Peer domain

Peer support

A peer support relationship is based in the equality of the participants. It centres around support and connection being provided by someone who is relatable and potentially more credible to the young person as a member of their peer group.

Peer programs comprise activities led by peers of the same age or older age in formal and informal settings such as schools, community centres, and youth clubs.¹¹ In education settings they are usually one component of a larger program, rather than a sole intervention.⁴

Evidence supporting this approach

There is evidence for peer support approaches that is promising,⁵ however, program design should be mindful that some peer support initiatives may

lead to an increase in AOD use.^{4, 5}

A systematic review and meta-analysis of peer-led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11-21 years identified 17 eligible studies representing 13,706 young people from 220 schools.¹¹ This review could not compare or assess the various types of peer interventions to identify the most or more effective types, nor could it identify the most effective sites for action or the most effective duration of programs. Nor were all the studies positive or neutral in outcome. In two studies the intervention group increased their use of substances over the control group.

The authors concluded that peer interventions have a role to play in preventing alcohol and drug use among adolescents, but they noted that their findings were limited as they could not identify effects on socio-economic, gender and ethnic subgroups.

Analysis of six of the studies supported an association between peer-led interventions and lower odds of alcohol use and a meta-analysis of three studies suggested peer-led interventions reduced cannabis use. The authors noted, however, that their findings were limited by poor quality evidence, recognising a need for more rigorous studies with a longer follow up period.

Research further suggests that, if implemented, peer-led interventions should be part of a larger program of prevention and not stand-alone programs.

Best practice peer education programs include the following attributes:⁴

• are led by peers who are nominated by peers; rather than non-peer adults
• if the initiative involves peers sharing the messaging through their social networks, that the peer group has not already started using alcohol or other drugs
• peer leaders role-model the desired behaviour
• involve young people who will be engaged in the program in the development of the content.