Effectiveness of Peer-Led Interventions in Improving the Dietary Behavior of Adolescents in Low- and Middle-Income Countries: A Systematic Review.

Abstract

Context: Adequate nutrition is crucial during adolescence due to significant physical, mental, and emotional changes, yet in many adolescents poor dietary behaviors lead to inadequate nutrient intake and increased health risks. Peer-led interventions have shown promise in improving these behaviors. Thus, synthesizing evidence from primary studies is crucial to enhance their effectiveness and policy implications.

Objective: In this review we synthesized evidence on the effectiveness of peer-led interventions in improving the dietary behavior of adolescents in low and middle-income countries (LMICs).

Data sources: We searched thePubMed, CINAHL, PsycINFO, ERIC, Cochrane Library, and SCOPUS databases for studies on peer-led interventions among adolescents aged 10-19 years. No specific publication timeframe was set for the search. Studies lacking quantitative outcome measures were excluded.

Data extraction: Of the 3177 records initially identified, 8 studies were included. Study quality was assessed by use of Joanna Briggs Institute quality appraisal tools. Data extraction involved capturing study characteristics, intervention components, outcomes, and key findings.

Data analysis: The studies were conducted in the regions of Sub-Saharan Africa, the Middle East, Southeast Asia, and South Asia, with intervention durations ranging from 3 weeks to 3 years. Interventions included peer leaders facilitating group discussions, making posters, and providing practical demonstrations. Most studies reported improvements in dietary intake such as increases in fruit and vegetable consumption and reductions in unhealthy snack intake following the intervention. Knowledge and attitudes toward healthy dietary behavior also improved. None of the studies included explicit detail involving adolescents in the initial design of interventions. Multicomponent interventions and longer durations were more successful.

Conclusion: Peer-led interventions effectively improved the dietary behaviors of adolescents in LMICs. The findings of this review underscore the importance of multicomponent strategies and longer intervention durations. Involving adolescents in program design is recommended to enhance the relevance and impact of interventions. Researchers should identify the most effective intervention components and delivery methods.