Scott M. Butler, PhD (c.), MPH, MS, CPPE*
Rose M. Hartzell, MS, CHES
Catherine Sherwood-Puzzello, HSD, MPH, CHES
* Contact information for first author
Department of Health and Kinesiology
800 W. Stadium Avenue
West Lafayette, IN 47907-2046
Peer education, facilitation, and counseling programs are commonly utilized in primary and secondary prevention programs within colleges and universities. In addition, peer-based human sexuality discussions have been used as an adjunct to traditional human sexuality pedagogic programs over the last 20 years. Whereas ample evidence suggests that peers can be successful in reaching target populations, few evaluations have assessed the perspective of the peer helper. This study qualitatively assessed the perceived benefits among human sexuality peer facilitators. Transcript analysis of focus group sessions revealed five categories of benefits associated with participation in the program: professional development, exposure to diversity, sexual attitude reassessment, relationship enhancement, and presentation/group facilitation/communication skills. These results have programmatic and practical implications for college health and peer helping professionals. The variety of perceived benefits associated with participation in the program can be used to recruit facilitators and provide a basis for funding peer-based pedagogic and prevention programs.
Peer-based education strategies have been utilized on college campuses over the last 50 years (Helm, Knipmeyer, & Martin, 1972). Since then, peer helping has become a critical component of college health programming and pedagogic programs at many colleges and universities. Peer helping can best be viewed as an umbrella term covering a diverse range of different approaches used to empower others about relevant topics, scenarios, and life skills. The term “peer” has taken on several cultural constructions with regard to the collegiate population. Peers may exhibit a similarity in age, ethnicity, sexual orientation, lifestyle, social economic status, or other social ecological factor. Peers have been utilized in a variety of scenarios and situations and can be used to educate, facilitate, and counsel (Shiner, 1999).
The use of small group discussion, including sessions facilitated by peers, has been utilized in collegiate sex education settings to enhance the learning process since the 1980s (Barbour, 1989; DeLamater, Hyde, & Allgeier, 1994; Strouse, Krajewski, & Gilin, 1990). Peers also have been used as an effective outreach risk-reduction tool regarding sexuality-related topics. An investigation conducted by Richie and Getty (1994) discovered first-year college students who attended a peer-based sexuality program were more likely to have had an HIV-antibody test during the school year and use condoms during their sexual encounters. In addition, they were more likely to ask their sexual partners about previous sexual behaviors, request their partners be tested for HIV, cease sexual activity without the availability of a condom, and negotiate sexual monogamy.
Sexuality-related pedagogic programs in which peers are included as a fundamental programmatic asset have been implemented in adolescent populations (Evans, Rees, Okagbue, & Tripp, 1998; Strange, Forrest, & Oakley, 2002; Ebreo, Feist-Price, Siewe, & Zimmerman, 2002). In a study of peer educators, single session educational lectures, and a control group,peer education was found to be an effective HIV/AIDS pedagogical tool and was found to elicit change in students’ knowledge and attitudes (Ergene, Cok, Turner, & Unal, 2005).
Strange and colleagues (2002) conducted a randomized controlled trial of peer-based human sexuality pedagogic programs in secondary schools located within the United Kingdom. Twenty-seven schools were selected for participation in the study. Fourteen schools were randomly assigned to include a peer-based pedagogic method and 13 were assigned traditional teacher-based teaching techniques. Pre- and post data from 268 peers indicate statistically significant increases in knowledge related to female condoms, emergency contraception, cervical caps, and intrauterine devices. When assessing the change in the peers’ attitudes towards sexological issues, results indicate 19% (n=51) of the participants adopted more positive attitudes towards men having sex with other men and 20% (n=53) more positive attitudes towards women having sex with other women. When asked if participation in the program facilitated an increase in teaching and presentation-related confidence, statistically significant changes were observed in implemented classroom sessions, dealing with difficult behavior, alleviation of embarrassment, having adequate sexuality-related knowledge, and dealing with personal questions.
Data from 331 of the peers were procured in which the perceived impact of the program upon the peers’ sexual attitudes, confidence and behavior was assessed.
Fifty-eight percent of the participants (n=193) responded “very or quite likely” when asked if the program changed their opinion on sexual matters, 40% (n=133) when asked if the program made them more confident about getting what you want from a relationship, and 35% (n=115) when asked if the program influenced their sexual behavior.
Although ample investigations such as these and others have assessed the outcomes of peer-based programs, few studies have assessed the perspective of the peer. However, peer perspective studies are warranted as the peer’s viewpoint and experiences may provide valuable information regarding decisions to volunteer as a peer helper and the overall impact of the program upon the peer.
In a focus group study conducted by Klein and Sondag (1994), peer health educators’ motivations for participation in the program were assessed.Nineteen peers participated in five focus group sessions at a midsized university. Results indicate that participatory motivations were thematically based upon previous family experiences, personal experiences, previous observations of their peers in the program, perceived ability to help others or themselves, and the procurement of an experience that would enhance their public speaking and/or future career potential.
Participation in peer-based programs has been shown to be beneficial to the peer (Hamilton, 1992; HEA, 1993; Klepp, 1986). Collegiate sexuality-related peer programs have been hypothesized to facilitate a change in self-esteem and reduction in high-risk sexual behavior. Sawyer, Pinciaro, and Bedwell (1997) recruited 65 participants from sexual health peer programs located within 10 universities. Preliminary data were collected prior to participation in the peer program and posttest collections took place after one and two semesters. While non-significant changes occurred in the quantitative assessment of the variables, the assessment of open-ended questions indicate that 81.5% (n=53) of the peers believed they had changed as a result of the peer training and/or experience. Thirty percent (n=19) of the participants indicated that they had increased their level of sexuality knowledge, 20% (n=14) had increased their self-esteem, 15% (n=10) practiced safer sex more frequently, and 14% (n=9) indicated that they were more open to their peer’s behaviors and opinions.
The overarching purpose of the present study was to qualitatively assess the perceived benefits associated with participation in a human sexuality peer facilitation program. Focus groups were used to provide a more in-depth assessment of the perceived benefits exhibited by the peers regarding their experience.
Peer Facilitation Program
The university sponsoring the peers of the current study hosts a survey undergraduate human sexuality course that routinely enrolls 1,000 or more students per academic year. In order to provide an experience that is intellectually sound, non-judgmental, and innovative in nature, the professors/instructors recruit undergraduate and graduate peers to serve as course adjuncts. The core responsibility of the peers includes the facilitation of weekly in-person human sexuality discussions, attendance management, grading of assignments, and assistance in solving student dilemmas. Topics of weekly discussions include contemporary sexological issues such as safer sex, gender construction, sex research, sexual communication, sexual scripts, and sexual reform. For their contributions to the program, peers earn three academic credits.
Although the program has been in existence in its original format for 20 years, instructors have recently implemented an online option wherein the peers facilitate weekly discussions through threaded online forums. In addition, faculty members also have piloted a combination experience in which the peers host several in-person discussions per semester in addition to weekly online forums.
Human sexuality peer facilitators from a state-funded Midwestern university were recruited to participate in focus group sessions. A qualitative design and analysis was chosen as the ideal data collection method due to the stimulation of discussion that is created through this strategy and the richness of data procured. In addition, previous investigations have successfully utilized focus group methods in assessing sexuality-related topics (e.g., Graham, Sanders, Milhausen, & McBride, 2004; Yarber & Sanders, 1998). All study procedures were approved by the institutional review board at the university. The primary investigator contacted five faculty members who were currently sponsoring the undergraduate human sexuality course and asked permission to recruit participants during instructor-peer debriefing sessions. Upon receiving permission from interested faculty, the investigator visited five debriefing sessions to recruit participants through the distribution of a flier and a class announcement. Three of the faculty members utilized the in-person only method, one the online only method, and one the combination method. Inclusion criteria for the participants were: English speaking, at least 18 years of age, and registered for the peer facilitation course at the university. Compensation of $20 was offered to participants.
Standard suggested procedures were utilized in the conduction of the focus groups (Denzin & Yvonna, 1994; Morgan, 1988). Four semi-structured mixed focus group sessions were conducted in the fall of 2004 and spring of 2005 with the primary investigator serving as the moderator. After previously recruited participants responded to an invitation by e-mail, the primary investigator sent (by e-mail) a brief demographic questionnaire and a study information sheet. The demographic questionnaire included questions pertaining to age, gender, class standing, sexual orientation, academic major, and previous job experience related to the fields of sexology and education. Participants were asked to review the study information sheet and complete the demographic questionnaire prior to attending a focus group session and completed materials were collected by the primary investigator prior to participation in a session. All participants were sent reminder e-mails two days before the focus group with the time and place of the session that they were scheduled to attend.
The focus groups were conducted during weekends in a private conference room located near campus and participants were given one hour to discuss the various perceived benefits associated with participation in the program. Each session occurred thirteen weeks into the academic semester, allowing ample time for the peer facilitators to develop opinions regarding their involvement in the program. While the only structured question for the focus group sessions was “How have you benefited from being a sexuality peer facilitator?”, the moderator allowed ample interaction between the participants to provide more in-depth responses. Each focus group was moderated by the primary investigator and audio taped for later transcription. The transcripts did not identify individual participants.
A total of 21 peer facilitators attended the four focus group sessions (n=7, n=7, n=4, n=3). The M age of the participants was 21.76 years. Sixteen of the participants were female and five male. Nineteen identified as Caucasian, one as Asian/Pacific Islander, and one as African American. Twenty of the participants identified as heterosexual and one as bisexual. Seventeen were undergraduate students and four were enrolled in a masters program. The majority of the participants (n=11) were enrolled in an academic major in the School of Health, Physical Education, and Recreation. In addition, seven of the participants were enrolled in the School of Arts and Sciences, two in the School of Education, and one in the School of Continuing Studies. Five of the participants were currently enrolled in the university undergraduate human sexuality minor, and 11 had previously held a part time job related to sexology or education. Thirteen of the participants utilize the in-person discussion method, three the online method, and five the combination method.
To establish reliability, the transcripts were analyzed by both the lead author and second author for emerging themes. Strategy for analyzing the results reflecting recommendations made by Krueger (2002) and included initial coding by multiple investigators, preliminary establishment of themes, consensus by the investigators, and finalization of themes. Because this was an exploratory investigation, the participants were given ample time to provide a variety of responses to the primary research question as well as interact with each other. When the participants created a potential theme associated with participation in the program, the moderator allowed for ample discussion and response time to further investigate its importance. Overall, all of the participants contributed to the sessions with varying degrees of participation depending on their own assessment of their ability to contribute to particular themes.
Initially, the two investigators analyzed the transcribed sessions independently and coded the themes as they emerged throughout the sessions. Afterwards, the investigators met to discuss the results of their coding schemes and to establish potential themes. After comparison of findings and the establishment of consensus by the investigators, it was decided that the codes reflected five themes which reflected benefits associated with participation in the sexuality peer facilitation program. These themes included: professional development, exposure to diversity, sexual attitude reassessment (SAR), relationship enhancement, and presentation/group facilitation/communication skills. These themes have been presented below with illustrative quotes. In each case, quotes from multiple participants were chosen to represent the interactions and beliefs of the group . In all of the quotes, “P-1”, “P-2”, “P-n” represents quotes from different participants.
Career preparation experiences have been shown to enhance job procurement potential in recent college students (Sagen, Dallam, & Laverty, 2000). In the present study, participation in the program acted as a form of professional development for several of the participants. This included increased interest in a field related to human sexuality or education and/or a field experience that may enhance their ability to acquire a future occupation.
P-1 If someone came to me today and told me that he would pay me a salary to do this, I would do it without a second thought, I would just do it, I mean …I love it…I don’t know if I am going to end up in graduate school but I have been studying psychology for 3 years. I have always wanted to go into counseling and the interpersonal relationships which I get out of this are helpful. I don’t want to do research. I’m more interested in applied health science, key word “applied” so that is something I will definitely look for and I hope that I can find something very close to what I am doing here because I really do like it a lot.
P-2 I was talking to my friend the other night and I was like, “you know this is my last semester here. I have been here for four years.” I was like, “I am not quite sure what I want to do, but nothing has been more enjoyable to me then teaching this discussion.” And it’s like I don’t really know if I want to be a teacher or work in a university but maybe do something like peer education and human sexuality. That’s almost like, exactly like, something I would like to do. I really would have never found that out so if I wouldn’t have done this, because I never really considered something like that.
P-3 My major is public health with a minor in human sexuality so I know I want to talk to minorities about issues and most of the issues we have are related to sex anyway like AIDS and pregnancy. So this is what I would want to talk about. There are a lot of things that my instructor did that I know if I did have to plan a group I would use. I mean I would have a lot of resources and ideas. [Group 1].
P-1 I think this was the turning point for me because after being a discussion leader I decided to go ahead and apply for my PhD and fortunately I did get admitted into it and I want to concentrate in human sexuality. I think this class was my turning point.
P-2 I think that when you go to an employer or a law school and graduate school or whatever and they look at your resume they will see that you were a human sexuality discussion leader and be like “oh that’s interesting, tell me more about that.” Then they start getting some answers other than the ones that were just given by others. And I think that at least in their mind that might give you more skills and you might stick out more in their minds.
P-3 I’m currently an education major and it’s a great experience to understand. This is my first time kind of being in a classroom setting, and just understanding the time management, and the time you have, and the material that you have to get through in that day. It’s been a great experience.
P-4 I think I am learning to be a leader and I think that’s going to be part of my career in some way. So I think that I am the president of a club and I think that this and all of those experiences just help me shape my leadership skills more and I think that it will always be useful no matter what I am doing. [Group 2].
P-1 I not really sure exactly what I want to do, but it helps, I definitely think it helps because I know I want to do something with counseling or with education or public health and it’s just kind of broad so, I mean doing this is and having to actually grade their assignments and having students be like “oh, I am sorry that I turned it in late” and that kind of teaching effort I know I don’t really like that and I would just sit back and think “Oh, maybe I don’t want to do the education side of it.” It helps you think about it a little more too, I don’t know, I think it helps.
P-2 I also think that being a discussion leader has helped me because not only am I a discussion leader, I am going to minor in human sexuality and I think that is going to help my career even if I don’t necessarily use it. It still makes me more qualified for whatever I am going to do. [Group 3].
P I think that this is going to help me down the line because whatever I am doing is definitely going to have presenting ideas to people and I think I have …and really what we are doing in this class are presenting ideas and trying to get them to grab onto them and move forward with them. Because no matter what you do, you don’t want to come in and preach to people. You want them to be interested from the first word you say. So that’s a really a tool and skill to build. [Group 4].
Exposure to Diversity
Diversity within the collegiate environment is seen as an asset and an overall critical tool for the facilitation of learning by collegiate sex educators. Although many individuals may feel intimidated or underexposed to diversity related to human sexuality, the constructed environment provided by the sessions appears to enable the expression of diverse opinions. The participants reported that participation in the program provided useful exposure to diverse opinions and attitudes related to human sexuality. This included views of individuals of various ethnic backgrounds and sexual orientations.
P I think it’s more personal because you get to hear like people’s views that are straight, people that are gay, White, Black you know you just get to get a different expression of everybody’s. . . sexual … you know experience . . .it’s cool . . . you learn a lot. [Group 1].
P-1 I really enjoyed getting to know other people’s opinions on the topic of sex and see all of their views and how they have been brought up and stuff like that, and collaborating together and really talking about it. That’s meant a lot to me to. Just learning about other people’s perspectives.
P-2 For me, my major is in higher education and student affairs so I interact with college students in a variety of settings from traditional conferences to programming to dealing with incidents. And so it’s nice to have a different avenue to try to get to know the students because if gives you a different perspective to what students are dealing with in the residence halls and to try to understand where students are coming from, personalities, views, opinions, experiences. It’s been another avenue to try to get to know the students.
P-3 When you are a discussion leader you definitely hear everyone else’s opinions and it kind of broadens your horizons like you get to know more of what everyone’s opinions are about different subjects and why they feel this way and stuff like that.
P-4 I think I have gotten somewhat of a range for what the students are thinking, what behaviors they are engaging in, what sort their backgrounds are, and you realize the diversity of experience and information and just the background information that they bring with them. So I think to understand the range of what students are feeling and how they are interpreting their sexuality and expressing that. I think I learned that more so than what’s in the book. [Group 2].
P I also feel that having the experience with the instructor . . . like he’ll talk about it. You get more of an interview about how the sexuality education system works. That’s the things that when you are in a human sexuality class you are not necessarily listening to everyone else’s opinions. When you are a discussion leader you definitely hear everyone else’s opinions and it kind of broadens your horizons like you get to know more of what everyone’s opinions are about different subjects and why they feel this way and stuff like that. [Group 3].
P I think that I have learned from the students, like she said before. Just like their views and their backgrounds and how they were raised. We have online discussions, and just reading how they were brought up with religion, and how sex was taught to them, just how different families deal with the whole sex issue because everyone is different. [Group 4].
Sexual Attitude Reassessment.
Sexual attitude restructuring/reassessment (SAR) programs were created in the 1960s by the National Sex Forum and have been utilized in academic classroom settings (Vandervoort & McIlvenna, 1979 ). The purpose of contemporary SAR programs is to provide an opportunity for the attendees to assess their own cultural influences, deconstruct their own assumptions about human sexuality, and become desensitized to unfamiliar sexual practices and sexological issues. The instructors/professors utilize SAR components within their course through the use of explicit media and the discussions facilitated by the peers. The participants reported that leading the sessions facilitated a reassessment of their attitudes related to sexological topics.
P-1 When I discuss some of the issues with the students I notice on a real general level along with them I’m sort of breaking my own discomfort zone on whatever issues that we’re tackling with them.
P-2 I really thought that I knew how guys think, through this I’ve found that a lot of guys are insecure and uncomfortable with a lot of different things …I’ve learned a lot like they are more sensitive than I thought, and they are kind of like, I don’t know, uncomfortable, and embarrassed about certain things.[Group 1].
Because the collegiate environment is associated with increased autonomy and the transition from adolescence to young adulthood, relationships between significant others and parents can be challenging. Participation in the programs appears to enable students with the ability to overcome previous difficulties related to relationships. Several peers revealed that participation in the program has enhanced their relationships with their significant other, friends, and/or family members.
P-1 I live with a lot of girls. I’m not in a sorority, but I live with five other girls and we all have extremely different sexual backgrounds and just to come together with that and also like with my boyfriend, like it’s been really good because, like I kind of see more of the guy’s perspective on this. Like I realize a lot like you were saying that guys have a lot of insecurities and I really have been horrible at recognizing those and addressing those in my relationships and I think that was really important. . . I think this is a great thing for relationships. It’s so awesome.
P-2 It made me realize weakness in my relationships, um like where I need work on even though I know how relationships work out. So great, I know the good things to do, I realize that I am not perfect, and event though I’m open about sexuality there are some things about myself that I’m not open about and that really made me realize those. Like my limits and my boundaries and what I like and don’t like...all that kind of stuff. It really made me realize those kinds of things even though I know a lot about it, it doesn’t mean that I am perfect at it.
P-3 With relationships like with my mom, like it has helped soo much, like she is such like a sex negative kind of person. Like the only kind of sexual talk she has had with me is that I can’t bring home a Black chick, and if I get someone pregnant I get kicked out of the house. Like that was it, but now we talk every week and I’m like “Oh, this is what we talked about” and she’s like, “Oh, cool.”
P-4 I’ve noticed that with my parents too. The more I talk about how excited I am that somebody brought up this in my human sexuality discussion. They’re kind of like, “OK, that’s really neat. Awesome.” But at least they are hearing that and trying to be supportive. [Group 1].
P-1 I used to be shy and my mom used to talk and try to educate me about the subject and I would just walk away. After being a discussion leader, I made a point to call her and let her know everything that we discussed and I think that made a whole lot of difference. Now I am really expressive and I can talk about everything and it’s really helped me.
P-2 My boyfriend and I have been together for a while and we are pretty open about talking about it. But after discussion every Monday night I would call him to talk about it and then we would begin discussing. I would talk about the topic and then in our relationship how that relates, and then we end up having an hour talk about our relationship. So it definitely helps, you know, the sex aspect. [Group 2].
P I have had more friends come to me in sexual situations like trying to get a hold of emergency contraception and different sexual problems and sometimes friends of friends come to me asking things which was kind of really weird since I didn’t really know them but now I am used to it. When I start talking about something most of my friends are used to that…which I think is good because it’s opened my big group of friends to it. Even if it’s me just saying that I do this on a regular basis. [Group 4].
Presentation/Group Facilitation Skills/Communication.
A critical component of the program is its reliance upon effective presentation, facilitation, and communication skills. Prior to becoming a peer facilitator, many of the participants expressed feeling anxious and uneasy about their responsibilities. Most felt very comfortable with the sensitive and sometime controversial nature of the topics to be discussed; however some anxiety was provoked due to their feelings of not having the necessary skills to facilitate a discussion among a group of their peers. After attending weekly training sessions led by their professor/instructor and gaining experience in group facilitation, many of the participants expressed a decrease in their anxiety levels and an increase in their self-efficacy. Specifically, they indicated that their involvement in the program enhanced their group facilitation, presentation, and communication skills.
P-1 I think that I am not so afraid to get up in groups. I am definitely not the kind of person that likes get up in front of groups and this has helped me to just get on there level and just talk to them and be their leader even though they are my peers. I think it’s helped me.
P-2 I think that I always used to be very shy in being in a group because the greatest fear that I had was that the other people would really listen to me and think that whatever I was talking about didn’t make sense. So this really gave me a chance to have an audience that was in a way forced to listen to me and it helped in a way overcome that fear and become more comfortable talking in front of a group.
P-3 Well, I think for me, my undergraduate degree is in English secondary education so I’ve had the experience and plenty of opportunity getting to talk in front of a group of people but I think that to talk about sex with a group of people…It’s hard to find a topic that is more taboo for people or makes them as uncomfortable, and to be able to have that open discussion with people is great. And like to learn about, as someone said when to dive in, when to sit back, how to make that work. You get some communication skills that you can’t get in certain other settings due to the content. [Group 2].
P-1 You have to facilitate a discussion and make sure that everyone is talking and listening and everything so that means that you have to do some active listening and basically hear the underlying statements that everybody is saying and not necessarily what they are saying but like why they are saying it.
P-2 I think it’s good for enforcing responsibility and stuff like that, and also it’s good in bettering your public speaking skills because every time you speak to them you have to present in a manner that isn’t offensive to anyone and that induces their opinions and thoughts about it. Overall, I think that it helps with my writing and public speaking.
P-3 Yeah, I definitely think it helps with public speaking and I …I’m not afraid to talk about anything but like I’ve never had to encourage other people to talk about something and say make a question out of it to make them continue, cause I like…like that’s what we have to do to encourage them to do things instead of just sit there and leave 20 minutes early. [Group 3].
P-1 It’s gotten me to open up and talk about stuff that I wouldn’t usually say. When I was in the discussion group as a student I was the quiet one. I mean, I would say something every once in a while, but now it’s really opened me up to talk a lot more.
P-2 It taught me how to argue. Because they all agree on everything so I’m always trying to think of something else so I can be like, “What about this. . .” Even if they can’t discuss it among themselves they at least thought all together how to shoot down my ideas. It’s really taught me to be on both sides because I’ll be agreeing with them but, I’ll be like, “What about this.” And they’ll be like “I can’t believe she said that, “ and they will fight for their point.
P-3 I was nervous about being in front of the group because I don’t like being in front of groups and talking so I guess I kind of had to…to be in charge you kind of have to. I kind of had to get over fears about being in front of everybody. [Group 4].
The results of this investigation suggest that a variety of benefits are procured from the participation in a human sexuality peer facilitation program. Furthermore, these findings corroborate previous studies that suggest that investigators should consider the influence of the program upon the peer as well as the target population. Finally, focus groups can be utilized when assessing the perspective of the peer and are a useful tool in procurement of detailed beliefs and opinions regarding the peer experience.
The present study may have limitations. Because of the limited sample size, the results may not generalize to all sexuality peer facilitators. However, this is generally the case; the sample size of the present study is consistent with that of Klein and Sondag (1994), who utilized a similar investigation methodology with peers as participants. In addition, the use of peers from multiple faculty members may facilitate varying degrees of participation and/or perceived benefits from the participants. However, since the participants were all recruited from the same university under similar programs, the participants may exhibit a higher degree of homogeneity when compared to previous investigations.
This study has implications for future research. Additional investigations are needed to assess the peer perspective and its relationship to effective programming. This study has provided more detailed results than quantitative counterparts and could be used as a basis for the creation of reliable and valid peer programming instruments.
The findings of this study may have programmatic and practical implications for college health and peer helping professionals. The variety of perceived benefits associated with participation in the program can be used to recruit peers for future pedagogic and primary prevention programs. Moreover, the benefits from the program provide ample demonstration of impact evaluation and could be used to procure additional funding for peer-based programs. In summary, the findings in this sample of collegiate human sexuality peer facilitators demonstrate the efficacy and power of peer helping and its ability to influence young adults. The results disseminate the need for data-based evaluations of peer-based programs.
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