Table 1.

Data extraction of included studies

Author, year and country	Aim, study design and data type	Participants	Intervention and setting	Control or comparator	Description of peer leaders	Mental health measure	Key findings
Psychotherapy and counselling
Dow et al. 2020 Country: Tanzania	Aim: To establish (1) the feasibility and acceptability of the pilot Sauti ya Vijana (SYV) intervention and (2) to conduct exploratory analyses on the impact of SYV on outcomes including mental health, stigma, ART adherence and HIV RNA Study design: Randomised controlled trial Data type: Quantitative	Young people living with HIV who attended the adolescent HIV clinic at Kilimanjaro Christian Medical Centre (KCMC) or Mawenzi Regional Referral Hospital (MRRH) Age range: 12–24 Mean age: 18.1 N = 93	Intervention: Psychotherapy Description: SYV, 10 weekly group sessions (two held jointly with caregivers) and two individual sessions incorporating trauma informed cognitive behavioural therapy, interpersonal psychotherapy, and motivational interviewing. Participants were split into same sex groups with sex-concordant peer leaders. Setting: Community	Routine monthly attendance to adolescent clinic with adherence counselling following Tanzanian guidelines	Young adults (23–30 years old) with background of either living with HIV and/or having prior experience with mental health research. They underwent a two-week intensive training with the Principal Investigator and clinical psychologists with weekly supervision sessions.	Patient Health Questionnaire (PHQ–9) Strengths and Difficulties Questionnaire (SDQ) UCLA Post Traumatic Stress Symptoms Exposure Screener and Reaction Index Survey	Mental health scores had greater improvements in the intervention arm compared to the standard-of-care (SOC) arm Change in PHQ–9 score − 0.60 (95% CI −2.67, 1.47) Change in SDQ Total Difficulties Score 0.88 (95% Cl −3.22, 1.47) Change in UCLA Trauma Score − 0.03 (95% Cl −2.38, 2.32)
Ferris France et al. 2023 Country: Zimbabwe	Aim: To increase self-worth and wellbeing by reducing self-stigma among adolescents and young people living with HIV (AYPLHIV) Study design: Quasi-experimental design Data type: Qualitative	Zvandiri Community Adolescent Treatment Supporters (CATS) living with HIV (LHIV), trained, mentored and supported to deliver structural support groups, counselling and tailored community-based adherence support to their peers. Age range: 18–24 N = 60	Intervention: Psychotherapy Description: The Wakakosha intervention (second delivery by peer coaches), a 10-day face-to-face intervention consisting of theory, meditation, group and individual experiences of Inquiry-Based Stress Reduction (IBSR), music reflection, sharing of insights, singing and songs, activity journaling, poem and letter writing, and podcast making Setting: Community and online (COVID–19)	None	15 CATS identified from the first delivery of the intervention were trained as peer coaches to lead the second delivery of the intervention. They attended residential face-to-face, six-day immersive Training of Trainers. They were supported by adult coaches when delivering the intervention	Self-confidence and self-agency Sense of purpose and meaning in life Self-forgiveness and forgiveness of others	Participants gained various skills including self-confidence Participants affirmed a new sense of purpose in their lives and inspired a sense of self-worth Participants experienced positive changes in self-forgiveness and forgiveness of parents for passing on HIV
Osborn et al. 2020a Country: Kenya	Aim: To evaluate if students in the Shamiri intervention would experience reductions in depressive and anxiety symptoms and improvements in social support, perceived control, and academic outcomes in a preliminary proof-of-concept trial. Study design: Randomised controlled trial Data type: Quantitative	Adolescents with depression or anxiety Age range: 12–19 N = 51	Intervention: Psychotherapy Description: The Shamiri intervention consists of four weekly sessions that use didactic lectures, reading activities, group discussions and writing activities to explore self-growth, gratitude and values to address depression and anxiety Setting: School	Didactic sessions on study skill strategies, group discussions and activities.	Five trained group leaders (17–21 years old) who are high school graduates and able to read in English. Training included 20 h of session.	PHQ–8 GAD–7 Multidimensional Scale of Perceived Social Support (MSPSS) Perceived Control Scale for Children (PCS)	Depressive symptoms Intervention: Youths reporting mod-severe-to-severe depressive symptoms decreased by 21.42% Control: Youths reporting mod-severe-to-severe depressive symptoms decreased by 4.35% At end point, only 21.44% of adolescents in intervention qualify for intervention on merit of depressive symptoms, compared to 26.09% in the study skills Anxiety symptoms Anxiety symptoms declined more rapidly from baseline to Week 4 for youth in intervention. (p = 0.039, d = .54[−.20,1.29] Intervention: Youths reporting mod-to-severe anxiety symptoms decreased by 42.86% Control: Youths reporting mod-to-severe anxiety symptoms decreased by 17.39% At end point, only 46.43% of adolescents in intervention qualify for intervention on merit of anxiety symptoms, compared to 78.26% in the study skills
Osborn et al. 2021 Country: Kenya	Aim: To assess whether Shamiri intervention can alleviate depression and anxiety symptoms in symptomatic Kenyan adolescents Study design: Randomised controlled trial Data type: Quantitative	Adolescents with elevated symptoms on standardised depression or anxiety measures Age range: 13–18 years Mean age: 15.4 N = 413	Intervention: Psychotherapy Description: The Shamiri intervention consists of four weekly sessions that use didactic lectures, reading activities, group discussions and writing activities to explore self-growth, gratitude and values to address depression and anxiety Setting: School	Peer-led study skills session to teach skills on note-taking, study strategies, time management, study cycle.	High school graduates fluent in English and Kiswahili 18–26 years old who underwent 10 h of training and weekly supervision.	PHQ–8 GAD–7	Depression 2-week follow-up: non-significant End-point: Youths in Shamiri experienced greater declines in depression symptoms from baseline to end point than control group youths (Cohen d = 0.35 [95% CI, 0.09–0.60] Anxiety 2-week: Symptoms reduced significantly more for youths in Shamiri than in control 7-month: significantly lower Anxiety symptoms at 7-month follow-up for the Shamiri than study skills groups (imputed values model: B = 1.78 [95% CI, 0.53–3.03]; t = 2.8; df = 25.54; p = .01; unimputed values model: B = 2.25 [95% CI, 1.08–3.4]; t = 3.8; df = 345.25; p < .001) End-point: Youths in Shamiri experienced greater declines in anxiety symptoms from baseline to end point than youths in the control group per the model using unimputed values (Cohen d = 0.37 [95% CI, 0.11–0.63]
Osborn et al., 2023 Country: Kenya	Aim: To evaluate the effectiveness of Pre-Texts arts-literacy intervention for adolescent depression and anxiety in Kenyan high school students Study type: Randomised Controlled Trial Data type: Quantitative	Students in Grades 9–11 from two community-run schools Age range: 12–19 Mean age: 16.36 N = 235 (intervention = 106 and control = 129)	Intervention: Psychotherapy Description: An afterschool Pre-Texts art literacy intervention involving group (5–6 youth) meetings of 1 h over a one-week period for a total of five meetings. Literary, technical, scientific text extracts are provided and participants are invited to use the text as inspiration to understand and engage with themes and messages, thereby facilitating psychological change. This is followed by reflective discussions. Setting: School	Study skills control group involving notetaking, time management, effective reading strategies.	Trained youth facilitators with a high school diploma and from around the Nairobi area.	PHQ–8 GAD–7	Non-significant effects for time, intervention condition and covariates age and sex Significant Time X Condition interaction suggests that youth who receive Pre-Text intervention experienced greater reductions in depressive symptoms from baseline to 1-month follow up compared to those in the control group. (d = 0.52, 95% CI [0.19, 0.84]) Significant Time and Time X Condition effect at 1 month follow up that those participating in the intervention experienced greater reductions in anxiety from baseline to 1-month follow up compared to control-group youth (d = 0.51, 95% CI [0.20, 0.81]) Adolescents who received Pre-Texts intervention experienced larger declines in depression symptoms from baseline to 1-month follow-up than control group youths (d = 1.10, 95% CI [0.46, 1.75]) Youth who received Pre-Texts generally experienced larger declines in anxiety symptoms from baseline to 1-month follow-up than control group youths (d = 0.54, 95% CI [−0.07, 1.45])
Simms et al. 2022 Country: Zimbabwe	Aim: To evaluate if enhancing the counselling skills of CATS to provide problem-solving therapy (PST) reduces virological non suppression and improves mental health among adolescents living with HIV in Zimbabwe, compared with standard Zvandiri care Study design: Cluster-randomised trial Data type: Quantitative	Adolescents living with HIV Age range: 10–19 N = 842	Intervention: Psychotherapy Description: Zvandiri-Problem-solving therapy (Zvandiri-PST) which consists of standard Zvandiri program (HIV care, counselling and home visits) and PST (a cognitive behavioural approach for problem solving) Setting: Health clinic	Zvandiri standard care consisting of HIV care following Ministry of Health and Child Care guidelines, counselling and home visits by trained CATS, monthly support groups and weekly text messages	Community Adolescent Treatment Supporters (CATS) who are 18–24 years old living with HIV who are trained and mentored to provide peer counselling and support	Shona Symptom Questionnaire (SSQ) PHQ–9	Intervention effect on prevalence and severity of common mental health outcomes SSQ ≥ 8: 2.4% versus 10.3% (AOR = 0.19; 95% CI 0.08, 0.46; p < 0.001; AMD = −1.14; 95% CI −1.80, −0.49; p = 0.001) PHQ–9 ≥ 10: 2.9% versus 8.8%; (AOR = 0.32; 95% CI 0.14, 0.78; p = 0.01; AMD = −1.14; 95% CI −2.01, −0.27; p = 0.01)
Venturo-Conerly et al., 2022b Country: Kenya	Aim: To test key, short term outcomes of a universal, classroom-based, single session version of each component of Shamiri intervention (i.e. growth, gratitude, and value affirmation) against an active control intervention. Study design: Cluster Randomised Trial Data type: Quantitative	Students from two sub-county (lowest academic ranking) public boarding high schools in Kiambu Country, Kenya, one an all-girls and one an all-boys school N = 895 Mean age: 16.2 (all-girls school), 15.86 (all-boys school)	Intervention: Psychotherapy Description: A single 1-h session version of the Shamiri intervention (Osborn et al., 2020b) testing each component (i.e. growth, gratitude, value affirmation) separately Setting: School	Study skills control involving discussing helpful study strategies and implementation.	Lay-providers who were recent Kenyan high school graduates	GAD–7 PHQ–8	Value affirmation intervention reduced anxiety symptoms in the universal sample Value affirmation (B = −2.22, p < .01; Cohen’s d = 0.49 [0.09–0.89]) and growth mindset (B = −1.78, p < .05; Cohen’s d = 0.39 [0.01–0.76]) interventions reduced anxiety in sub-sample endorsing moderate-to-severe symptoms at baseline Adolescents in all conditions including control experienced decreases in self-reported depression symptoms from baseline to 2-week follow-up
Venturo-Conerly et al., 2024 Country: Kenya	Aim: To provide a more rigorous, long-term, and adequately powered examination of the Shamiri intervention, involving each intervention component, all components combined, and the study-skills condition. Study design: Randomised Controlled Trial Data type: Quantitative	Students from four high-schools in Kenya N = 1,252 Age range: 12–21 Mean age: 16.25	Intervention: Psychotherapy Description: The Shamiri intervention consisting of all components (growth mindset, gratitude, and values affirmation) were tested against single-component sessions. Each intervention was tested against an active control group. Setting: School	Study skills control involving discussing helpful study strategies and implementation	Lay-providers who were recent Kenyan high school graduates aged 18–22	GAD–7 PHQ–8 Short-Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS)	Within the main sample: Anxiety scores significantly improved on average compared to baseline at two-week midpoint (B = −0.847; [95%CI −1.57 −0.13]; p.adj < 0.001), four-week endpoint (B = −2.948; [95%CI −3.60 −2.30]; p.adj < 0.001), one-month follow-up (B = −1.587; [95%CI −2.55 −0.63]; p.adj < 0.001), three-month follow-up (B = −2.374; [95%CI −2.99 −1.76]; p.adj < 0.001), and eight-month follow-up (B = −1.917; [95%CI −2.59 −1.25]; p.adj < 0.001). Depression scores were significantly improved in full sample compared to baseline at two-week midpoint (B = −0.796; [95%CI −1.67 0.08]; p.adj = 0.011), four-week endpoint (B = −3.126; [95%CI −3.79 −2.46]; p.adj < 0.001), one-month follow-up (B = −2.382; [95%CI −3.53 −1.23]; p.adj < 0.001), three-month follow-up (B = −2.521; [95%CI −3.42 −1.62]; p.adj < 0.001), and eight-month follow-up (B = −2.237; [95%CI −3.19 −1.29]; p.adj < 0.001). Well-being scores were significantly improved than baseline at two-week midpoint (B = 1.73; [95%CI 0.76 2.66]; p.adj < 0.001), four-week endpoint (B = 3.44; [95%CI 2.27 4.60]; p.adj < 0.001), one-month follow-up (B = 2.21; [95%CI −0.32 4.75]; p.adj = 0.02), three-month follow-up (B = 1.78; [95%CI 0.09 3.47]; p.adj = 0.004), and eight-month follow-up (B = 1.59; 16 [95%CI 0.35 2.84]; p.adj < 0.001). There were no significant differences between conditions on measures of depression, anxiety, or wellbeing. Within the clinical sub-sample: Anxiety scores significantly improved compared to baseline at two-week midpoint (B = −4.00; [95%CI −5.18 −2.82]; p.adj < 0.001), four-week endpoint (B = −7.13; [95%CI −8.13 −6.14]; p.adj < 0.001), one-month follow-up (B = −6.51; [95%CI −8.02 −4.99]; p.adj < 0.001), three-month follow-up (B = −6.26; [95%CI −7.54 −4.99]; p.adj < 0.001), and eight-month follow-up (B = −6.10; [95%CI −7.25 −4.95]; p.adj < 0.001). Depression scores were significantly improved in full sample compared to baseline at two-week midpoint (B = −2.89; [95%CI −4.01 −1.77]; p.adj < 0.001), four-week endpoint (B = −6.60; [95%CI −7.54 −5.66]; p.adj < 0.001), one-month follow-up (B = −6.34; [95%CI −7.57 −5.11]; p.adj < 0.001), three-month follow-up (B = −5.45; [95%CI −6.75 −4.14]; p.adj < 0.001), and eight-month follow-up (B = −5.29; [95%CI −6.59 −3.99]; p.adj < 0.001). Symptoms of depression and anxiety showed no significant differences across five groups. Wellbeing scores significantly improved at two-week midpoint than at baseline (B = 2.51; [95%CI 1.39 3.64]; p.adj < 0.001), 4-week endpoint (B = 5.02; [95%CI 3.02 7.02]; p.adj < 0.001), 1-month follow-up (B = 4.41; [95%CI 3.12 5.69]; p.adj < 0.001), three-month follow-up (B = 3.38; [95%CI 1.97 4.80]; p.adj < 0.001), and eight-month follow-up (B = 3.19; [95%CI 1.87 4.52]; p.adj < 0.001)
Peer education and psychoeducation
Balaji et al. 2011 Country: India	Aim: To assess the acceptability, feasibility, and potential effectiveness of the pilot project Yuva Mitr in improving a range of priority health outcomes for youths 16–24 in urban and rural communities in Goa Study design: Randomised controlled trial Data type: Quantitative	Youth living in urban communities in the wards of Margao and rural communities from the catchment area of Balli Primary Health Centre Age range: 16–24 Mean age: 19 N = 3,663 (baseline) N = 3,562 (follow-up)	Intervention: Peer education Description: A 12-month intervention comprised of institution-based and community peer education involving group sessions and street plays, a teacher training program and dissemination of health information materials Setting: Community and school	Not specified	Selected based on a pre-determined criteria (non-specified), trained by psychologists and social workers, and supported by community advisory board trained teachers.	General Health Questionnaire (GHQ–12)	Rural: Probable depression decreased in the intervention arm by 60.1%, where it increased by 1.1% in the comparison arm (p < 0.001). Probable depression odds ratio 0.33, 95% CI 0.23–0.48 Community peer education was feasible and acceptable Urban: Suicidal behaviour decreased by 65.1% in the intervention arm compared to a decrease of 11.4% in the comparison arm (p = 0.02) Suicidal behaviour odds ratio 0.38 95% CI 0.17–0.84 Probable depression decreased by 38.8% in the intervention arm compared to a decrease of 2.1% in comparison (p = 0.001) Probable depression odds ratio 0.57 95% CI 0.41–0.79 Significant increase in knowledge levels for the topic on mental health Peer education in educational institutions showed acceptability but limited feasibility
Im et al. 2018 Country: Kenya	Aim: To explore the effect of a trauma-informed psychoeducation (TIPE) intervention on both mental health and psychosocial domains among Somali refugee youth affected by trauma Study design: Quasi-experimental design Data type: Quantitative	Somali youth refugees living in an urban business district affected by multiple refugee traumas Mean age: 20 N = 141	Intervention: Psychoeducation Description: 12 sessions of Trauma-informed Psychoeducation (TIPE) over three months that include (1) psychoeducational modules to promote refugee resilience, peace education, conflict resolution, problem-solving methods, (2) education on the impacts of trauma on the body, mind, social relationships, spirituality, and (3) psychosocial competencies such as emotional coping, problem solving, community and support systems and conflict management skills Setting: Community	None	25 youth leaders Week long training of trainer (TOT) training 10 youth leaders paired with five community health counsellors	PTSD Check List – Civilian Version (PCL-C)	TIPE intervention had positive impacts on PTSD symptoms and psychosocial factors: Youths with no/low baseline PTSD symptoms had their post-TIPE symptom score increase from 27.42–34.48 (t = −4.476 p = 0.000) Youths with high PTSD score reported lower PTSD symptoms post-TIPE from 50.09–31.93 (t = 8.188 p = 0.000)
Kermode et al. 2021 Country: India	Aim: To implement and evaluate an intervention to promote social inclusion for young people affected by mental illness Study design: Quasi-experimental design Data type: Quantitative	Young people affected by mental illness, including those experiencing a mental health problem and those caring for a family member with a mental health problem Mean age: 18.9 N = 142	Intervention: Psychoeducation Description: A 4–6-month intervention consisting of the formation of 11 Youth Wellness Groups (peer-facilitated, participatory groups of young people divided by gender) guided by a series of interactive modules adapted from the Nae Disha curriculum. Setting: Community	None	Eight peer facilitators affected by mental illness, with at least Class 12 education, ability to travel to intervention sites and communication skills. They were trained by the Burans Community Mental Health Project Team. (Qualitative outcomes of the same study has been described in Mathias et al., 2019)	GHQ–12 SDQ	GHQ improved from 6.6 to 2.2 (p < 0.001) SDQ improved from 16.1 to 11.8 (p < 0.001)
Mathias et al. 2018 Country: India	Aim: To evaluate the effectiveness of Nae Disha intervention to reduce anxiety and depression, promote attitudes of gender equality, self-efficacy and resilience among highly disadvantaged young women outside of a school setting in India Study design: Quasi-experimental repeated measures design Data type: Quantitative	Young women not attending school Age range: 12–24 Mean age: 16.7 N = 106	Intervention: Psychoeducation Description: Nae Disha, a 15-week intervention to facilitate health promotion, development of psycho-social assets to promote youth citizenship and positive youth development. Modules include exploring self-identity and esteem, identifying and managing emotions, mental health communication skills, relationship skills and forgiveness, self-care and drawing boundaries Setting: Homes of community members	None	Local young women 20–30 years old expressing enthusiasm to work in youth resilience and have completed 12th Class. Had five days of training and two days of refresher training.	Connor-Davidson Resilience Scale (CD-RISC) Schwarzer’s General Self-Efficacy Scale PHQ–9 GAD–7	Statistically significant improvement between pre- and post-intervention in all scales for self-efficacy, resilience, anxiety, depression and gender attitudes Improvement in mental health and gender attitudes at follow up, but not in emotional resilience and self-efficacy.
Mathias et al., 2019 Country: India	Aim: To assess the impact of a peer-led, community-based, participatory group intervention on social inclusion and mental health among young people affected by psycho-social disability in Dehradun district. Study type: Quasi-experimental design Data type: Qualitative	Young people affected by psycho-social disability (PSD) in four communities in Uttarakhand, India. Age range: 12–24 N = 142	Intervention: Psychoeducation Description: The Nae Disha curriculum that builds on youth development and mental health promotion approaches using an interactive, participatory facilitation style of 17 learning modules (i.e. accepting differences, managing emotions, communicating confidently etc.). It also includes participation in community activities, access mental health services and visit a de-addiction centre. Setting: Community	None	Peer facilitators selected from the four target communities that were young people aged under 30 years, with personal experience of mental ill-health and who had completed 12th class in high school (Quantitative outcomes of the same study have been reported in Kermode et al., 2021)	Intermediate and primary outcomes of the intervention Mechanisms through which they were achieved	Experienced by both genders Formation of new peer friendship networks Increased self-efficacy Improved mental health Increased community participation Experienced by young women: Increased freedom of movement Greater confidence in communicating Experienced by young men: Changes in community perceptions of them
Merrill et al., 2023 Country: Zambia	Aim: To explore youths’ experiences with Project YES! to strengthen the understanding of the intervention’s effectiveness and implementation, while enhancing the literature on peer-centered approaches to improving HIV outcomes among youth living with HIV Study design: Randomised Controlled Trial Data type: Qualitative	Youth living with HIV Age range: 15–24 N = 276	Intervention: Peer education Description: Six-month peer-mentoring program, including an orientation meeting, and monthly individual and monthly group meetings with a youth peer mentor. The goal is to support youth to successfully adhere to ART and decreased internalised stigma to achieve viral suppression. Setting: HIV clinics	Standard of care, including regular clinic visits and option of joining monthly youth group meetings.	Youth Peer Mentors (YPM), aged 21–26 years old selected by healthcare providers as successfully managing their HIV. Completed a two-week training and underwent one month of practice meetings with youth before the intervention launch.	Overcoming shame Self-worth Community building	Participants overcame feelings of shame and developed greater self-worth. Participants reported how community building could alleviate feelings of isolation
Mohamadi et al. 2021 Country: Iran	Aim: To compare the methods of motivational interviewing led by a specialist and peer-to-peer education in promoting the knowledge and performance about puberty health and mental health in adolescent girls Study design: Cluster randomised controlled trial Data type: Quantitative	Eighth grade adolescent female students Age range: 13–15 Mean age: 14.44 N = 334	Intervention: Peer education Description: Peer educators led one formal training on puberty and mental health to other students, followed by the informal passage of information to peers in groups of 5–6 students within 1 month Setting: School	Two training sessions on puberty health conducted by the researcher Comparator: Group counselling involving motivational interviewing presented by a master in consultation in midwifery during five sessions of 60–90 min.	Active volunteers who scored higher on the puberty health questionnaire prior to the start of the study, responsible for transmitting information to 5–6 other students.	Persian Standard Symptom Checklist–25 (SCL–25)	Immediately and 1 month after intervention, the Intervention group scored significantly higher in knowledge and performance, and improved in mental health than the control group Scores in knowledge, performance, and mental health were better in the peer group (intervention 2) than intervention 1 and control group
Yuksel et al. 2019 Country: Turkey	Aim: To determine the effect of mentoring program on adjustment to university and ways of coping with stress in nursing students Study design: Quasi-experimental study Data type: Quantitative	First-year undergraduate nursing students Mean age: N = 91	Intervention: Peer education Description: Eight weekly sessions of peer mentoring program including acquaintance and group awareness, life in Aksaray and its features, communication skills, techniques that facilitate communication, interpersonal communication, stress and coping Setting: University	None	Ten fourth year students with 10 h of training over 5 days	Ways of Coping Inventory (WCI)	Posttest mean scores of active ways of coping with stress (Optimistic Approach and Seeking Social Support Approach) of the experimental group were statistically higher than that of the control group.
Peer support
Duby et al. 2021 Country: South Africa	Aim: To explore the perceived benefits of participation in peer-group clubs to better understand how combination interventions can incorporate social support and mental health components that ensure their relevance and effectiveness Study design: Quasi-experimental design Data type: Qualitative	Adolescent girls and young women (AGYW) in and out of school Age range: 15–24 N = 185	Intervention: Peer-support Description: Peer-group clubs (The Keeping Girls in School Program and Rise Young Women’s Clubs) designed to build self-esteem, confidence, life skills, provide supportive peer networks, and offer a platform for group discussions on sexual and reproductive health rights and gender equality Setting: Community clubs and schools	None	Trained peer-educators of similar age	Self-esteem Empowerment, self-worth, and self-respect Well-being and coping	Peer-group clubs: Positively affected their well-being through building self-esteem and self-confidence Allowed AGYW to feel empowered with improved self-worth and emotional strength Improved mental health and wellness by teaching how to communicate feelings and emotions Peer facilitation was regarded as beneficial to AGYW in providing SRH, emotional support and counselling
Harrison et al., 2023 Country: South Africa	Aim: A pilot study to examine the acceptability, feasibility and preliminary impact of a peer support group for youth living with a range of chronic illnesses Study type: Quasi-experimental design Data type: Mixed methods	Adolescents living with a range of chronic illness (i.e. HIV, renal disease, psychiatric conditions, diabetes, etc.) and receiving care at Groote Schuur Hospital (GSH) Age range: 13–24 Mean age: 18.74 N = 58 (intervention = 20 and control = 38)	Intervention: Peer-support Description: The Better Together Programme, which helps adolescents with chronic conditions build social networks that enhance psychosocial support, develop a sense of belonging with peers, create a space where adolescents can share their experiences and build empathy. Setting: Hospital	Non-peer group	Peer mentors who are also living with a chronic condition	Quantitative: CD-RISC 10 Child Attitude Toward Illness Scale (CATIS) Beck Youth Inventories Second Edition (BYI-II) Qualitative: Support and acceptance in support group Benefits of participation in peer support group	Quantitative: Those who attended at least five peer group sessions had higher self-reported individual-level resilience (p = 0.004), positive attitude toward their chronic illness (p < 0.001), stronger self-concept (p = 0.039), lower depressive symptoms (p < 0.10) Average total or T-scores on Beck Anxiety Inventory for Youth, Beck Anger Inventory for Youth, and Beck Disruptive Inventory for Youth did not statistically significantly differ between peer group and non-peer group patients. Statistically significant association between mental health improvement as a function of peer group participation overall (Wilks’ Lambda = 0.7349, F (8,49) = 2.21, p = 0.043) and for individual domains of resilience, attitudes toward illness, chronic disease stigma, self-concept, depression Attending more than 5 group sessions was positively associated with a reduced odds of screening positive for depression or anxiety Qualitative An eye opening and powerful experience for most young people Finding support and acceptance in the support group Social support
Tinago et al., 2023 Country: Zimbabwe	Aim: To test the effectiveness of a community-based peer support intervention to mitigate social isolation and stigma of adolescent motherhood Study type: Quasi-experimental design Data type: Quantitative	Adolescent mothers who were pregnant and/or had a child or children who resided in the two selected communities in Harare Age range: 15–18 years N = 104 (intervention), 79 (control)	Intervention: Peer-support Description: Peer support groups that met in-person twice a month and completed 12 total 75-min peer-group sessions. WhatsApp was used to schedule meetings, answer queries or further discuss peer support topics. Average of 12 participants per group. Setting: Community	A community similarly low-income and high-density in Harare.	12 peer educators co-facilitated the peer support groups with Community Health Workers	PHQ–9 MSPSS SSQ Peer and Significant Adult Support (PSAS)	PHQ–9 and SSQ had greater improvements in the intervention arm than control arm by 5.01 (p < 0.001) and 3.10 (p < 0.001) points Probability of moderate to severe depression decreased in intervention arm from 0.408 to 0.231 (p = 0.005), and increased in control arm 0.267 to 0.333. Participants were four times less likely to become moderately-to-severely depressed than were control participants Each of the four scores of MSPSS (family, friends, significant other, and total) had greater improvements in the intervention arm than control by 0.691 (p = 0.003), 1.03 (p < 0.001), 1.61 (p < 0.001) and 1.11 (p > 0.001) points respectively Overall score of PSAS survey had greater improvement in intervention arm than control arm by 0.508 points (p < 0.001)