Peer work works.

“Despite the apparent value of peer education and its widespread involvement within harm reduction initiatives for illicit drug users, there is a lack of research about the factors that contribute to the success of these initiatives and of the processes and approaches that could be considered best practices.”

Toronto Harm Reduction Task Force in Peer Manual, A guide for peer workers and agencies


Peer work has not only been acknowledged as effective by those working in the field, but numerous research studies have proven its international success.

However, it is important to remember that peer involvement (no matter how perfectly designed and implemented) is not a complete solution to major health/social issues like mental health problems, health inequalities or social exclusion. It should be seen as one component of a range of interventions, programmes and policies.  A discussion of the challenges and limitations of peer work can be found here:  WHY?/Challenges and limitations

The diversity of the different kinds of peer-led practices is huge and research is often limited to specific types of peer-led interventions:  there are few studies that cover the overall concept.

However, the existing research on peer-led interventions and the benefits to peer workers can be a very useful resource when implementing peer support work projects.

Evidence from the health field

International research on peer involvement in health documents the supportive effect peer work has on changing people’s attitudes, risk behaviour, levels of information, negotiation skills and self-esteem.  An example is Medley et al. (2009) who reviewed 30 studies on peer programmes in the period 1990-2006).

Research also focuses on the impact on peers themselves.  Involvement in programmes is reported to be largely a positive experience, resulting in increased knowledge, positive changes in attitudes and improved health and wellbeing.
The peer advocates of certain health interventions are reported to be effective in supporting in people in making health choices, such as taking HIV prevention measures.  One example is a study from Fogarty and al. (2001) on condom and contraceptive measures. )

Peer educators also tend to report greater confidence, maturity and independence and have developed interpersonal and presentation skills (for example, Strange et al., 2002b)

A Peer Support Forum briefing paper makes interesting reading for further reading on evidence on peer work in sex education.

Evidence from the drugs field

Peer work in the drugs field has been shown to be effective as a method of HIV risk reduction among drug user communities in the Netherlands, the US, the UK and Australia. (source: Dowsett$File/hepc-idu.pdf).

It has become internationally accepted that outreach work including peer workers is extremely effective in reaching ‘hard to reach’ communities and in providing information to support behavioural changes.

Data from research in the US, Ukraine and China show that outreach that included peers (peer-driven interventions) ‘were more effective in contacting a wider range of hidden groups and supporting them in less risky behaviour than outreach without peers’ (see, for instance, a study on individual and network interventions with injecting drug users in 5 Ukraine cities, Latkin et al., 2011;id=20395584&n=Carl+Latkin&u_id=582)

Cost effectiveness

Peer programmes can be economical.  They are relatively less costly to operate than programmes that do not involve peers, as they build on existing experiences, existing networks and are often based on having many voluntary participants.

Although often underestimated, it is not prohibitively expensive to start peer work, especially when the activities can be dovetailed with other activities and integrated into overall programming.

Combined with its efficacy, cost effectiveness is another argument for undertaking peer work, as UNAIDS and WHO document.

Peer work gives’ bangs for your buck’ and is a wise use of limited resources.  Its cost effectiveness is a good argument for programme managers to use to solicit support for including peer work in their programmes.