- Email: [email protected]
Peer education, Exercising, and Eating Right (PEER): Training of Peers in an Undergraduate Faculty Teaching Partnership
GEM NO. 463 Peer education, Exercising, and Eating Right (PEER): Training of Peers in an Undergraduate Faculty Teaching Partnership Naiman A. Khan, BS1; Chris Nasti, BS2; Ellen M. Evans, PhD3; Karen Chapman-Novakofski, RD, PhD4 INTRODUCTION Peer Educators (PEs) are people from the target group who are trained to assist in an educational program. The theoretical roots of peer education can be traced back to Social Cognitive Theory. The theory proposes that behavior and attitude can be influenced, in part, by interactions and observation of others.1 The concept of using PEs has been successful in extension and outreach programs such as the Expanded Food and Nutrition Education Program (EFNEP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding promotion.2,3 These successes suggest that PEs may be a good solution in other areas, including large undergraduate courses. Studies have demonstrated that student-assisted teaching in undergraduate classes can have positive outcomes for both instructors and PEs.4 Peer educators, unlike teaching assistants, provide a less expensive and renewable source of teaching support. One of the major barriers in using a peer educator system is development of adequate training and monitoring methods for PEs for quality control. Training models developed in the past have been short and implemented between 2 and 3 days.5 The
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use of PEs to deliver nutrition or exercise education is not novel. However, the aim of the present project was to develop and evaluate a training module for peers that combined teamed senior-level nutrition and kinesiology students to act as PEs to a general education course. This project developed and evaluated a training module for peers that combined nutrition and kinesiology in the training and selection of students to reflect the course content.
PROGRAM DESCRIPTION ‘‘Peer education, Exercising and Eating Right (PEER): An Undergraduate Faculty Teaching Partnership’’ was a 1-semester feasibility study to support the development of an undergraduate general education course. The first 8-week session focused on training peers; the second 8-week session reflected a general education course with a faculty and graduate student lecture and a peer-led discussion for tandem concepts in nutrition and kinesiology. The first goal was to develop a training model for undergraduate PEs in nutrition and kinesiology that could be implemented at other institutions or in other communities.
Department of Nutritional Sciences, University of Illinois at Urbana-Champaign Department of Exercise Physiology, University of Illinois at Urbana-Champaign 3 Department of Kinesiology and Community Health, University of Illinois at UrbanChampaign 4 Department of Food Science and Human Nutrition, University of Illinois at UrbanaChampaign The fourth author of this article (Chapman-Novakofski) serves on the JNEB staff as Editorin-Chief. Review of this article was handled, exclusively, by the Associate Editors to minimize conflict of interest. Address for correspondence: Naiman A. Khan, 238 Bevier Hall, 905 S. Goodwin Ave, Urbana, IL 61801; Phone: (404) 697-6923; Fax: (217) 265-0925; E-mail: [email protected] J Nutr Educ Behav. 2009;41:68-70 Ó2009 SOCIETY FOR NUTRITION EDUCATION doi:10.1016/j.jneb.2008.03.116 2
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Materials Development A literature review and Google search provided no optimal training manual for adoption. The most comprehensive manual found was the World Health Organization (WHO): Training of Trainers Manual (ToT).6 The WHO ToT manual is a 6-day program focused on sexual health education using PEs. The authors modified the training activities to focus on nutrition and physical activity. Topics adopted from the ToT manual included icebreakers, energizers, theory and practice of peer education, motivational techniques, public speaking, and cofacilitation skills. Additional topics were based on development and implementation of the nutrition and physical activity class content.
Implementation Six PEs were recruited from upperlevel undergraduate dietetics and kinesiology classes (3 from each discipline) based on a target class size of 40 with a ratio of 6 or 7 students per PE. This ratio was based on recommended focus group size of 6-9 students.7 Acceptance into the peer training program depended on the instructor’s impression of the candidate’s leadership skills, motivation, and work ethic. Peer training was weekly for 8 weeks in 1-hour sessions and was led by 2 graduate assistants (GAs) (1 in nutrition and 1 in kinesiology). The faculty attended a segment of the training to provide input and visibility but did not stay for the entire class to avoid ‘‘top-down’’ lectures or impede discussion among PEs and GAs who considered one another closer to peers themselves. The first 4 weeks of training emphasized the role of PEs in undergraduate education. Peer educators also completed face validation of the general education course curriculum
Journal of Nutrition Education and Behavior Volume 41, Number 1, 2009
Journal of Nutrition Education and Behavior Volume 41, Number 1, 2009
Khan et al 69
Table. Peer Educator Training Topics and Objectives Week 1
Training Topics Introduction to training methodology and self-efficacy Introduction to icebreakers, warm-up activities, and energizers Peer expectations
2
Evaluation of course content
3
Review student self-efficacy assessment tools Peer education – theory and practice
4
Motivational tools and techniques Group discussion: Motivation for behavioral change
Objectives Clarify the workshop’s objective and introduce concept of self-efficacy Allow participants to understand the purpose of icebreakers and to get experience in using them Clarify instructors’ expectations of peers and peers’ expectations of instructors Receive feedback from peers regarding the course content and increase their ownership of the course material Introduce evaluation tools of the program to PEs Allow participants to understand the nature and purpose of peer education Allow participants to gain insight in the mechanisms of behavior change and how these relate to peer education Provide participants with experience in motivational techniques Consider the potential contribution of self-efficacy in creating behavior change
Group discussion: Barriers to change in exercise and nutrition behavior 5
Introduction to public speaking Exercise: 30 seconds of fame
Provide peers with an opportunity to learn public speaking skills
6
Co-facilitation skills Develop class activities and discussion questions
Build on and advance participants’ co-facilitation styles Allow PEs to share ideas for class activities in an effort to increase their participation in course development Allow PEs to practice teaching
7 and 8
Practice: Team presentations
and provided insight into proposed class activities and recommended additional topics. The second 4-week training period was designed to provide the PEs with public speaking, co-facilitation, and presentation skills. The last 2 meetings allowed paired PEs to lead a class activity followed by a group discussion, with many of these activities later incorporated into the class curriculum. The Table summarizes the components of the 8-week training program.
Evaluation The evaluation of the training program was conducted 5 weeks into the teaching phase of the study. Peer educators filled out qualitative and quantitative questionnaires assessing faculty support, adequacy of training activities, and suggestions for future implementation. Peer educators indicated, overall, that the training was beneficial. However, they all expressed the need to spend more time
practicing the teaching material during training. One PE responded to a teaching efficiency question by saying, ‘‘Have us review/teach the lecture material beforehand. That way we are better prepared for their questions in discussions.’’ The peers also recommended increased emphasis on public speaking training. All PEs agreed that they had adequate support from faculty and GAs, and approved the lecture/discussion structure. All peers also agreed that the teaching experience was valuable for them. According to one of the PEs, ‘‘I liked doing the discussion activities and I felt like the group really liked having someone their age lead.’’ Students who participated in the class (N ¼ 39) agreed or strongly agreed that they had deeper understanding of the class content (92%) and were more engaged in the learning process (89%) as a result of having an appointed PE. The peer training manual for nutrition/kinesiology upperclassmen provides a framework to facilitate both
training of students and general education course delivery. More teaching practice time was the only consistent revision suggested by peers.
ACKNOWLEDGMENT This project was supported by the United States Department of Agriculture Higher Education Challenge Grant.
SUPPLEMENTARY DATA Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.jneb.2008. 03.116
REFERENCES 1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
70 Khan et al 2. Havas S, Anliker J, Damron D, Feldman R, Langenberg P. Uses of process evaluation in the Maryland WIC 5-A-Day Promotion Program. Health Educ Behav. 2000;27:254-263. 3. Boyd NR, Windsor RA. A formative evaluation in maternal and child health practice: the Partners for Life Nutrition Education Program for Pregnant Women. Matern Child Health J. 2003;7: 137-143. 4. Adams EM, Brown SC, Cook TL. Establishing a common ground: a conjoint training model for instructors and peer
Journal of Nutrition Education and Behavior Volume 41, Number 1, 2009 educators. In: Miller JE, Groccia JE, Miller MS, eds. Student-Assisted Teaching: A Guide to Faculty-Student Teamwork. Boston, MA: Anker Publishing Company, Inc.; 2001:2-7. 5. Stover LA, Story KA, Skousen AM, Jacks CE, Logan H, Bush BT. The teaching teams program: empowering undergraduates in a student-centered research university. In: Miller JE, Groccia JE, Miller MS, eds. Student-Assisted Teaching: A Guide to Faculty-Student Teamwork. Boston, MA: Anker Publishing Company, Inc.; 2001:40-43.
6. United Nations Interagency Group on Young People’s Health, Development and Protection in Europe and Central Asia, Subcommittee on Peer Education. Peer Education: Training of Trainers Manual. 2003. Available at http://www.aids mark.org/ipc_en/pdf/sm/tm/Peer%20 Education%20Training%20of%20Trai ners%20Manual.pdf. Accessed October 16, 2008. 7. Kruger RA. Focus Groups: A Practical Guide for Applied Research. 2nd ed. Thousand Oaks, CA: Sage Publications; 1994.
1
use of PEs to deliver nutrition or exercise education is not novel. However, the aim of the present project was to develop and evaluate a training module for peers that combined teamed senior-level nutrition and kinesiology students to act as PEs to a general education course. This project developed and evaluated a training module for peers that combined nutrition and kinesiology in the training and selection of students to reflect the course content.
PROGRAM DESCRIPTION ‘‘Peer education, Exercising and Eating Right (PEER): An Undergraduate Faculty Teaching Partnership’’ was a 1-semester feasibility study to support the development of an undergraduate general education course. The first 8-week session focused on training peers; the second 8-week session reflected a general education course with a faculty and graduate student lecture and a peer-led discussion for tandem concepts in nutrition and kinesiology. The first goal was to develop a training model for undergraduate PEs in nutrition and kinesiology that could be implemented at other institutions or in other communities.
Department of Nutritional Sciences, University of Illinois at Urbana-Champaign Department of Exercise Physiology, University of Illinois at Urbana-Champaign 3 Department of Kinesiology and Community Health, University of Illinois at UrbanChampaign 4 Department of Food Science and Human Nutrition, University of Illinois at UrbanaChampaign The fourth author of this article (Chapman-Novakofski) serves on the JNEB staff as Editorin-Chief. Review of this article was handled, exclusively, by the Associate Editors to minimize conflict of interest. Address for correspondence: Naiman A. Khan, 238 Bevier Hall, 905 S. Goodwin Ave, Urbana, IL 61801; Phone: (404) 697-6923; Fax: (217) 265-0925; E-mail: [email protected] J Nutr Educ Behav. 2009;41:68-70 Ó2009 SOCIETY FOR NUTRITION EDUCATION doi:10.1016/j.jneb.2008.03.116 2
68
Materials Development A literature review and Google search provided no optimal training manual for adoption. The most comprehensive manual found was the World Health Organization (WHO): Training of Trainers Manual (ToT).6 The WHO ToT manual is a 6-day program focused on sexual health education using PEs. The authors modified the training activities to focus on nutrition and physical activity. Topics adopted from the ToT manual included icebreakers, energizers, theory and practice of peer education, motivational techniques, public speaking, and cofacilitation skills. Additional topics were based on development and implementation of the nutrition and physical activity class content.
Implementation Six PEs were recruited from upperlevel undergraduate dietetics and kinesiology classes (3 from each discipline) based on a target class size of 40 with a ratio of 6 or 7 students per PE. This ratio was based on recommended focus group size of 6-9 students.7 Acceptance into the peer training program depended on the instructor’s impression of the candidate’s leadership skills, motivation, and work ethic. Peer training was weekly for 8 weeks in 1-hour sessions and was led by 2 graduate assistants (GAs) (1 in nutrition and 1 in kinesiology). The faculty attended a segment of the training to provide input and visibility but did not stay for the entire class to avoid ‘‘top-down’’ lectures or impede discussion among PEs and GAs who considered one another closer to peers themselves. The first 4 weeks of training emphasized the role of PEs in undergraduate education. Peer educators also completed face validation of the general education course curriculum
Journal of Nutrition Education and Behavior Volume 41, Number 1, 2009
Journal of Nutrition Education and Behavior Volume 41, Number 1, 2009
Khan et al 69
Table. Peer Educator Training Topics and Objectives Week 1
Training Topics Introduction to training methodology and self-efficacy Introduction to icebreakers, warm-up activities, and energizers Peer expectations
2
Evaluation of course content
3
Review student self-efficacy assessment tools Peer education – theory and practice
4
Motivational tools and techniques Group discussion: Motivation for behavioral change
Objectives Clarify the workshop’s objective and introduce concept of self-efficacy Allow participants to understand the purpose of icebreakers and to get experience in using them Clarify instructors’ expectations of peers and peers’ expectations of instructors Receive feedback from peers regarding the course content and increase their ownership of the course material Introduce evaluation tools of the program to PEs Allow participants to understand the nature and purpose of peer education Allow participants to gain insight in the mechanisms of behavior change and how these relate to peer education Provide participants with experience in motivational techniques Consider the potential contribution of self-efficacy in creating behavior change
Group discussion: Barriers to change in exercise and nutrition behavior 5
Introduction to public speaking Exercise: 30 seconds of fame
Provide peers with an opportunity to learn public speaking skills
6
Co-facilitation skills Develop class activities and discussion questions
Build on and advance participants’ co-facilitation styles Allow PEs to share ideas for class activities in an effort to increase their participation in course development Allow PEs to practice teaching
7 and 8
Practice: Team presentations
and provided insight into proposed class activities and recommended additional topics. The second 4-week training period was designed to provide the PEs with public speaking, co-facilitation, and presentation skills. The last 2 meetings allowed paired PEs to lead a class activity followed by a group discussion, with many of these activities later incorporated into the class curriculum. The Table summarizes the components of the 8-week training program.
Evaluation The evaluation of the training program was conducted 5 weeks into the teaching phase of the study. Peer educators filled out qualitative and quantitative questionnaires assessing faculty support, adequacy of training activities, and suggestions for future implementation. Peer educators indicated, overall, that the training was beneficial. However, they all expressed the need to spend more time
practicing the teaching material during training. One PE responded to a teaching efficiency question by saying, ‘‘Have us review/teach the lecture material beforehand. That way we are better prepared for their questions in discussions.’’ The peers also recommended increased emphasis on public speaking training. All PEs agreed that they had adequate support from faculty and GAs, and approved the lecture/discussion structure. All peers also agreed that the teaching experience was valuable for them. According to one of the PEs, ‘‘I liked doing the discussion activities and I felt like the group really liked having someone their age lead.’’ Students who participated in the class (N ¼ 39) agreed or strongly agreed that they had deeper understanding of the class content (92%) and were more engaged in the learning process (89%) as a result of having an appointed PE. The peer training manual for nutrition/kinesiology upperclassmen provides a framework to facilitate both
training of students and general education course delivery. More teaching practice time was the only consistent revision suggested by peers.
ACKNOWLEDGMENT This project was supported by the United States Department of Agriculture Higher Education Challenge Grant.
SUPPLEMENTARY DATA Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.jneb.2008. 03.116
REFERENCES 1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
70 Khan et al 2. Havas S, Anliker J, Damron D, Feldman R, Langenberg P. Uses of process evaluation in the Maryland WIC 5-A-Day Promotion Program. Health Educ Behav. 2000;27:254-263. 3. Boyd NR, Windsor RA. A formative evaluation in maternal and child health practice: the Partners for Life Nutrition Education Program for Pregnant Women. Matern Child Health J. 2003;7: 137-143. 4. Adams EM, Brown SC, Cook TL. Establishing a common ground: a conjoint training model for instructors and peer
Journal of Nutrition Education and Behavior Volume 41, Number 1, 2009 educators. In: Miller JE, Groccia JE, Miller MS, eds. Student-Assisted Teaching: A Guide to Faculty-Student Teamwork. Boston, MA: Anker Publishing Company, Inc.; 2001:2-7. 5. Stover LA, Story KA, Skousen AM, Jacks CE, Logan H, Bush BT. The teaching teams program: empowering undergraduates in a student-centered research university. In: Miller JE, Groccia JE, Miller MS, eds. Student-Assisted Teaching: A Guide to Faculty-Student Teamwork. Boston, MA: Anker Publishing Company, Inc.; 2001:40-43.
6. United Nations Interagency Group on Young People’s Health, Development and Protection in Europe and Central Asia, Subcommittee on Peer Education. Peer Education: Training of Trainers Manual. 2003. Available at http://www.aids mark.org/ipc_en/pdf/sm/tm/Peer%20 Education%20Training%20of%20Trai ners%20Manual.pdf. Accessed October 16, 2008. 7. Kruger RA. Focus Groups: A Practical Guide for Applied Research. 2nd ed. Thousand Oaks, CA: Sage Publications; 1994.