LaunchPad is an online substance use prevention program for high school seniors. The program is designed to help seniors develop skills and make informed decisions as they transition from high school to young adulthood. The purpose of this clinical trial is to learn whether individual LaunchPad lessons improve the specific attitudes, intentions, and skills they are designed to address. For example, researchers will examine whether the stress management lesson increases students' intentions to use healthy ways of managing stress. The main question this study aims to answer is: Does each individual LaunchPad lesson improve the specific outcomes it was designed to address? Researchers will compare students who receive a particular lesson with students who do not receive that lesson to determine whether the lesson changes the intended outcome. Participants will: * Complete a brief baseline survey * Complete two introductory online lessons * Complete one or more randomly assigned LaunchPad lessons * Complete a brief follow-up survey All surveys and lessons will be completed online.
LaunchPad is an online substance use prevention program designed for high school seniors as they prepare for the transition to young adulthood. The program is being developed and optimized using the Multiphase Optimization Strategy (MOST), an engineering-inspired framework for building effective and efficient behavioral interventions. Rather than evaluating the program as a single intervention "package", researchers evaluate individual lessons and determine which lessons contribute meaningfully to desired outcomes before assembling an effective and efficient (i.e., "optimized") intervention package. The current study, Trial I, is the first of two planned trials in the Optimization Phase of MOST. Trial I is designed to evaluate whether five theory-informed LaunchPad lessons produce their intended short-term effects on risk and protective factors associated with substance use during the transition out of high school. All participating students will receive two introductory lessons. Students will then receive different combinations of five additional lessons that target factors such as perceptions of substance use among young adults, stress management skills, making friends without using alcohol or other drugs, and other skills and beliefs associated lower risk of substance use among young adults. The study will recruit approximately 48 high schools across the United States. To make it easier for schools and because students within a school may discuss intervention content, schools will be assigned to study conditions rather than individual students. Participating schools will be randomly assigned to one of 16 experimental conditions using a cluster-randomized fractional factorial design. This design allows researchers to efficiently estimate the effect of each lesson on its targeted outcomes. Parents or guardians of seniors at each participating high school will be notified about the study and provided an opportunity to opt their child out of participation. Students whose parents do not opt them out and who provide assent (\<18 years old) or consent (18 or older), will be eligible to participate. When required by participating schools, active (opt in) consent procedures will be used for parents or guardians. Schools will be able to implement the program between September 1 and April 2, depending on when it works for them. Participating schools will complete: a brief baseline survey, the LaunchPad lessons assigned to their school, and an immediate post-intervention survey. Students will access LaunchPad through a learning management system using a computer, tablet, or smartphone. Survey responses will be linked across assessment periods using unique study identifiers generated within the course management system. The primary purpose of Trial I is to determine whether each lesson changes the factors it was designed to influence. Primary outcomes include changes in the targeted attitudes, beliefs, perceptions, and skills assessed immediately following intervention completion. Information from participant surveys, behavioral engagement data, and participant feedback will also be used to assess the acceptability and usability of the lessons and to identify opportunities for improvement. Findings from Trial I will be used to identify which lessons do not yet achieve the desired effects on their targeted outcomes. Findings will be combined with feedback from participating students, young adults, school staff, and expert consultants to inform revisions to lesson content and delivery. The revised lessons will be tested in a subsequent optimization trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
5,000
Discusses choices and challenges students face as they transition out of high school to promote participant buy-in. Explains the consequences of SU, focusing on how these consequences can interfere with their life plans.
Provides messages from young adults that reveal positive attitudes (i.e., high injunctive norms) about using protective strategies to limit exposure to risky situations and behaviors. Messages will also emphasize low approval toward negative consequences of SU to motivate the need for PBS use.
Teaches social and decision-making skills such as SU refusal skills and strategies for coping with stress and anxiety.
Provides normative feedback about intervening on behalf of peers and teaches strategies to intervene on behalf of peers.
Teaches strategies to make friends without SU.
Corrects misperceptions about prevalence of SU among young adults and young adults' approval of SU.
Substance Use Injunctive Norms
To capture students' perceived approval of substance use among their peers, they will indicate how much typical same-sex college students and typical same-sex young adults not in college approve of: Drinking daily; Having 4-5 drinks nearly every day; Having 5 or more drinks once or twice each weekend; Trying marijuana once or twice; Using marijuana occasionally; Using marijuana regularly; Smoking one or packs of cigarettes a day; Using e-cigarettes/vaping. Response options will be 1=strongly disapprove to 7=strongly approve. Responses will be averaged across reference groups but each substance will be analyzed separately.
Time frame: This measure will be completed at the pretest and immediate posttest
Substance Use Descriptive Norms
To capture students' perceived frequency of substance use among their peers, students will indicate what percentage of typical same-sex college students and typical same sex young adults not in college have done the following in the past 30 days: Drank alcohol, been drunk, used marijuana, smoked cigarettes, used e-cigarettes / vaped. Students will also indicate what percentage of each group they think have had 5 or more drinks in the past 2 weeks. The questions will allow open ended responses ranging from 0-100. Responses will be averaged across reference groups but each substance will be analyzed separately.
Time frame: This measure will be completed at the pretest and immediate posttest.
Social self-efficacy
Students will report how confident they are that they could do things to meet new people in real situations. For example ("Start a conversation with someone you don't know or just met"; "Get to know new people without using alcohol or other drugs"). Response options will be 1 = Not at all confident to 4 = Completely confident. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Beliefs about social belonging without substance use
Students will indicate how much they agree with statements about the importance of substance use for young adults to make friends. Response options will range from 1 = strongly disagree to 6 = strongly agree. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Substance use refusal self efficacy
Students will indicate how confident they are that they could resist drinking or using drugs in different situations. There are three subscales: For emotional relief (e.g., When I feel upset), opportunistic situations (e.g., when I am at a party), and in situations where there is social facilitation (e.g., when I want to feel more accepted by my friends). Response options will range from 1 = I am very sure I could NOT resist drinking or using drugs to 6 = I am very sure I could resist drinking or using drugs. Responses will be averaged across items to create a single measure.
Time frame: This measure will be completed at the pretest and immediate posttest.
Injunctive norms about Protective Behavioral Strategies
Students will report "how you think young adults feel if their friends did the following." Item content will be adapted from measures of alcohol, marijuana, and smoking / vaping harm prevention / protective behavioral strategies (e.g., "Refused to ride with a driver who had been drinking alcohol"; "Refused to play a drinking game even when everyone else is playing"). Response options will be 1=strongly disapprove to 6=strongly approve. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Injunctive norms about consequences of substance use
Students will report "how you think young adults feel if their friends did the following." Item content will be adapted from measures of alcohol, marijuana, and smoking / vaping consequences (e.g., "Said or did embarrassing things while drinking or using marijuana"; "Got into an argument or fight with someone after they had been drinking or using marijuana"). Response options will be 1=strongly disapprove to 6=strongly approve. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Attitudes about using Protective Behavioral Strategies
Students will identify how they feel about using protective behavioral strategies. Response options will be on a 5 point scale with anchors such as 1 = harmful vs 5 = beneficial and 1 = not worth it and 5 = worth it. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Intentions to use stress management skills
Students will complete a measure adapted from several subscales from the Brief COPE to indicate how often they intend to use different strategies to cope with stress over the next 3 months. The substance use items are: "Use alcohol to feel better", "Use marijuana (weed) to relax or feel better" and "Use nicotine pouches to relax". Response options will range from 1 = Never to 4 = Often. Responses will be averaged across items within the same subscale.
Time frame: This measure will be completed at the pretest and immediate posttest.
Self efficacy to use different stress management skills
Students will complete a measure adapted from several subscales from the Brief COPE to indicate how confident they are that they could use different adaptive coping strategies. For example, "Break a big problem into smaller, manageable steps" and "Refrain from using alcohol, marijuana, nicotine (smoking, vapes, pouches) or other substances." Response options will range from 1 = Not at all confident" to 4 = Completely confident. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Injunctive norms about Bystander Intervention
To capture students' norms around the social acceptability of bystander intervention, they will indicate how they think most young adults would feel about their friends intervening in different ways, such as "Suggested their friends create a plan to stay safe before drinking or using drugs" and "Call for emergency help if someone is passed out, even if that person could get in trouble". Response options will range from 1 = Strongly disapprove to 6 = Strongly approve. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Attitudes about Bystander Intervention
Students will indicate how much they agree with several statements about bystander intervention: "It's my responsibility to look out for my friends when alcohol or drugs are involved" and "It's important for me to say or do something if a friend's drinking or drug use seems risky, even if it feels awkward". Response options will range from 1 = Strongly disagree to 6 = Strongly agree. Responses will be averaged across items.
Time frame: This measure will be completed at the pretest and immediate posttest.
Self efficacy to intervene
Students will rate how confident they are that they could engage in different bystander behaviors, such as "Ask a peer who seems very drunk or high if they are okay, even if you don't know them well" and "Tell a friend you are worried about how much they had been drinking or using drugs."
Time frame: This measure will be completed at the pretest and immediate posttest.
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