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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.

Background Prescription writing skills are essential for physician practice. This study describes the development and implementation of a curricular intervention focused on improving the knowledge and confidence of preclerkship medical students’ prescription writing practices utilizing an interprofessional education model, with a focus on electronic prescribing. Methods Medicine and Pharmacy Faculty from a large, urban university collaborated to develop the content of the workshop and a simulation platform was used for the e-prescribing activity. Second-year medical students attended a mandatory in-person workshop facilitated by fourth-year pharmacy students. A pre and post knowledge test and confidence survey were used to assess students’ knowledge, confidence, and satisfaction. Outcomes from the knowledge test were evaluated with paired-samples proportions tests, and confidence survey data was evaluated with paired t-tests and Wilcoxon signed-rank tests in a pre-post study design. Results Students demonstrated a significant increase in prescription writing knowledge and confidence after completing the workshop. On the pre-test, 7% of students (21/284) completed the electronic prescribing assessment correctly and 51% of students (149/295) completed it correctly on the post-test. All items on the confidence survey showed a significant increase in pre- versus post-survey comparisons ( p  < 0.001). Conclusions This interprofessional prescription writing workshop facilitated by pharmacy students shows promise for improving the knowledge and confidence of prescription writing and electronic prescribing practices in preclerkship medical students.

Background Reflective practice is a key skill for healthcare professionals. E-learning programmes have the potential to develop reflective practice in remote settings and low- and middle-income countries (LMICs), where access to in-person reflective groups may be reduced. ‘Aqoon’ is a global mental health peer-to-peer e-learning programme between Somaliland and UK medical students. We aimed to explore participants’ experiences of participating in the Aqoon programme, including their experiences of reflective practice. Methods Thirty-three medical students (22 Somaliland, 11 UK) enrolled in Aqoon. We matched volunteer learners in trios, to meet online to discuss anonymised clinical cases relevant to chapters of the World Health Organization’s mental health gap action programme (mhGAP) intervention guide. We conducted thematic analysis of learners’ reflective writing and post-programme focus group transcripts. Results Twenty-four students (73%) attended at least three online discussions (14 Somaliland, 10 UK). Somaliland and UK students described improved reflective skills and greater recognition of stigma towards mental ill-health. Themes included gaining memorable insights from peer discussions which would impact their medical education. UK students emphasised improved cultural understanding of common psychiatric presentations whilst Somaliland students reflected on increased clinical confidence. Discussion Integrating reflective practice into Aqoon showed the potential for low-cost e-learning interventions to develop cross-cultural reflective practice among medical students in diverse settings.

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.

Background Peer-assisted learning (PAL) is a common teaching and learning method in medical education worldwide. In the setting of skills laboratories (skills labs), student tutors are often employed as an equivalent alternative to faculty teachers. However, to the best of our knowledge, there is a lack of qualitative studies which explore the reasons for the personal commitment of student tutors. The aim of our study was to examine how undergraduate students experienced and evaluated their roles as skills lab student tutors, what their motivation was, and whether social and cognitive congruence played a role in their teaching experiences. Methods We conducted in-depth, semi-structured interviews with student tutors who were currently teaching in a skills lab. After the interviews had been transcribed verbatim, two independent investigators performed a qualitative content analysis according to Mayring. Results In total, we conducted nine interviews with student tutors. Our results revealed that all student tutors showed great enthusiasm and motivation for their jobs as peer teachers. One of the main motivating factors for student tutors to teach in a skills lab was the possibility to simultaneously share and improve their knowledge and expertise. In general, the participants of our study had high aspirations for their teaching. They found it particularly important to be empathetic with the student learners. At the same time, they thought they would personally benefit from their teaching activities and develop a certain expertise as student tutors. Conclusions With the present study we are able to gain some insight into what motivates student tutors to teach in a skills lab and what kind of experiences they have. Our results provide an important input for the future training of highly qualified student tutors.

Introduction: Long-acting and permanent methods of contraception (LAPMs) are known as highly-effective contraception. The Department of Health of East Java Province stated that LAPM participation is still below target. One of the factors is the Interpersonal Communication (IPC) skill of the Health Practitioners. This study aimed to identify the influence of health lectures using media and peer-education on the knowledge and attitude of pregnant women regarding LAPMs. Peer-education is the novelty of this study.Methods: A two-group quasi experimental design was applied with all of the pregnant women at Kesugihan Public Health Center (PHC) as the treatment group. They were given lectures with media inclusion (contraception booklets and visual aids) and peer-education during a pregnancy class. Pregnant women at Ngebel PHC were the control group. One woman who had experience with LAMPs was trained as a peer-educator. Thirty participants in each group were chosen using the total sampling technique. The data collected was analyzed using univariate and bivariate analyses by applying the Wilcoxon Signed-Rank and Mann-Whitney tests.Results: The participants showed an increased knowledge before and after the intervention in the treatment group (83%), while in control group, it was slightly increased (1%). Attitude differences were also found in both groups (treatment = 56.7%, control = 13.3%). The Mann-Whitney test resulted in significant differences on knowledge (p <0.001) and attitude (p = 0.016) between the two groups.Conclusion: The local department of health may optimize IPC using media and peer-education to improve the knowledge and attitude of pregnant women regarding LAPM participation.

Background Prisoners experience significantly worse health than the general population. This review examines the effectiveness and cost-effectiveness of peer interventions in prison settings. Methods A mixed methods systematic review of effectiveness and cost-effectiveness studies, including qualitative and quantitative synthesis was conducted. In addition to grey literature identified and searches of websites, nineteen electronic databases were searched from 1985 to 2012. Study selection criteria were: Population: Prisoners resident in adult prisons and children resident in Young Offender Institutions (YOIs). Intervention: Peer-based interventions. Comparators: Review questions 3 and 4 compared peer and professionally led approaches. Outcomes: Prisoner health or determinants of health; organisational/process outcomes; views of prison populations. Study designs: Quantitative, qualitative and mixed method evaluations. Results Fifty-seven studies were included in the effectiveness review and one study in the cost-effectiveness review; most were of poor methodological quality. Evidence suggested that peer education interventions are effective at reducing risky behaviours, and that peer support services are acceptable within the prison environment and have a positive effect on recipients, practically or emotionally. Consistent evidence from many, predominantly qualitative, studies, suggested that being a peer deliverer was associated with positive effects. There was little evidence on cost-effectiveness of peer-based interventions. Conclusions There is consistent evidence from a large number of studies that being a peer worker is associated with positive health; peer support services are also an acceptable source of help within the prison environment and can have a positive effect on recipients. Research into cost-effectiveness is sparse. Systematic review registration PROSPERO ref: CRD42012002349 .

Medication nonadherence is an important barrier to achieving optimal clinical outcomes. Currently, there are limited data on methods used to train medical students about medication adherence.To evaluate the knowledge, confidence, and attitudes of first-year osteopathic medical students before and after a 30-minute peer-to-peer medication adherence education program led by a third-year pharmacy student.All first-year medical students from Touro University California College of Osteopathic Medicine were invited to participate in 1 of 3 medication adherence educational sessions held in May 2019. A third-year pharmacy student who received training from Touro University California College of Pharmacy faculty served as the peer educator. Each session took approximately 1 hour to complete. The session included a preprogram survey, a 30-minute program, and a postprogram survey. Survey items included demographics; medication adherence knowledge, confidence, and attitudes; and attitudes toward the peer-to-peer educational format. Statistical comparisons of preprogram and postprogram knowledge, confidence, and attitudes were made using a paired t test, the McNemar test, and the Wilcoxon signed-rank test. P<.05 was considered statistically significant. A sample size calculation was performed using mean knowledge scores to determine whether the study achieved 80% power.Twenty-three students participated in the study. Medication adherence knowledge scores improved after the program (17.4 [77.4%] vs 9.98 [92.2%]; P<.001). Confidence scores also improved for all 7 survey items (P<.001). Medical students had more positive attitudes toward medication adherence after the program, with 8 of 10 survey items in this domain showing improvement. Most students had a positive attitude toward the peer-to-peer educational format. All participants reported that they would implement the medication adherence skills learned at the program with future patients.A 30-minute peer-to-peer program led by a pharmacy student improved first-year medical students’ knowledge, confidence, and attitudes with regard to medication adherence and provided an effective format to enhance interprofessional learning and collaboration.

Background Peer education is an education model applied to change knowledge, behavior, and attitude in groups equal to each other regarding age, education, and status. This model is preferred in universities to improve teaching skills and reduce the stress level of students. This study aims to apply the peer education model at Trakya University Faculty of Medicine to receive feedback from students and to examine its effect on exam results. Methods This cross-sectional, descriptive, and analytical study was conducted with second-year medical students in parasitology laboratory lessons. Eighteen out of a total of 264 students were selected as peer educators. Peer educators have reached the level of providing education to students by taking the training before the laboratory lessons. At the end of the study, questionnaires were applied to peer educators and students. The students’ of 2021–2022 exam results were compared with the 2018–2019 academic year results. Results A total of 233 students were surveyed, and 78.5% (183/233) of them believe peer education is helpful, 69.9% (163/233) think it can help them reinforce what they have learned in theoretical lessons, 54.5% (127/233) think it should be used in other practical lessons, and 64.3% think it should be used in the coming years. While there was no significant difference between the exam results of the students in 2021–2022 and the 2018–2019 period (p: 0.462), a significant difference was found between the exam results of peer educators and students (p < 0.05). Conclusions It is known that with the peer education model, student stress will decrease, and interest and participation in the lesson will increase. Continuing this education model in the coming years and expanding it to other laboratory courses will benefit medical education.

Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of searching and data abstraction were utilized. Merged effect sizes were calculated using random effects models. Thirty studies were identified. In meta-analysis, peer education interventions were significantly associated with increased HIV knowledge (odds ratio [OR]: 2.28; 95%, confidence interval [CI]:1.88, 2.75), reduced equipment sharing among injection drug users (OR: 0.37; 95% CI: 0.20, 0.67), and increased condom use (OR: 1.92; 95% CI: 1.59, 2.33). Peer education programs had a nonsignificant effect on sexually transmitted infections (OR: 1.22; 95% CI:0.88, 1.71). Meta-analysis indicates that peer education programs in developing countries are moderately effective at improving behavioral outcomes but show no significant impact on biological outcomes. Further research is needed to determine factors that maximize the likelihood of program success.