Peer Education Project Research Articles

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.

Exploring mechanisms andcontexts ina Peer Education Project to improve mental health literacy inschools inEngland: a qualitative realist evaluation.

Poor adolescent mental health calls for universal prevention. The Mental Health Foundation's 'Peer Education Project' equips older students ('peer educators') to teach younger students ('peer learners') about mental health. The peer-led lessons cover defining good and bad mental health, risk and protective factors, self-care, help-seeking and looking after one another. While previous pre-post evaluations have suggested effectiveness, the mechanisms through which the intervention improves mental health literacy remain unclear. We purposively recruited seven secondary schools across England from 2020 to 2022 and collected data through five observations, 12 staff interviews and 15 student focus groups (totalling 134 students; 46 peer educators aged 14-18 years and 88 peer learners aged 11-13 years). Our realist analysis adopted retroductive logic, intertwining deductive and inductive approaches to test the initial programme theory against insights arising from the data. We developed Context-Mechanisms-Outcome configurations related to four themes: (i) modelling behaviours and forming supportive relationships, (ii) relevant and appropriate content, (iii) peer educators feeling empowered and (iV) a school culture that prioritises mental health support. Our refined programme theory highlights key mechanisms, contexts conducive to achieving the outcomes and ways to improve training, recruitment and delivery to maximise effectiveness for similar peer-led initiatives.

Assessing the Feasibility of a Peer Education Project to Improve Mental Health Literacy in Adolescents in the UK

Many mental health problems begin in adolescence and occur on a spectrum of severity: early recognition and intervention is important. This study is a quantitative feasibility study of the Mental Health Foundation’s Peer Education Project (PEP). Attrition, psychometric properties of questionnaires, indications of improvement on a range of outcomes, and sample size required for a powered trial of effectiveness were assessed. 203 students completed the survey both pre and post-intervention. It was found that existing previously-validated measures had good psychometric properties, with two new questionnaires demonstrating reasonable reliability (self-help confidence alpha = 0.78, mental health knowledge alpha = 0.59). There were indications of improvement in help-seeking intentions, the number of sources likely to seek help from, and mental health knowledge from pre- to post-intervention. A future trial of PEP with a sample of approximately 36 schools, researcher-led data collections, and help-seeking intentions or sources as a primary outcome appears to be feasible.

The Peer Education Project to improve mental health literacy in secondary school students in England: a qualitative realist evaluation

BackgroundWorsening of adolescent mental health and exacerbated health inequalities after the COVID-19 pandemic calls for universal preventative strategies. The Mental Health Foundation's school-based Peer Education Project seeks to improve students' mental health literacy through peer educators (aged 14–18 years) teaching peer learners (aged 11–13 years) to recognise good and bad mental health, identify risk and protective factors, and seek help accordingly. Although previous before and after quantitative assessments have found the intervention to be effective, this realist evaluation aimed to qualitatively develop the theory of change, exploring how the mechanisms played out in different contexts to achieve the desired outcomes. MethodsOur initial programme theory was developed following expert stakeholder consultation and reviewing the literature. We divided mechanisms into resources and reasoning to explain how the intervention components (ie, resources), experienced within specific contexts, engendered responses in the participants (ie, reasoning), to produce observable outcomes. Data collected from six purposively recruited schools in England comprised staff interviews (n=11), student focus groups (n=15), and observations (n=5). Deductive and inductive analysis was undertaken, using NVivo-informed multiple causal statements represented as context-mechanism-outcome configurations (CMOcs), to test and refine the programme theory. FindingsWe created several distinct CMOcs. For example, in learners accustomed to didactic teaching methods (context), conversing with educators having similar life experience (mechanism resource) endorsed and destigmatised help-seeking behaviour (mechanism reasoning) and facilitated a realisation that seeking help was appropriate and acceptable (outcome). Other mechanisms included the following: learners perceiving the information as tailored and relevant, educators feeling empowered, and a cultural shift percolating across the school. InterpretationOur findings show how peer education can work to improve mental health literacy, which will inform changes to the intervention to maximise its effectiveness in different operational contexts. Future research could test our theory of change in a randomised controlled trial, and examine impacts on inequalities in a more diverse sample. FundingNational Institute for Health and Care Research School for Public Health Research.

A process evaluation of a peer education project to improve mental health literacy in secondary school students: study protocol

BackgroundEmotional disorders in young people are increasing but studies have found that this age group do not always recognise the signs and symptoms of mental health problems in themselves or others. The Mental Health Foundation’s school-based Peer Education Project (PEP) has the potential to improve young people’s understanding of their own mental health at a critical developmental stage (early adolescence) using a peer teaching method. This study is a process evaluation to understand: the mechanisms through which PEP might improve young people’s mental health literacy, any challenges with delivery, how the project can be embedded within wider school life and how it can be improved to be of most benefit to the widest number of young people. We will also validate a bespoke mental health literacy questionnaire, and test the feasibility of using it to measure outcomes in preparation for a future study evaluating effectiveness.MethodsAll schools recruited to the study will receive the PEP intervention. The process evaluation will be informed by realist evaluation approaches to build understanding regarding key mechanisms of change and the impact of different school contexts. The evaluation will test and revise an existing intervention logic model which has been developed in partnership with the Mental Health Foundation. Process evaluation data will be collected from newly recruited schools (n = 4) as well as current PEP user schools (n = 2) including training and lesson delivery observations, staff interviews and student focus groups. Baseline and follow-up data will be collected in all newly recruited intervention schools (n = 4) from all students in Year 7/8 (who receive the PEP) and recruited peer educators in Year 12 via a self-report survey.DiscussionThis study will enable us to refine the logic model underpinning the peer education project and identify areas of the intervention that can be improved. Findings will also inform the design of a future effectiveness study which will test out the extent to which PEP improves mental health literacy.

The missing study: a characterization of peer education practice

Peer education interventions have grown significantly in recent decades, but sociological studies on the subject are limited. To respond to this need, we carried out an exhaustive inventory and characterization of 67 peer education projects developed in Portugal. The information given by the project managers was processed using a content analysis technique. This practice is growing, benefiting from public and private promotion. Although it has demonstrated some efficacy, further improvements can be made. The characterization undertaken allowed us to build a typology that summarizes this practice and that can be useful for researchers and practitioners in a context of globalization of risks and increased social intervention and reflexivity.

Internet safety, online radicalisation and young people with learning disabilities

Accessible Summary A lot of people with learning disabilities enjoy using the Internet every day and use social media on their mobile phones. Staying safe online is important. This research used interviews and focus groups to find out what children, young people, their parents and teachers thought about Internet safety, extremism and online radicalisation. Extremism is when people have strong and dangerous views about laws or religion. Radicalisation is when people support extremism in a dangerous way. People can be targeted on the Internet to talk them into supporting extremism. The young people said they knew a lot about staying safe online, but parents were concerned about risks. When people with learning disabilities learn about staying safe online, they should be given information about online radicalisation and grooming for terrorism. AbstractBackgroundYoung people with learning disabilities are increasingly using the Internet but can be vulnerable to being victimised online. As learning disability services develop guidance on how to support Internet use, it is important to explore what support is necessary.MethodsThis research used interviews and focus groups to explore what children, young people, their parents and teachers thought about Internet safety, extremism and online radicalisation.ResultsResults showed that the students were active Internet users and were confident about online safety but parents were concerned about the risks associated with Internet use. Following taking part in a peer education project that focussed on Internet safety and specifically about risks of online radicalisation and extremism, the students understood possible links between grooming and online radicalisation and their teachers increased their understanding of the importance of digital engagement for their students.

Improving the Lifestyle of Adolescents Through Peer Education and Support in Vietnam: Protocol for a Pilot Cluster Randomized Controlled Trial.

BackgroundIn Ho Chi Minh City, Vietnam, recent studies found a rapid increase in overweight and obesity in adolescents. There is a need for effective health promotion interventions to support healthy diets and encourage a physically active lifestyle. This study will help fill an evidence gap on effective interventions to prevent excess weight gain in adolescents and generate new insights about peer-led education to promote healthy lifestyles.ObjectiveWe aim to assess the feasibility and acceptability of a combined peer-led and peer support intervention among junior high school students in Ho Chi Minh City. Additionally, the efficacy of the intervention on adolescents’ dietary practices and time spent on physical activity will also be measured in this pilot study.MethodsThe Peer Education and Peer Support (PEPS) project is a pilot cluster randomized controlled trial with 2 intervention and 2 control schools. The intervention consists of 4 weekly education sessions of why and how to choose healthy food and drinks and how to be more physically active. Additionally, the intervention includes a school-based and online support system to help maintain student engagement during the intervention. We will use in-depth interviews with students, peer leaders, teachers, and parents; focus group discussions with peer educators; and direct observation of the school environment and peer leaders’ interactions with the students. Acceptability and feasibility of the intervention will be assessed. We will also quantitatively assess limited efficacy by measuring changes in student’ physical activity levels and dietary behaviors.ResultsWe delivered the peer education intervention at the start of each school year over 3 months for all new grade 6 adolescents in the selected schools, followed by peer support and home engagement activities over 6 months until the end of the school year. There was a baseline assessment and 2 post-intervention assessments: the first immediately after the intervention to assess the short-term impact and the second at the end of the school year to assess the sustained impact on changes in adiposity, diet, and physical activity.ConclusionsThe findings of this study will be used to develop a larger-scale cluster randomized controlled trial to examine the impact of a multicomponent, school- and home-based health promotion intervention. The trial will use innovative peer education methods to reduce overweight and obesity and improve dietary choices and physical activity levels in Vietnamese adolescents.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12619000421134; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376690&isReview=trueInternational Registered Report Identifier (IRRID)DERR1-10.2196/15930

Evaluating the Peer Education Project in secondary schools

PurposeThe purpose of this paper is to determine the efficacy of the Peer Education Project (PEP), a school-based, peer-led intervention designed to support secondary school students to develop the skills and knowledge they need to safeguard their mental health and that of their peers.Design/methodology/approachSix schools from across England and the Channel Islands took part in an evaluation of the PEP across the 2016/2017 academic year. In total, 45 trained peer educators from the sixth form and 455 Year 7 students completed pre- and post-questionnaires assessing their emotional and behavioural difficulties, perceived school climate, and knowledge, skills and confidence related to mental health.FindingsResults indicate that participation in the PEP is associated with significant improvement in key skills among both peer educators and student trainees, and in understanding of key terms and readiness to support others among trainees. Most students would recommend participation in the programme to other students.Originality/valueWhile peer education has been found to be effective in some areas of health promotion, research on the effectiveness of peer-led mental health education programmes in schools is limited. This study contributes evidence around the efficacy of a new peer education programme that can be implemented in secondary schools.

The New Mexico Peer Education Project: Filling a Critical Gap in HCV Prison Education.

Hepatitis C (HCV) is an epidemic in the incarcerated population in the United States. In New Mexico, more than 40% of people entering the prison systems test positive for HCV antibodies. Project ECHO's New Mexico Peer Education Project (NMPEP) was developed to educate prisoners about HCV and impact the cycle of HCV transmission in the prison system. Evaluation of NMPEP included multiple methods. Surveys focused on the short-term impact of training. Focus groups and post-release interviews were conducted to assess the intermediate impact of training on peer educators. Significant changes were observed in knowledge, attitudes, behavioral intention and self-efficacy. The program had a powerful positive impact on peer educators giving them a unique skill set, a sense of agency and a passion to help others. Prison peer educators can learn to effectively teach HCV prevention and harm reduction strategies and disease specific information to their peers.

Awareness and Knowledge of Adolescent Young People and Their Parents in Mongolia Regarding Sexuality

The authors are running a peer education project in Ulaanbaatar. The objectives of this survey are to evaluate the project and clarify the awareness and knowledge that students and their parents have regarding sexuality. The population samples are 748 students from 7th through 10th grades of two schools in Sukhbaatar district and 748 of their parents. A self-administered survey was conducted before the commencement of the project in October, 2015. The response rate was (95.3 %) and that of their parents was (96.8 %). As for a source of information for the students regarding sexuality, “Teachers” had the highest rate (48.9 %), followed by “Doctors/nurses” (22.4%) and “I do not know” (18.8%). As for the students’ knowledge of contraception, percentages of correct answers were as follows in descending order: “Emergency contraceptives are methods which prevent unwanted pregnancy”, “Checking based on period days is not an effective contraceptive method”, and “Coitus interruptus is not an effective contraceptive method”. However, percentages of correct answers did not exceed 20% for any of the items. As for the percentages of correct answers among parents did not exceed 50% for any of the items. 50.3% of parents had a positive response to the question, “Can you talk to your children about sex?” On the other hand, over 80% of students had a negative response to the question, “Can you talk to your family about sex?” However 38.2% of them had a positive response, “Can you talk to your friends about sex?”.

Impact of peer education on HIV/AIDS behaviour change among secondary school youths: a static group comparison analysis of a peer education project in Rachuonyo County, Kenya

BackgroundBy the end of 2011, about 1·6 million Kenyans were living with HIV; this number is expected to reach 1·8 million by 2015, mainly due to new infections. The age bracket 15–24 years is a crucial period for interventions such as peer education to prevent new infections and save future generations from the scourge. The aim of this study was to determine the difference between peer education club members (beneficiaries) and non-members (non-beneficiaries) in the adoption of preventive behaviours including abstinence, faithfulness to a partner, condom use, and HIV testing. MethodsThe study covered eight public secondary schools in Rachuonyo County, where peer education clubs had been operational for 2 years. We applied a static group comparison design to guide the research process, and primary data were sourced from 260 beneficiaries and 212 non-beneficiaries. We used club membership and class registers to develop sampling frames for beneficiaries and non-beneficiaries, respectively. In order to select participants, we applied a systematic random sampling procedure, and to determine sample sizes we used Fisher's formula. The county education authority and school boards were informed and approved of the study. Participants provided their consent to ensure voluntary participation. Inclusion in the sample was based on the grade level and 1-year minimum membership to a peer education club. Quantitative analysis techniques included cross-tabulations with χ2 statistic, beta coefficients (β), and odds ratios (Exp [β]). FindingsThe study found that 27 beneficiaries (10·4%) and eight non-beneficiaries (3·8%) were not sexually active and were therefore likely to be practising abstinence. Controlling for gender, age, religion, orphanhood status, and schooling consistency, the odds ratios indicated that beneficiaries were about 1·1 times more likely to embrace abstinence than non-beneficiaries (β=0·136; p=0·068; CI=90%). Among those who reported sexual activity, 166 beneficiaries (71·2%) and 110 non-beneficiaries (53·9%) reported sexual relations with only one partner over the preceding 18-month period. The beneficiaries were about 2·4 times more likely to practise faithfulness than non-beneficiaries (β=0·856; p=0·021; CI=95%). Up to 142 beneficiaries (60·9%) compared with 99 non-beneficiaries (48·5%) used a condom during the last sexual encounter. The beneficiaries were about twice as likely to use condoms consistently as compared with non-beneficiaries (β=0·737; p=0·037; CI=95%). Furthermore, beneficiaries were about 1·3 times more likely to have been tested for HIV than non-beneficiaries (β=0·269; p=0·051; CI=90%). InterpretationThe peer education project encouraged abstinence, faithfulness to a partner, condom use, and HIV testing. Given the results of our study, we suggest that stakeholders should take the following steps: pursue the integration of peer education into school extracurricular activities, identify and train selected teachers as patrons of peer education clubs, develop peer education manuals for youths in primary and secondary tiers, and extend peer education to out-of-school youths. Even though the study controlled for the effect of background attributes, the results remain liable to confounding from social interaction between members of the two groups, given that beneficiaries and non-beneficiaries were sampled from the same schools. FundingThe Kenya Red Cross Society funded the study as part of their routine project evaluation.

Peer education for people who inject drugs in New South Wales: Advantages, unanticipated benefits and challenges

Aims: This article reports on an evaluation of a community-controlled peer education project led by a drug user organization (DUO) that aimed to contribute to hepatitis C prevention. This article also examines broader contextual issues, particularly the funding and governance arrangements affecting the conduct of peer education.Method: This project was evaluated in three sites in New South Wales, Australia. Monthly activity reports were completed by peer educators. Interviews were conducted with five groups of stakeholders: peer educators, peers, staff of the DUO, staff of non-government and government organizations that were partners in this project.Findings: Of the 3373 events categorized, 37% (n = 1154) were categorized by peer educators as being about hepatitis C, 39% (n = 1234) about safer injecting techniques and 24% (n = 760) about other issues. Peer educators described strategies they used particularly when their peers did not want to discuss hepatitis C or had other priorities.Conclusions: This project was successful in disseminating harm reduction information to the targeted community through the recruitment, training and support of peer educators. The results suggest the importance of broadening programme funding parameters to enable services to tailor their work to specific needs, while working towards the shared goal of hepatitis C prevention.

Team Teaching with Undergraduate Students: Feminist Pedagogy in a Peer Education Project

The academy is not paradise. But learning is a place where paradise can be created. The classroom, with all its limitations, remains a location of possibility. In that field of possibility we have the opportunity to labor for freedom, to demand of ourselves and our comrades an openness of mind and heart that allows us to face reality even as we collectively imagine ways to move beyond boundaries, to transgress. This is education as the practice of freedom.

Reflections on a falls prevention peer education project

There is an extensive body of research around ways to prevent falls in older people, however how to best engage older people with fall prevention advice is a complex health promotion issue with mes...

Peer education in sexual and reproductive health programming: a Cambodian case study

This article analyses in detail the impact and effectiveness of peer-education projects implemented in Cambodia under the Reproductive Health Initiative for Asia (RHI), in an attempt to provide important lessons for the design and implementation of such interventions and to contribute to the development of best practice. Under RHI, which was the first programme in Cambodia designed specifically to address the sexual and reproductive health needs of young people, peer education was implemented as if it were a directly transferable method, rather than a process to be rooted in specific social and political contexts. Consequently, peer-education concepts of empowerment and participation conflicted with hierarchical traditions and local power relations concerning gender and poverty; peer educators were trained to deliver messages developed by adults; and interventions were not designed to reflect the social dynamics of youth peer groups.

Yesterday, today…and tomorrow: The future of girlhood in the age of AIDS

abstract This article works with the visual from different angles to consider the reality of girlhood in the context of HIV/AIDS and ways of working towards mediation of this reality. It is located within the framework of feminist visual studies and the idea that the treatment of girlhood is a critical area of investigation that can draw on the place of female protagonists and relationships through both film and forum theatre. The article begins with analysis of the film Yesterday focused on the viewpoint of the child. Beauty, and her lived experience as daughter of HIV-positive parents in a community where stigma exacerbates the attendant difficulties her parents' health presents. This leads to discussion of realities for girls in this era of HIV/AIDS and ways in which participatory visual arts-based methods such as forum theatre could contribute towards enhancing their futures. Evidence for this discussion is drawn from the research findings of the ‘From our frames’ and ‘Youth as knowledge producers’ HIV peer education projects for which the author was principal investigator.

Reflections on a falls prevention peer education project

Reflections on a falls prevention peer education project

Evaluation of STD/HIV/AIDS peer-education and danger: a local perspective

An evaluation of peer-education projects with sex workers, men who have sex with men and marginalized adolescents, was introduced in a remote region of Brazil. The context of varied limits of predictability made it difficult to conduct inquiry. To go beyond available epidemiological surveys and questionnaires on sexual behavior, a self-evaluation aimed at increasing pragmatic knowledge about prevention in a challenging socio-political context. During five-months, a participatory-action research explored participant observation; individual and collective exchanges with users, peer-educators, coordinators, administrators, politicians and regional health professionals. Collective understanding of peer-education in prostitution zones underlines the reality of unforeseen social repercussions and confluence/divergence of multiple actors' perspectives. It identifies meaningful dimensions at a community-level, such as the collective history and dangerous working conditions. Nurses face complex struggles and negotiations over multiple actors in their practice. This study suggests that nurses have a role to play in the conceptualization of participatory evaluation. It also underlines the threats to their physical and social safety, which they might share with peer-educators.

Using peer education projects to prevent HIV/AIDS in young people

This article discusses the use of peer education to reduce sexually transmitted infections, including human immunodeficiency virus/acquired immunodeficiency syndrome, in young people. It describes experiences gained from a peer education project for young people in Uganda.