Submitted to the Faculty of Arts in partial fulfillment of the requirements for the degree of MA (Counseling Psychology) in the Department of Psychology at the University of Zululand, South Africa, 2009. / The reported study evaluated the effectiveness of the Zululand University HIV/AIDS peer educator programme. The evaluation was surnmative in nature. The research design was a pre-post-test control group design and both qualitative and quantitative methods were used for data collection and data analysis. The outcome measures used for the evaluation were changes in participants' HIV/AIDS knowledge, attitude, and behavioural practices. Results indicated that changes had occurred in the experimental groups attitudes regarding HIV/AIDS, knowledge of HIV/Aids, and the behavioural practices of the participants. A two-way analysis of variance (ANOVA) was conducted on attitude, knowledge, and behavioural practices between gender and groups. The analysis of variance (ANOVA) revealed that there were no significant differences in knowledge, attitude, or behavioural practices for both gender and groups. However, a qualitative analysis revealed that the programme was significantly beneficial to participants with regards to their own relationships and empowerment. It has been suggested that further research should be conducted using a larger time frame and larger sample for evaluation.

The rise of unhealthy beverage consumption, such as soft drinks, in children and youth for the last 25 years has increased the risk of low bone mass density by replacing milk (a major source of calcium intake), compromised dental health, and possibly contributed obesity. A school-based nutrition education intervention was developed to promote a change in this behavior. This study examined the effectiveness of this nutrition education program, called FUEL (Fluids Used Effectively in Living), in promoting healthy beverage consumption among high school students. The FUEL nutrition education manual consisted of six classroom sessions; it was delivered in four classes of grade nine students using different approaches, either multiple or single strategies. The nutrition intervention used multiple teaching methods which included six lessons delivered as visual, group interaction, tactile, individual, and auditory teaching styles. The multiple strategies approach was delivered through peer educators (led by a dietitian) in one class and dietitian-only in another class. In the single strategy approach, also called self-taught, two classes received only the handouts in the FUEL manual. This latter approach was considered the control to the nutrition intervention. The two classes that received either peer education or self-taught approach were in two high schools in Saskatoon. The two classes with either dietitian-taught or self-taught approaches were in a high school in Prince Albert. The beverage intake, knowledge, and attitude of students were assessed by a self-administered questionnaire before the intervention, a week after the intervention, and three months after the intervention. In Saskatoon only, a one year follow-up beverage intake assessment was performed. None of the schools in the FUEL study provided healthy beverage choices for the students. Generally, students in our study consumed an adequate amount of milk, but they drank sugary beverages daily. There was a tendency to replace milk and 100% fruit juices with sugary drinks. After the intervention, students in multiple teaching strategies decreased their sugary beverage intake significantly. The findings indicated that a school-based nutrition education with multiple teaching strategies may lead to positive knowledge, attitude and behavioural change which will have beneficial effect on long-term health.

The rise of unhealthy beverage consumption, such as soft drinks, in children and youth for the last 25 years has increased the risk of low bone mass density by replacing milk (a major source of calcium intake), compromised dental health, and possibly contributed obesity. A school-based nutrition education intervention was developed to promote a change in this behavior. This study examined the effectiveness of this nutrition education program, called FUEL (Fluids Used Effectively in Living), in promoting healthy beverage consumption among high school students. The FUEL nutrition education manual consisted of six classroom sessions; it was delivered in four classes of grade nine students using different approaches, either multiple or single strategies. The nutrition intervention used multiple teaching methods which included six lessons delivered as visual, group interaction, tactile, individual, and auditory teaching styles. The multiple strategies approach was delivered through peer educators (led by a dietitian) in one class and dietitian-only in another class. In the single strategy approach, also called self-taught, two classes received only the handouts in the FUEL manual. This latter approach was considered the control to the nutrition intervention. The two classes that received either peer education or self-taught approach were in two high schools in Saskatoon. The two classes with either dietitian-taught or self-taught approaches were in a high school in Prince Albert. The beverage intake, knowledge, and attitude of students were assessed by a self-administered questionnaire before the intervention, a week after the intervention, and three months after the intervention. In Saskatoon only, a one year follow-up beverage intake assessment was performed. None of the schools in the FUEL study provided healthy beverage choices for the students. Generally, students in our study consumed an adequate amount of milk, but they drank sugary beverages daily. There was a tendency to replace milk and 100% fruit juices with sugary drinks. After the intervention, students in multiple teaching strategies decreased their sugary beverage intake significantly. The findings indicated that a school-based nutrition education with multiple teaching strategies may lead to positive knowledge, attitude and behavioural change which will have beneficial effect on long-term health.

Each year, teen pregnancy occurs in 750,000 15-to-19 year-old women in the United States (U.S.). Utah has the youngest population and the lowest teen abortion rates in the U.S. Approximately 73% of teen pregnancies in Utah result in live births. The prevalence of teen pregnancy and the nutritional risk to mother and child result in a much greater need for social support, such as nutrition education. Current literature shows that the paraprofessional model is effective in increasing positive behavior change through nutrition education. Presently, there is a lack of evidence that paraprofessional teens are capable of accurately and effectively teaching their peers nutrition information. This pilot study aims to measure the effectiveness of the peer-teaching-peer paraprofessional model in teen parenting nutrition education, and to demonstrate that peer educators ages 18-22 are capable of teaching their peers accurate nutrition information as effectively as adult paraprofessionals. In this pilot study, two females were trained to become paraprofessional peer educators. To supplement the training of peer educators, this pilot study developed and recorded a nutrition presentation for all six lessons of the paper version Missouri Extension Teen Parenting curriculum. Each trained peer educator taught 10 to 13 clients (ages 14 to 19) over three weeks. For evaluation, the study used pre/post comparisons. Assessment tools include teaching evaluations, pre-post test on nutrition knowledge, 24-hour dietary and physical activity recalls, and behavioral checklist. There was a significant difference in pre-post tests in knowledge, behavior, and exit survey among participants, indicating that peer educators are able to teach their peers effectively. Although not significant, peer educators' teaching accuracy score was high and improved consistently. Eighty-three of participants like or very much liked to be taught by their peers. Findings from this study showed great potential in having adolescents teach their peers as effectively as older educators.

In community-based peer education models, it is necessary to understand the relationship between learning, context and paraprofessional identity construction. Social relations are important in community education program implementation (Merriam, Caffarella, & Baumgartner, 2007); impacting power structure within communities and organizations (Cervero & Wilson, 1994, 2006; Forester, 1989). This study explored the conceptual and practical role of experience in a paraprofessional educator model and focused on the situated, contextual experiences of paraprofessionals in the communities they work and live as unique, challenging, and potentially positive for learning outcomes. Schön's narrative dialogue of reflection (1983) proved to be the essential missing piece in working with community educators toward successful development and autonomy. In-depth qualitative interviews with 19 paraprofessional community-based peer educators with a state level family nutrition program contributed to findings relevant to how social context, critical reflection, and identity development influence an understanding of experience and the ability to impact knowledge and behavior change in clients. Individual interviews and focus groups allowed narrative exploration of topics as they evolved throughout the study; giving voice to paraprofessional program assistants in a way not previously done. The findings of this study provide insight necessary for the assessment of new conceptualizations of practice for paraprofessional models in expanding community impact and highlight the need for assessment of contemporary program delivery in a way that fosters the continual development of lay educators through reflective practice. Recommendations are made for a reassessment of historically significant program models in order to embrace paraprofessionals as more broadly defined socially mediated and socially situated influential practitioners. / Ph. D.

This multi-article dissertation explores the potential for the undergraduate peer mentoring experience to contribute to transformative learning for those who serve in peer mentoring or peer leadership roles. While past research has established that peer mentors experience a variety of positive outcomes associated with their leadership experience, there are gaps in the literature with regard to how the peer mentor experience can be intentionally designed as a high-impact practice for student leaders. Through three qualitative studies, as well as a comprehensive literature review, this dissertation addresses this gap by exploring what peer mentors report learning through their mentoring experiences (Article #1), the types of experiences that contribute to transformative learning (Articles #2 and #3), and how transformative learning can be facilitated through a particular designed training intervention (Article #4). Based on the findings of these four studies, an emerging framework is proposed to describe the characteristics of high-impact and transformative PM learning environments. This framework suggests that transformative PM learning is most likely when (a) the learning of PMs themselves is an explicit objective of the program or initiative, (b) PMs are engaged in purposeful routines and structured practices that facilitate learning, (c) PMs are exposed to unfamiliar and challenging situations in their mentoring practice, (d) theoretical and conceptual understandings (e.g., selected readings) are integrated into PM development; (e) PMs are provided with frequent and structured opportunities for reflection on their experiences, and (f) PMs are part of a supportive mentoring community. Recommendations for the design of high-quality PM learning environments are made based on the elements of this framework. Additionally, directions for future research on peer mentoring as a high-impact practice are made.