Influential Factors for the Improvement of Peer Education in Adolescents

According to the world health organization (WHO), an adolescent is a person within the age range of 11 to 19 years old. More than 1.2 billion people in the world are adolescents. Adolescents may encounter many problems and crises during the adolescence period that may endanger their health in all bio-psycho-social aspects . For instance, an adolescent may experience changes in their biological system including puberty and physical appearance, psychosocial changes such as identity and inclination to socialization, the feeling of belonging to a peer group, replication with peers and a sense of perfection. 

Moreover, adolescents in different societies face problems when attempting to acquire appropriate information about their age-related concerns. Therefore, there is a need for designation of appropriate educational programs to meet their needs.

Adolescents’ educational programs by healthcare professionals, schools and non-profit organizations aim to meet adolescents’ healthcare needs and help them choose a healthy life style. 

One of the most important sources of information for adolescents with regards to sexual and reproductive health is their peers. Therefore, peer education is recognized as a suitable strategy for improving adolescents’ health.

Peer education is the process of sharing knowledge and experiences among members of a group, who have similar concerns and characteristics, with the aim of achieving positive health outcomes. 

According to another definition, peer education is a series of educational strategies presented by members of a subculture, society, or a group of people for their peers. Peer education may involve tutoring, counseling, helping, buddying and support.

Peer education can be implemented for different age groups with the aim of improving knowledge, changing attitudes and beliefs, and supporting and empowering participants to make informed decisions. Many studies have shown that peer education was an acceptable approach of education of adolescents, and could improve their knowledge and attitudes. Also, peer education was more acceptable for adolescents compared to the education provided by others. A probable reason is the amount of time spent with peers, which can be used to reinforce behavioral models. Since peer education aims to change the behaviors of groups, it could create a sense of collective action and lead to the progression and empowerment of both the educator and peers. Other aims of this approach include sharing positive experiences to help personal development, strengthening the relationship between schools and social communities, changing high-risk behaviors, and providing access to psycho-social support as well as cost-effective and available preventative services.

Peer educational strategies have been shown to be effective in health-related projects such as the prevention of cigarette smoking, alcohol and drug abuse, sexually transmitted diseases (STDs), human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and education on sexual behaviors. Moreover, it has been used in different fields of general public health including nutrition education and family planning.

While from a historic perspective, peer education stems from theories of behaviorism and primary prevention, peer education interventions have recently been established on cognitive and harm reduction theoretical perspectives, prevention and early intervention, and interactive and participative learning. It is believed that peer education needs technical framework, education and supervision to meet the needs of volunteer adolescents. One of the most important requirements for planning peer education is the necessity of being accountable to peers’ needs and concerns.

The success of any program depends on the identification of facilitators and barriers to its implementation. Taking into account the importance of adolescence period and the significance of peers in adolescent’s quality of life, this study was conducted with the aim of investigating influential factors on the improvement of adolescents’ education through peer education.

Factors Influencing the Improvement of Peer Education

Characteristics of Peer Educators

Appropriate identification and selection of peer educators were crucial factors that influenced the educational program by peers. In this respect, the selection of a peer educator as a very sensitive aspect affected the effectiveness of educational interventions and efforts made to achieve education goals. The process of peer educator’s selection depended on the target group’s needs and the context of education. Some suggested methods were: individual and group interview, volunteer’s knowledge test, elections, self-nomination, nomination by the community, target group and project staffs, participatory group activities, and interactive discussions. The majority of peer educational projects used the volunteer method and nomination by staffs or their combination. Moreover, people who volunteered for peer education should have had acceptable social activities in their past.

Personal Characteristics

Peer educators as members of the same age group received information and education from educational classes. They aimed to bring a positive and durable change to peer groups. The peer educator was introduced in different literature reports with various names as peer educator, peer trainer, peer facilitators, peer counselor, peer tutor, peer leader, and peer helper. They should be active listeners, to be able to make obvious and convincing communication with peers. They should also have a socio-cultural background similar to target audiences and should be respected by them. In addition to having a non-judgmental attitude towards others, they should have self-confident and the potential of leadership. Passing the practical exam at the end of the educational courses, and having the required time and energy to work with peers in irregular hours were other characteristics of the peer educator. Some believed that being sensitive and open-minded and having interpersonal skills were other characteristics of the peer educator.

Skill Characteristics

Peer educators needed to obtain certain skills before they would be able to take the leadership role. Some of the required skills were: the ability to teach and hold educational workshops extract ideas and concerns and find solutions to resolve them. Also, they needed to learn consultation skills, present lectures and facilitate open discussions regarding sensitive topics such as sexual issues. Other skills were: being positive and healthy role models, providing opportunities for peers to share their ideas, feelings, attitudes and perspectives, and supervising peers and assessing their needs. 

Finally, they should have been able to become directly involved in planning for designation of programs and identification of information sources as well as consultation centers in the society for peer’s referral if required.

Communication Characteristics

Peer educators needed communication skills to assess peers’ abilities, make appropriate relationships with others and organizations such as healthcare settings. They needed to have the required skills for the transmission of messages both verbally and nonverbally and receive messages through active listening, sending feedback and empathy. It was said that the verification of others’ ideas and reflection of feelings to others helped the peer educator develop constructive communication. Peer educators should have the ability to face problems through adaptation, problem solving, and resistance against psychological issues.