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Active Learning With Peer-to-Peer Health Communication in School Health Education and Student Behavior Change: A
1Special Course for School Health Nurses, Niigata University, Niigata, Japan.
The Journal of School Health
|July 8, 2026
Summary
Active learning with peer-to-peer health communication in schools shows promise for short-term behavior change in students. However, evidence on long-term sustainability and reliable measurement remains limited.
Area of Science:
- Health Education
- Behavioral Science
- Pedagogy
Background:
- School health education increasingly utilizes active learning strategies.
- Peer-to-peer health communication is a key component of these active learning approaches.
- Evidence is needed on the impact of these strategies on student behavior change and sustainability.
Purpose of the Study:
- To map evidence on the association between active learning with peer-to-peer health communication and behavior change in elementary and junior high school students.
- To identify challenges related to sustaining behavior change.
Main Methods:
- A scoping review following PRISMA-ScR guidelines.
- Searched Ichushi Web, PubMed, and ERIC databases for studies published between 2014 and 2024.
- Included studies evaluated peer-communication-based active learning in school health education with behavioral outcomes.
Main Results:
- Seventeen studies were included; 14 reported behavioral change, 2 partial change, and 1 emotional change.
- Theory-informed interventions, particularly those using Social Cognitive Theory, showed promise for behavioral change.
- Limitations include heterogeneity in study designs, outcome measures, limited long-term follow-up, and concerns about measurement reliability.
Conclusions:
- Peer-to-peer health communication-based active learning may support short-term behavior change in students.
- Significant evidence gaps exist regarding the sustainability of behavior change and the quality of measurement used in studies.
- Schools can enhance primary prevention by integrating structured peer interaction and theory-informed techniques.
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