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Cited by 189School Health and Nursing EducationAdolescent Sexual and Reproductive HealthAdolescent Health and Behaviors

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

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Dodd, Steven, Widnall, Emily, Russell, Abigail Emma, Curtin, Esther Louise, Simmonds, Ruth, Limmer, Mark, Kidger, Judi·2022·BMC Public Health
DOI 10.1186/s12889-022-14688-3PMC PMC9719233
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Abstract

Introduction: Peer education, whereby peers (‘peer educators’) teach their other peers (‘peer learners’) about aspects of health is an approach growing in popularity across school contexts, possibly due to adolescents preferring to seek help for health-related concerns from their peers rather than adults or professionals. Peer education interventions cover a wide range of health areas but their overall effectiveness remains unclear. This review aims to summarise the effectiveness of existing peer-led health interventions implemented in schools worldwide. Methods: Five electronic databases were searched for eligible studies in October 2020. To be included, studies must have evaluated a school-based peer education intervention designed to address the health of students aged 11–18-years-old and include quantitative outcome data to examine effectiveness. The number of interventions were summarised and the impact on improved health knowledge and reductions in health problems or risk-taking behaviours were investigated for each health area separately, the Mixed Methods Appraisal Tool was used to assess quality. Results: A total of 2125 studies were identified after the initial search and 73 articles were included in the review. The majority of papers evaluated interventions focused on sex education/HIV prevention (n = 23), promoting healthy lifestyles (n = 17) and alcohol, smoking and substance use (n = 16). Papers mainly reported peer learner outcomes (67/73, 91.8%), with only six papers (8.2%) focussing solely on peer educator outcomes and five papers (6.8%) examining both peer learner and peer educator outcomes. Of the 67 papers reporting peer learner outcomes, 35/67 (52.2%) showed evidence of effectiveness, 8/67 (11.9%) showed mixed findings and 24/67 (35.8%) found limited or no evidence of effectiveness. Of the 11 papers reporting peer educator outcomes, 4/11 (36.4%) showed evidence of effectiveness, 2/11 (18.2%) showed mixed findings and 5/11 (45.5%) showed limited or no evidence of effectiveness. Study quality varied greatly with many studies rated as poor quality, mainly due to unrepresentative samples and incomplete data. Discussion: School-based peer education interventions are implemented worldwide and span a wide range of health areas. A number of interventions appear to demonstrate evidence for effectiveness, suggesting peer education may be a promising strategy for health improvement in schools. Improvement in health-related knowledge was most common with less evidence for positive health behaviour change. In order to quantitatively synthesise the evidence and make more confident conclusions, there is a need for more robust, high-quality evaluations of peer-led interventions using standardised health knowledge and behaviour measures.

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  • Digital peer support systems have potential in promoting mental well-being.

    “A systematic review published in the Journal of Medical Internet Research Mental Health highlighted the potential of digital peer support systems in promoting mental well-being [111].”

    From The Impact of Social Media & Technology on Child and Adolescent Mental Health (2025) · cites this paper as [111]

    The Discussion reports that several school-based peer education studies showed evidence of effectiveness for mental health, supporting the general point about potential benefits. The review concerns school-based peer education, not digital peer support systems, and our copy identifies it as a BMC Public Health paper, not a Journal of Medical Internet Research Mental Health review. (LLM, conf=0.88)

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Sorted by citations

Authors
Dodd, S., Widnall, E., Russell, A. E., Curtin, E. L., Simmonds, R., Limmer, M., & Kidger, J.
Affiliations
  • Lancaster University (GB)
  • University of Bristol (GB)
  • University of Exeter (GB)
  • London School of Hygiene & Tropical Medicine (GB)
  • Mental Health Foundation (GB)
Corresponding author
Widnall, Emily
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2022-12-02
Volume
22
Issue
1
Pages
2247-2247
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-022-14688-3
PMC
PMC9719233
OpenAlex
W4310947207
Cited by
189
References
5
Citations by year
2026: 55 · 2025: 61 · 2024: 52 · 2023: 21
FWCI
7.16
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Lancaster EPrints (Lancaster University) (submittedVersion)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by)
  • Explore Bristol Research (submittedVersion, cc-by)
Funders
  • National Institute for Health and Care Research (PHPES025)
  • School for Public Health Research (SPHR PHPES025)
Topics
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
  • Health Sciences › Health Professions › General Health Professions › Adolescent Health and Behaviors
Keywords
peer education, school-based intervention, adolescents, health behavior change, HIV prevention, sex education, substance use prevention, alcohol and tobacco use, healthy lifestyle, peer educators, intervention effectiveness, health knowledge
MeSH terms
Adolescent, Adult, Child, Educational Status, Humans, Peer Group, Schools, Sex Education, Students

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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