Centre for Public Health, University of Bristol, Bristol, United Kingdom.
Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom.
PLoS One. 2024 May 31;19(5):e0302431. doi: 10.1371/journal.pone.0302431. eCollection 2024.
Peer education interventions are widely used in secondary schools with an aim to improve students' health literacy and/or health behaviours. Although peer education is a popular intervention technique with some evidence of effectiveness, we know relatively little about the key components that lead to health improvements among young people, or components that may be less helpful. This review aims to identify the main mechanisms involved in school-based peer education health interventions for 11-18-year-olds.
Five electronic databases were searched for eligible studies during October 2020, an updated search was then conducted in January 2023 to incorporate any new studies published between November 2020 and January 2023. To be included in the review, studies must have evaluated a school-based peer education intervention designed to address aspects of the health of students aged 11-18 years old and contain data relevant to mechanisms of effect of these interventions. No restrictions were placed on publication date, or country but only manuscripts available in English language were included.
Forty papers were identified for inclusion with a total of 116 references to intervention mechanisms which were subsequently grouped thematically into 10 key mechanisms. The four most common mechanisms discussed were: 1) Peerness; similar, relatable and credible 2) A balance between autonomy and support, 3) School values and broader change in school culture; and 4) Informal, innovative and personalised delivery methods. Mechanisms were identified in quantitative, qualitative and mixed methods intervention evaluations.
This study highlights a number of key mechanisms that can be used to inform development of future school-based peer education health interventions to maximise effectiveness. Future studies should aim to create theories of change or logic models, and then test the key mechanisms, rather than relying on untested theoretical assumptions. Future work should also examine whether particular mechanisms may lead to harm, and also whether certain mechanisms are more or less important to address different health issues, or whether a set of generic mechanisms always need to be activated for success.
同伴教育干预措施在中学中广泛应用，旨在提高学生的健康素养和/或健康行为。尽管同伴教育是一种流行的干预技术，具有一定的有效性证据，但我们对导致年轻人健康改善的关键因素或可能不太有帮助的因素知之甚少。本综述旨在确定针对 11-18 岁青少年的基于学校的同伴教育健康干预的主要机制。
2020 年 10 月，在五个电子数据库中搜索符合条件的研究，然后在 2023 年 1 月进行了更新搜索，以纳入 2020 年 11 月至 2023 年 1 月期间发表的任何新研究。为了被纳入审查，研究必须评估一项旨在解决 11-18 岁学生健康方面的基于学校的同伴教育干预措施，并包含与这些干预措施效果机制相关的数据。对出版日期或国家没有限制，但仅包括英语语言的手稿。
确定了 40 篇论文，其中共有 116 篇文献涉及干预机制的参考文献，随后将这些参考文献按照主题分为 10 个关键机制。讨论最多的四个机制是：1）相似性，相似、可关联和可信；2）自主权和支持之间的平衡；3）学校价值观和更广泛的学校文化变革；4）非正式、创新和个性化的交付方法。干预措施的评估涉及定量、定性和混合方法研究。
本研究强调了一些关键机制，可以用来为未来基于学校的同伴教育健康干预措施的开发提供信息，以最大限度地提高效果。未来的研究应旨在创建变革理论或逻辑模型，然后测试关键机制，而不是依赖未经测试的理论假设。未来的工作还应研究特定机制是否会导致伤害，以及某些机制对于解决不同的健康问题是否更为重要，或者一组通用机制是否总是需要激活才能取得成功。
