Abstract:
Background Substance use disorders are prevalent among youth in sub-Saharan Africa (SSA), yet treatment
resources are scarce. Peer provider delivered brief interventions (BIs) represent an affordable and potentially scalable
strategy for addressing youth substance use disorders. The goal of this study is to assess the acceptability of a peer
provider delivered substance use BI from the perspective of youth in Kenya.
Methods We conducted qualitative semi-structured interviews with youth participants (n = 25) to explore
acceptability of a substance use BI. Youth were participants in a two-arm mixed-methods pilot randomized controlled
trial (RCT) investigating the feasibility of a peer provider delivered single-session substance use BI for youth aged
15–24 years with moderate-risk substance use. The semi-structured interviews were conducted three months after
the BI was delivered and were guided by the Theoretical Framework of Acceptability (TFA). Qualitative data were
analyzed through thematic analysis.
Results We interviewed 25 of 38 participants in the BI arm, 18 males and 7 females; 15 were ages 18–24 years, and
10 ages 15–17 years. Affective attitude: Most youth reported that they enjoyed the session content and enjoyed
interacting with the peer provider. Burden: Most youth felt that it was easy to understand the session and participate
in it. Perceived effectiveness: Most of the youth perceived the intervention to be effective in helping them reduce
substance use and improve their well-being. Ethicality: All youth perceived that the counselling session fit in with
their goals and values. Intervention coherence: Most youth understood the overall goal of the intervention. They
reported that the goal of the intervention was to help youth stop substance use, and to bring about behavior change.
Opportunity costs: Some youth reported that they had to forgo other activities to attend the session, such as work,
school, sports, gaming, visiting family, or house chores. Self-efficacy: Most youth felt confident about being able to cut
down or stop using substances following the intervention.Conclusion and recommendations Our findings indicate that the peer provider delivered single-session substance
use BI was acceptable to youth. The youth recommended that follow-up sessions be provided to ensure sustained
behavior change. This study supports the utility of the TFA in exploring acceptability of a substance use intervention
from the perspective of young people.