 2014).In the present study, McDonald's omega value was ω =.94.

Intentions to promote and support youth mental health
Module-specific items were developed to measure coaches' intention to engage in mental health promotion behaviors.These items were initially developed by the lead author and then reviewed by members of the research team for appropriateness.Coaches were asked how likely they would be to engage in a list of behaviors drawn from the content of the module (e.g., "encourage young people to talk about small problems") using a 7-point Likert scale, ranging from 1 "extremely unlikely" to 7 "extremely likely."A mean of the items was also computed to represent an overall intention to promote mental health.The internal consistency as measured by McDonald's omega was ω = .87. • Access to the Foresight report which the 5-a-Day concept for mental health was adapted from.
• Video that discusses the 5-a-Day for mental health and how it can help a young person's mental health.
• Self-reflection questions about how a person can use the 5-a-Day with their own athletes (1) Knowledge about how to help young people • To introduce how coaches can sup- port young people by engaging in active listening • To promote signposting of resources for further help • Video explaining and demonstrating how to apply active listening with a young person.
• Information on and access to addi- tional content regarding support and signposting young people to services • Self-reflection questions about pro- cedures in your club to support young people

Role breadth and role efficacy
Role breadth (i.e., whether a person regards an activity as part of their role) and role efficacy (i.e., an individual's confidence in his or her capabilities to carry out a particular task or behavior) were measured with items from McAllister et al. (2007).For each of the statements related to the coaches' intention to engage in the behaviors promoted in the One Good Coach™ module, coaches answered, "This behavior is an expected part of my role" for role breadth and "I am completely confident in my capacity to engage in this behavior" for role efficacy.Responses were given on a 5-point Likert scale, ranging from 1 "strongly disagree" to 5 "strongly agree."These scales have been used in a range of studies regarding mental health promotion and have demonstrated high levels of reliability (Duffy et al., 2021).In this study, McDonald's omega for role breadth was ω = .87and for role efficacy was ω = .88.

Module feedback
The acceptability of the One Good Coach™ module was partially measured with study-specific items completed one week after the module.These items assessed coaches' overall satisfaction with the course, their rating of the module content and quality of presentation within the module.These items were measured on a 5-point Likert scale, ranging from 1 "very dissatisfied/ poor" to 5 "very satisfied/excellent."There were also open-ended questions for coaches to detail what they liked, did not like, or would change about the module.Coaches were also asked if they would recommend the module to other coaches.

Interview guide
An interview guide was designed to investigate the acceptability of the One Good Coach™ module to coaches The initial section of the guide reiterated the coaches' ethical rights and asked them to provide informed consent before a set of introductory questions explored the coaches' backgrounds.
A number of open-ended questions related to the acceptability of the module followed.These questions were informed by principles from the theoretical framework for acceptability, i.e., affective attitudes, intervention coherence, burden, and perceived effectiveness (Sekhon et al., 2017).These questions included, how the module aligned with coaches' underlying beliefs and values regarding the coach's role (affective attitudes), how mental health promotion fit as part of that role (intervention coherence), and the perceived effort it took to complete the module (burden).Coaches' views of the perceived effectiveness of the module from both an individual perspective and with respect to its wider integration within their sport were then explored (perceived effectiveness).
Finally, a summary question was asked that invited coaches to discuss any other issues they felt were important to the topic.

Data analysis
The quantitative data in this study were analyzed using IBM SPSS V26.An a priori power calculation using G*Power software (Faul et al., 2009) was conducted.It was revealed that a minimum sample of 34 participants was required to perform the analyses.The effect size entered into this calculation was based on a medium effect (β = 0.50) reported in prior research (Sutcliffe et al., 2021), and was entered with an alpha of .05 and power of .80.As one of the aims of this study was to assess the potential efficacy of the intervention, analyses were based on the sample of coaches who completed both baseline and 1-week follow-up assessments.Thus, seventeen participants were excluded due to noncompletion of the follow-up survey, leaving a sample size of 35.There were no significant differences between those who completed measures at both time points and those who only completed the baseline survey, except gender, where more female than male coaches did not complete the 1-week follow-up survey (χ2 (1, N = 52) = 7.11, p < .001).Within this sample of 35 participants, there were multiple instances from one participant of missing responses to more than two items in a number of scales.Therefore, this participant was excluded from any analysis that required those scales.The normality of the data was confirmed.Changes in scores on mental health knowledge, intention to engage in mental health promotion behaviors, role breadth and role efficacy at baseline and 1-week follow-up assessments were analyzed using paired samples t-tests.We used an alpha level of .05,with results adjusted for multiplicity using a Bonferroni correction when examining scale items.These scale items were examined to further understand how the One Good Coach™ module influenced coaches' knowledge of specific aspects of mental health knowledge and their intentions to engage in particular behaviors outlined in the e-learning module.Effect sizes were reported using Cohen's d criteria (i.e., 0.2 = small effect 0.5 = medium effect; 0.8 = large effect; Cohen, 1988).Descriptive statistics were also computed for the quantitative data assessing the acceptability of the intervention to coaches.
The semi structured interviews conducted with coaches were transcribed verbatim.In line with our critical realist philosophy (Maxwell, 2012), Braun and Clarke's (2019) principles of reflexive thematic analysis were used to analyze the qualitative data, facilitated by the Nvivo data management tool.Reflexive thematic analysis is a theoretically flexible, iterative process that involves moving back and forward between stages of analysis and revisiting the raw data as often as needed to refine understanding (Braun & Clarke, 2019).To ensure the validity of the qualitative data analysis, empirical adequacy, ontological plausibility, and the practical utility of the data were considered (Ronkainen & Wiltshire, 2021).For empirical adequacy, we applied mixed methods and triangulated the data sources, thus enabling us to develop a greater understanding of the acceptability of the module to the coaches.To ensure ontological plausibility, we engaged with critical friends throughout the data analysis process.These critical friends reviewed the lead author's interpretation of the data and posited alternative explanations for consideration (Smith & McGannon, 2018).Further, member reflections were used, inviting participants to review the preliminary findings and discuss them with the lead author to see if further insight would be developed through this dialogue (Ronkainen & Wiltshire, 2021).No new themes were established following dialogue with a small number of participants.Finally, practical utility was demonstrated by enhancing our understanding of how a mental health promotion initiative can be delivered in an acceptable and scalable way to those working in community settings such as sports coaches.

Mental health knowledge
Coaches' overall knowledge of mental health significantly increased from baseline to the 1-week follow-up (t(34) = −2.12,p = .04,d = 0.92).However, no scale items retained significance following a Bonferroni correction (See Table S1 Supplemental File).

Intentions to promote and support youth mental health
Coaches' overall intentions to engage in mental health-promoting behaviors significantly increased from baseline to the 1-week follow-up (t(34) = −3.04,p < .001,d = 0.39).Three specific items significantly increased from baseline to the 1-week follow-up, and two of these items retained significance after a Bonferroni correction.These were "help a young person to find ways to lend support or help out another person" (t(34) = −3.65,p < .001,d = 0.71) and "be aware of the mental health support for young people in my area" (t(34) = −3.19,p < .001,d = 0.86) (See Table S2 Supplemental File).

Role breadth and role efficacy
Coaches' overall beliefs regarding the relevance of these mental health promoting behaviors to their coaching role significantly increased from baseline to the 1-week follow-up (t(33) = −2.46,p = .02,d = 0.41).This was particularly evident for the behavior "to encourage young people to talk about small problems," which remained significant after a Bonferroni correction (t(33) = −3.19,p < .001,d = 0.86).Coaches' overall confidence to engage in these behaviors as part of their coaching role also significantly increased from baseline to the 1-week follow-up (t(33) = −2.42,p = .02,d = 0.49).Three specific items significantly increased from baseline to the 1-week follow-up.However, none retained significance after a Bonferroni correction was applied (See Tables S3 and S4 Supplemental File).

Acceptability of the one good coach™ e-learning module
Table 2 highlights how coaches responded favorably to the module.Coaches reported an overall mean satisfaction score of 4.46 out of 5 for the module, and 97% would recommend it to other coaches.A summary of the responses to the open-ended questions is presented in Table 3. Common themes were, the usefulness of the module strategies such as the "5-a-Day" or "active listening" to the wider themes of the important role of the coach and being aware of a young person's mental health.A small number of coaches wanted more information within the module, reporting the module was too simple, while others wanted case studies to be included.The follow-up semi structured interviews allowed for a more detailed exploration of the acceptability of the module to coaches.These findings are organized under four themes: "the usefulness of the OGC module," "sport coaches' motivations for undertaking the OGC module," "normalizing conversations around mental health" and "integrating the OGC module and wider mental health promotion into sport.These themes are described with representative quotes.

The usefulness of the one good coach™ module
In this theme, coaches discussed their experience of completing the module.There was consensus among the coaches regarding the design of the One Good Coach™ module.They discussed how it was engaging, the information provided was clear and simple, and how it was a useful starting point that could be built upon with further programs to provide more detailed information.Some coaches suggested that the inclusion of case studies in the module would be beneficial for demonstrating the types of situations that coaches might have with the young athletes they work with and strengthen their confidence as to what they can and cannot say to them.Coaches described other aspects of the module they found impactful.In particular, many coaches talked about the "5-a-Day" concept being easily understandable and one that they could try to use with the athletes they work with.Coaches also highlighted active listening as an important message from the module.For many coaches, the idea of active listening was a fundamental part of being a good coach.Indeed, one coach discussed how simply applying the principles of active listening might make a difference: "there's a nice piece in the presentation about what is active listening and nonverbal and verbal skills for listening. . .And I suppose, like oftentimes if people just did that much, it could be really supportive for someone."(Coach 2) Coaches highlighted how this type of module could help to keep the importance of mental health at the forefront of what they do as coaches.There was also a recognition of the role coaches could play in being "one good adult" for a young person.This was exemplified by one coach who explained: My big one was I think that every child normally needs an adult to confide in or even just talk to . . .Sometimes that's not the parent.It is we'll say someone that they respect or admire in authority, and that when you're in authority, it's kind of your obligation to actually just give them that five minutes or two minutes or whatever just to talk . . .I think that's the big thing that I got out of it.I think everybody knows it, but until you read it you don't understand, or it makes it more clear and that's the big thing that I got out of it (Coach 9).

Sports coaches' motivations for undertaking the one good coach™ module
A prominent motive for undertaking the module was coaches recognizing the importance of youth mental health and their desire to develop knowledge to support it.This was highlighted in different ways, with some coaches describing experiences they had had with athletes who needed support, while others wanted to be ready to help a young person if they needed to.There was also consensus among the coaches to look beyond simply helping the young person to develop as an athlete to a wider view of their development as a person.This is illustrated by a coach discussing how: We could contribute more. . .I suppose to their holistic development as well as the rugby.So, it (One Good Coach™ module) was appealing from that perspective you know?You know why would you not take up that opportunity if you're around kids and you've got an opportunity to teach them how to pass the ball properly and also how to be happier in themselves and to grow up happier.It's a win win, isn't it (Coach 1).

Normalizing conversations around mental health
While there was still a level of stigma in discussing mental health, coaches believed conversations around mental health were becoming more normalized inside and outside of sport, and athletes were more comfortable talking about their mental health than previous generations.Coaches recognized their role in normalizing these conversations, that it did not have to be onerous, and that small gestures and interactions could make a difference as detailed in the One Good Coach™ module.
I really like the one good adult idea and one good coach idea.And again, for people who haven't done this kind of work, that they realise that they can be that.And all it takes is a tiny little thing, even just to say, look, if you ever need to chat, just pull me aside.It's not a problem.We've got two coaches here.He can take the guys for five minutes so that we can talk.That can actually change a life (Coach 12).
Coaches discussed the importance of normalizing conversations around mental health by being consistent and clear in the language they use with the athletes they work with and how this can help provide a language they can use to talk about their mental health, as one coach described.
The idea of coaches, at a young age, starting to talk about this, and thus helping young men and young women have the language . . .so we get to a place where as youngsters grow up, and get to the 18s, 20s, 25, they are able to say I'm struggling with my mental health because we've given them words, we've given them frameworks, we've given them resources to be able to direct them (Coach 4).

Integrating the one good coach™ module and wider mental health promotion into sport
The coaches supported the wider implementation of the One Good Coach™ module within their sports.Coaches discussed whether initiatives such as the One Good Coach™ module should be compulsory, and there was broad agreement that it should be built into coaching qualifications.Indeed, some coaches also felt that it is the type of initiative that could be revisited every couple of years to reaffirm the key messages as described by this coach: "So as well as doing your police vetting every couple of years or whatever, you might do the one good coach program or a variant of it every couple of years, just to promote the ideas."(Coach 4) The culture or focus of the sport club was also raised as important by some coaches.Coaches discussed how this type of initiative needed to be "owned and driven" by the executive group in the club.Others highlighted the lack of focus on mental health in the club being due to an emphasis on activities more directly related to the club/sport, such as fundraising, as summed up by this coach: "it's whether the clubs sometimes want to do that because we get lost in the game sometimes, and we get lost with raising money for new changing rooms or a new kit or something."(Coach 3)

Discussion
This aim of this study was to conduct a preliminary evaluation of the efficacy and acceptability of a brief e-learning module to increase coaches' positive mental health literacy and their intention to engage in youth mental health promotion.Coaches' knowledge, confidence and intentions to engage in mental health-promoting behaviors increased following completion of the e-learning module.Coaches also found the module to be acceptable, with the content perceived be simple and informative, the design visually appealing, and the module realistic to be implemented more broadly within their sport.
A number of mental health literacy interventions have been conducted in sport-based settings in recent years, with increasing evidence that enhancing the mental health literacy of coaches may lead to an increase in promotion and prevention behaviors.In the present study, coaches' overall mental health knowledge increased from baseline to the 1-week follow-up.This finding is in line with much of the recent experimental research conducted within the sport setting (Breslin et al., 2022;Sutcliffe et al., 2021).However, these studies have tended to focus on increasing coaches' knowledge of the signs and symptoms of mental ill-health rather than the factors that promote good mental health.Thus, this study is one of the few studies to focus on coaches' knowledge of the factors related to good mental health.This focus is important as research findings highlight how promoting the factors related to good mental health can enhance youth mental well-being (Bjørnsen et al., 2018).Coaches' intention to engage in mental health-promoting behaviors also increased one week after completing the One Good Coach™ module.This finding is encouraging as there is considerable evidence that intention is a robust predictor of behavior (Sheeran & Webb, 2016).Coaches reported their intention to become more familiar with the mental health supports in their area which may help address the key barrier of young people's lack of awareness of the mental health services available to them and how to access those services (Salaheddin & Mason, 2016).Furthermore, coaches intended to ensure that their athletes were aware of how they could help or support other young people.This may help to facilitate young people to seek support if needed, as peers are a key source of informal support (Gulliver et al., 2010).
Alongside knowledge and intention, there are other important determinants that influence engagement in a behavior, such as the alignment of the behavior to a person's social or professional role, and their beliefs about their capabilities to engage in the behavior (Cane & O'Connor, 2012).In the present study, role breadth and role efficacy were considered important determinants to assess as recent research has highlighted the importance of these factors to promote engagement in mental health promotion behaviors (Duffy et al., 2021).Consequently, the One Good Coach™ module highlighted the role of the coach in promoting youth mental health, thus targeting role breadth, while the module also highlighted the simple behaviors that coaches could engage in to support their athletes, with the aim of increasing coaches' confidence to engage in such behaviors.Encouragingly, both coaches' role breadth and role efficacy increased after completing the module, a finding that mirrors other recent research in the community sport setting (Hurley et al., 2018).Future interventions should ensure there is a clear alignment of the proposed behavior with a person's social or professional role and should aim to increase a person's confidence to engage in the behavior/s.The inclusion of behavior change techniques within the intervention such as persuasion from a credible source, demonstrations of the behavior, and practicing the behavior via activities such as case studies and shared group discussion might facilitate this (Connell et al., 2019).
The One Good Coach™ module was developed to enhance coaches' mental health literacy specifically, their knowledge of the factors that can help a young person to maintain good mental health.The acceptability data indicated that the module was valued by coaches.Specifically, coaches reported that the module and its content aligned with their beliefs regarding the role of the sports coach and how they can support young people on a more holistic basis.This finding aligns with the quantitative study findings and with the wider literature which suggests that coaches, parents and youth see the coach's role as broader than simply a young person's athletic development (Ferguson et al., 2019).Furthermore, coaches reported how they believed initiatives such as the One Good Coach™ module and the concepts within it can help to normalize conversations about mental health between coaches and their athletes.Indeed, research has highlighted that youth who have conversations with adult caregivers about mental health tend to have more positive views of mental health and help-seeking (Newcomb-Anjo, 2019).The coaches also highlighted the acceptability of the One Good Coach™ module from a burden perspective.They reported that it was well designed, easy to use and took an acceptable amount of time to complete.This is important as oftentimes, the complexity of health promotion interventions can prevent sustained engagement by the target audience.Coaches also recognized the usefulness of the module being online from an access and scalability perspective.Recent research with teachers found no difference in the effects of a mental health literacy intervention between a version delivered online and one delivered face-to-face, suggesting that online can be a viable alternative to face-to-face delivery, potentially increasing the reach and ease of delivery of mental health promotion programs (Wei et al., 2020).However, a cohort of coaches did express a preference for blended delivery to allow for the sharing of experiences with peers.Future research is required to explore the value of a blended approach.
In terms of the perceived effectiveness of the module, coaches were positive in their beliefs that the intervention enhanced their knowledge of specific concepts.Coaches were also asked to consider the perceived effectiveness of the module to the wider community of coaches within their sport.Coaches were clear that this module could be integrated into their sports and suggested it could be made mandatory within coaching qualification pathways.However, coaches highlighted that there was a need to ensure that there was a strategic approach taken with tangible support from the hierarchies within sport clubs.Thus, the module needs to be situated within an ecological context that promotes the overarching aims of the initiative, as a brief e-learning module is unlikely to sustain the desired behaviors unless it is reinforced by the environmental context of the sport or sport club (Kroshus et al., 2019).This type of strategic approach might be facilitated by considering some of the recommendations provided in the recently published mental health promotion framework for sports (Purcell et al., 2022).
It is important to acknowledge the limitations of this work.The study included coaches from two sports who were very experienced, who coached in the community and were predominantly male.Thus, the findings may not be generalizable to other sports, to less experienced coaches, to those coaching in other contexts such as schools or to female coaches.Future research should ensure that female coaches are adequately represented in studies as there is some evidence to suggest they have higher levels of mental health literacy than male coaches (Gorczynski et al., 2020), and the reasons for this increased knowledge should be explored.Furthermore, recent studies have suggested that mental health difficulties are more commonly reported in youth athletes who take part in individual sports compared to those who participate in team sports (Hoffmann et al., 2022).This may be due to factors such as, youth athletes who participate in individual sports, attributing any failures they experience to internal factors as they do not have teammates who can share the responsibility for performance (Nixdorf et al., 2016).Thus, future studies may need to particularly target coaches of individual sports to ensure these athletes are appropriately supported.As coaches self-selected into the study, it is likely that the coaches who took part were motivated and held positive views on mental health.However, those who hold stigmatizing attitudes might be in greatest need of developing their mental health literacy (Hurley et al., 2018).Thus, future studies need to consider how best to engage these more difficultto-reach individuals.This may require further tailoring of content and the possible use of role models to promote the module and encourage participation (Morgenroth et al., 2015).There were high levels of dropout at the followup timepoint.Therefore, future studies should consider how to maximize recruitment for mental health promotion interventions in sports.This study focused solely on the factors that promote good mental health.Future studies should compare the effects of this type of intervention against those that target traditional elements of mental health literacy or which apply a combined approach.Furthermore, there was no control group utilized in this study.While single-arm studies can have a role in feasibility and pilot testing, further testing of this intervention should apply a randomized controlled trial design.

Implications for practice
This study showed promising initial changes in coaches' knowledge, confidence and intention to engage in mental health promotion after completing the module with some medium to large effect sizes demonstrated.Coaches also perceived the module to be acceptable and could be integrated more widely within their sports.This positive response to the module suggests it has the potential for use as a mental health promotion tool within sport, and could be formally incorporated within coaching qualification pathways in a similar fashion to child and young person safeguarding training.Future research should consider adaptions to the module with respect to content and mode of delivery to enhance its efficacy (e.g., the use of case studies, and videos for demonstration).
Further research can also build on the current study by assessing the possible longitudinal effects of this module by examining whether coaches implement these behaviors over the course of a season with their athletes, and the impact on their subjective well-being (Rato Barrio et al., 2021).

Conclusion
Mental disorders are increasingly prevalent in youth populations; however, many young people do not seek support.Sports coaches engage with young people on a regular basis and could be in a position to promote and support their mental health.This pilot study found that a brief e-learning module improved coaches' knowledge, confidence and intention to engage in mental health promoting behaviors with the athletes they coach.These findings are promising and could be used to encourage and inform sports clubs and their associated national governing bodies to provide the opportunity for their coaches to develop the knowledge, confidence and skills to promote mental health as part of a holistic and integrated approach to developing the young people who play their sport.

Table 1 .
One good coach™ module outline.

Table 2 .
Coach feedback responses from the 1-week follow-up survey.

Table 3 .
Coaches'responses to the open-ended questions from the 1-week follow-up survey.