Download this fact sheet: Peer education-issues and challenges [PDF: 422 KB]
Number 4.14 March 2006
for workers
Introduction
Peer education models have been used to target a range of health issues, particularly sexual health and alcohol and other drug use. It is not always easy to evaluate peer education programs because their goals, such as achieving long-term behavioural change within a particular target group, can be difficult to measure. However, despite these challenges, many researchers believe that peer education can be a very effective method of delivering alcohol and other drug education.
Managing the peer education process can be complex, and highly skilled personnel are required in order to achieve success. This fact sheet explores some of the issues and challenges associated with setting up and evaluating a peer education program.
Peer education versus other methods of drug education
Evaluation problems make direct comparison between peer education and other drug education programs difficult. In the case of drug education for young people, some studies report better knowledge acquisition after adult-led programs and others have found peer-led programs superior. It is possible to speculate that, since teachers have been shown to be best at didactic (instructive) teaching, any information-intense elements of drug education may be best referred to teachers or health educators. Similarly, since peers have been shown to be most effective in interactive settings, those aspects of drug education that address attitudes, skills and behaviours may be more effectively delivered in this format.
Some programs that are called "peer education" are not true peer education programs because professional health workers are directing the process and determining the information that is being delivered. Programs should include peers in the development rather than just in the delivery phase. Information should be factual, truthful and credible to the target group.
The challenges of developing a peer education program
Aims of peer education
The aims of the project should be clear and realistic. Keeping aims specific assists in the evaluation process and helps to keep costs down.
Training peer educators
During training, peer educators gain a lot of knowledge and may perceive themselves as more expert than group members. In such instances, they may transfer the information in a way that is similar to the teacher–student interaction in schools. Research has shown that members of the group may not participate fully in this type of interaction. Therefore, it is important to evaluate and monitor the way in which peer educators deliver the information to their group members.
Peer educators are often used to reach populations that may not otherwise access health or community services. In some cases, peer educators working in this setting may be expected to provide information and counselling beyond their training, knowledge and skills. These peer educators require adequate support and a range of supplementary resources, such as referral lists, wallet cards and pamphlets.
Difficulties reported by peer educators
Peer educators have expressed concerns about:
- the need to become an expert source of information
- lack of ongoing support
- lack of payment
- conflict with other sources of information or control.
In school-based programs, in particular, peers found:
- it difficult to control other young people
- problems in dealing with personal questions about their own experiences
- they were undermined by the teacher present trying to take control
- constraints on the message they were allowed to deliver
- lack of trust from other young people who were viewing them more as teachers than as peers.
It has also been noted that much of the work of peer educators is unsupervised because workers in the field are inexperienced in organising this type of program.
Effect on the target group
Documenting the impact of peer education on the target group is harder than documenting the impact on peer educators. A number of evaluations have focused on the implementation process itself, or on the effect on the peer educators rather than on determining the effect on the target group.
Perhaps the most consistently reported finding to emerge from the peer education literature is the preference of young people for health education to be delivered by peers. This may reflect a preference for interactive delivery methods over approaches that are more instructive.
Evaluation
The problems associated with evaluating peer education programs include:
- The program methods and goals are sometimes not clear, making it hard to assess the impact of the intervention.
- Poor reporting of any difficulties adhering to the planned methods.
- A lack of control group and/or pre and post-test comparison.
- Problems controlling for the wide range of possible influences on program outcome.
- Programs aimed at achieving cultural change.
Things to consider when planning a peer education program
- Have clear and realistic aims and objectives for the project.
- Establish boundaries between peer educators, project managers and the target group. Project managers should strike the right balance between being approachable and setting sensible boundaries with the educators.
- Ensure adequate investment in both social and financial aspects of the project. This may influence the quality of design of the project, the quality of training, the quality of different phases of project evaluation, the level of satisfaction of the educators themselves and the quality of materials used. Peer educators need intensive guidance and counselling that extends beyond the training phase.
- Design the project so that it fits the environment in which it will be implemented.
- Use experienced personnel to reduce the chance of mistakes in the design and implementation.
- Follow scientifically based guidelines for project design and evaluation (for example, pre-testing, process evaluation, outcome evaluation).
- Secure the support of stakeholders. Successful projects are those that seek the involvement of a broad range of relevant stakeholders. This can assist by increasing funding opportunities, limit any communication problems and promote the interest of the project.
Conclusion
Despite the difficulties associated with designing and implementing a peer education program, many researchers believe that peer education is an effective method of delivering alcohol and other drug education to young people. Although it is not conclusive, research into the outcomes of peer education suggests that it is an effective strategy. There is also evidence to suggest that peer education is at least as, or more, effective than adult-led drug education.
More information
For more information on drugs and drug prevention contact the DrugInfo Clearinghouse on tel. 1300 85 85 84, email druginfo@adf.org.au.