What do we want to know?
Using peers to deliver health promotion interventions to young people is an increasingly fashionable strategy, especially in Europe and North America. It is based on the assumption that peers may be seen as more credible sources of information than adult, professionally trained, health educators, and may be particularly helpful in reaching 'at risk' young people. The aim of this review is to examine critically the claim that the peer-delivered approach is a more appropriate and effective method of promoting the health of young people (aged 11 to 24 years) than more traditional approaches.
Who wants to know?
Policy-makers, practitioners, young people, researchers.
What did we find?
A small number of well-designed evaluations were identified and these revealed mixed evidence on effectiveness and appropriateness. More than half of the effectiveness evaluations showed a positive effect on at least one behavioural outcome. However, it was difficult to identify any specific characteristics of an effective model of peer-delivered health promotion.
There was evidence that simply using peer leaders to deliver didactic information does not lead to changes in behaviour. There was also evidence of negative views about peer education and of conflicts between schools and the idea of young people and adults working in partnership.
The studies reviewed in this report are not encouraging on the issue of peer-delivered health promotion reaching young people at enhanced risk of adverse health behaviours. Additionally, there is a significant gender issue, with young men being notably more reluctant to take on the role of peer educator.
What are the implications?
Because the evidence is mixed it cannot be assumed that implementing peer-delivered health promotion will be effective. More rigorous evaluation is needed of both process and outcome. Several key questions remain including whether the greatest effect of peer education is on the peer educators themselves and the issue of what constitutes a credible peer (similar ages, backgrounds or experiences).
Health promotion interventions for young people should only be implemented on the basis of a thorough assessment of both young people’s self-defined health needs and their views on what kind of intervention they would find most appropriate. Peer-delivered health promotion may or may not be the most appropriate strategy.
How did we get these results?
The report reviewed in-depth fifteen process studies and twelve outcome evaluation studies.
This summary was prepared by the EPPI-Centre
This report should be cited as: Harden A, Weston R, Oakley A (1999) A review of the effectiveness and appropriateness of peer-delivered health promotion interventions for young people. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.