4. Discussion
SECONDARY
This is the first study to evaluate the effectiveness of the peer-led BASICS intervention in reducing alcohol consumption among Spanish university students. The results confirm our main hypothesis, indicating that the intervention positively impacts alcohol use by significantly decreasing the number of drinks consumed in a typical week. In addition, the findings in the secondary outcomes were promising, demonstrating significant reductions in the drinks per weekend, drinks on peak occasion, binge drinking episodes, peak BAC on a typical week, peak BAC on peak occasion, alcohol-related consequences and the motivation to change alcohol use. These findings are in line with a recent meta-analysis that showed that BASICS was the most effective intervention among brief alcohol interventions delivered in the college setting (Our main finding was that participants in the intervention group significantly reduced the number of drinks per week by 5.7 compared to the control group. In line with our results, only three studies including the peer-led BASICS intervention have shown a significant reduction in the number of drinks per week by 5.24 (In addition, to reinforce the encouraging results related to the main hypothesis, our study is the first investigation demonstrating the impact of peer-led BASIC intervention on drinks per weekend, drinks on peak occasion, peak BAC on a typical week, and the motivation to change alcohol use. Regarding the number of binge drinking episodes, our results suggest that the intervention exceeds the results of previous studies. While our study revealed a reduction of 1.4 episodes of binge drinking, Pueyo-Garrigues et al. (There could be several explanations for these encouraging findings. First, BASICS intervention has been shown to be effective in addressing alcohol use in college students (Given the demonstrated effectiveness of BASICS, we believe that the size of the effect obtained is also due to the fact that the intervention was led by peers who have received specific training. This can be a strength since the values, habits and lifestyles of young people are especially susceptible to peer influence (Additionally, the training of the peer counselors who have led the BASICS intervention might be another key element related to the success of this study. Students received a training program with proven effectiveness in conducting motivational interviews about alcohol consumption with their peers (Three main limitations in this study need to be recognized. First, the study was carried out at a single university, so the participants in the treatment groups could have influenced each other. However, the importance of not sharing the information received to participants in the control group was impressed upon participants in the intervention group and an intention-to-treat analysis was applied to avoid the effects of crossover. Second, as we aimed to determine the short-term effects of the intervention, the follow-up period was short. For future studies, it would be interesting to carry out measurements over an extended follow-up period to determine the long-term effects of the intervention. Third, the outcome measures were all self-reported. To try to avoid any bias in these measurements, participants were insisted that they were not going to be judged and that they should respond as honestly as possible. In addition, we follow recommendations to improve the reliability and validity of these measures, such as: collecting data online, asking for longer timeframes and questions which involve specified timeframes; and, including beverage-specific questions (Despite these limitations, this study had some strengths. First, all the participants assigned to the intervention group received the motivational interview. Furthermore, no participants in either group were lost to follow-up. This may be due to the commitment that the students acquired by participating in the study, their positive experience when receiving the interview, the relationship established with the peer counselors, or the reminders sent through WhatsApp. Second, the students who led the intervention were totally devoted to the project, and after each interview, peer facilitators spoke with the research team to discuss how the interview had gone, their concerns and areas for improvement. Finally, the selected intervention is underpinned by a strong foundation in behavior change theory, peer-led interventions, motivational interviewing principles, and harm reduction approaches, which have been shown to be appropriate for this age group.