Peer-facilitated community-based interventions for adolescent health in low- and middle-income countries: A systematic review

Kelly Louise Rose-Clarke, Abigail Bentley, Cicely Marston, Audrey Prost

Research output: Contribution to journalReview articlepeer-review

26 Citations (Scopus)
163 Downloads (Pure)

Abstract

Background
Adolescents aged 10–19 represent one sixth of the world’s population and have a high bur- den of morbidity, particularly in low-resource settings. We know little about the potential of community-based peer facilitators to improve adolescent health in such contexts.

Methods
We did a systematic review of peer-facilitated community-based interventions for adoles- cent health in low- and middle-income countries (LMICs). We searched databases for ran- domised controlled trials of interventions featuring peer education, counselling, activism, and/or outreach facilitated by young people aged 10–24. We included trials with outcomes across key areas of adolescent health: infectious and vaccine preventable diseases, under- nutrition, HIV/AIDS, sexual and reproductive health, unintentional injuries, violence, physical disorders, mental disorders and substance use. We summarised evidence from these trials narratively. PROSPERO registration: CRD42016039190.

Results
We found 20 studies (61,014 adolescents). Fourteen studies tested interventions linked to schools or colleges, and 12 had non-peer-facilitated components, e.g. health worker train- ing. Four studies had HIV-related outcomes, but none reported reductions in HIV prevalence or incidence. Nine studies had clinical sexual and reproductive health outcomes, but only one reported a positive effect: a reduction in Herpes Simplex Virus-2 incidence. Three stud- ies had violence-related outcomes, two of which reported reductions in physical violence by school staff and perpetration of physical violence by adolescents. Seven studies had mental health outcomes, four of which reported reductions in depressive symptoms. Finally, we found eight studies on substance use, four of which reported reductions in alcohol consumption and smoking or tobacco use. There were no studies on infectious and vaccine preventable diseases, undernutrition, or injuries.

Conclusions
There are few trials on the effects of peer-facilitated community-based interventions for ado- lescent health in LMICs. Existing trials have mixed results, with the most promising evidence supporting work with peer facilitators to improve adolescent mental health and reduce sub- stance use and violence.
Original languageEnglish
Article numbere0210468
JournalPL o S One
Volume14
Issue number1
DOIs
Publication statusPublished - 23 Jan 2019

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