Peer health promotion in prisons: a systematic review

The purpose of this paper is to review systematically the available literature relating to the implementation of peer education to promote health and healthy behaviour in prisons.

The authors undertook a narrative systematic review of Medline, EMBASE, CINAHL, Psychinfo, Web of Science and Cochrane databases. Relevant journals and reference lists were hand searched for relevant articles to be included in the review. Of the abstracts found, full-text papers were retrieved for those papers deemed as possibly fulfilling the inclusion criteria of the review.

A total of 3,033 abstracts were identified leading to 46 full-text articles being retrieved, of which ten were included in the review. Peer education in prisons can have an impact on attitudes, knowledge, and behaviour intention regarding HIV risk behaviour. The research findings were inconclusive for the impact of peer education upon illicit drug use and injecting practice. There was a paucity of research evaluating the impact of peer education upon mental ill health, obesity, diet, smoking, or self-management of chronic physical diseases.

Peer education is effective in reducing risk of HIV transmission. It is possible that peer education for mental health issues is stigmatising, presenting an opportunity for further research activity. The impact of peer education upon illicit drug use practice, obesity, diet, smoking, and self-management of chronic physical diseases also presents further research opportunities. Research evaluating models of active peer educator involvement in health service delivery and organisation is also lacking.