Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.
PLoS One. 2021 Apr 15;16(4):e0249553. doi: 10.1371/journal.pone.0249553. eCollection 2021.
Schools worldwide have implemented many different peer-led interventions with mixed results, but the evidence base on their effectiveness as mental health interventions remains limited. This study combines a scoping review and systematic review to map the variations of peer-led interventions in schools and to evaluate the quality of the existing evidence base. This scoping review and systematic review evaluated the existing literature across 11 academic databases. Studies were included if they reported a peer-led intervention that aimed to address a mental health or wellbeing issue using a peer from the same school setting. Data were extracted from published and unpublished reports and presented as a narrative synthesis. 54 studies met eligibility criteria for the scoping review, showing that peer-led interventions have been used to address a range of mental health and wellbeing issues globally. 11 studies met eligibility criteria for the systematic review with a total of 2,239 participants eligible for analysis (929 peer leaders; 1,310 peer recipients). Two studies out of seven that looked at peer leaders showed significant improvements in self-esteem and social stress, with one study showing an increase in guilt. Two studies out of five that looked at peer recipient outcomes showed significant improvements in self-confidence and in a quality of life measure, with one study showing an increase in learning stress and a decrease in overall mental health scores. The findings from these reviews show that despite widespread use of peer-led interventions, the evidence base for mental health outcomes is sparse. There appear to be better documented benefits of participation for those who are chosen and trained to be a peer leader, than for recipients. However, the small number of included studies means any conclusions about effectiveness are tentative.
世界各地的学校已经实施了许多不同的同伴主导干预措施，结果喜忧参半，但作为心理健康干预措施的有效性证据基础仍然有限。本研究结合了范围综述和系统评价，以绘制学校同伴主导干预措施的变化，并评估现有证据基础的质量。这项范围综述和系统评价评估了 11 个学术数据库中的现有文献。如果研究报告了一项同伴主导的干预措施，旨在使用来自同一学校环境的同伴来解决心理健康或幸福感问题，则将其纳入研究。从已发表和未发表的报告中提取数据，并以叙述性综合形式呈现。有 54 项研究符合范围综述的入选标准，表明同伴主导的干预措施已被用于解决全球范围内的一系列心理健康和幸福感问题。有 11 项研究符合系统评价的入选标准，共有 2239 名符合分析条件的参与者（929 名同伴领导者；1310 名同伴接受者）。在七项研究中，有两项研究表明同伴领导者自尊心和社会压力显著提高，其中一项研究表明内疚感增加。在五项研究中，有两项研究表明同伴接受者的自信心和生活质量衡量标准显著提高，其中一项研究表明学习压力增加，整体心理健康评分下降。这些综述的结果表明，尽管广泛使用同伴主导的干预措施，但心理健康结果的证据基础仍然匮乏。对于那些被选为并接受培训成为同伴领导者的人来说，参与似乎有更好的记录效益，而对于接受者来说则不然。然而，纳入的研究数量较少意味着关于有效性的任何结论都是初步的。
