July 7, 2016

A recent study by researchers at the UNC Gillings School of Global Public Health shows that peer support is an especially effective strategy for helping people not easily reached by conventional prevention and health-care initiatives.

Rebeccah Sokol, headshot

Rebeccah Sokol

Dr. Ed Fisher, headshot

Dr. Edwin Fisher

The systematic review, published online May 19 in the July issue of the American Journal of Public Health, was co-authored by Rebeccah Sokol, health behavior doctoral student at the Gillings School, and Edwin Fisher, PhD, professor of health behavior and global director of Peers for Progress, an organization founded in 2006 to promote peer support as a key part of health, health care and prevention around the world.

Sokol and Fisher reviewed 47 studies to assess the reach and effectiveness of peer support among people they called “hardly reached” individuals, i.e., those with psychological, socio-economic and cultural-environmental disadvantages that prevented them from having easily accessible knowledge about and assistance with health issues.

The studies examined interventions in maternal and child health, diabetes and other chronic diseases. Forty-four of the studies (94 percent) reported significant changes resulting from peer support interventions.

Interventions engaged more than half of those who agreed to participate in the studies (55.1 percent) and retained more than three-quarters (78.6 percent) of participants.

In five of the six studies that examined factors related to the effects of peer support, peer support benefits were greater among disadvantaged individuals, e.g., those who had little knowledge or understanding of ways to improve health.

“Our review showed that peer support is an especially effective strategy for reaching and benefiting those too often ‘hardly reached’ by conventional prevention and health-care initiatives – those with low income or education, ethnic minorities, those troubled by psychosocial distress, etc.,” Fisher said. “We refer to these people as ‘hardly reached’ because our public health programs fail at reaching them. This failure contributes to substantial and avoidable costs, not only for ‘hardly reached’ populations but for the entire health care system.”

“Populations are not intrinsically hard to reach,” Sokol said. “Rather, our approaches for delivering health interventions may not reach individuals with certain circumstances. Peer support is a different type of strategy. Our review demonstrates that peer support engages members of previously hardly-reached populations and facilitates an improvement in health outcomes. All of the studies we reviewed followed a model of delivering programs and services that worked with members of the priority populations, rather than acting upon them.”

Reducing costs and engaging those who are “hardly reached” should be a public health priority, the authors suggest. Peer support is a “broad and robust” strategy to accomplish that.

Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu


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