Health Education Research, Vol. 17, No. 3, 339-349,
June 2002
© 2002 Oxford University Press
What influences peer-led sex education in the classroom? A view from the peer educators
Social Science Research Unit, Institute of Education, University of London, London WC1H 0NR and 1 Department of Sexually Transmitted Diseases, University College London Medical School, London WC1E 6AU, UK
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Abstract |
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This paper is the second of two presenting data gathered from peer educators in the RIPPLE study—a randomized controlled trial of peer-led sex education in English secondary schools. Peer educators were recruited from Year 12 students (aged 16/17 years) in 13 schools in two successive cohorts in 1997 and 1998. Following a standardized training programme they delivered sex education sessions to Year 9 students (aged 13/14 years). Through analysis of 18 focus group discussions and of post-programme questionnaire data (n = 301), this paper aims to identify the issues and processes considered by peer educators to be important in implementing a peer education programme, and to examine peer educators' views on the relationship between themselves and the Year 9 students. Methodological issues arising when collecting, analysing and presenting such data are discussed, and some recommendations are outlined for carrying out school-based peer education.
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Introduction |
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This paper is the second of two presenting data from a multi-centre research study of peer-led sex education. Peer education is increasingly popular, especially as a method of delivering health information in schools (Svenson, 1998
; Social Exclusion Unit, 1999; DfEE, 2000). Its proponents claim that peer leaders have an advantage over teachers because they are regarded as more credible sources of information, and a number of psychosocial theories, e.g. Social Learning theory [for an overview, see (Turner and Shepherd, 1999)], have been applied to peer-led methods to support their use. While there are some summative evaluations reporting on peer education programmes implemented in schools [see, e.g. (Frankham, 1993; Phelps et al., 1994; Backett-Milburn and Wilson, 2000)], robust evidence of their effectiveness is limited (Harden et al., 2001). As Backett-Milburn and Wilson note, there are also many issues concerning the development, delivery and impact of peer-led education which have received little systematic attention in the literature to date. The two papers in this series present data collected from peer educators in the RIPPLE (Randomized Intervention of PuPil-Led sex Education) study. The first paper discussed the characteristics and views of the young people who volunteered to become peer educators. This paper explores some of the issues identified by peer educators as important when implementing a peer education programme in schools, and attempts to contribute to the methodological literature on standards in qualitative research by describing the development of systematic methods for collecting and analysing qualitative data collected in focus group discussions.
The paper has four aims:
- To identify the important issues for peer educators implementing a school-based peer education programme.
- To examine peer educators' views on the relationship between themselves and the target students.
- To suggest some issues to be considered by those implementing and researching peer education programmes in schools.
- To discuss methodological issues arising in the collection and analysis of focus group and questionnaire data in studies of this kind.
The RIPPLE study
The RIPPLE study is a randomized controlled trial of peer-led sex education, funded by the Medical Research Council, in English secondary schools. Twenty-seven co-educational comprehensive secondary schools in central southern England were recruited to the study in 1997 and randomly allocated to receive either a programme of peer-led sex education (in 14 schools) delivered by Year 12 students (aged 16/17 years) to two successive cohorts of students in Year 9 (aged 13/14 years) or to act as controls by continuing with their teacher-led provision (13 schools). The effectiveness of peer-led sex education is being assessed through questionnaires completed by young people 6 months and 2 years after the intervention. Full details of the study design are given elsewhere (Strange et al., 2001).
Recruitment and training of peer educators and organization of the intervention
Peer educators in the 14 schools allocated to receive the peer-led programme were recruited from two successive cohorts of students entering Year 12 (aged 16/17 years). Year 12 students were told about the programme during assembly and/or form time. They were informed about the commitment involved in taking part and those who expressed an interest were asked to attend a further meeting. There was no formal screening of recruits; in some cases individuals were approached by teachers and encouraged to take part, and in a few others teachers actively deterred students from volunteering.
The peer educators participated in a standardized training course (four 1-h meetings in school and a 2-day training workshop at a local community venue) developed and implemented by a team of experienced health promotion practitioners. The training course provided information on a range of sexual health issues under the broad headings of relationships, STDs and contraception, and aimed to develop teaching/presentation skills. Trainers encouraged peer educators to work in small groups, to test different activities (e.g. brainstorming, role-playing, small group discussion) and lesson plans on one another, and to develop strategies for managing Year 9 students' potential loss of enthusiasm or disruption. Peer educators were encouraged to deal honestly and openly with factual questions, to respect confidentiality, to encourage the articulation of students' implicitly held values, and to use ground rules designed to deter personal comments and questions in their interaction with the target students. Opportunities to practise putting condoms on demonstrators and information on local sexual health services were offered on all the training courses.
After being trained, the peer educators worked in mixed sex groups (where possible) of two to four students, delivering a minimum of three sex education sessions to mixed sex classes of about 30 Year 9 students. Wherever possible, peer educators worked with the same group of students for all the sessions.
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Methods |
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Data collection
This paper draws mainly on data from the focus group discussions undertaken with peer educators after they had delivered the programme of sex education. It also includes some data from the post-programme questionnaires completed by peer educators. In one of the 14 schools allocated to deliver peer-led sex education, the programme was not implemented because of problems recruiting enough volunteers. Of a possible 26 focus group discussions (two each in 13 schools), 18 were carried out in 10 of the 13. Some focus groups were not undertaken because of difficulties finding time or communication problems in schools. In the 13 schools which did mount the peer-led programme, a total of 505 young people volunteered as peer educators and completed pre-programme questionnaires, approximately 463 were subsequently involved in the delivery of sex education sessions and 331 of the 463 (71%) completed post-programme questionnaires. Pre- and post-programme questionnaires could be linked for 268 (58%) peer educators. Non-linkage of questionnaires was due to a number of factors, including some young people withdrawing after completing the first questionnaire, others joining the study after this point, some being absent or busy elsewhere in the school on the days questionnaires were administered and problems with linking some ID codes.
One of three researchers (two female and one male) worked with each of the 14 schools. They observed and recorded all the training sessions with peer educators and a sample of the peer-delivered sessions, administered questionnaires prior to programme training and after programme delivery, and facilitated focus group discussions with groups of peer educators in each cohort in each school at the end of the programme. Peer educators were recruited to the discussions on an ad hoc basis; the constraints of the school timetable meant that some were excluded from the focus groups because of their academic commitments. The groups comprised between four and eight peer educators. Researchers worked to a structured schedule of questions focused on the peer educators' experiences of delivering sex education sessions, their views of the organizational context, quality of training and support for the programme within and outside the school, their perceptions of the impact of the intervention on Year 9 students and on themselves, and how they thought the programme could be improved. All focus group discussions were tape-recorded.
Analysis of data
A method of analysing the focus group data was developed that was as systematic as possible, combining analyses by more than one researcher in a process intended to yield a clear relationship between the data collected and the interpretation of it (Mays and Pope, 1995). The aim of the analysis was to identify issues that peer educators perceived as important in implementing the programme and the implications for them of being involved in it. Adopting an approach based on grounded theory, two researchers read the transcripts of the focus groups, identified relevant and recurrent themes present in the data, generated, through discussion, a list of marginal codes which could be applied to all the transcripts, and independently hand-coded the transcripts. Guidelines for coding outlined by Robson (Robson, 1993) and largely derived from Strauss were adopted (Strauss, 1987). A code was applied to highlight each aspect of the discussion that related to a particular theme and, where the discussion related to more than one theme, the text was marked for each of these. At three stages in the analytic process the researchers met to examine concordance and disagreement on the application of codes. In general, problems were most likely where codings dealt with discourses consisting of `embedded' accounts and/or where an issue was implicitly rather explicitly raised. An example of this is where peer educators implicitly acknowledged a difference between their approach and that of teachers by talking about how a teacher might manage a situation in the classroom.
A total of 1157 codes were applied to the transcripts. The two researchers agreed on 49% (n = 561), disagreed on 4% (n = 48) and one researcher coded when the other did not in 48% (n = 548) of cases. All cases of disagreement were discussed and a resolution reached. The process of clarifying codes and resolving disagreements mirrored closely the process recommended by Vaughn et al., who describe this method of analysis as `negotiating' categories (Vaughn et al., 1996).
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Results |
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The themes emerging from the analysis of the focus groups are grouped in the discussion below into three topic areas:
- Peer educators' descriptions of their role in relation to the Year 9 students.
- Peer educators' concerns and strategies for classroom management.
- Perceptions of other factors influencing the implementation and delivery of the programme.
Role of the peer educators
Discussions about the role of peer educators constituted 13% of the total codes applied to the transcripts and were part of all the focus groups analysed. Peer educators compared the relationships they had with the Year 9 students and their approach to working with them, on the one hand, and the relationships and approach teachers were perceived to have, on the other. They highlighted a number of dimensions of difference, including the importance of being able to talk openly, the balance between informality and keeping control, joking and humour, and gender as a factor affecting interaction and power relations. Common to all these discussions was the perceived greater informality of the peer educators' interaction with the students. They noted that students could feel more relaxed than they would with teachers. One said:
I think teachers are quite reserved in what they would say and how explicit they would go. They [Year 9] are not really worried about what they say to us...it was quite open.
Some peer educators described how allowing jokes or even joining in with them may have further cemented a good and open relationship with the Year 9 students. Some thought humour made it easier for Year 9 students to engage with, and benefit from, the sessions. One young man commented:
...[because we did] not writing but jokes, and just by speaking to them and feedback and doing it in a more relaxed way, they'll remember things.
Some peer educators explicitly set out to be more like friends than teachers to the Year 9 students. As one commented, the shift from `talking at' to `chatting to' Year 9 students and from the traditional physical arrangement in which the teacher stands at the front of the class helped to achieve this more informal style of interaction:
It started off just sort of standing there talking but it ended up as like all around a little table chatting as normal, they didn't want it to be a formal presentation and neither did we.
In making and allowing these shifts peer educators described some tensions between maintaining informality and exerting authority and control over the class. Many were aware that their status, by virtue of age and non-uniform dress, placed them apart from the Year 9 students, but as students they also shared some common experiences. Peer educators also expected to do some `teacherly' activity around classroom management and direction, and thought that Year 9 students expected it of them. However, for some peer educators, trying to be `like teachers' was not a successful management strategy, because the Year 9 students did not perceive them to have the same authority as teachers. For example, one male peer educator described the relationship between another peer educator and Year 9 students as follows:
They kind of took the Mickey out of him as well because he was trying to control everyone and stuff.
A number of peer educators noted that the ability to forge relationships with Year 9 students in which they could balance equality with authority was influenced by norms about gender. There were many comments about the role of male peer educators and the nature of their interaction with Year 9 students. For young men as peer educators there were some particularly acute tensions flowing from preconceptions and stereotypical views about male behaviour and the role of men in managing groups. It was also felt that male peer educators were important as they represented a male perspective, thereby legitimating the involvement of Year 9 boys in the sessions and contributing to the successful management of groups.
The emphasis on boys rather than girls in the focus group discussions reflects the importance attached by trainers and teachers to the involvement in the programme of young men as peer educators, stereotypical expectations that boys will `act up' more than girls and the tendency observed by researchers for boys in Year 9 to be a visible source of disruption. One female peer educator identified the tension between male peer educators and male Year 9 students as flowing from contestations about male authority:
It was like the boys (thinking) oh yeah well he can't boss me around kind of thing and started taking the Mickey and I thought oh well when the girls [peer educators] do it they [Year 9 boys] don't think about it at all...it's like a power thing between the boys.
Peer educators' concerns about and strategies for classroom management
Table I provides information about the extent to which themes relating to concerns and strategies for classroom management were identified across the focus groups. Various concerns were mentioned in all the focus groups, though the extent of the discussion was very variable between groups.
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In 15 of the groups disruption in the classroom was mentioned as an issue. One male peer educator summed up the worst experiences, saying of the Year 9 students in his group:
...they were really horrible, I think...they just wouldn't do anything at all.
General disengagement and disruption of Year 9 students was less common than problems with individual students or groups of students. Achieving lively engagement with the group was important to peer educators, but maintaining this vibrancy while simultaneously keeping control often proved difficult. This issue was discussed in 10 of the 18 focus groups. As one peer educator put it:
It was very hard to keep them quiet `cause you like had to try and make them lively but not too lively.
Peer educators in seven of the focus groups discussed their experience of discomfort from questioning, feeling that it undermined their control of the lesson. Similarly, in seven focus groups there was discussion about difficulties with, or concerns about, managing bullying, teasing or personal comments made by the Year 9 students. Data from the post-programme questionnaires showed that 27% of peer educators reported having had either `a lot' or `quite a lot' of difficulty with behaviour in the classroom and 14% said they would have liked a teacher to be in the room.
There was considerable discussion about different strategies for working with pupils, usually with a focus on how to manage difficult behaviour or how to keep people engaged with the lesson. The most common strategy (mentioned in 15 focus groups) was to split the students into smaller or different groups, in order to separate people who were being disruptive, but also to encourage students to work with people they would not normally work with. Additionally this was seen as a way of involving students who seemed excluded from groups or who did not seem to be participating in the lesson. Other strategies included: directly confronting individuals; actively embarrassing them; threatening to send people out or to a teacher; sitting with or near particular students; `empathy' or trying to see the lesson from their perspective; showing respect and focusing on an end product or summary message to improve comprehension and hence engagement with the lesson.
Perceptions of other factors which influenced the implementation and delivery of the programme
Table II summarizes the analytic themes discussed in this section and provides information about the extent to which these themes were identified across the focus groups.
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In every focus group peer educators mentioned the importance of identifying activities and teaching strategies which engaged, stimulated and informed the Year 9 students. For example, peer educators generally emphasized the positive reaction of Year 9 students to activities such as the condom demonstration and games with condoms which were offered in one session. In contrast, they suggested that Year 9 students seemed less engaged by, and enthusiastic about, aspects of the session on relationships. Peer educators theorized that successful activities tended to be practical, involved moving around, involved learning something new and were experienced as `fun'.
The composition of Year 9 groups was cited in all 18 focus groups as a factor influencing the impact of peer-led sex education. For example, some felt that it was preferable for students in Year 9 to be mixed into groups with people they did not know well, as this would act as a brake on any `playing up'. In contrast, others felt that it was better for the Year 9 students to be in groups with people they did know well, as this would increase how comfortable they would feel. Some peer educators observed that a student's experience of being taught as part of a particular group influenced their behaviour. For example, in one school the peer-led lessons were delivered to Year 9 students in their form groups, an arrangement reserved normally for non-curricular and non-streamed subjects and activities. Peer educators felt that this influenced these Year 9 students to experience the lessons as a `social gathering'.
The extent to which peer educators already knew or got to know the Year 9 students over the course of the three sessions was mentioned by peer educators in 15 of the focus groups. Some of the peer educators commented on how dealing with disruptive students and relating to students more generally, became easier as they got to know the students over the three sessions.
Time management within the lessons was mentioned in 10 focus groups. Most sessions lasted for a double period (between 50 and 80 min). Some peer educators complained about not having sufficient time to cover everything that they had planned for a lesson. Results from the questionnaire survey show that 20% of the peer educators thought there was not enough time in each lesson to deliver the sex education, 54% thought the time available was about right and 19% reported that the appropriateness of time available varied from lesson to lesson.
Issues relating to classroom space and the timing of the sessions in the school day were raised in nine of the focus groups. Peer educators described difficulties with moving around in small rooms and those where the furnishings were fixed, science laboratories being singled out as particularly inappropriate. Working in a drama room was reported as problematic, because peer educators perceived that Year 9 students were used to being noisy in this space and were consequently harder to control.
In terms of the timing of the lessons within the school day, some peer educators described delivering sessions at the end of the day, when student enthusiasm and concentration was exhausted, particularly difficult. Others felt that the gap between lessons was too great. This was the case where lessons were timetabled a week apart, where they were cancelled or where long gaps were necessary because of timetable clashes. Some peer educators also felt that the Year 9 students' enthusiasm for the sex education lessons was influenced by the lessons or activities that these replaced or were timetabled against. The peer-led sessions were delivered in most schools in the summer term. This sometimes produced a clash with examinations and was an issue raised by peer educators in six focus groups. The constraints of school timetables often led to a substantial period elapsing between the two peer education training days and the delivery of the peer-led lessons. This issue was mentioned in 13 focus groups. The optimum time period between training and delivery was suggested as around 2 weeks. Despite these problems, in the post-programme survey only 23% of peer educators reported that participation in the programme had interfered with their studies and only 7% thought that it had taken up too much of their time.
Comments were made about teacher support in 16 of the focus groups and this was the topic of considerable amount of discussion. In 12 of the groups peer educators were critical of teachers' support and in 11 they were positive. Negative comments often related to a perceived lack of help in finding resources such as teaching and writing materials and photocopying, and failure to provide advice on classroom management. Where teachers did provide support, it was welcomed. One peer educator said:
Ms M. was very good because she said that we could buy resources if we needed them and then she would make sure we got the money.
Other peer educators felt that teachers showed insufficient interest in the project and they would have liked affirmation and recognition that what they were doing was important. Criticism of teachers was voiced in relation to their `taking over' by dictating the content of the lessons to be delivered, or interfering by disciplining Year 9 students. One peer educator reported that:
The thing that put us off to a bad start was that teachers sort of laying down the law... big threats that if they [Year 9 students] played us up they were in big trouble.
Another described how she had felt reluctant to draw on teachers for support around classroom management:
I think the teachers underestimated how much power we could probably have...and if we said to them something had gone wrong they thought they had to take over.
Overall, 34% of the peer educators completing the post-programme questionnaire reported that they were very well supported by teachers and only 10% thought that they were not well supported.
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Discussion |
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Most of the peer educators in the RIPPLE study had positive views about school-based peer-led sex education, confirming the findings of previous research (Guy and Banim, 1991
; Fox et al., 1993; Frankham, 1993; Orme and Starkey, 1999). Much of this previous research has focused on two categories of factors which may influence the implementation of a programme: broad contextual factors, e.g. relationships between teachers, health co-ordinators and peer educators (Milburn and Wilson, 2000), and the personal qualities of the peer educators, e.g. how similar they are to the target group or how `outgoing' they are (Orme and Starkey, 1999).
Data presented here suggest that the quality and characteristics of the interaction between peer educators and students within a school-based programme are heavily influenced by contextual factors. When peer education takes place in the school, the context and prevailing culture contribute to defining roles and interaction between young people. Perhaps elements of `teacherlyness' and `disruption' as a ritualized mode of resistance to pedagogy are bound to occur. The cultural weight of the classroom and school context places enormous expectations, in terms of prescribed roles and patterns of behaviour, on all the players in a peer education programme. In her evaluation of an AIDS peer education project in Norwich schools, Frankham theorizes that models of interaction between older and younger students are based on the only available, situated model—that of a teacher teaching—which therefore imposes limits on peer educators' ability to develop a different approach (Frankham, 1998). If it is intended that peer educators are surrogate teachers then training needs to focus closely on developing their classroom management skills. Alternatively, if the interaction desired is to be more informal, then it might be preferable for peer education to be taken out of the classroom or school altogether (Frankham, 1998).
Practical constraints operating in the school context profoundly influence the quality of peer educator–student interaction and the scope for the implementation of a peer-delivered programme. These constraints include limits on available classroom space and teaching time, and difficulties in fitting the training of peer educators and the delivery of the programme around complicated teaching and examination timetables.
Humour and the use of jokes would seem to be a particularly rich vein for further research. In highly hierarchical settings such as schools, humour is particularly important as a way of managing interaction. It serves both to differentiate and unite power relations between people and groups. The role of humour in the formation and management of relationships between young men as peer educators and as members of the target group is particularly interesting. Parody, and physical and verbal joking among boys and young men have all been described in other contexts (Measor et al., 2000), generally as destructive behaviour, but also as behaviour which can be used productively. In the RIPPLE study these ways of behaving were important in determining the limits of relationships between students and peer educators, and as mechanisms for jointly acknowledging their sophisticated resistance to school norms about teaching, learning and behaviour.
Other studies have examined the relationship between adults and peer educators, and, in particular, ways in which adults can work in partnership with peer educators (Massey and Neidigh, 1990; Health Education Authority, 1993; Fife Healthcare NHS Trust, 1996). Our data suggest concrete ways in which teachers can support peer education programmes in schools. Some of the problems reported could be resolved through teachers being more involved in the development of peer-led programmes, and developing ways of providing sustained practical and emotional support to peer educators while leaving control of the programme in their hands.
In presenting these data, we have attempted to make transparent the extent to which an issue was discussed by peer educators by noting the number of focus groups in which it was mentioned and the proportion of codes applied to it by researchers reading the transcribed material. By providing a quantified measure of the frequency with which each theme occurred, we have aimed to provide some additional insight into the data themselves, at the same time as acknowledging that a range of factors may be influencing the frequency with which a theme emerges. Of course, whether something is mentioned more or less times is influenced by factors other than the salience of this issue to the peer educators, including the extent to which researchers prompt for information, how talkative and articulate students are, and the amount of disagreement/debate there is about particular issues. An alternative approach might be for each researcher to score each issue as an assessment of its perceived relative importance to the peer educators. Our initial attempts to adopt this approach were time-consuming and like others, we found it difficult in practice to reach agreement [e.g. (Weinberger et al., 1998)].
The motive for undertaking such a thorough and time-consuming analytic process is to respond to calls for high methodological standards in qualitative research (Blaxter, 1996; Mays and Pope, 2000; Oakley, 2000). Issues of trustworthiness and credibility arise just as much in relation to `qualitative' as to `quantitative' research data; their resolution demands similar standards of rigorous, systematic transparency (Boulton et al., 1996; Medical Sociology Group, 1996; Harden et al., 2000, 2001).
The themes under which findings are reported in this paper result from the independent analysis of the data by two researchers. Although this is a recommended approach (Mays and Pope, 1995; Fenton and Power, 1997), it is rarely undertaken: of 15 process studies of peer-led health education included in one review, only three involved more than one researcher in data analysis (Harden et al., 2001). Weinberger et al. (Weinberger et al., 1998) have noted the difficulty of achieving consistent coding of focus group transcripts by multiple analysts, especially as regards consensus on the salience of particular issues. They also conclude that a single analyst cannot be guaranteed to identify all the relevant data in a transcript. This accords with our experience: disagreement was much rarer than one analyst identifying a theme and the other missing it, and seems to provide a powerful mandate for the use of multiple, independent analysts in order to maximize data extraction. In reflecting upon the use of various methods designed to improve the rigour of qualitative research, Barbour suggests that the value of multiple coding comes from the insights that discussion around disagreements can provide for refining coding frames (Barbour, 2001). Certainly our experience using this approach leads us to conclude that undertaking collaborative analysis of qualitative data has the advantage that it forces researchers to be clear about how they define concepts and justify their choice and application of codes.
One possible source of bias in the experiences and perceptions reported in this paper arises because of missing data, both from whole cohorts of students within some schools and from particular students in others. Despite our efforts, only 71% of those thought to have delivered sessions completed post-programme questionnaires, focus groups were not carried out in three schools, no data were collected in another school where no intervention was carried out and no data were collected from students who volunteered to be peer educators, but who left the programme before the delivery of sex education sessions. In all these instances, the experiences of non-responders may be qualitatively different and possibly more critical than those reported in this paper.
Finally, it is important not to infer from this analysis any conclusions about the effects of the peer-led sex education intervention on the sexual health knowledge, attitudes or behaviour of the students to whom it was delivered. Such conclusions await analysis of the data from the main RIPPLE trial. The data discussed in this paper reflect the peer educators' views of the peer-led intervention; they are valuable in themselves, as descriptions of the processes involved in implementing this approach in schools, and in filling some of the gaps in previous research, but it is also hoped that they will be useful in the main trial analysis in helping to explain why the intervention is, or is not, effective.
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Conclusion |
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This paper has identified and discussed a number of processes identified by peer educators as being central to the implementation of a school-based peer education programme. These included: the nature of the peer educators' role and interaction with other students; peer educators' concerns when carrying out sex education sessions; strategies used by peer educators in the sessions; factors that seem important in determining the younger students' reactions to the sessions; and types of teachers support. We have also outlined some of the methodological issues that arise when collecting, analysing and presenting data from samples such as peer educators in the RIPPLE study in a way that hopefully allows readers to assess the reliability and validity of the conclusions drawn from these data.
We conclude by outlining some recommendations for carrying out a school-based peer education programme based on the issues identified by the peer educators involved in the RIPPLE study.
- Those designing peer education projects in schools need to reflect on the style of interaction desired between peer educators and the target group, to consider peer educators' need for training in classroom management skills, and for being provided with strategies for dealing with bullying and personal comments between students.
- Activities covered in training and included in peer-led sessions should have clear aims, have an obvious relevance to the students, involve learning something new, be practical, not involve too much sitting still and, above all, they should be fun.
- Peer educators should be reassured that even groups of students who have reputations for being difficult to manage may engage well with peer-led sessions. Talking and playing about is to be expected. Joking and humour play an important part in establishing the relationships between peer educators and the target group.
- The time period between the peer educators' training and the delivery of sessions to the target group should ideally be no more than a few weeks. Care should be taken to organize the programme to maximize the numbers of people who can be involved.
- Efforts should be made to ensure that peer educators work with small groups, that the space is suitable and that sessions are not scheduled for the end of the day. It may be a good idea to organize the programme so that peer educators deliver a number of sessions to the same group of students.
- Teachers can most usefully provide support for peer educators by: accessing resources; ensuring sessions are sensibly scheduled in relation to other school activities and that other staff are aware of the peer educators' role; and showing an interest in the peer educators and the programme, and recognizing the potential value of their efforts.
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Acknowledgments |
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We would like to thank the schools and all the young people attending them for their support of the project. Our thanks, too, to the reviewers of an earlier draft of this paper for their helpful comments and suggestions. The study is funded by the Medical Research Council. The RIPPLE team includes Vicki Strange and Ann Oakley (Social Science Research Unit, Institute of Education, University of London), Simon Forrest, Anne Johnson, Judith Stephenson and Stephanie Black (Department of Sexually Transmitted Diseases, University College London Medical School), Angela Flux (State of Flux), and previously included Susan Charleston, Amanda Brodala, Gayle Johnson and Sarah Hambidge.
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Received on March 27, 2001; accepted on July 23, 2001
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