Peer-led Health Education Research Articles

The The Influence of Peer-Led Health Education Intervention on Medication Adherence Practices Among Youths Living with HIV In Nigeria

Medication adherence and antiretroviral therapy retention are required for successful durable, virologic suppression and treatment outcomes among youths. The use of peer-led health education in increasing medication adherence and antiretroviral therapy retention has been advocated. Therefore, this study investigated the effect of peer education on medication adherence and antiretroviral-therapy retention practices among Youth Living with HIV in Niger state, Nigeria. The study was a quasi-experimental design in two selected hospitals. One hospital was assigned to a one-hour peer-led health education session for six weeks, and the 2nd served as the control group. Data were collected at baseline, immediate post-intervention, and at the sixth-week follow-up. Data were analyzed using descriptive and inferential statistics at a 0.05 level of significance. Majority of respondents practice Islam and are within the ages of 20-24 years (control: 100%, 89%; intervention: 83%, 73%), from the Hausa Ethnic group (control: 62%; intervention: 56%). Majority of respondents in the control group have Islamic education (50%) and Secondary education (50%), while the majority of those in the intervention group have primary education (35%), secondary (29%), tertiary (19%) and Islamic (17%) respectively. Medication adherence and ART retention was higher in the intervention group (27%, 16%) compared with the control (17%, 9%). A significant association between knowledge and perception due to peer education on medication adherence was found (24%, 80%) in the intervention group and (11%, 36%) in the control group. Subsequently, the 6th week follow-up sustained findings from the intervention period on medication adherence and ART retention (27%, 16%) in the intervention group compared with control group (17%, 9%). Similarly, knowledge and perception follow-up post intervention was sustained (24%, 80%) in the intervention group and (11%, 36%) in the control group. Interventions leveraging peer-led health education enhanced HIV medication adherence and antiretroviral therapy retention practices among youths. Thus, we recommend scale-up of the structured peer-led curriculum and integration into the health systems to improve health outcomes among HIV positive youths, achieve epidemic control and accelerate progress for the UNAIDS 95:95:95 goals.

A comparative study of direct health intervention and peer-led intervention on menstrual hygiene management of adolescent girls in rural India

Background: Menstrual hygiene management (MHM) among adolescents in rural India is negatively influenced by myths and taboos which predispose them to infections which can be dispelled by health education by experts or peers. The study aimed to demonstrate the relative effectiveness of direct health education over peer led health education on MHM.Methods: A longitudinal follow up intervention study recruiting 486 school going adolescent females divided in three groups I, II and III was conducted. Group I received peer led, while group II received direct health education and group III was control. Pre and post intervention scores of participants were compared.Results: Direct intervention group demonstrated highest improvement in number of participants having good MHM scores (p<0.05). Mean MHM scores of direct intervention group participants were the highest among all the three groups (p<0.05). Knowledge score of direct intervention group was significantly higher than group 1 (p=0.001) and group III with no difference in practice scores between group I and II (p=0.147).Conclusions: Direct health education as an intervention is more relatively effective than peer led in MHM of adolescent females.

Peer-support to increase uptake of screening for diabetic retinopathy: process evaluation of the DURE cluster randomized trial

BackgroundThere is limited evidence on how implementation of peer support interventions influences effectiveness, particularly for individuals with diabetes. We conducted a cluster randomized controlled trial to compare the effectiveness of a peer-led health education package versus usual care to increase uptake of screening for diabetic retinopathy (DR).MethodsOur process evaluation used a mixed-method design to investigate the recruitment and retention, reach, dose, fidelity, acceptability, and context of implementation, and was guided by the Consolidated Framework for Implementation Research (CFIR). We reviewed trial documents, conducted semi-structured interviews with key informants (n = 10) and conducted four focus group discussions with participants in both arms of the trial. Three analysts undertook CFIR theory-driven content analysis of the qualitative data. Quantitative data was analyzed to provide descriptive statistics relevant to the objectives of the process evaluation.ResultsThe trial had positive implementation outcomes, 100% retention of clusters and 96% retention for participants, 83% adherence to delivery of content of group talks (fidelity), and 78% attendance (reach) to at least 50% (3/6) of the group talks (dose). The data revealed that intervention characteristics, outer setting, inner setting, individual characteristics, and process (all the constructs of CFIR) influenced the implementation. There were more facilitators than barriers to the implementation. Facilitators included the relative advantage of the intervention compared with current practice (intervention characteristics); awareness of the growing prioritization of diabetes in the national health policy framework (outer setting); tension for change due to the realization of the vulnerability to vision loss from DR (inner setting); a strong collective sense of accountability of peer supporters to implement the intervention (individual characteristics); and regular feedback on the progress with implementation (process). Potential barriers included the need to queue at the eye clinic (intervention characteristic), travel inconveniences (inner setting), and socio-political disruption (outer setting).ConclusionsThe intervention was implemented with high retention, reach, fidelity, and dose. The CFIR provided a valuable framework for evaluating contextual factors that influenced implementation and helped to understand what adaptations may be needed during scale up.Trial registrationPan African Clinical Trials Registry: PACTR201707002430195 registered 15 July 2017

The Impact of Being a Peer Sexual Health Educator: Lessons Learned from Mobilizing African American Adolescents Against HIV in Flint, Michigan

Although peer-led health education is common, the long-term impact of being a peer educator is under-studied. The purpose of this qualitative study is to investigate the long-term impact of being a peer sexual health educator. The sample consists of African American young adults who had served in this role. Being a peer sexual health educator had perceptual, cognitive, and relational impacts. This study has implications for the design and evaluation of sexual health programs.

Educating Hispanic Women about Cervical Cancer Prevention: Feasibility of a Promotora-Led Charla Intervention in a Farmworker Community.

Hispanic women suffer disproportionately from cervical cancer incidence and mortality compared with non-Hispanic Whites in the United States. Peer-led health education and coaching via charlas (talking circles) may improve cervical cancer screening and early detection rates among specific sub-groups such as farmworker communities. This pilot study sought to collect preliminary evaluation data about the feasibility of implementing a promotora-led cervical cancer education intervention among women from a farmworker community. The study took place between April 2014 and November 2014. Created based on an established network (Tampa Bay Community Cancer Network, TBCCN), in partnership with a local farmworker organization (Farmworkers Self-Help, Inc.), the project entailed refinement of a curriculum guide including Spanish-language educational resources (teaching cards). Social Cognitive Theory and the Health Belief Model provided the conceptual framework for the study. Six women from the farmworker community helped to refine the intervention and were trained as promotoras. They successfully delivered the program via charlas to a total of 60 participants who completed baseline and post-intervention measures on knowledge (cervical cancer/HPV), beliefs, self-efficacy, and intentions. Findings demonstrated gains in knowledge and self-efficacy among charla participants (P<.0001), and support the promise of a community-driven intervention that is delivered by promotoras who use their cultural knowledge and trustworthiness to educate women about cancer screening practices. Results also add to the literature on the use of a charla approach for cancer prevention education within a farmworker community to prompt discussions about health. Future research should evaluate peer-led programs on a larger scale and among other at-risk groups in other community settings.

EVALUATING THE EFFECTS OF HEALTH EDUCATION ON ADOLESCENTS' KNOWLEDGE AND PERCEPTION OF RISK TO HIV/AIDS IN SOUTHWESTERN NIGERIA

Adolescents constitute a sizeable proportion of new HIV infections. Their reported poor risk perception to HIV/AIDs calls for a more formidable way of reaching them with HIV prevention messages. This study evaluated the effects of peer-led health education on secondary school adolescents' perception and knowledge of risk to HIV/AIDs in urban slum communities of Osun state. Descriptive cross-sectional study of the pre and post-test type was carried out among intervention and control groups of 700 secondary students each, selected using multi-staged sampling method. The intervention group had a six months’ peer-led health education sessions. Research instruments were semi- structured self-administered pre-tested questionnaires. Data was analysed using the SPSS software version 17.0 Two hundred and ninety-six (84.6%) and 283(80.9%) of respondents were aware of HIV/AIDs in the pretest of intervention and control groups respectively. An increase of 12.0% and 1.7% in awareness was recorded among intervention and control group respectively during post-test. With a high-risk knowledge but poor risk perception scores reported among both groups during pretest, there was an increase of 7.4% in risk perception scores among intervention and 3.2% among control group during post-test. Higher education classes and male gender were predictors of good risk knowledge and good risk perception respectively. Adolescents under study had high awareness, high-risk knowledge but poor self-risk perception towards HIV/AIDs. Peer-led health education significantly increased risk knowledge and perception among study group than the control group.

The Effectiveness of a Peer-Led HIV/AIDS and STI Health Education Intervention for Prison Inmates in South Africa

This article reports on the effectiveness of the first systematically developed health education intervention for the reduction of risky sexual behavior among soon-to-be-released prisoners in South Africa. Data from three out of four prisons are eligible for data analysis including 263 inmates. Using a nested experimental design, short-term evaluation while inmates were still in prison demonstrate that experimental groups showed higher knowledge of sexually transmitted infections and had a more positive intention to reduce risky behavior than the control group in two out of three prisons. Long-term assessment 3 to 6 months after release from prison indicates that experimental groups were more positive about sexual communication, self-efficacy, and intention. Groups educated by an HIV-negative educator perform marginally better than those in groups with an HIV-positive peer educator. It is argued that peer-led health education programs may be effective in reducing risky behavior amongst soon-to-be-released inmates.

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

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.