Improving Peer Relationships Through Positive Deviance Practices and the HOPE (Healthy Outcomes from Positive Experiences) Framework.

Positive Childhood Experiences (PCEs), including supportive peer relationships, are crucial for optimal adult health and socioeconomic outcomes. As part of a broader initiative to address trauma in youth, we conducted a quality improvement project using a Positive Deviance (PD) approach. We aimed to improve peer relationships among members of the Asbury Park Boy & Girls Club and evaluate the feasibility of using a PD approach in a community-based setting. Using PD methodology, we identified practices used by staff to improve members' experiences. Pre-intervention focus groups with staff and youth, discovery and action dialogues and staff observations identified positive deviants (PDs) and PD practices. PD practices were further defined during staff observations and developed into staff training. Post-intervention focus groups assessed perceived changes. Qualitative data was analyzed using deductive thematic analysis through the HOPE (Healthy Outcomes from Positive Experiences) framework domains of PCEs: Relationships, Environment, Engagement and Emotional Growth. In vivo coding generated subthemes, preserving participant language. Post-intervention focus group analysis suggested improvements in peer-to-peer relationships with club members referring to their peers as "nice" and "kind", a contrast from pre-intervention findings. Findings were supported by club staff during member checking. These results suggest that the PD approach is a promising strategy for improving peer relationships and increasing access to PCEs in a community-based setting.