Active Learning With Peer-to-Peer Health Communication in School Health Education and Student Behavior Change: A Scoping Review.

backgroundThis scoping review mapped evidence on whether school health education using active learning with peer-to-peer health communication is associated with behavior change among elementary and junior high school students and identified challenges to sustaining change.

methodsFollowing PRISMA-ScR, we searched Ichushi Web, PubMed, and ERIC (February 14, 2024) for studies (2014-2024) evaluating peer-communication-based active learning in school health education with behavioral outcomes.

findingsSeventeen studies were included; 14 reported behavioral change, 2 partial change, and 1 emotional change without clear behavioral outcomes. Nine studies used behavioral or learning theories, and in this small set of studies, theory-informed interventions were reported to show overall or partial behavioral change, most often with Social Cognitive Theory (5 studies). These findings should be interpreted cautiously given the heterogeneity of study designs and outcome measures. Key limitations were limited long-term follow-up assessing sustainability of behavior change (5 studies) and concerns about measurement reliability (4 studies). The included studies were heterogeneous in terms of interventions and outcome measures, and many relied on self-reported behavioral indicators. As this was a scoping review, no formal risk-of-bias assessment was conducted. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Schools may strengthen primary prevention by embedding structured peer interaction and theory-informed techniques, while ensuring inclusive participation and supports that do not depend on family resources.

conclusionsPeer-to-peer health communication-based active learning may support short-term behavior change, but sustainability and measurement quality remain major evidence gaps.