Peer Educators lead the way: How London Borough of Lambeth lowered teenage pregnancy rates and improved sex education

In 2002 the London Borough of Lambeth – population 270,000 - had one of the highest levels of teenage pregnancy in Britain.  A group of young people who were members of Lambeth’s Youth Council decided that they wanted to do something practical to address teenage pregnancy and improve sex education in schools. They were sure that they could be much more effective in getting messages across to their peers than an adult.

Groups of young people aged 14 to 19 have been trained in each of the last eight years as peer educators and have led hundreds of workshops in local schools and colleges. The workshops have been very well received by students and staff, Rates of teenage pregnancy have been falling steadily, and the peer educators have developed valuable skills and confidence.

The objective of the peer education programme is to use young people aged 14 -19 to raise awareness about sex and relationship matters and to positively influence other young people in Lambeth.  Working with schools colleges and the youth service, peer educators deliver workshops that take place in classrooms, at ‘health days’ and with youth groups. The workshops are designed by the peer educators. The project works with teachers, youth workers and sexual health agencies to make sure that the workshops compliment and add to the young people’s learning.

The workshops are designed to:

• Challenge attitudes
• Explore beliefs
• Campaign for greater understanding of others
• Promote responsibility for self and others
• Encourage respect for self and others
• Support young people’s right to make informed choices
• Promote young people’s right to have access to, and information about services

With support for the Youth Council’s then recently appointed full time worker, Andy Hamflett (now Chief Executive of the UK Youth Parliament) a group of young people from the Youth Council did some research on sexual relations and sexual health issues, developed lesson plans around what they felt young people wanted to know, developed a proposal for a peer approach, and submitted a bid for funding.

Funding was obtained for a six month pilot project and Andrea Legal-Miller took up post at the end of 2002 to organise recruitment, training and delivery working with the young people from the Youth Council. Following the success of the pilot the project was put on an established footing and has been running now for eight years with around 30 new peers being trained each year.

Recruitment has not proved a problem.  The majority of new recruits are attracted through word-of-mouth or are recruited through the delivery of the workshops. 

Typically, the training consists of 12 to 16 weeks of 2 hour sessions. Modules cover:

•  Working as a group
• Presenting to and managing a class of young people
• Equalities and diversity
• Sexual relations and sexual health
• Attitudes to gender and sex

Lots of time is spent looking at attitudes and exploring the fact that these are very sensitive issues about which people have very different beliefs. 

Professionals contribute to the training around sexual health, substance misuse, domestic violence and Lesbian Gay, Bisexual and Transgender issues. This means the peer educators are able to see firsthand professionals who work in the borough on these issues.  They also make visits to sexual health clinics to meet with staff and ask questions when no patients are present. This means they can speak from experience when discussing services in the borough.

Sessions in schools are delivered by pairs of peer educators. Peer educators have the advantage of speaking to young people in a clear and relevant way. They also challenge attitudes and discuss values and beliefs. One popular workshop addresses young people’s attitudes. In these sessions the peer educators break down some of the common slang words used for boys and girls, and attempt to show how loaded and often inaccurate they are.  Although the sessions are made to feel fun and light at first, the students do come to realise how stereotypes aren’t always helpful and that it is important to think a little deeper before labeling people based on just their appearance.

The peer educators are involved in the creation and development of the workshops.  They know how best to involve their peers and ensure each workshop has a range of activities to engage both shy and boisterous young people in voicing their views.

The project works to a quality assurance framework.   Every session has the class teacher present. At the end of the session the teacher completes an evaluation sheet as do all the students.  The peer educators also complete de-brief forms with each other on how their sessions went and how they can be improved. Although Lambeth staff sit in on some sessions peer educators are trusted to manage the sessions with the principal form of monitoring being through the evaluation forms.

Most peer educators are between 15-19 years old and in full time education.  Around two thirds are girls. The majority are Black African and Black Caribbean which is broadly reflective of the borough.  Lambeth teenage mothers are also known to be over-represented in the Black Caribbean and Mixed Black Caribbean-White communities. One of the challenges in future is to make the peer educators a little more diverse in terms of both ethnicity and gender. Indeed the latest intake is half and half male and female for the first time.

Peer educators are treated as unqualified youth workers and paid accordingly (£8.31 ph). This is seen as important in recognising their commitment and professionalism.

Over eight years around 250 young people have been involved as peer educators and several hundred workshops have been held.  Impact and outcomes can be looked at in a number of ways.

1.      The impact on students

This is principally judged by the feedback forms from students and their teachers. Lambeth have carried out an evaluation of all forms received from 111 workshops in 2009/10. These used a 10 point scale and also invited general comments.

On the questions to students:

Have you learnt anything useful today? Only 1.8% said ‘nothing’; 89% scored from 5-10 (10 being ‘a lot’)

Are your thoughts and or feelings different as a result of this session? Only 6% scored ‘not at all’; 76% scored from 5-10 (10 being ‘quite a bit’)

Comments included:

“it was perfect and fun I loved it cause we could express our feelings and thoughts of what we think”

“this lesson helped me to understand more about respect and changed my mind of how to treat others differently”

“I think this session was really good because I’ve learnt a lot and also I’ve finally got to tell people how I feel”

If anything the teachers’ evaluations of the sessions and the peer educators were even more positive.  Almost all their scores for effectiveness were 6 or above.

“I watched both sessions… I was impressed with both! Pupils who can be difficult were engaged and participating in the lesson and felt that the Peer educators were relevant, knowledgeable and had a confident delivery style.”

“the educators were able to engage the class to participate through using student familiar language and creating a safe environment to express opinions with icebreaking starters”

“Handled a difficult group of 14 year old boys extremely well.”

“The presenter’s ability to establish a relationship with the girls very quickly.  Students were receptive because she was young”.

2.  The impact on the peer educators

As well as benefiting the students, feedback from the peer educators is very positive about their increased skills, confidence and aspirations. Peers have been offered jobs as learning mentors and teaching assistants in schools and have worked in the youth service.  Many have gone on to university. Very few drop out of the training (average 3 out of 20) and many stay with the programme for 3 or even four years.

By being part of the peer education project I have gained a lot of skills, as well as boosting my confidence to talk in front of large crowds as that would have been something I would have found intimidating. Now I feel I can do it with my eyes closed…I've also realised that youth work could actually be a field that I'd like to work in on a long term basis when I have finished all my studies, because I like making an impact with young people…

I love being a peer-educator. I find it interesting to learn of others experiences and meet new people. I feel it has helped me to change my perspective of first impressions of others.

The Peer Education project was a really enjoyable experience. It allowed me to discover my talent for working with young people. I was given the opportunity to help young people socially and also become a better speaker. I would recommend the programme as I think that it is a great way to help others while helping yourself too. Plus the staff are great too: fun and extremely supportive.

The under 18 conception rate in Lambeth reached a peak in 2003 at just over 100 per 1000 15 -17 year old women. The figure has fallen every year since 2003 to 2009 (latest available statistics). The provisional 2009 under 18 conception rate has fallen to 59.5 per 1000 girls aged 15-17 years old. 

Between 1998 and 2009 Lambeth's conception rate has been reduced by 30.2%

While the peer education programme would not claim all the credit for this reduction, and indeed reductions, at a slower rate, have occurred elsewhere in London, it can certainly be argued that it has made a significant contribution to a wider programme to successfully address teenage pregnancy.

The peer educator programme is supported by a full time member of staff – cost approx £32k and has a budget of £27k to cover all training, materials, publicity, refreshments and payments to the peer educators (at £8.31 ph). 

The programme recognises that young people have a special knowledge, if this can be augmented by some training and then put back into the community it is a very valuable resource.  It is important for young people to see that their knowledge is valued by others.  This spurs them on to do things which are positive for themselves and their community.

It is important to be clear about remit and honest about rules and limitations.  Part of the learning for young people is to see how they can work within rules and where necessary, around them.

The peer principle can be extended to other groups.  For example, older people have special knowledge and experience which can be harnessed to support other older people who may be isolated. But this knowledge could also be used to do intergenerational work such as sharing life skills like cooking.

Further details of the programme can be found here

For hard copies of the Peer Education Guidance and Peer Education Handbook please contact the project manager Andrea Legal-Miller -alegal_miller@hotmail.com

The peer education project has been included in a report on community participation in Europe. This report was enabled by a study visit that Governance International organised for Rainer Nubel, Mario Wezel, and Hannes Wezel. Click to read the report (in German)