Peer Education Program Research Articles

HIV incidence and recreational drug use among men who have sex with men aged 18-24 years in Tianjin, China: a retrospective cohort study.

Recreational drug use has been identified as a significant risk factor for the transmission of human immunodeficiency virus (HIV). This behavior is particularly prevalent among young men who have sex with men (YMSM). However, limited research has been conducted to investigate the correlation between recreational drug use and HIV incidence within this population. To examine HIV incidence and explore the association between recreational drug use and HIV incidence among YMSM. A retrospective cohort study was conducted by a local non-governmental organization (NGO) among MSM aged 18-24 years from October 2017 to December 2023 in Tianjin, China. Participants were included if they had at least two HIV test records during this period. HIV incidence density and its 95% confidence interval (CI) were calculated using person-years (PYs) with a Poisson distribution. Risk factors for HIV incidence were identified using univariable and multivariable Cox proportional hazards regression models. A total of 56 HIV seroconversions were reported with 2901.9 PYs, resulting in an overall incidence density of 1.9/100 PYs (95% CI: 1.4-2.4). Among YMSM who do not use recreational drugs (YMSM-URD), the incidence density was 1.1/100 PYs (95% CI: 0.5-1.6), while it was 2.8/100 PYs (95% CI: 1.9-3.7) among those who do use recreational drugs (YMSM-RD). Adjusted for confounders, factors associated with HIV infection included recreational drug use (adjusted hazard ratio = 2.6, 95% CI = 1.4-4.7) and unprotected anal intercourse in the past six months (adjusted hazard ratio = 2.3, 95% CI = 1.2-4.4). Recreational drug use and unprotected anal intercourse significantly increase the risk of HIV infection. To effectively mitigate the spread of HIV, interventions should focus on these risk factors by employing HIV counseling and testing clinics, collaborating with NGOs focused on MSM, and establishing peer education programs aimed at YMSM.

Adapting the Theory of Planned Behavior to Analyze Smoking Intentions Among Adolescents in Urban School

Introduction: The prevalence of smoking among adolescents continues to increase each year. The Theory of Planned Behavior states that behavior is preceded by intention. Objective: This study aims to identify the factors associated with and most dominant in influencing smoking intentions among adolescents. Method: This research is quantitative with a cross-sectional study design. The study was conducted at State Junior High School 3 in South Tangerang City, which is located in an urban area. The research sample consisted of 276 adolescents who were non-active smokers, selected using a proportional stratified sampling technique, and data collection was carried out through a questionnaire. Data analysis included univariate analysis, bivariate analysis using the chi-square test, and multivariate analysis using multiple logistic regression. Result: The results showed that most adolescents had strong smoking intentions (56.5%), supportive attitudes toward smoking (52.2%), negative subjective norms (54.7%), and weak perceived control over smoking behavior (55.8%). There was a significant relationship between smoking attitudes (PR=2.658; 95% CI=2.028-3.485; P<0.05), subjective norms (PR=3.338; 95% CI=2.439-4.568; P<0.05), and perceived control over smoking behavior (PR=2.739; 95% CI=2.046-3.666; P<0.05) with smoking intention. Subjective norms were identified as the dominant variable influencing the intention. Conclusion: There is a relationship between attitude, subjective norm, and perceived behavioral control with respect to smoking intention, with subjective norm being the dominant variable influencing intention. Therefore, it is essential to intensify peer education programs to influence peers to avoid smoking, as well as to conduct a deeper analysis of the factors shaping subjective norms and design school-based interventions specifically targeting changes in these norms.

Resettlement needs of refugee women in the United States: An American Academy of Nursing consensus paper

When people must flee their homes due to persecution or conflict, they embark on a journey from loss toward safety that is a global concern and the resettlement country’s responsibility. Refugees experience stressors as they secure basic needs such as adequate nutrition, healthcare, transportation, housing, education, and income-generating activities. For refugee women, these stressors are further exacerbated by gender related roles and experiences. Addressing the unique healthcare needs of refugee women is vital to their wellbeing as they resettle into life in the United States. Access to care that is provided with cultural humility and fosters trust is critical. Policies are needed that expand health literacy programs and interpreting services, grow, diversify, and train the physical healthcare workforce, grow and diversify the mental healthcare workforce, expand Medicaid coverage in all 50 states, develop and fund peer to peer education programs for refugee women, finance access to care and programmatic services and expand federal funding toward refugee health research.

Implementation outcomes of peer education programme comparing state-led and NGO-facilitated models in two Indian states: qualitative findings

Implementation outcomes of peer education programme comparing state-led and NGO-facilitated models in two Indian states: qualitative findings

Experiences of peer educators in a high school sexual and reproductive health peer education programme in Rwanda

Background: To contribute to a reduction in teenage pregnancy among in-school adolescents in Rwanda, a sexual and reproductive health peer education programme (SRHPEP) was developed and implemented. Reflecting on the unique characteristics of this newly implemented programme, and understanding peer educators’ (PEs) and facilitators’ perspectives, can provide insights into the programme’s effectiveness and feedback to improve the programme in the future. This study explored the experiences of being a PE in the SRHPEP from the perspectives of PEs and facilitators. Design: Qualitative exploratory design. Setting: Data collection took placed in three public high schools in Rwanda. Method: Three focus group discussions (FGDs) with 22 PEs and 5 in-depth interviews with facilitators were conducted. Results: Thematic analysis identified the benefits of being a PE, including increased competence, enhanced relationships and an improved society’s understanding of sexual and reproductive health (SRH). PEs faced challenges, however, including bullying, limited resources and time constraints. A support system (comprising PEs themselves, facilitators and school leadership) and refresher training made being a PE easier. Study participants suggested allocating enough time, training larger numbers of PEs and the provision of contextually relevant educational materials to improve the programme. Conclusion: Findings from this study can be used to guide the development of future ways of strengthening the SRHPEP in schools. They can also help to ensure that PEs are adequately supported in their roles and the needs of the students are met.

Abstract B070: Addressing health disparities around breastfeeding: Development of a braided curriculum

Abstract Purpose: Breastfeeding initiation and longer duration are known to reduce risk of breast and ovarian cancer. While racial disparities in breast cancer diagnosis and mortality rates exist in the United States, disparate rates of breastfeeding initiation and duration continue to widen. The positive effects of these community lactation support through peer education programs among Black mothers have been demonstrated, but these programs are limited by the lack of reach to vulnerable families. Integration of lactation education and support within parenting programs targeting complementary maternal behaviors, such as psychosocial stress does not exist. This proof-of-concept study uses novel Systematic Braiding methodology to develop an integrated maternal behavior parenting curriculum. Methods: In line with the systematic braiding technique, key stakeholders of two evidence based programs, Intergen (a culturally competent breastfeeding peer-educator program) and SafeCare® (a widely disseminated evidence-based parenting program), were consulted to identify core program components, shared and unique theoretical constructs, and programmatic targets including: population of interest, behaviors, delivery mode, program content, dose and length, assessment, fidelity monitoring. Results: 10 program developers and content experts identified shared and unique theoretical constructs and programmatic targets including: population of interest – at-risk minority parents, behaviors (parenting, breastfeeding, and cancer prevention), delivery mode (in person and self-guided), program content, dose and length, assessment, and fidelity monitoring. Areas of integration were captured to inform the braiding of the new curriculum based in social cognitive theory and the theory of planned behavior including modules on cancer education, prevention through breastfeeding, and screening were captured to inform the braiding of the new curriculum. Future directions will assess the acceptability and feasibility of the braided curriculum via user-centered feedback across informants from each of four key informant groups: 1) target recipients of the curriculum including Black women, <36 weeks gestation; 2) potential program providers; 3) community health care professionals; and 4) state-level legislative representatives. Interim findings will be presented. Discussion: There is limited exploration on using widely disseminated parenting programs to increase breastfeeding uptake among African American mothers. This study takes first steps towards developing a robust intervention to increase the reach of breastfeeding education to expecting African American mothers through a widely disseminated parenting model. Improving knowledge of cancer prevention through breastfeeding along with behavior (initiation and duration) among this at-risk population may positively impact breast and ovarian cancer risk. Citation Format: Marlo Vernon, Ashwini Tiwari, Elinita Pollard, Biplab Datta, Zach Hoffman, Kate Guastaferro, Shannon Self-Brown. Addressing health disparities around breastfeeding: Development of a braided curriculum [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B070.

Abstract B071: Mothers Informed Lactation Knowledge and Support (MILKS): Addressing Cancer Disparities through Community Action

Abstract Purpose: The Mothers Informed Lactation Knowledge and Support (MILKS) project aims to increase breastfeeding initiation and duration in Aiken County, South Carolina, specifically among Black/African American (B/AA) and Hispanic women. Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death from 2012-2016 in this county. Methods: In collaboration with the Aiken Maternal Health Workgroup, a community health needs assessment was conducted. Listening sessions, health data review, and an environmental scan were conducted. A community report card was developed to disseminate and identify intervention needs. Areas assessed include: knowledge of cancer prevention, breastfeeding resources, lactation consultant/peer educators, breastfeeding friendly employers, and community support. Results: Aiken Co. has a total population of 174,150, 37% of the population lives in rural areas, 24.7% are non-Hispanic B/AA, 6.3% are Hispanic, and 12% of the population is uninsured. The breastfeeding initiation rate is 77.2 % (64.3%, B/AA and 86.7% Hispanic), compared to 78.5 percent for South Carolina and 83.2 percent for the United States. Breast cancer 5-year incidence rate all women is similar between Aiken (124) and South Carolina (129) /100,000, and breast cancer mortality rate is higher in Aiken (25) vs. SC (22) / 100,000 age-adjusted population. B/AA women have a significantly higher rate of breast cancer incidence (98.0) and mortality (37.8)/100,000 than state and national averages. There is an inappropriate number of lactation consultants and peer educators – only 1 is available to a limited population in-person, 2 are available to WIC recipients virtually. The WIC office also has two peer counselor positions, both of which were vacant at the time of research. Community listening sessions (n=4) provided insight into language and cultural barriers in accessing breastfeeding resources. Specifically, Hispanic women expressed difficulties in finding culturally relevant information and assistance. Participants highlighted the importance of education, advocating for improved workplace accommodations, such as designated lactation spaces and flexible scheduling, to enable breastfeeding mothers to manage the challenges of returning to work while continuing to breastfeed. No one reported previous knowledge of cancer prevention through breastfeeding. A lack of social norms for breastfeeding was also identified. Conclusions: Recommendations based on the report card include expanding peer education programs, enhancing workplace support, and ensuring cultural and linguistic inclusivity in breastfeeding education and support, and cancer prevention resources. The next steps include implementing additional peer education programs in the community, with a focus on cancer prevention through education, screening, and community support. This project provides a replicable blueprint for addressing cancer disparity through community engagement and collaboration. Citation Format: Marlo Vernon, Brianna McIndoe, Ananya Chakraborty, Elinita Pollard. Mothers Informed Lactation Knowledge and Support (MILKS): Addressing Cancer Disparities through Community Action [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B071.

Social Acceptance Among Children with Learning Difficulties

This study explores social acceptance among children with general learning difficulties/children with special needs (CSN) using a qualitative approach involving structured interviews with 144 students and in-depth interviews with three teachers. The research highlights the social dynamics of CSN inclusion, emphasizing the importance of a supportive environment, positive teacher attitudes, and peer education programs in promoting social integration. Findings show that students, particularly females at the junior high level, generally hold positive attitudes towards CSN. At the same time, concerns over emotional behaviors like tantrums create interaction challenges, especially among elementary school boys. Teachers ensure equal participation for CSN through individualized support, inclusive activities, and peer support systems. This study's originality lies in its comprehensive exploration of peer attitudes across educational levels. It offers insights into gender differences, behavioral challenges, and the teacher's role in promoting inclusive education through adaptive teaching methods and social support.

Students’ Perception of Their Self-Efficacy by Being a “Hey Peer Educator” in Drug Abuse Prevention

Background: Peer education programs provided in schools are one method to help prevent drug abuse; however, the effectiveness of these programs relies, in part, on their delivery to the population in need. Therefore, the effectiveness of the program relies on the self-efficacy of peer educators. The peer education program helps students to practice their skills as peer educators in avoiding drug abuse. Aims: This study aimed to explore the students’ self-efficacy as peer educators after being a peer educator in the peer education program. Methods: In-depth semi-structured interviews were conducted with 45 student peer educators in Middle schools located in Surabaya, Indonesia. Results: Adolescents who acted as student peers perceived and experienced an improvement in their knowledge and ability to help their peers avoid drug abuse. Conclusion: The peer education program is perceived to improve students’ self-efficacy in counseling tasks, to learn analytical skills, and to maintain positive behavior.

Expanding Hepatitis C Virus Treatment in the New Mexico State Prison System: Using the ECHO Model for Provider and Prison Peer Education.

It is critical to address hepatitis C virus (HCV) in carceral settings to achieve worldwide elimination of the virus. We describe New Mexico's (NM) experience expanding HCV treatment in state prisons, supplemented with Project ECHO (ECHO; virtual mentorship through guided practice) and the NM Peer Education Program (NMPEP). We describe how using these programs may be a model for expanding treatment in prisons globally. ECHO, NM Corrections Department (NMCD) and Wexford Health Services (WHS) collaborate to treat HCV in state prisons and increase HCV knowledge among incarcerated persons using NMPEP. Each person arriving in prison is tested for HCV and those with active infection receive baseline labs, which are reviewed. Patients not meeting criteria for simplified treatment are presented to ECHO for expert guidance. Otherwise, patients are treated by WHS without consultation. NMPEP provides patient-to-patient education in prisons, addressing HCV myths and exploring treatment refusals. From December 2020 to June 2023, 3603 people had HCV viremia. In this study, 1685 people started treatment: 1280 were treated using the simplified algorithm and 405 were presented to ECHO. Of the 988 people who completed treatment and had sustained virologic response (SVR) labs drawn, 89.2% achieved SVR (i.e., cure). Most of the 107 people who did not achieve SVR had presumed reinfection. NMPEP trained 148 peer educators who educated 3832 peers about HCV prevention and treatment. HCV treatment in prisons can be expanded by implementing simplified treatment algorithms, use of the ECHO model for patients with advanced disease and peer education.

Understanding Youth Vulnerability to HIV/AIDS in Uganda: Social, Economic, and Behavioural Dimensions

This review examines the multifaceted vulnerability of Ugandan youth to HIV/AIDS, emphasising the interplay of social, economic, and behavioural dimensions. Through a comprehensive analysis of HIV prevalence rates, trends, regional variations, and gender disparities, the review highlights key risk factors, including peer pressure, cultural norms, stigma, economic hardship, and substance use. It underscores the critical role of gender dynamics, with female youth facing unique challenges such as gender-based violence and economic dependence, while LGBTQ+ youth encounter compounded risks due to societal stigma and inadequate services. We also explore the disparities between rural and urban youth in access to information and services, uncovering significant barriers they face. Youth-led initiatives are critical in addressing these challenges, with peer education programs, youth-friendly services, and innovative digital campaigns all playing a crucial role in prevention efforts. We discuss barriers to youth participation, such as stigma, cultural norms, and educational gaps, and discuss strategies to overcome them, like culturally sensitive education and improved access to resources. We highlight the role of schools and educational institutions, emphasising the importance of integrating comprehensive sex education, school-based health services, and extracurricular activities to foster awareness and preventive behaviours. The review also highlights the importance of youth advocacy and leadership in shaping inclusive policies and driving effective interventions. We present economic empowerment strategies, including skills training andmicrofinance, as complementary to health-focused efforts by addressing socioeconomic vulnerabilities. The review concludes by advocating for a holistic approach that combines education, economic empowerment, gender-sensitive interventions, and collaborative partnerships among government, NGOs, civil society, and the private sector to effectively reduce HIV prevalence and improve the well-being of Ugandan youth. Keywords: Youth, HIV/AIDS, Uganda, social, economic, and behavioural dimensions

Peer Education as a Tool to Improve Health Knowledge for People Who Are Incarcerated: A Secondary Analysis of Data From the Indiana Peer Education Program ECHO.

Considerable health inequities occur among people who are incarcerated, with ripple effects into broader community health. The Indiana Peer Education Program uses the Extension for Community Health Outcomes (ECHO) model to train people who are incarcerated as peer health educators. This analysis sought to evaluate the effectiveness of this program and explore emergent themes not covered in survey instruments. Survey data for both peer educators and their students were assessed using multivariate regression. Qualitative data were used to triangulate survey findings and explore additional themes via thematic analysis. Students showed improvements in knowledge scores and postrelease behavior intentions; peer educators improved in knowledge, health attitudes, and self-efficacy. Qualitative data affirmed survey findings and pointed toward peer educators acquiring expertise in the content they teach, and how to teach it, and that positive results likely expand beyond participants to others in prison, their families, and the communities to which they return. Though preliminary, the results confirm an earlier analysis of the New Mexico Peer Education Program ECHO, adding to the evidence that training individuals who are incarcerated as peer educators on relevant public health topics increases health knowledge and behavior intentions and likely results in improvements in personal and public health outcomes.

Engagement of Peer Educators from India’s National Adolescent Health Programme for the COVID-19 response activities: Qualitative findings from i-Saathiya study

BackgroundThe COVID-19 pandemic strained India’s healthcare system and health workers unprecedentedly.PurposeThe extent of the contribution by peer educators (PEs) from India’s National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK) to...

Effect of Beneficiary Participation on Project Performance: A Case of an HIV Peer Education Project in Gicumbi District, Rwanda

The HIV/AIDS pandemic remains a significant global health challenge, particularly in Sub-Saharan Africa, where the prevalence rates are among the highest in the world. This study investigated the impact of beneficiary participation on the performance of an HIV peer education program implemented by the Rwanda Network of People Living with HIV (RRP+) in Gicumbi District from 2017 to 2020. Researchers examined three specific areas: project planning, implementation, and monitoring. Stakeholder and Engagement Theory alongside Participation Theory were reviewed. The study adopted a descriptive research design with qualitative and quantitative approaches. The total study population for this research was be 3,938 that included Recipients of Care (RoC) and stakeholders directly involved in the HIV peer education project implemented by the Rwanda Network of People Living with HIV (RRP+) in Gicumbi District, Rwanda, from 2017 to 2020. A mixed sampling approach was employed to select participants for this research. This approach involves a combination of probability and non-probability sampling methods. Therefore, the sample size calculated using the Yamane formula was 387 Recipients of Care (RoC) and stakeholders. Both descriptive and inferential statistics were used to analyse the data. Findings indicated significant beneficiary involvement in strategic planning and annual plans, with mean scores of 3.78 and 3.50, respectively, on a 1-4 scale. Moderate familiarity with the Work Breakdown Structure (WBS) (average 3.22) was observed. Statistical analysis confirmed a significant positive impact on Project Performance (p < 0.05). Beneficiaries reported satisfactory healthcare and psychosocial support (mean score 0.99) and moderate satisfaction with supportive supervision (mean score 1.62). Capacity-building (average 1.02) showed room for improvement, yet still had a significant positive influence on Project Performance (p < 0.05). Limited involvement in monitoring (mean score 1.04) was observed, with high satisfaction in feedback meetings (mean score 4.15). Feedback acceptability (average 3.42) indicated moderate acceptability, also positively impacting Project Performance (p < 0.05). The positive unstandardized coefficient (B) of 0.398 indicate that increased healthcare and psychosocial support are associated with higher project performance. The positive unstandardized coefficient (B) of 0.026 suggest that supportive supervision has a relatively positive relationship with project performance. The positive unstandardized coefficient (B) of 0.293 highlight the importance of training beneficiaries during project implementation. The study recommended foster greater beneficiary involvement in project planning by conducting regular consultations, workshops, and feedback sessions. Review and refine the supportive supervision approach to address the varying levels of satisfaction among beneficiaries. Maintain regular and productive feedback meetings to capture beneficiary input and concerns. Enhance feedback collection and analysis processes to ensure feedback is incorporated into project activities effectively. Form a strengthened system of monitoring and evaluation in order to consistently evaluate performance of project as well as adapt to evolving requirements of the beneficiary. Additionally, formulate models of sustainability to ascertain that favorable and positive impacts of the project are preserved after its overall completion.

Recovery among people with mental health challenges and alcohol and drug use issues in the Northern Territory, Australia

IntroductionThe Northern Territory (NT) has Australia’s highest mental health burden. It has a diverse and transient population, including Aboriginal and Torres Strait Islander people and various multicultural communities. While peer support has been widely used nationwide, in the NT, peer support is poorly implemented in psychosocial support activities.ObjectivesThe NT Lived Experience Network (NTLEN), in allyship with a team of researchers from Flinders University, has secured multiple fundings aimed to develop, implement, and evaluate a peer education and recovery program called Recovery Together (RT) for individuals with mental health and alcohol and drug use issues and related challenges.MethodsThe suitable evaluation approach was co-designed with live experience representatives from NTLEN and other local key stakeholders. It applied a mixed-method approach, including pre and post-program surveys (n=64) and individual interviews with program participants and the program delivery team (n=32). The evaluation findings were also informed by data collected by NTLEN via feedback forms n=38). We also used a co-design approach to develop survey instruments to ensure they were strengths-based and recovery-oriented.ResultsParticipants reported poor and fair self-perceived health, high stress levels, dissatisfaction with their relationships and relatively low recovery scores, which showed improvements at post-program completion. They discussed their journeys in the interviews and shared their experiences with local mental health services and the Recovery Together program. Many expressed that mental health professionals are not necessarily the care providers they feel comfortable engaging with. However, they described their experience with the peer program as highly positive, empowering, safe, non-judgmental, and beneficial, satisfying their support needs. The program gave them hope and tools to manage their mental health challenges and opportunities to gain insight into non-clinical aspects of recovery. Participants conceptualised personal recovery in their own words and described the facilitators and barriers to their recovery. They emphasised that recovery is being empowered, strong within themselves and the leader of their journey, living their best possible life, understanding themselves, having the necessary knowledge about mental health, and looking forward in a hopeful way.ConclusionsOur findings highlighted the demand and need for ongoing delivery of the RT program in the NT, which was highly effective in supporting personal recovery, addressing the service delivery gap and complementing the available clinical and mental health practices. They also showed the importance of providing recovery-oriented and trauma-informed education for medical and mental health professionals.Disclosure of InterestNone Declared

Examining Youth Flexible ACT Model Implementation in the Netherlands

Model adherence is a key indicator of mental health care quality. This study investigates the degree of model adherence, as well as content and staging of care, among the first Youth Flexible Assertive Community Treatment (ACT) teams in the Netherlands. Model fidelity was assessed in sixteen teams with the Youth Flexile ACT model fidelity scale (2014 version). Mental health workers completed a ‘content of care questionnaire’ to map the interventions applied in the teams. Model fidelity scores revealed that twelve teams adhered to the Youth Flexible ACT standard with ‘optimal implementation’ (≥ 4.1 on a 5 point scale) and four teams with ‘adequate implementation’. Most disciplines were well integrated within the teams; however, several items regarding the involvement of specific disciplines and the availability of treatment interventions (peer support worker, employment and education specialist and programs, family interventions, integrated dual disorder treatment) scored below the optimum. Frequency of contact during ACT and the use of Routine Outcome Monitoring instruments scored below the optimum as well. The ‘content of care’ data showed that most clients received an individual psychological intervention, and nearly half of the client sample received scaled-up / intensified ACT care. The findings indicate a predominantly successful translation of care from the theoretical Flexible ACT framework into practice, covering both ACT and non-ACT functions. Further room for improvement lies in the incorporation of specialized disciplines in the personal and social recovery domains, including the peer support worker and employment and education specialist, as well as in specific protocolled interventions.

Peer education program to improve fluid consumption in primary schools—lessons learned from an innovative pilot study

BackgroundAlthough it is widely recognized that more attention needs to be paid to children's fluid intake, there is little information on how to improve it. Peer education has been suggested as an effective approach to changing health behaviors among school children. As a new approach, our study piloted a peer education program to improve children's fluid intake in primary schools. MethodsUniversity students were prepared for their role as peer educators in an elective university course, including the concept of peer education and different pedagogical methods. The peer educators evaluated the training process by completing a questionnaire. The intervention took place during a School Health Day led by the peer educators. An anonymous survey with a questionnaire on knowledge of fluid intake was administered two weeks before, at the end of, and 15 weeks after the intervention. Changes in hydration knowledge were tested using repeated measures ANOVA. ResultsThe pilot program showed increased knowledge about fluid consumption (p < 0.001) in lower and upper primary school children (N = 326) at the end of the School Health Day compared to pre-intervention measures. A positive change was observed after 15 weeks only in upper primary students. Feedback from peer educators was useful for fine-tuning the program. ConclusionsThis innovative program induced positive changes in knowledge about fluid intake in primary school children. The persistence of the changes differed between lower and upper primary school children. Based on the results, the intervention should be replicated to adapt the program to the needs of lower primary school children. Because the training of peer educators and the peer education program appeared to be successful, this program is worthy of international replication. This approach may also be suggested for other behavior change issues.

Tuakana-teina peer education programme to help Māori elders enhance wellbeing and social connectedness

BackgroundThere are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. This study used a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation) to develop a tuakana-teina (literally older sibling-younger sibling) peer education programme to assist kaumātua (elders) in addressing health and social needs. The purpose of this study was to test the impact on those receiving the programme. Three aims identify the impact on outcomes, resources received and the cost effectiveness of the programme.MethodsFive Kaupapa Māori (research and services guided by Māori worldviews) iwi (tribe) and community providers implemented the project using a partnership approach. Tuakana (peer educators) had up to six conversations each with up to six teina (peer learners) and shared information related to social and health services. A pre- and post-test, clustered staggered design was the research design. Participants completed a baseline and post-programme assessment of health and mana motuhake measures consistent with Māori worldviews. Open-ended questions on the assessments, five focus groups, and four individual interviews were used for qualitative evaluation.FindingsA total of 113 kaumātua were recruited, and 86 completed the programme. The analysis revealed improvements in health-related quality of life, needing more help with daily tasks, life satisfaction, paying bills and housing problems. Qualitative results supported impacts of the programme on mana motuhake and hauora (holistic health) through providing intangible and tangible resources. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times GDP per capita.ConclusionsA culturally-resonant, strengths-based programme developed through a participatory approach can significantly improve health and social outcomes in a cost-effective way.Trial RegistryClinical trial registry: Trial registration: (ACTRN12620000316909). Prospectively registered 06/03/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379302&isClinicalTrial=False.

129. Facilitators and Barriers Influencing the Implementation of Peer Education Programme Under National Adolescent Health Strategy: Findings From I-Saathiya Study

129. Facilitators and Barriers Influencing the Implementation of Peer Education Programme Under National Adolescent Health Strategy: Findings From I-Saathiya Study

Improving adolescents' HIV/AIDS prevention behavior: A phenomenological study of the experience of planning generation program (GenRe) ambassadors as peer educators.

Adolescents face increased vulnerability to HIV/AIDS due to factors such as insufficient knowledge and awareness, stigma, and restricted access to information. The Indonesian government initiated a peer education program through the Planning Generation Program (GenRe) ambassadors. These ambassadors are tasked with educating their peers about HIV/AIDS. However, their experiences are largely underexplored. This study aimed to explore the GenRe ambassadors' experience in improving adolescents' HIV/AIDS prevention behavior. This study employed a qualitative phenomenological approach, with in-depth and semi-structured interviews of GenRe ambassadors who had served for at least three to six months within the South Jakarta Health Sub-Department, Indonesia. Purposive sampling and data saturation techniques were utilized. Data were collected from 13 May to 31 August 2022, and Colaizzi's steps were used to guide the data analysis. Nineteen GenRe ambassadors participated, predominantly female university students ages 18-22. Six themes were developed: 1) the impact of GenRe ambassadors' roles in improving HIV/AIDS prevention behavior, 2) activities to improve HIV/AIDS prevention behavior, 3) enhancement of self-concept as GenRe ambassadors, 4) obstacles to activities for improving HIV/AIDS prevention behavior, 5) support for activities to improve HIV/AIDS prevention behavior, and 6) hope for improving the GenRe ambassador program's implementation. GenRe ambassadors are influencers who play a critical role in promoting HIV/AIDS prevention behaviors and fostering positive change in the broader youth community. Despite their positive self-concept, they encounter challenges in fulfilling their roles. Utilizing their insights, community health nurses can create effective peer-led HIV/AIDS prevention programs and contribute to a model of health promotion for adolescents. Leveraging the role of GenRe ambassadors as peer educators is recommended to enhance HIV/AIDS prevention efforts among adolescents.