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Review
. 2023 Dec;73(6):975-982.
doi: 10.1016/j.jadohealth.2023.05.035. Epub 2023 Jul 13.

Can Peer-based Interventions Improve Adolescent Sexual and Reproductive Health Outcomes? An Overview of Reviews

Amanda J Mason-Jones  1 , Marlon Freeman  2 , Theo Lorenc  3 , Tina Rawal  4 , Shalini Bassi  4 , Monika Arora  4
Affiliations
Review

Can Peer-based Interventions Improve Adolescent Sexual and Reproductive Health Outcomes? An Overview of Reviews

Amanda J Mason-Jones et al. J Adolesc Health. 2023 Dec.

Abstract

Purpose: An overview of reviews was conducted to summarize the evidence and synthesize the results from systematic reviews.

Methods: The Cochrane and Preferred Reporting Items for Overviews of Reviews reporting guidelines were followed and the protocol was registered. Electronic and manual searches were conducted to identify systematic reviews, published between January 1990 and July 2022. Studies with outcomes relating to all areas of adolescent sexual and reproductive health (SRH) (changes in knowledge, attitudes, beliefs, skills, and practices) were considered. The ROBIS (Risk of Bias in Systematic Reviews) tool was used to assess quality.

Results: A total 1849 articles were retrieved, and eight reviews met the inclusion criteria. Three of the eight reviews included meta-analyses. All three of these reviews demonstrated a significant improvement in HIV knowledge. One reported improved attitudes toward people living with HIV but none found any statistically significant effect on condom use or other SRH behaviors. The remaining five reviews included reports of positive individual study outcomes related to knowledge and attitudes and provided narrative syntheses with regard to recruitment, training, support, and participation of peers. Five of the eight reviews were judged to have a low risk of bias.

Discussion: Our overview demonstrates that peer-based interventions can improve SRH knowledge and attitudes. Evidence of their effectiveness in promoting healthier SRH behaviors is less certain. Any future studies need to investigate which adolescent health outcomes peer-based programs could reasonably be expected to improve using robust methodologies. Additionally, peers need to be meaningfully engaged and acknowledged as experience-based experts.

Keywords: Adolescents; Intervention; Overview of reviews; Peer-based approaches; Peer-education; Sexual and reproductive health.

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Conflict of interest statement

Conflicts of interest: The authors received peer-reviewed funding from the Medical Research Council, UK. The Public Health Foundation of India and the University of York also funded the authors to undertake this work.

Figures

Figure 1
Figure 1
PRISMA flow diagram. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71. For more information, visit: http://www.prisma-statement.org/
See this image and copyright information in PMC

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