Online peer support training to promote adolescents’ emotional support skills, mental health and agency during COVID-19: A pilot randomised controlled trial

Background: Adolescents often look to their peers for emotional support, so it is critical that they are prepared to take on a supportive role, especially during a health crisis. Using a pilot randomised controlled trial (ISCRN registry, number ISRCTN99248812), we tested the efficacy of an online training programme designed to equip young people with skills to support to their peers’ mental wellbeing during the COVID-19 pandemic. Methods: We recruited one hundred young people (aged 16-18) living in the UK, through social media advertisements. In June 2020, participants were randomly allocated (1:1) to immediate 5-day peer support training (n=50) or a wait-list (n=50) via an independently generated allocation sequence. Primary outcomes were indicators of ability to help others (motivation, perceived skills, frequency of help provided, compassion to others and connectedness to peers). Secondary outcomes included emotional symptoms, mental wellbeing, and indicators of agency (civic engagement and self-efficacy). We also collected qualitative reports of participants’ experience. Assessments were completed at baseline and 1-week post randomisation (primary endpoint), and up to 4-weeks post-randomisation (training group only). Results: We found significant effects of online peer support training on all indicators of ability to help others, except for motivation to provide support. The training increased perceived support-giving skills, frequency of providing support, compassion and peer connectedness 1-week post-randomisation, compared to controls (medium-large effect sizes). Gains in the training group were maintained 4-week post-randomisation. Training also produced benefits in relation to emotional symptoms, wellbeing, and indicators of agency, and qualitative reports revealed further positive outcomes including increased personal self-care and feelings of empowerment. Conclusions: Online peer support training brought benefits across a range of outcomes. Leveraging digital platforms that are familiar to young people, peer support training has the potential to enable adolescents to support their own and their peers’ mental wellbeing during a health crisis.