Identifying influential young people to undertake effective peer-led health promotion: the example of A Stop Smoking In Schools Trial (ASSIST)

Abstract

The objective of the study was to develop and evaluate an effective whole-community approach to identifying a diverse group of influential young people to effectively diffuse health promotion messages among their peers. A peer nomination questionnaire, developed through extensive piloting work, was completed by 10 730 Year 8 students (aged 12-13 years) in 59 schools (30 intervention, 29 control) as part of a cluster randomized controlled trial. Influential students identified in 30 intervention schools were trained to disseminate smoke-free health promotion messages through informal contacts with peers. This approach successfully identified, recruited and retained a diverse group of students, broadly representative of their year group, to undertake the role of 'peer supporter'. Although students and staff expressed doubts about the suitability of some young people recruited as peer supporters, the intervention achieved a 22% reduction in the odds of being a regular smoker in intervention compared with control schools [odds ratio 0.78 (95% CI 0.64-0.96)]. Carefully designed and developed peer-led interventions have potential for delivering effective smoking prevention among adolescents. Paying close attention to the way in which peer educators are identified, and involving young people themselves in this process, may be the key to increasing the effectiveness of peer education.

Can community-based peer support promote health literacy and reduce inequalities? A realist review

“…It was therefore decided to operationalise this within the next iteration of the search process. The medical subject heading (MeSH) terms for 'health promotion' and 'peer group' were identified from a key highly relevant citation pearl 67 ( Table 1).…”

Approaches to the Prevention and Management of Childhood Obesity: The Role of Social Networks and the Use of Social Media and Related Electronic Technologies

“…However, a cluster-randomized, controlled trial of a peer-led program based on these strategies was effective for tobacco prevention among adolescents. 47 The association between social networks and participation in structured physical activity suggests that there is opportunity to develop school-based interventions within physical education classes to target obesity. 19 The Chefs Move to Schools initiative within First Lady Michelle Obama's Let's Move campaign encourages chefs to partner with schools to support the creation of healthy, affordable meals and to educate children on healthy cooking and eating.…”

School Children as Health Agent: An Explorative Study on Peers’ Perspectives

“…Positive beliefs towards model behaviour are translated into better sustained attention, whereas negative beliefs on behaviour manifest into less attentiveness towards health information delivered by DM (Borgia, Marinacci, & Schifano, 2005;Bloor et al, 1999). In short, how peers perceive the importance of health is directly correlated to the amount of attention they pay to the knowledge disseminated to them by DM (Falchikov, 2001;Fenella, Audrey, Holliday, Moore, & Campbell, 2009). …”

“…Obeying health practices among participants was also reinforced by spreading health information to family members which results from a blend of faith, attitude and positive health practices (Starkey, Audrey, Holliday, Moore & Campbell, 2009). Participants' interests on becoming a member of DM themselves also showcase the positive impact of this programme.…”