Background: Peer-led health education in schools can promote healthy behaviours amongst adolescents. Peers can be effective agents of behaviour change as an adolescent’s peer group can strongly influence health promoting (regular physical exercise) and health compromising (smoking, alcohol consumption) behaviours. Motivational interviewing (MI) is an evidence-based health behaviour change intervention. A feasibility trial of the effectiveness of a peer-delivered MI intervention in low SES communities to adolescents with one or more behavioural risk factors will be conducted.
Hypotheses: Compared to the control group, the MI group will show statistically significant decreases in frequency of (a) smoking and (b) alcohol consumption, and significant increases in physical activity levels.
Method: A cluster randomised controlled trial will be conducted: 6 low SES communities will be randomly assigned to either the MI intervention (n = 3 communities) or control (n = 3 communities) condition. Following a two-day MI training programme, 18 adolescent peereducators will implement the MI intervention to young people reporting problems with smoking, alcohol or sedentary behaviours in their communities. The control group youth organisations will receive peer co-delivered health behaviour education; at-risk young people will complete a self-directed health behaviour change programme. The RE-AIM framework guides the design so that the Reach, Effectiveness, Adoption, Implementation and Maintenance are evaluated in an outcome and process evaluation. Primary outcomes (smoking, alcohol consumption and physical exercise) are assessed at baseline, one-week following the intervention, 6 months and 12 months post-intervention. The process evaluation comprises focus groups and interviews with peer-educators, participants and key community stakeolders.
Analyses: Data will be analysed using mixed model ANOVA and Multi-Level Modelling to examine the effects of the intervention on the primary outcomes and secondary outcomes at the participant level. Thematic analyses will be conducted on the focus group and interview data.
