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PubMed2002

Parental and peer attachment and identity development in adolescence.

The main aim of this study was to test the situational hypothesis of parent-peer conflict and the parent-peer linkages hypothesis with regard to parental and peer attachment and identity. The situational hypothesis predicts that parental attachment will be associated with school identity and peer attachment with relational identity. The parent-peer linkages hypothesis suggests that parental attachment influences peer attachment and through peer attachment school and relational identity. Data from a survey of 148 middle adolescents from various ethnic groups were used. The findings offer strong support for the situational hypothesis, and only limited evidence in favor of the parent-peer linkages hypothesis. In addition, systematic links were found between parent and peer trust and commitment, and parent and peer communication and exploration. Adolescents from ethnic minority groups reported higher levels of school commitment and exploration compared with indigenous Dutch adolescents.

Adolescent↗

PubMed2006

The roles performed by peer educators during outreach among heroin addicts in India: ethnographic insights.

Peer-based outreach is a popular strategy in which former or current drug addicts are employed as peer educators to contact and educate out-of-treatment addicts. This study examines the interaction patterns that occur during outreach with particular regard to the roles that peer educators perform. Using ethnographic methods, it reports findings from a group of 'peer educators' and 'clients' from Yamuna Bazaar, New Delhi. In this context, peer educators assumed three roles that were co-constructed with clients: 'counsellor', 'doctor', and 'role model'. Analysis of these role-plays revealed three significant patterns. First, the performances involved a hierarchical structuring with the peer educator in an authority position in nearly all interactions. Second, the role-plays were fluid and evolving with peer educators often transitioning across roles during the same interaction. Lastly, role performances appeared to have an underlying role replication mechanism in which roles were learned by first playing the subordinate role (e.g. 'patient') and then performing the dominant role (e.g. 'doctor') with another peer (e.g. new 'patient'). These findings provide insight into issues of empowerment, peer relationship dynamics, and social diffusion processes among drug-using communities, and peer-based situations more generally.

Adolescent↗

PubMed2003

Peer education for HIV prevention in the Socialist Republic of Vietnam: a national assessment.

In 2000, the government of Vietnam conducted the first assessment of its national peer education program for HIV prevention. Twenty (32%) of Vietnam's 61 provinces and urban areas had functioning peer education programs, and program coordinators of all 20 were interviewed regarding their programs. In addition, on-site reviews were done for 10 of the 20 programs, including interviews of peer educators and high-risk persons in each program. The assessment found that a total of 500 peer educators were functioning either independently or as part of one of 79 teams. In the 20 provinces, the peer educators made an estimated 7,000 total contacts per month with high risk persons, but many persons were likely contacted repeatedly. Despite this, coverage was limited: some provinces with high numbers of persons reported with HIV/AIDS had few peer educators. Although most provinces targeted IDU and many targeted CSW, few provinces targeted sex partners of IDU or CSW. The definition of peer education and composition of teams varied substantially by province; only one province included persons living with HIV/AIDS as peer educators. The services provided by peer educators were primarily distributional: delivering information either through word of mouth, pamphlets, or brochures, providing condoms, and sometimes providing clean syringes and needles. Skills building or goal setting interventions aimed at HIV risk reduction were rarely provided. Most provinces had concerns about ongoing funding and sustainability of the programs. Based on the assessment, specific recommendations were provided for strengthening and expanding Vietnam's peer education programs.

Adolescent↗

PubMed2004

A comparison of clinical teaching evaluations by resident and peer physicians.

The purpose of this study was to compare the reliability of inpatient teaching evaluations by resident and peer physicians on Mayo internal medicine hospital services. Three resident and three peer evaluators observed 10 consecutively chosen attending physicians on the Mayo hospital services. Evaluations by resident and peer physicians were compared in terms of mean scores. Kendall's coefficient of concordance (KCC) was used to summarize inter-rater reliabilities and Cronbach's coefficient alpha was used to determine internal consistencies of evaluations by residents and peers. Results of this study revealed that mean scores of the 13 evaluation items were generally higher for resident than peer physicians. None of the items completed by residents had KCC scores >0.5, whereas 10 of the items completed by peers had KCC scores >0.5. Likewise, none of the residents' items had KCC p-values <0.05, whereas nine of the peers' items had KCC p-values <0.05. The overall internal consistency was higher for peers (alpha = 0.76) than for residents (alpha = 0.71). In conclusion, resident physicians uniformly rate faculty highly. Furthermore, peer evaluations yield higher inter-rater and internal reliabilities than resident evaluations, indicating that peer physicians are more reliable than residents for assessing bedside teaching.

Educational Measurement↗

PubMed2006

How the quality of peer relationships influences college alcohol use.

Peer relationships are consistently linked to alcohol use in college students. However, this disparate literature often reveals contradictory findings regarding the precise mechanisms of peer influence. In this review, we use an organisational framework based on social learning theory (SLT) to demonstrate how the quality of peer relationships may influence personal alcohol use. We propose that the quality of peer relationships enhance the influence of social reinforcement, modelling and cognitive processes on personal alcohol use. Research indicates that the quality of peer relationships influences drinking via three pathways: the lack or breakdown of quality peer relationships, alcohol use being an integral part of peer interactions, and if peers disapprove of alcohol use or do not drink. This conceptualisation of peer influence informs the consistent finding of gender differences in college student drinking. Limitations of the reviewed research include reliance on cross-sectional surveys, self-report and homogeneous populations. Future directions for research on quality peer relationships involve detailed longitudinal assessment and the application of advanced statistical methods.

Adult↗

PubMed2006

Peer referral for HIV case-finding among men who have sex with men.

OBJECTIVE: To evaluate the effectiveness and cost-effectiveness of a health department-based peer referral program for identifying previously undiagnosed cases of HIV among men who have sex with men (MSM). DESIGN AND METHODS: Between 2002 and 2005, 283 MSM peer recruiters were enrolled in a public health program in King County, Washington, USA. Peer recruiters were enrolled from a sexually transmitted disease (STD) clinic, an HIV clinic, via media advertisements and through collaboration with community-based organizations (CBO). The peer recruiters underwent a brief training and were then paid US$ 20 for each peer they referred to be tested for HIV, STD and viral hepatitis. Peers were paid US$ 20 for being tested. The main outcome measure was the number of new cases of HIV identified and cost per case of HIV identified. RESULTS: Recruiters referred 498 peers for HIV, STD and hepatitis testing. Among 438 peers not previously diagnosed with HIV, 22 (5%) were HIV positive, of whom 18 received their HIV test results. Other infections were variably prevalent among tested peers: gonorrhea [23/307 (8%)], chlamydia [6/285 (2%)], syphilis [1/445 (0.2%)], hepatitis C [61/198 (31%)], surface antigen positive hepatitis B [8/314 (3%)]. Excluding the costs of testing for viral hepatitis and STDs other than HIV, the cost per new HIV case identified was US$ 4929. During the same period, the cost per new case of HIV detected through bathhouse-based HIV testing and through the county's largest CBO-based HIV testing program were US$ 8250 and US$ 11 481, respectively. CONCLUSIONS: Peer referral is an effective means of identifying new cases of HIV among MSM.

AIDS Serodiagnosis↗

PubMed1996

Correlates of alcohol use and misuse in fourth-grade children: psychosocial, peer, parental, and family factors.

To determine level of alcohol use/misuse and to examine correlates of these behaviors, 1,314 fourth-grade students were surveyed. The questionnaire included 55 items concerning tolerance of deviance, deviant self-image, self-efficacy, susceptibility to peer pressure, personal and peer approval of alcohol use, peer adjustment, parent nurturance and monitoring, family adjustment, parental permissiveness, peer use of alcohol, and exposure to alcohol. The items were factor analyzed and indices constructed. The indices generally had acceptable alpha coefficients (alpha = .61-.91); two exceptions were peer adjustment (alpha = .51) and parental permissiveness (alpha = .42). Tolerance of deviance, deviant self-image, susceptibility to peer pressure, personal and peer approval, peer use and exposure by peers, and parental permissiveness were positively correlated with alcohol use/misuse. Self-efficacy, child-parent interactions, family adjustment, and peer adjustment were negatively correlated with alcohol use/misuse. Implications for the design of family-based alcohol use/misuse prevention programs are discussed.

Adaptation, Psychological↗

PubMed2002

Family physicians' selection of informal peer consultants: implications for continuing education.

INTRODUCTION: Studies of physicians' preferred sources of clinical information suggest that many rely heavily on advice from colleagues. This study examines the criteria that a sample of physicians used to select informal educational consultants, the characteristics of participants adhering to these criteria and those of the peers they consult, and the participants' approaches toward evaluating information gathered from peers. METHOD: In-depth interviews were conducted with 45 family physicians from three mid-sized Ontario cities. A typology of participants' approaches for selecting informal peer consultants was developed from participants' selection criteria. Seven themes emerged from analysis across the interviews, and three types of approaches to selecting peer consultants are characterized with respect to these themes. RESULTS: When seeking clinical information, most participants reported that their first resource was informal consultation with peers. Fifty-four percent turned to readily available and approachable peers, and 24% asked only those peers they considered to be experts. The remaining participants (22%) searched the literature before or in conjunction with consulting expert specialists or innovators. Participants who sought advice from their most readily accessible peers asked for advice most frequently, rarely consulted innovators, and were least critical of the advice they received. DISCUSSION: The profiles of those who sought clinical information from their most accessible peers suggested that the quality of informal peer consultations could be improved through explicit guidelines within formal continuing education programs. Longitudinal studies are needed to examine the effectiveness of this strategy in increasing the translation of research into family physicians' clinical practices and patient outcomes.

Diffusion of Innovation↗

PubMed1983

Improving peer relationships through contracting in primary nursing.

Effective peer group relationships are essential in both primary nursing and the peer review process. Yet professional peer behaviors are frequently lacking in primary nursing groups. These authors believe that if some of the problems in peer relationships are not resolved, primary nursing could be doomed to failure. Here they discuss the concept of "peer contracting" as a potentially useful method for facilitating the development of more professional peer group relationships. From their experience with peer contracting, they present some practical considerations regarding its use and value. Their discussion raises some critical points concerning problems in peer group relationships, and it stimulates further exploration of the nature, use, and implications of peer contracting as a vehicle that can help primary nursing realize its potential.

Evaluation Studies as Topic↗

PubMed1993

The attitudes of family physicians toward the peer review process.

We conducted a study to determine family physicians' attitudes and perceptions toward current peer review practices, and to discover if family physicians, general surgeons, and hospital-based physicians view the process differently. A survey instrument measured perceptions of physicians on the following four areas of the peer review process: (1) how peer reviews are administered, (2) the educational value of peer reviews, (3) the performance of peer review committees, and (4) the effect of the peer review process on physician morale. The survey was mailed to all 3528 practicing physicians who were members of a state medical society. A subgroup of 1695 family physicians, general surgeons, and hospital-based physicians was used for this study, of whom 774 (46%) responded to the questionnaire. Over one half of the family physicians responded negatively toward the peer review process on all items of the survey, with over 70% dissatisfied on five of the 17 items. Family physicians, general surgeons, and hospital-based physicians viewed the peer review process differently in the four areas measured. We found statistically significant differences of opinions regarding present peer review practices among the specialties cited. However, the overall dissatisfaction of the specialty groups studied may suggest that the concern resides more with the profession at large than with any one medical specialty group.

Analysis of Variance↗

PubMed1975

The reward value of peers. A variable influencing the efficacy of filmed modeling in modifying social isolation in preschoolers.

Sixteen socially isolate preschoolers were classified as peer- or non-peer-oriented on the basis of their responses to a test devised to measure the reward value of peers. Half of the subjects in each classification were assigned to a modeling treatment and viewed a film depicting appropriate social behavior in the nursery school; half served as controls and saw an animal film. Peer-oriented modeling film subjects increased significantly more in their peer social interactions at posttest and follow-up assessments than did the non-peer-oriented modeling group. In addition, both peer-oriented and non-peer-oriented modeling groups were significantly higher on peer interaction than the control groups. Alternative and supplemental procedures for increasing isolate preschoolers' social interaction are discussed.

Behavior Therapy↗

PubMed2006

Understanding the experience of being taught by peers: the value of social and cognitive congruence.

BACKGROUND: Medical schools use supplemental peer-teaching programs even though there is little research on students' actual experiences with this form of instruction. PURPOSE: To understand the student experience of being taught by peers instead of by faculty. METHODS: We conducted focus groups with first- and second-year medical students participating in a supplemental peer-teaching program at one institution. From the learner focus group themes, we developed a questionnaire and surveyed all first-year students. RESULTS: Focus groups revealed four learner themes: learning from near-peers, exposure to second-year students, need for review and synthesis, teaching modalities and for the peer-teachers, the theme of benefits for the teacher. Factor analysis of the survey responses resulted in three factors: second-year students as teachers, the benefit of peer-teachers instead of faculty, and the peer-teaching process. Scores on these factors correlated with attendance in the peer-teaching program (P < .05). CONCLUSIONS: Students valued learning from near-peers because of their recent experience with the materials and their ability to understand the students' struggles in medical school. Students with the highest participation in the program valued the unique aspects of this kind of teaching most. Areas for improvement for this program were identified.

Adult↗

PubMed2006

Peer standing and substance use in early-adolescent grade-level networks: a short-term longitudinal study.

Two competing hypotheses were tested concerning the associations between current alcohol and cigarette use and measures of individual, group and network peer standing in an ethnically-diverse sample of 156 male and female adolescents sampled at two time points in the seventh grade. Findings lent greater support to the person hypothesis, with early regular substance users enjoying elevated standing amongst their peers and maintaining this standing regardless of their maintenance of or desistance from current use later in the school year. In the fall semester, users (n=20, 13%) had greater social impact, were described by their peers as more popular, and were more central to the peer network than abstainers (i.e., those who did not report current use).Conversely, in the spring semester, there were no differences between users (n=22, 13%) and abstainers in peer ratings of popularity or social impact. Notably, the spring semester users group retained fewer than half of the users from the fall semester. Further, students who had reported current use in the fall, as a group, retained their positions of elevated peer standing in the spring, compared to all other students, and continued to be rated by their peers as more popular and as having greater social impact. We discuss the findings in terms of the benefit of employing simultaneous systemic and individual measures of peer standing or group prominence, which in the case of peer-based prevention programs, can help clarify the truly influential from the "pretenders" in the case of diffusion of risk-related behaviors.

Adolescent↗

PubMed1985

The consequences of child abuse for the formation of relationships with peers.

The peer interaction of 26 physically abused children was observed and compared to the peer interaction of normal children (n = 26), neglected children (n = 4) and children referred to a child guidance clinic (n = 21). The children were either enrolled in a day-care intervention program and observed in well-established peer groups or not enrolled in peer-based intervention and observed in newly formed peer groups. The hypothesis that abused children who were enrolled in day-care intervention programs would be more competent in peer interaction than abused children who were observed in newly formed groups and not enrolled in peer-based intervention programs was supported. The peer interaction of abused children in well-established groups was similar to that of normal children and more skillful than that of abused and clinic children in newly formed groups. Normal children engaged in similar peer interaction in newly formed and well-established groups. The results are discussed in terms of the social support network provided by the day-care intervention and missing in the family environment of abused children.

Child Abuse↗

PubMed2006

Measuring peer caring behaviors of nursing students: scale development.

BACKGROUND: Caring is one of the most important domains of nursing research, peer caring among student nurses, and its potential effects on nurse caring behaviors remains largely unexplored. Few tools in the literature target peer caring interactions, and which were either irrelevant to our research purpose or culturally inappropriate for nursing student population in Taiwan. OBJECTIVES: The purpose of this study was to develop a culturally sensitive instrument to measure peer caring behavior from the student perspective and to offer a descriptive answer to "what is peer caring in Taiwan." DESIGN: The study uses both qualitative and quantitative methods in developing the "Peer Caring Measurement (PCM)" questionnaire. SETTINGS: Students from a 5-year associate degree nursing program in a university of technology in southern Taiwan were recruited into this study. PARTICIPANTS: Thirteen first- through fourth-year student volunteers between the ages of 16 and 20 were interviewed to explore caring behavior in student peer-to-peer interactions. Two classes from each of the first, second, third, and fourth year students, a total of 360 students were randomly selected to assess the internal consistency of "PCM", and 47 first-year students were conveniently selected to examine the stability of the tool. METHODS: Interviews were conducted in an unstructured manner. Qualitative data were analyzed by a constant comparative method. The questionnaire survey was used to assess the validity and reliability of "PCM". RESULTS: A 17-item "PCM" was developed; the content validity, construct validity, and reliability of the tool were ensured by expert review, factor analysis, and internal consistency. Three factors, labeled assistant caring, academic caring, and affective caring, accounted for 63.197% of the variance. CONCLUSIONS: The "PCM" addressed the multidimensional construct of peer caring. It was validated in a Chinese language version and can be used in college settings to evaluate student interactions and their peer caring behaviors.

Adolescent↗

PubMed2006

African-American and Hispanic adolescents' intentions to delay first intercourse: parental communication as a buffer for sexually active peers.

PURPOSE: Parents and peers often create conflicting influences on adolescent sexual delay. This study examines the moderating effects of mothers' responsiveness during sex discussions on the negative relationship between sexually active peers and sexual delay among African-American and Hispanic adolescents. METHODS: Interview data from 530 African-American and Hispanic non-sexually active high school students were used to examine the effects of mother-adolescent sex discussions and peer norms on intentions to delay or initiate intercourse within the next year. Logistic regression was performed to test the moderating effects of adolescents' reports of mothers' responsiveness (openness, comfort, and understanding during sex discussions) on the relationship between perceived peer sexual activity and adolescent sexual delay. RESULTS: The relationship between mothers' responsiveness during sex discussions, peer sexual activity, and their effects on adolescent sexual delay is complex. Mother's responsiveness had a buffering effect on the negative effects of sexually active peers. Among adolescents who perceived a high percentage of their peers to be sexually active, those who reported that their mothers had above-average responsiveness were 1.6 times more likely to plan to delay intercourse than were adolescents who reported that their mothers had average responsiveness. CONCLUSIONS: Parents and peers are mutually contingent influences in the dynamic social context of adolescents' lives. Although sexually active peers have a negative effect on adolescent sexual delay, responsive parent-adolescent sex discussions can buffer these effects. Intervention efforts can help parents develop the knowledge and communication skills they need to discuss sexual topics with their children effectively.

Adolescent↗

PubMed2006

Escalation and initiation of younger adolescents' substance use: the impact of perceived peer use.

PURPOSE: The middle school years are peak years for substance use initiation. The current study assessed the impact of peer influence on both initiation and escalation of cigarette, alcohol, and marijuana use among sixth, seventh, and eighth graders. METHODS: Youth (n = 974; 45% male) were surveyed twice over an academic year and reported on their personal substance use and their perception of peer substance use. The sample ranged in age from 10 to 15 years at Time 1 (M age = 11.95) and was 44% White, 26% Latino, 7% Asian American/Pacific Islander, 4% African American, and 14% mixed ethnic origin. RESULTS: Hierarchical regressions examined whether personal and perceived peer substance use predicted later substance involvement, and logistic regressions assessed whether Time 1 perceived peer and personal use of other substances discriminated between initiates and noninitiates. After controlling for personal substance use, perceived peer alcohol use predicted both increased alcohol and marijuana use, and perceived peer marijuana use predicted increased alcohol use. Only perceived peer alcohol use was associated with initiation of alcohol, and both perceived peer alcohol and marijuana use predicted onset of marijuana use. CONCLUSIONS: Results highlight the importance of perceived peer use in predicting both onset and escalation of use and suggest utilizing a multifaceted prevention approach that targets multiple substances.

Adolescent↗

PubMed2006

It's good to talk: adolescent perspectives of an informal, peer-led intervention to reduce smoking.

Although peer education has enjoyed considerable popularity as a health promotion approach with young people, there is mixed evidence about its effectiveness. Furthermore, accounts of what young people actually do as peer educators are scarce, especially in informal settings. In this paper, we examine the activities of the young people recruited as 'peer supporters' for A Stop Smoking in Schools Trial (ASSIST) which involved 10,730 students at baseline in 59 secondary schools in south-east Wales and the west of England. Influential Year 8 students, nominated by their peers, were trained to intervene informally to reduce smoking levels in their year group. The ASSIST peer nomination procedure was successful in recruiting and retaining peer supporters of both genders with a wide range of abilities. Outcome data at 1-year follow-up indicate that the risk of students who were occasional or experimental smokers at baseline going on to report weekly smoking at 1-year follow-up was 18.2% lower in intervention schools. This promising result was supported by analysis of salivary cotinine. Qualitative data from the process evaluation indicate that the majority of peer supporters adopted a pragmatic approach, concentrating their attentions on friends and peers whom they felt could be persuaded not to take up smoking, rather than those they considered to be already 'addicted' or who were members of smoking cliques. ASSIST demonstrated that a variety of school-based peer educators, who are asked to work informally rather than under the supervision of teaching staff, will engage with the task they have been asked to undertake and can be effective in diffusing health-promotion messages. Given the serious concerns about young people's smoking behaviour, we argue that this approach is worth pursuing and could be adapted for other health promotion messages.

Adolescent↗