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PubMed2002

Breastfeeding peer support: maternal and volunteer perceptions from a randomized controlled trial.

BACKGROUND: Several studies have demonstrated the positive effects of peer support on various breastfeeding outcomes, but no study has assessed women's and peer volunteers' views on, or the nature and intensity of, the supportive intervention. The objective of this study was to describe maternal and peer volunteer perceptions of their experience while participating in a breastfeeding peer support trial. METHODS: A randomized controlled trial was conducted to evaluate the effect of telephone-based peer (mother-to-mother) support on breastfeeding duration. Two hundred and fifty-six primiparous breastfeeding women were randomly allocated to receive either conventional care or conventional care plus peer support. Three primary outcome measures were peer volunteer activity logs, maternal perceptions of peer support, and evaluations of the peer volunteer experience. RESULTS: Questionnaires were completed by 98.5 percent (n=130) of the mothers in the peer support group. Mothers reported their peer volunteers were available when difficulties were experienced, increased their confidence, decreased their concerns, and assisted them in reaching their breastfeeding goals. These supportive interactions resulted in 81.5 percent of mothers (n=106) being satisfied with their peer support experience and suggesting that every new mother should be offered this intervention. Similarly, all the peer volunteers interviewed (n=30) viewed their experience positively. They suggested some intervention modifications as follows: ensure that mothers enrolled in the program want peer support; provide peer volunteers with ongoing educational sessions and opportunities to "socialize" with other volunteers; and disseminate the results of peer support efforts. CONCLUSIONS: Both mothers and peer volunteers perceived their intervention experiences positively. Whereas maternal satisfaction was related to the number and duration of peer volunteer contacts, peer volunteers enjoyed their training session and the opportunity to assist mothers for a variety of reasons. Specific intervention modifications should be implemented to enhance peer volunteer satisfaction and retention.

Adult↗
PubMed1988

Lessons drawn from observing young peers together.

Based on studies during the past 13 years of what transpires between young peers, lessons are drawn about the nature of human sociability and the development of social skill during the first three years of life. Peer encounters have proven especially helpful for discovering the forms of sociability and social skill the infant is capable of without the aid of a more skillful social partner. From early in infancy, children are quite sociable with peers (age-mates), both in novel play settings and in their own home or customary group care settings, both with an unfamiliar peer and with those quite familiar, both at the start of acquaintanceship with a particular peer and after many encounters with that peer. Their sociability is seen in their attraction to peers, their directing to peers of such distinctively social behaviors as vocalizations, smiles, and gestures, and the predominantly friendly nature of their behavior. Peer encounters in the absence of customary play materials refute claims that attraction to peers is a by-product of interest in toys and the inanimate spectacles peers create through their actions on toys. Distinctions should be drawn between sociability and social skills, especially interactive skills. Interactive skills are systematic ways the young child relates his/her own behavior to the details of a partner's behavior that function to facilitate such valued social outcomes as the generation of a cooperative game or a conversation or the resolution of a dispute. Observations of young peers highlight the distinctive nature of the infant's interactive skills. Social influence between peers is present from 6 months, but rarely takes the form customary for older children. Joining a peer and manipulating the same play material as the peer are rudimentary interactive skills that emerge by 12 months. Interactive skills enabling the generation of extended sequences of social interaction on a common cooperative theme progress rapidly during the third year of life. The distinctive form of the young child's interactive skills produces distinctive patterns of interaction among young peers. Their interactions are managed largely nonverbally well into the third year of life, and extended cooperative interactions most often take the form of games in which one or both children imitate each other's actions. Despite the predominance of imitation, their encounters are also marked by complementary role relationships. The distinctive features of peer encounters prompt speculations about the role peer encounters can play in early development.

Child, Preschool↗
PubMed1981

Peer and maternal influences on the expression of foot-clasp mounting by juvenile male rhesus monkeys.

The display of adultlike foot-clasp mounts by male rhesus monkeys occurs during the 1st year of life in animals reared with their mothers in social groups where peer interaction is possible 24 hr per day. In contrast, this form of mount is rarely displayed if infants are separated from their mothers at 3 months of age and allowed daily .5-hr periods for peer interaction. To distinguish between maternal and peer access-time influences upon the development of this response, we housed rhesus monkeys with their mothers and allowed either .5-hr or 24-hr daily access to peers in the presence of their mothers during the 1st year of life. Male infants restricted to .5-hr periods with peers rarely or never foot-clasp-mounted peers, although 3 of 6 males foot-clasp-mounted their mothers. In contrast, males given 24-hr access to peers regularly mounted peers using the foot-clasp mount. Males from the 2 groups did not differ in total frequencies of all mount types displayed, only in the display of foot-clasp mounts. After maternal separation at the end of the 1st year, rearing effects on the display of mounting persisted into the 2nd year. Males that received 24-hr daily peer access during the 1st year continued to foot-clasp-mount peers whereas .5-hr males failed to do so, indicating that the experience of mounting one's mother with the adult posture was not sufficient to support peer-oriented foot-clasp mounting at a later age. In addition to deficits in peer-oriented foot-clasp mounting. .5-hr infants displayed higher frequencies of threat and withdrawal behaviors to peers and presented to peers less frequently than did infants from the 24-hr rearing condition. These results contradict a motor deficiency hypothesis to account for the rare display of foot-clasp mounts to peers by males receiving .5-hr daily access to peers during the 1st year of life. Instead, data support the view that .5-hr animals either failed to develop positive response patterns necessary for the execution of the foot-clasp mount, or learned negative patterns of social interaction that prevented the display of this cooperative behavior.

Aging↗
PubMed2002

Tapping youth as agents for change: evaluation of a peer leadership HIV/AIDS intervention.

PURPOSE: To evaluate the impact of a community-based HIV/AIDS peer leadership prevention program on newly enrolled peer leaders and youth enrolled as peer educators for one or more years (repeat peer leaders). METHODS: Quasi-experimental nonrandomized design with two intervention groups (newly enrolled and repeat peer leaders) and one comparison group. The sample consisted of 235 adolescents, 164 peer leaders, and 71 comparison youth, drawn from nine communities in Massachusetts. The intervention consisted of a short course and ongoing group work with an adult advisor to plan and implement HIV/AIDS outreach activities for youth. A confidential questionnaire administered at baseline and postintervention measured change in (a) HIV/AIDS knowledge, (b) planning and presenting skills, (c) self-efficacy, (d) perception of one's self as a change agent in the community, and (e) sexual risk-taking behaviors. Information was collected from both groups of peer leaders on specific activities resulting from the program and perceived benefits. Data were analyzed by both descriptive and multivariate statistics. RESULTS: Over a 9-month period newly enrolled peer leaders had significantly higher mean scores for HIV/AIDS knowledge and perception of one's self as a change agent in the community than comparison youth. On all baseline outcome measures except risk-taking behaviors, repeat peer leaders reported higher scores than newly enrolled peer leaders. Post-intervention, HIV/AIDS knowledge continued to increase significantly more among repeat peer leaders compared with those newly enrolled in the program. Repeat peer leaders also reported more benefits from peer leadership training. CONCLUSIONS: A peer education program was found to have benefits to adolescent peer leaders. Benefits gained from the program were sustained and enhanced over time as evidenced by repeat peer leaders included in the study.

Acquired Immunodeficiency Syndrome↗
PubMed2000

STI prevention and the male sex industry in London: evaluating a pilot peer education programme.

OBJECTIVE: To evaluate the effectiveness of a pilot peer education STI prevention programme with male sex workers. DESIGN: A process and outcome evaluation of the pilot programme undertaken in three London male escort agencies, using a quasi-experimental design. SUBJECTS: Workers in three London escort agencies, including 88 who completed a questionnaire, five peer educators, and a further 16 men (including management) working in two of these agencies. METHODS: A peer education STI prevention programme run by the Working Men Project (WMP), a specialist sexual health service for male sex workers, was piloted in two London escort agencies. Five male sex workers participated in a 2 day peer education training programme. They then returned to their respective agencies to disseminate information and condoms, in an attempt to influence norms of behaviour. An outcome evaluation aimed to assess changes in STI related knowledge, high risk sexual behaviour, and attendance at a sexual health service. A pre-intervention questionnaire assessing variables such as STI related knowledge, sexual behaviour, and demographic information was administered in both agency A and agency B and a third agency, C, which acted as a control. Ten weeks after the peer educators returned to their agencies, the same questionnaire was administered in the same agencies. Peer educator referrals to the WMP were also recorded over this time period. The process evaluation involved interviews and focus groups with peer educators, and the completion of diaries about their experiences in the role. A further 16 men working in the agencies (including managers and an owner) were interviewed about their experience of the programme. Participant observation was also undertaken through regular outreach work to the agencies. RESULTS: 57 men completed the questionnaire at time 1 and 44 at time 2. Unfortunately, only 13 of these were matched, precluding any meaningful analysis of change in STI related knowledge and sexual behaviour. The questionnaire provided a profile of the men working in the agencies. Of the 88 men who completed the questionnaire at least once, the majority were homosexual, and in their late teens/early 20s. Most were of a "white" ethnic group, though there was some range within these categories. Most preferred to speak English and education levels were high. Relative STI knowledge revealed a high understanding of HIV and hepatitis B, moderate understanding of gonorrhoea, syphilis, genital warts and herpes, and little knowledge of non-specific urethritis (NSU) or chlamydia. Sexual behaviour suggested a highly sexually active population with both male and female paying and non-paying partners. Condom use was highest for paying partners, particularly for anal sex. Condom use for oral sex with all partners was less consistent, and condom use for all types of sex with regular partners was lower than with other partners. The small number of men engaging in vaginal sex with paying and regular partners were less likely to use condoms. 26 new patients registered at the WMP as a result of peer educator referrals, representing 65% of all new contacts over the study period. The process evaluation revealed that while the training programme was considered adequate and while peer educators felt the programme and their roles to be a success, their experience of the role was difficult. The role of management support was crucial in supporting the programme. The assumption that "peers" are particularly effective educators was not borne out by the results. While peers were considered suitable to discuss some aspects of the industry, many preferred to consult "professionals" about health related matters. The concept of "peers" was problematic with most of the men drawing "peers" from subgroups within the agencies. Other constraints on behaviour such as a lack of power, particularly with regard to a lack of management support, or poverty, had a substantial impact on behaviour which were not influenced by the peer educators. CONCLUSIONS: The study illustrated the difficulties of utilising quasi-experimental evaluation methodology with this client group. It also demonstrated the limitations of peer education based on information provision health education models which focus on individual behaviour change. Suggestions are given for future interventions.

Adolescent↗
PubMed2006

Effects of rater selection on peer assessment among medical students.

CONTEXT: Although peer-assessment appears promising as a method to assess interpersonal skills among medical students, results may be biased by method of peer selection, particularly if different kinds of classmates are assigned systematically by different methods. It is also unclear whether students with lower interpersonal skills may be more negative towards their classmates than students with higher levels of interpersonal skills and, if so, how much bias this may introduce into the results of peer assessment. It is also unclear whether low-rated students are more likely to ask to rate one another. DESIGN, SETTING, AND PARTICIPANTS: Participants were 296 medical students from the classes of 2004, 2005 and 2006 at the University of Rochester School of Medicine and Dentistry. All participants were evaluated by between 6 and 12 classmates near the end of both their second and third years. In some classes peer-raters were assigned from class lists, while in other classes students were asked to recommend classmates to rate and be rated by. MAIN OUTCOME MEASURES: Mean numerical ratings of interpersonal-attributes scores received from peers, compared with mean scores simultaneously assigned to peers. We also examined students' selection of peer-raters, as well as scores received by their peer-raters. RESULTS: For all 3 classes in both second and third years, students in the lowest quartile of received scores were significantly more likely to simultaneously assign lower scores to their peers. Among third-year students, such low-scoring students were significantly more likely to ask to rate and be rated by other low-scoring students. Among third-year students, low-rated students were more likely to rate and be rated by other low-rated students, irrespective of how rater assignments are made. Most students who were originally in the lowest quartile of received scores remained so after removing the scores assigned by low-rated raters. Among pre-clinical second-year students, however, low-rated students were no more likely than high-rated students to be rated by other low-rated students. CONCLUSION: Students with low levels of peer-assessed interpersonal attributes are more negative in their judgements of classmates. Third-year medical students with low levels of interpersonal attributes are more likely to be rated by other students with low levels of interpersonal attributes, irrespective of method of rater assignment. This effect was not seen in the second year of medical school. Biases in selection of raters among third-year students, however, do not appear to affect the results of peer assessment. Thus, medical schools that choose to institute peer assessment can select the method of peer-rater assignment based on practicality and logistical considerations. Students' affiliations with one another in the third year appear to be related to peer-assessed interpersonal attributes.

Clinical Competence↗
PubMed2006

Learning partnership--the experience of peer tutoring among nursing students: a qualitative study.

BACKGROUND: Peer tutoring involves students helping each other to learn. It places teaching and learning commitments and responsibilities on students. Considerable evidence supports the positive effects of peer tutoring, including cognitive gains, improved communication, self-confidence, and social support among students. Peer tutors are also said to better understand the learning problems of fellow peer learners than teachers do. OBJECTIVE: This study intended to facilitate the development of 'cooperative learning' among nursing students through a peer-tutoring scheme. STUDY METHOD: Undergraduate nursing students were invited to join a peer-tutoring scheme. Fourteen students studying year 3 were recruited to serve as peer tutors and 16 students from year 2 of the same program participated as tutees. Peer tutors attended a training workshop and received a guideline for peer-tutoring activities. They were to provide a total of '10 weekly tutoring sessions throughout the semester on a one-to-one basis for their tutees. Focus groups and individual interviews were conducted in the middle and at the end of the semester to evaluate the students' experiences in the tutoring process. RESULTS: Content analysis of the interview scripts identified that students had both positive and negative experiences from the peer tutoring, but that positive experiences predominated. Positive aspects included enhancement of learning skills/intellectual gains and personal growth. Negative experiences stemmed mainly from frustrations in dealing with mismatched learning styles between tutors and tutees, and the required time commitment. CONCLUSIONS: Both tutors and tutees benefited to some extent from this peer-tutoring process. Further studies in an education program for students in all years should be implemented to examine peer-tutoring effects. Implementation of peer tutoring should address the frustrations and difficulties encountered by the students to facilitate better outcomes.

Adult↗
PubMed2005

Peer and parental influences on adolescent smoking.

PURPOSE: The purpose of this study was to determine the relationship between peer and parental factors and smoking behavior of adolescents in urban cities and to investigate whether there are gender differences. METHODS: A stratified and random cluster sampling design was used to obtain a cross-sectional sample of high school students in two urban cities. The sample consisted of 512 Korean adolescents (256 boys and 256 girls) aged 15 to 18 (mean age 16.7+/-.58). Self-reported questionnaire consisted of adolescent smoking behavior, peer smoking and alcohol use, parental smoking and alcohol use, father-mother-peer relationships and perceived social support from peers and parents. Multiple logistic regression analysis was used to examine the hypothesized model. RESULTS: The findings showed that peer and parental factors accounted for 30.3% of the variance in adolescent smoking and peer smoking was most strongly associated with adolescent smoking behavior (OR=10.18). In addition, peer smoking (OR=4.71), peer alcohol use (OR=4.21), and peer relationships (OR=1.03) were significantly associated with boys' smoking behavior. In girls, peer smoking (OR=26.50) and parent smoking (OR=5.48) were significantly associated with smoking behavior. CONCLUSIONS: Consistent with previous findings, peer smoking is a significant factor on adolescent smoking. Specifically, boys would be more influenced from peers than girls. Therefore, smoking prevention programs for adolescents might be focused on the social context such as, resisting to peer pressure and enhancing the self-efficacy to control.

Adolescent↗