Challenges in theory

Research, theory and definitions for peer-based programs is inconsistent

There are a number of challenges in identifying the best way in which to achieve a good fit between available theories and models and a particular health issue.1 There is a lack of consistency in the research with regard to the theory that underpins peer-based programs as well as the definitions used in the delivery of peer-based programs.

Those working with peer-based programs are often drawn to the approaches due to their perceived simplicity both in development and implementation.1 As peer based programs are often conducted by agencies, schools and groups who do not have the time or resources to fully develop a rigorous program model, theory is left behind, or in many cases left out entirely.1

However, research has shown that both development and implementation of peer-based programs benefit from a clear theoretical basis.2

There may be a rush to embrace peer-based initiatives without fully appreciating the need to be critical in reviewing the body of evidence for the most effective ways to implement peer-based programs. It has also been remarked that the research has not been able to keep up with the burgeoning rise in popularity of peer-based programs.1,3,4

There is also some difficulty in identifying consensus about terminology related to peer-based initiatives and what constitutes “peerness”. This can result in inconsistency between programs and developing a reliable research base as to which approaches actually work.4

Often “peerness” is defined with simple reference to age when in actual fact a multiplicity of factors may exist and age may be the only commonality. For example sharing the experience of being a teenage parent is more than just sharing a common age range, but the experience of parenting.  Therefore, age should not be considered the only defining characteristic of peer status.4

Read more about theories relevant for youth peer-based programs.


  1. McDonald, D 2004, ‘Alcohol and Other Drug Peer Education in Schools: A review for the ACT Alcohol, Tobacco and Other Drug Strategy Implementation and Evaluation Group’, Social Research and Evaluation, Canberra.
  2. Green, J 2000, ‘The role of theory in evidence-based health promotion practice’, Health Education Research, vol. 15, no. 2, pp. 125-129.
  3. Cuijpers, P 2002, Peer-led and adult-led school drug prevention: a meta-analytic comparison. Journal of Drug Education, 32(2): 107-19.
  4. Shiner, M 1999, Defining Peer Education. Journal of Adolescence, 22: 555-566.