An Online Peer Support Training to Improve Mental Health Literacy and Support Skills among College Students: Pilot Randomized Controlled Trial

Abstract Background Many young adults rely on their peers for emotional and social support. Yet some may feel ill-equipped to safely and effectively support peers experiencing mental health challenges. This study evaluates the feasibility, usability, acceptability, and preliminary efficacy of an online peer support training intervention, the Be There Certificate (BTC), among college students living in shared housing. Methods We used a convergent-parallel mixed-methods design and conducted a two-arm cluster-randomized, waitlist-controlled trial in two Northeastern US universities in Fall 2025. We randomized housing units within participating universities to the two conditions, and all students in each housing unit received the same assignment. Primary quantitative outcomes include the BTC’s feasibility, usability, and acceptability. We used difference-of-differences analysis to compare changes in secondary efficacy outcomes (mental health knowledge, attitudes and perceptions, behaviors, psychosocial, and psychological outcomes) between the two groups from baseline to 12-week follow-up. Semi-structured in-depth interviews further explored intervention participants’ perceptions of the BTC. Three researchers conducted abductive coding based on Kirkpatrick’s evaluation model and used thematic analysis. We followed the intervention mixed-methods framework and integrated the mixed-methods findings using the weaving approach. Trial registration ClinicalTrials.gov, Trial Number NCT07460635, retrospectively registered on March 3, 2026