Assessing participation and effectiveness of peer-led approach in Youth Sexual Health Education - systematic review and meta-analysis in more developed countries

Abstract

Sexual health education for youth is not only crucial for norm development but also for protection against vulnerabilities during this stage in life. Although several systematic reviews have examined the effectiveness of peer-led sex education, none have focused on the extent of peer participation. The purpose of this review was to evaluate peer-led sexual health education interventions in More Developed Countries (MDC). Electronic and hand searches across five social science, education, and medical databases were conducted. Fifteen articles were selected in total. Most (10/15) studies gave low or no responsibility to peers. The majority of articles found improvements in sexual health knowledge (13/14) and attitudes (11/15) at post-intervention stages. Two studies showed improved self-efficacy and three showed behavioural changes. A preliminary synthesis of effectiveness and level of participation was done. Meta-analysis revealed a large effect on knowledge change (Hedges’ g=0.84, 95% CI: 0.43-1.25) and a medium effect on attitude change (Hedges’ g=0.49, 95% CI: 0.19-0.80). Peer-led sexual health education could be a powerful tool. However, further research and action are needed to understand optimal implementation better.