UNDERSTANDING THE ‘PULL’ OF PEER-LED SEX EDUCATION: A MODEL FOR THE PRODUCTION AND EVALUATION OF PROGRAMME THEORY

Abstract

In the face of mixed evidence of effectiveness, research of peer-led sex education needs to consider the theory at the beginning, and mechanisms in the middle of an intervention, to better understand its outcomes. In making this recommendation, this thesis set out to appraise the utility of undertaking such an approach when researching peer-led sex education. Its research objectives were to: identify mechanisms underlying peer-led sex education, specify and refine programme theory, and test resultant theory via pattern-matching. This led to the production of five separate research studies. Study I, a review of existing theoretical literature to identify claims made to
support peer-led sex education. Study II, a systematic review of empirical literature to ascertain whether identified claims were supported by research evidence. Study III, a series of interviews
with practitioners to create programme theory. Study IV, an ethnographic case study to illustrate contextual features present in settings utilising participatory practices identified by practitioners
as empowering youth volunteering as peer educators. Study V, a feasibility trial of peer-led sex education was not possible, inhibiting the thesis aim to test programme theory. The thesis proposes that efforts to identify programme theory and its constituent parts is a useful focus of inquiry to apply in a field where there is uneven evidence of effectiveness. Undertaking such an approach led to the categorisation and subsequent evaluation of the provenance and empirical basis for claims used to promote peer-led sex education; pinpointing areas of empirical or theoretical weakness worthy of further investigation. Successful operationalisation of this investigative intent is, however, much more difficult to realise. This issue can be attributed to the intuitive appeal of peer education, as well as wider debates about the utility and purpose of evaluation amongst practitioners. As a result, the thesis concludes by considering ways to overcome some of these evaluative obstacles and suggests a model of evaluation through which theory testing may be achieved in future.