Peer-led and adult-led school health education: a critical review of available comparative research

Abstract

Peer-led health education in school is widely used. Advocates suggest it is an effective method based on the belief that information, particularly sensitive information, is more easily shared between people of a similar age. Critics suggest that this is a method not based on sound theory or evidence of effectiveness. This review evaluates school-based health education programmes which have set out to compare the effects of peers or adults delivering the same material. The identified studies indicated that peer leaders were at least as, or more, effective than adults. Although this suggests that peer-led programmes can be effective, methodological difficulties and analytical problems indicate that this is not an easy area to investigate, and research so far has not provided a definitive answer.

Peer‐led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21 years: a systematic review and meta‐analysis

“…Our findings corroborate and strengthen earlier reviews, which suggested that the inclusion of peers in public health interventions would have benefits in preventing harmful behaviours during adolescence 17, 18, 28, 56. Our findings also suggest that there may be scope to consider the more extensive trial and implementation of peer‐led intervention models, given current gaps in the evidence base regarding the prevention of substance use among young people.…”

“…Our systematic review and meta‐analysis supports previous evidence 18, 27, 28 by highlighting the promise and effectiveness of peer‐led interventions. However, our study goes further in strengthening the evidence by including more recent studies and by providing a quantified estimate of the effect of such interventions in relation to tobacco, alcohol and cannabis use.…”

“…The protocol for this systematic review is registered with PROSPERO (registration number CRD42014009790) 28. The primary objective was to identify and review the effects of peer‐led interventions that aim to prevent tobacco, alcohol and/or illicit drug use among young people aged 11–21 years.…”

“…Search terms included MESH and text word combinations relating to young people, the behaviours of interest, peer‐leaders and randomized controlled trials (RCTs). The Medline search strategy is provided in Supporting information, Table S1 and via the PROSPERO record 28. Searches in other databases were adapted accordingly.…”

“…Earlier systematic reviews suggested that there was evidence that peer interventions could change behaviour, as well as improve knowledge 18, 27, 28. Notably, process evaluations showed that young people reported positive views towards peer interventions, such as: finding peer‐led sessions fun, feeling that peers are credible sources of information and preferring peer‐led sessions over teacher‐led sessions 27.…”