SOFTPEERS: feasibility, acceptability, and preliminary effectiveness of a peer-led intervention to prevent binge drinking in adolescents. Results from a mixed-methods pilot cluster-randomized controlled trial

Introduction Population surveys indicate that binge drinking is highly prevalent among adolescents worldwide and is associated with a wide range of harmful consequences. School-based peer-led interventions are considered a promising strategy, as adolescents are especially receptive to preventive messages delivered by their peers. The present pilot study aimed to assess the feasibility, acceptability, and preliminary effectiveness of the SOFTPEERS program, a peer-led intervention designed to prevent binge drinking in French high school students. Methods A mixed-methods design was used. The quantitative component consisted of a cluster-randomized controlled trial involving 2,021 students in grades 10–11 (15–18 years) from eight high schools (four intervention, four control) assessing the 6-month impact of the SOFTPEERS program on binge drinking prevalence. The qualitative component consisted of a process evaluation conducted through 13 individual interviews and 8 focus groups, examining delivery conditions, perceptions of individuals involved, and contextual factors influencing implementation. Quantitative data were analyzed using generalized linear mixed models with a logit link function, and qualitative data through thematic analysis. Results Quantitative analyses revealed a significant time x group interaction on binge drinking prevalence ( b = −0.08, 95% confidence interval [−0.12, −0.04]), indicating that the increase in binge drinking prevalence in the past 30 days between baseline and 6-month follow-up was significantly smaller in the intervention group (+1.3 percentage points) than in the control group (+9.2 percentage points). Qualitative analyses indicated that peer educators considered the program appropriate, enjoyable, and personally enriching. Peer recipients appreciated the peer prevention approach, considering it more open and pleasant than an adult-led approach, and demonstrating a certain degree of effectiveness in terms of knowledge gained and behavioral regulation. Members of the high school staff also appreciated the peer-to-peer approach. However, logistical and scheduling constraints required local adaptations from both professional health educators and peer educators to ensure program delivery. Discussion These findings suggest that the SOFTPEERS program is a feasible, acceptable, and potentially effective peer-led intervention to prevent binge drinking among French high school students. In light of these results, a full-scale cluster-randomized controlled trial should be conducted to confirm the program’s effectiveness. Clinical trial registration https://doi.org/10.1186/ISRCTN11897676 , ISRCTN11897676.