A process evaluation of a peer education project to improve mental health literacy in secondary school students: Study Protocol

Emily C Widnall*, Steven Dodd, Ruth Simmonds, Helen Bohan, Abby E Russell, Mark Limmer, Judi L Kidger

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Emotional disorders in young people are increasing but studies have found that this age group do not always recognise the signs and symptoms of mental health problems in themselves or others. The Mental Health Foundation’s school-based Peer Education Project (PEP) has the potential to improve young people’s understanding of their own mental health at a critical developmental stage (early adolescence) using a peer teaching method. This study is a process evaluation to understand: the mechanisms through which PEP might improve young people’s mental health literacy, any challenges with delivery, how the project can be embedded within wider school life and how it can be improved to be of most benefit to the widest number of young people. We will also validate a bespoke mental health literacy questionnaire, and test the feasibility of using it to measure outcomes in preparation for a future study evaluating effectiveness.
All schools recruited to the study will receive the PEP intervention. The process evaluation will be informed by realist evaluation approaches to build understanding regarding key mechanisms of change and the impact of different school contexts. Theevaluation will test and revise an existing intervention logic model which has been developed in partnership with the Mental Health Foundation. Process evaluation data will be collected from newly recruited schools ( n =4) as well as current PEP user schools ( n =2) including training and lesson delivery observations, staff interviews and student focus groups. Baseline and follow-up data will be collected in all newly recruited intervention schools ( n = 4) from all students in Year 7/8 (who receive the PEP) and recruited peer educators in Year 12 via a self-report survey.
This study will enable us to refine the logic model underpinning the peer education project and identify areas of the intervention that can be improved. Findings will also inform the design of a future effectiveness study which will test out the extent to which PEP improves mental health literacy.
Original languageEnglish
Article number1879
Number of pages8
JournalBMC Public Health
Issue number1
Early online date18 Oct 2021
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information:
This research study is funded by the National Institute for Health Research (NIHR) School for Public Health Research (project number SPHR PHPES025). The views and opinions expressed in the paper are those of the authors and do not necessarily reflect those of the NIHR. The funding body played no role in the design, collection, analysis, interpretation or writing of the manuscript.

Publisher Copyright:
© 2021, The Author(s).


  • Mental health
  • peer education
  • school
  • adolescents
  • process evaluation


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