Peer Education and Peer Counselling for Health and Well-Being: A Review of Reviews

Abstract

Peer education and peer counselling for health and wellbeing have been recognized as complementary approaches to professional intervention for over 50 years, but it is relatively recently that research into effects has become adequate. Potentially, they have advantages in reaching where professionals cannot, but it has not been clear if that potential is fulfilled, although the measurement of effects is difficult. The present paper examines 58 narrative and systematic reviews and meta-analyses on the topic. In peer education, there were many reviews of sexual health and of HIV/AIDS interventions, followed by reviews of various medical conditions and in the context of prisons. More general reviews covered a wider field. In peer counselling, there were several reviews of breast-feeding and mental health. Many early reviews complained of the lack of evaluation; then, later reviews found knowledge gains but not behavior gains; then, still later reviews found both knowledge and behavior gains. Thus, peer education and counselling appear effective but only if organizational factors are well managed and the cultural context of the country respected. The implications for future practice, policy and research were outlined.

School-based peer education interventions to improve health: a global systematic review of effectiveness

“…In terms of frequency of health areas covered, our findings are similar to a recent ‘review of reviews’ of peer education for health and wellbeing which found that the majority of reviews focused on sexual health and HIV/AIDS interventions [ 13 ]. This previous review focused on both children and adults, however, in line with our findings, it found mixed effectiveness and considerable diversity in methods, findings and rigour of evaluation.…”

“…A recent review of peer education and peer counselling for health and well-being highlights how peer education interventions are inherently difficult to quality control and evaluate [ 13 ], partly due to what makes peer education attractive; peer education defies the conventions of traditional formal education and allows young people to learn by more unstructured means, in more ‘real world’ ways, benefiting from meaningful examples and conversations with their peers. Although there are an increasing number of well-designed peer education studies [ 13 ], new evaluation methods may be needed given the complexity and multi-component nature of peer-education approaches (i.e., training, more informal teaching approaches and informal diffusion of knowledge).…”

“…Existing peer education interventions cover a wide range of health areas, including mental health, physical health, sexual health, and a general promotion of healthy lifestyles including eating habits and smoking prevention [ 10 – 13 ]. There is also variation in the format or delivery of peer-led interventions including 1:1 peer mentoring, peer buddy initiatives, peer counselling, and peer education [ 14 – 17 ].…”

Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners

“…FDs' attitudes toward and practices concerning traditional SHGs as well as expected benefits from PSPs highlight important barriers to and facilitators for the adoption and maintenance of PSPs. Ensuring optimal conditions for the implementation of PSP requires careful attention to context factors [27] particularly organisational and cultural fit [12] . FDs saw several facilitators at the patient and group level.…”

“…Given worldwide shortages in health care professionals [10] and problems of rising health care costs, a structured "lay person-integrating support system" may be a cost-effective, complementary structure within modern health care systems [11]. A recent review of peer education and counselling found that such interventions can be effective if organisational and cultural aspects are well managed [12] . Provider referral to PSPs is a crucial step in patients' participation; both provider referral as well as organisational climate and support towards new programmes are important determinants at the "meso"-level of implementation [13].…”