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Abstract

Background:

Effectively supporting and promoting mental health education for at-risk populations is crucial. In New Zealand, risks in relation to the suicide for young farm labourers, alongside the stress associated with the transition to university and the vulnerability of rural communities, place agricultural students in a vulnerable position. The use of peer educators has been identified as an important way of building connections in health and wellbeing education and increasing engagement and mental health knowledge. This article reports on the experiences of peer educators in delivering a mental health and wellbeing programme to agricultural students at two universities in New Zealand.

Design:

As part of evaluating a mental health and wellbeing programme, researchers sought to learn more about the experiences and learnings of peer educators. Drawn on findings from a wider mixed-methods study, this article reports on qualitative findings related to the use of peer educators. These findings emerged from semi-structured interviews with the peer educators involved in the delivery of the programme.

Findings:

Peer-led mental health and wellbeing programmes have benefits not only for the students participating but also for the peer educators leading them. These benefits include increased mental health knowledge, confidence and skills. In addition, the peer educators found value in delivering important mental health and wellbeing messages.

Conclusions:

Peer educators can benefit from the experience of delivering mental health and wellbeing programmes. Furthermore, they can be utilised to deliver these programmes with little prior knowledge of the topics they are delivering provided they have support from professionals with teaching and clinical expertise. These findings are important for informing the development and delivery of mental health interventions for at-risk communities looking to increase connectedness and build resilience.

Keywords

Agriculture suicide prevention higher education mental health peer education rural communities wellbeing

Introduction

Studies have shown the efficacy of peer-led programmes in delivering health-promotion messages to vulnerable groups of young people, positively affecting student engagement and knowledge retention (Bulanda et al., 2014; Gilham et al., 2018; Moir et al., 2016; Reis et al., 2023; Winder et al., 2024). It is important for mental health interventions for at-risk populations to be effectively supported and promoted. The mental health and wellbeing of agricultural students in New Zealand is of particular concern. Suicide rates in rural New Zealand communities are higher than national rates, and concerningly, of the 185 people who died by suicide on farms in NZ between 2007 and 2015, 25% were farm labourers younger than 25 years, many of whom did not seek help prior to their death (Beautrais, 2018).

New Zealand research on younger farmers’ wellbeing has identified a variety of challenges impacting their wellbeing such as workload and lack of good quality sleep (Wyllie, 2018). This research calls for a collaborative approach between stakeholder organisations to improve younger farmer wellbeing. There have also been calls for research to consider the relationship between education and wellbeing in farming (Klerkx, 2020). The mental health and wellbeing programme WellMates was developed by academic staff at a university in New Zealand in response to concern for this vulnerable group of young people.

WellMates is a mental health and wellbeing programme delivered by peer educators to first-year agricultural students. The programme’s goal is to increase the mental health and wellbeing skills, knowledge and confidence of the first-year university agricultural student participants (Hay et al., 2024; Winder et al., 2024). The programme was first developed in 2020 and has been delivered at two universities delivering agricultural programmes since 2022. Research to understand the effectiveness of the programme took place in 2022 and in 2023. However, there was a further need identified to evaluate the roles of peer educators in the delivery of the WellMates programme.

This article reports on qualitative findings from a mixed-methods study evaluating WellMates. The study included semi-structured interviews with the peer educators from the WellMates programme. A key aim was to learn more about the experiences and learning of peer educators in delivering mental health and wellbeing messages to their peers to better develop and support such programmes for vulnerable communities. While focusing on the outcomes for the peer educators in training and delivering the mental health and wellbeing programme, this article considers the personal value of the topic for the peer educators and their communites. It also discusses the importance of peer educators receiving good support through training and preparation and in the delivery of the programme.

Peer educator learning and development

The effectiveness of participation in peer-led educational programmes for young people is confirmed (Bulanda et al., 2014; Jorm, 2012, 2015; Winder et al., 2024). Research details that mental health and wellbeing messages are more likely to be heard when they are delivered by peers from within the same community (Azizi et al., 2017; Goetz et al., 2011; Kirsch et al., 2014; Sloane and Zimmer, 1993). In addition, young people are more likely to seek help from peers who they see as similar to themselves (Frohn et al., 2013; Goetz et al., 2011; Hay et al., 2024; Kirsch et al., 2014; Sloane and Zimmer, 1993). This use of peers for delivering health promotional information is also supported by ideas found in behavioural change theories such as the role of the credible model in social learning theory and the use of trusted sources or social leaders from within a community in diffusion in innovations theory (Bandura, 1977; Rogers, 2003; Turner and Shepherd, 1999).

Recent research discusses the key motivators for people who take on peer educator roles within their communities, such as helping others and sharing valuable information (Crisp et al., 2020; Lammers et al., 2023; Reis et al., 2021). However, there is little research on the outcomes for young people who act as peer educators and on understanding the factors that best support them to fulfil these roles (O’Reilly et al., 2016; Reis et al., 2021). The research that does exist, as evidenced in the study by Reis et al. (2021), found benefits not only for those participating in the programme but also for the students who were peer educators for the development of leadership skills. Similarly, O’Reilly et al. (2016) evaluated a school-based training programme for young people delivering a mental health workshop to their peers. The authors concluded that training to become a peer educator may increase young people’s mental health knowledge, workshop-presentation skills and beliefs about help-seeking by reducing self-stigma (O’Reilly et al. 2016). As peer educators are drawn from the same community as their students, understanding the benefits for them may help to support further change within at-risk communities (Maticka-Tyndale and Barnett, 2010; Winter, 2013). In addition, understanding the factors that best support peer educators in delivering health-promotion programmes is crucial for continuing to improve the development and delivery of these courses (Abdi and Simbar, 2013; Azizi et al., 2017). It was with this experience in mind that we sought to find out more about the peer educator experience.

Methodology and methods

This article reports on the qualitative findings from an exploratory study using semi-structured interviews with peer educators involved in a mental health programme for first-year agricultural students at two universities in New Zealand. The article’s findings come from a wider mixed-methods study involving quantitative and qualitative data collection. The wider project was aimed at reducing lives lost by suicide in rural communities by further strengthening the mental health education programme, WellMates, for in-person classroom delivery as well as supporting its translation to an online module.

Ethical approval for all stages of the research was received from Massey University’s ethical review body (Massey University Human Ethics Ohu Matatika 1: OMI 23/17). The research was guided by the ethical principles of beneficence, informed consent, confidentiality and avoidance of conflict of interest. As the programme was about delivering key messages about mental health and suicide prevention to a vulnerable community, of which the peer educators were members, these principles were of utmost importance. They were also important from a professional perspective for the researchers, as although they were not involved in the delivery of the programme, they were employed by their respective universities, and two of the researchers (NS-C and LW) were involved in the training of the peer educators and in a non-active role during the workshops to provide support if required to any participant who may need clinical expertise.

This article focuses on findings from eight semi-structured qualitative interviews conducted with WellMates peer educators. The six female and two male peer educators were volunteers from the Young Farmers Club¹ at both universities. The peer facilitators were either from a farming background or in their second or third year studying agriculture. Following the delivery of the WellMates programme, the peer educators were invited to participate in an interview to explore their experiences, including any personal benefits, challenges and learnings, and to provide feedback on the support they received in their roles. The interviews were conducted online using Zoom. All the peer educators agreed to be interviewed. No other demographic information was collected to retain confidentiality. The interviews were conducted in October 2023 by an experienced interviewer and researcher (AH), who had had no prior relationship to the educators. Researcher reflexivity was an important part of this interview process and thematic analysis. It required the researcher to carefully manage their presence and subjectivity, being mindful of how their personal worldview might impact the data (Patton, 2015). The interviews lasted for approximately 1 hour.

Purposive sampling approach was used to recruit the peer educators to capture their experiences. They were asked to volunteer and were not paid for their time but were given a meal voucher to thank them for their contribution. While an interview schedule was used, the use of semi-structured interviews enabled the interviewer to use open questions and to ask follow-up questions to gather rich contextual data (Patton, 2015). The interview topics explored peer educators’ experiences of facilitating the mental health programme and what they enjoyed and found challenging, along with specific feedback on the course. Questions included:

What attracted you to becoming a WellMates student facilitator?

Can you tell me about your overall experience delivering WellMates this year?

In delivering the programme, what have been your own key learnings?

Responses to the interview questions were digitally transcribed using Otter.ai transcription software and then checked and verified for accuracy. All peer educators were allocated pseudonyms, and any identifiable information was anonymised or removed from the transcripts. Prior to analysis, participants were sent their transcripts to ensure they were accurate and trustworthy (Lietz and Zayas, 2010).

The data were analysed thematically by a researcher (AH) using the processes outlined by Braun and Clarke (2022), and then checked by another researcher (NS-C) to ensure inter-coder reliability. The process began with data familiarisation, looking for similar ideas from across the transcripts and then centrally organising these into main themes. Four main themes were identified: finding value, improved mental health knowledge, workshop presentation and leadership skills and feeling supported.

Results and discussion

Research shows that peer-delivered health and wellbeing programmes have benefits not only for the students participating but also for the students leading them as well (O’Reilly et al., 2016; Reis et al., 2021). These benefits became evident as peer educators discussed their learning from the process of delivering the programme. Overall, peer educators found value in delivering the mental health programme. It not only provided them with increased knowledge about mental health but also challenged them to pass this on to their peers, building their confidence and leadership skills and providing them with a sense of purpose. Their involvement derived a willingness to help others and a passion for the topic, which in some cases was driven by personal experience. Educators also reflected on the importance of support from both those leading the programme and the overall institution where the programmes were delivered. These findings are explored here under the titles of the four main themes identified through thematic analysis.

Finding value

The likelihood of helping others has been found to be a key motivator for young people to take on roles as peer educators in mental health and wellbeing programmes (Crisp et al., 2020; Reis et al., 2021). All the peer educators in this study expressed a willingness to help others and support their peers, and for many, this was a key factor in their decision to become a WellMates peer educator. As stated by Chloe:

‘I think it feels good knowing that you are taking an active role in helping students and your peers’. Ivy shared: ‘I do enjoy giving and helping people . . . I felt quite good imparting knowledge on to young people’. The task of helping their peers and imparting knowledge provided educators with a sense of purpose, which was heightened by the relevance of the topic to their everyday lives as agricultural students. Three sub-themes were evident: sharing information, sharing experiences and peer leadership.

Sharing information

The delivery of mental health and wellbeing messages that are meaningful for a community can encourage young people to take on leadership and facilitation roles in their dissemination (Reis et al., 2021). Peer educators expressed a passion for the mental health and wellbeing messages that the programme imparted, acknowledging that mental health in the rural sector in New Zealand is important for reducing lives lost by suicide. As Alice explained:

I think probably just that rural mental health and suicide rates are so high compared to, in comparison with those rates in New Zealand, and just how the isolation of being in a rural area or being on a farm and stuff and how it affects so many people, especially how much farmers rely on the climate . . . they can get affected by things a lot of people don’t get affected by because it’s their livelihoods. And so being able to be in a space where I am contributing positively hopefully, to those people that are going into those areas, is probably what attracted me.

Sharing experiences

Alongside this passion for sharing information about mental health and wellbeing, for some of the peer educators, motivation also came from personal experiences of mental health. Mia shared that her lived experience of mental health struggles had motivated her to help others by presenting another perspective to students who attended the workshop:

I think quite a big thing that is missed is the people that struggle the most are the ones that you, that often look like they’re never struggling, you know, like . . . So I tried to, like go from like being on one side of it, to trying to emphasise that it’s the people that look like they’re always doing the best that are obviously struggling the most.

For Ivy, James and Libby, the motivation came from knowing people around them with lived experience of mental illness that made it personal and contributed to their willingness to be involved. Ivy and James had both lived with people or family members who had struggled with their mental health, and Libby had known someone who had taken their own life. Peer educators’ personal experiences of mental health provided relevance to the topic and their everyday lives. The opportunity to use their experiences to help others in a positive and constructive way gave value and meaning to their engagement while also potentially benefitting their own personal development (Lammers et al., 2023; Reis et al., 2021).

Peer leadership

Another facet of value to peer educators was their belief that supporting their peers in the programme would strengthen student engagement and learning around the topic. The literature shows that mental health and wellbeing messages are more likely to be heard and acted upon when they are delivered by peers (Azizi et al., 2017; Goetz et al., 2011; Kirsch et al., 2014; Sloane and Zimmer, 1993). All the peer educators in this study were agricultural students or came from a farming background. In line with existing research, they recognised that the delivery of the programme by familiar faces and peers would provide participants with access to someone they might be able to relate to and were therefore more likely to listen to and engage with on the topic. Emma reflected the views of the other educators when she said:

I think the general idea of having familiar faces delivering the course worked quite well. And for us to be able to bring in that engagement from the first years that we had already had connections with, that definitely helped other first years feel a bit more inclined to participate.

Ben and Mia also referred to the relatability of having a fellow student delivering the programme. Mia explained:

mental health is quite a touchy subject for a lot of people in one way or another, and if I heard it from like, a kid who was at uni, just like me that, you know, struggles with the pressure of lots of assignments and things like that, and social pressures, and that if they come from a student, as well it would be a lot more relatable than, I don’t know, like, a lecturer giving it to you.

As familiar faces from within the university agricultural cohort, and as representatives of an influential farming club, along with knowing the relevance of the topic for their community, peer educators could see that their involvement was purposeful and provided a valuable connection for their peers. In accordance with the findings of Reis et al. (2021), it gave them a sense of purpose that facilitated their engagement in the delivery of the programme.

Students’ willingness to become peer educators and facilitate the WellMates mental health programme stemmed from different motivations that gave value to what they could give back to their community. It also provided connection to their everyday lives and personal interests (Cole et al., 2004; Wynters et al., 2021).

Improved mental health knowledge

Although four of the eight peer educators had some personal experience of mental health, only one had prior knowledge of the topics that were being discussed in the mental health and wellbeing programme. However, with the support of professionals with teaching and clinical expertise, this did not affect their ability to learn the content and share it with their peers. This finding is supported by results from the wider study that demonstrates the effectiveness of the programme for those who attended (Knook et al., in press). After completing this training and delivering the programme, seven peer educators identified learning about mental health and wellbeing they gained from the programme. Libby noted that the messages delivered in the programme had a dual purpose, providing learning not only for the participants in the workshop but for herself as well:

well, I guess even some of the messages that we were delivering, even learning that myself was good, so like, not just giving a talk on mental health to first years, it was actually, you know . . . I can use those tools myself as well, as well as sharing them with the class.

Others identified specific things that they had learned from the programme and how these had contributed to their increased mental health knowledge. Chloe said,

how to act towards someone if they come to you with like issues about their own mental health, and just how to support them and be there, and like who to refer them to, and I think how to take an active role in those conversations.

While other peer educators connected to specific terms or models in the programme. Emma discussed learning about the Māori health model Te Whare Tapa Whā² (Mental Health Foundation of New Zealand, 2024), and James identified ‘. . . there were a lot of sayings in there that I learned like . . . resilience is the ability to bounce back from adversity, that was quite a good one’ (James). These experiences increased peer educators’ confidence to support themselves and others with mental health struggles. Ben reflected on how being a peer educator had made him feel more confident ‘within myself . . . I’ll probably recognise it more I think and hopefully act on it’. Chloe stated that she felt being a peer educator had given her ‘the confidence to be able to talk to and have those difficult conversations with people’.

Peer educators’ involvement in the delivery of the mental health and wellbeing programme provided them not only with increased knowledge but also the confidence to apply this knowledge in their everyday lives and within their community. This increased knowledge and confidence was also confirmed by data from the students who participated in the programme (Winder 3 et al., 2024), as well as by other research (Bulanda et al., 2014; Jorm, 2012, 2015). In time, the shared outcomes for both the peer educators and the participants in WellMates may help normalise the conversation about mental health within their university agricultural student community and, in turn, the rural working context which many return home to or will leave study to work in. As mentioned earlier, the peer educators were familiar faces to students attending the workshop, thus providing connection and continuity, which may help to build relationships and break down stigma within their community (Hay et al., 2024).

Workshop presentation and leadership skills

In line with the findings of O’Reilly et al. (2016), this study found that peer educator training, practice for delivery, and the presentation of a workshop contributed to improved workshop presentation and leadership skills. A beneficial outcome identified by peer educators was the opportunity to increase their leadership skills, including public speaking and delivering information to their peers.

Participants discussed increased confidence in presenting and leading a workshop for their peers. Ben explained that the training was good but that he got more out of the delivery process:

[I] learned so much more, yeah in the process of actually doing it than the training . . . but yeah the training was good . . . and it’s pretty much just knowing like, the structure of the PowerPoint and that, to give you confidence in what you’re going to do next, so you can kind of be yeah, a confident presenter. (Ben)

Emma, like others, noted delivering the programme had improved her public speaking skills: ‘. . . it’s definitely helped with public speaking’ (Emma), and James spoke about how enjoyable the experience had been.

the experience of actually standing up there in front of your peers . . . I really enjoyed being up there and actually learning how to, actually what you have to do and, then the content was quite good. (James)

Feeling supported

Research has identified the importance of good support for peer educators during training, preparation and delivery of peer education programmes (Abdi and Simbar, 2013; Azizi et al., 2017). As part of the WellMates programme, the peer educators from both universities participated in a joint day of training led by two registered health professionals (NS-C and LW). They later connected with these professionals on a regular basis while preparing for the delivery on the programme through email and face-to-face meetings. Opportunity was also provided for the educators to practise aspects of the programme and ask questions of the professionals throughout this process.

The effectiveness of peer education programmes is closely associated with how carefully designed, developed and supported peers are (Abdi and Simbar, 2013; Azizi et al., 2017). This support was important for the peer educators in this study as they had taken on the responsibility of delivering key messages about mental health to an at-risk community that they were a part of as university agricultural students. Although the peer educators had little prior knowledge of delivering a mental health and wellbeing programme, they mostly felt well supported by professionals with teaching and clinical expertise. Chloe said,

I think we had really open communication with [professional] which was awesome. So she was always there whether we had any questions, or needed any help, and when we were doing the presentation, we had guidance counsellors, whether it was [professional] or someone else from her cohort sitting in the back of the room, which was good. So we felt that if something did happen, they were always there for other people to talk to. It wasn’t put on our shoulders, which was nice.

To ensure successful outcomes for both peer educators and students attending mental health and wellbeing programmes, it is important that they feel supported not just by the professionals who are driving the programme but also by the university or higher education institution where the programme is delivered (Abdi and Simbar, 2013; Azizi et al., 2017). Despite feeling supported by the professionals overseeing the programme, some peer educators expressed apprehension at delivering the material. They were nervous about the possible ‘heaviness’ of the topic and the questions they might be asked during the workshops.

Ivy talked about feeling: ‘wary of . . . people getting upset . . . [and] that people could be asking some pretty hefty questions’, but went on to state that the support she had received both before and during the programme delivery was reassuring. Mia shared that they had felt well supported by their peers and [the professionals] but that they had not felt that same level of support from the university where the programme was being delivered.

Probably not from the university . . . It probably just felt like us four and [professional], you know, like, and we were supportive of each other, but then like, the uni wanting us to do that, but there was never anything from like, how are you getting on? Do you want us to, you know, it’s like if you’re doing this and you’re missing this class, like don’t panic.

Reviews of peer education programmes have found that good support and collaboration from all the stakeholders involved enhance programme effectiveness (Abdi and Simbar, 2013; Azizi et al., 2017). This is important to take into account in the delivery of peer wellbeing programmes where overt support from the wider institution may foster increased confidence among peer educators.

Conclusion

This paper has discussed the experiences of peer educators involved in delivering a mental health and wellbeing programme to their peers. It identified the benefits to young people of becoming peer educators and delivering important messages to their peers in at-risk populations such as university agricultural students.

The findings highlight the value of young people becoming peer educators and increasing their mental health knowledge, confidence and skills. The importance of the topic for members of the agricultural community gave meaning to their role as peer educators in delivering the key messages to their peers. Students’ involvement came out of a willingness to help others in their community and, in particular, to address mental health issues within it. The findings also highlight the need for robust support from key stakeholders if peer educators are to feel fully supported in their roles. In the study, although students had little prior knowledge of the topics covered, with support from key professionals with teaching and clinical expertise, participants were able to deliver mental health and wellbeing messages to their peers.

Limitations and future directions

Identifying the best way to provide mental health education to at-risk populations is important. Peer education has been shown to be beneficial for the participants in mental health education, and this study confirms it also has positive outcomes for young people tasked with delivering key health messages to their peers. The study is the first of its type to ask peer facilitators in a mental health and wellbeing programme in New Zealand to talk about their experiences. Its unique rural context, within two universities serving the vulnerable agricultural student community, makes it a valuable contribution to the existing literature in the area. Although the findings are not generalisable due to the context and small sample size, they may inspire work with other at-risk groups (Lietz and Zayas, 2010). They are also valuable in considering how best peer education programmes are developed and delivered to promote mental health messaging and enhance connection within vulnerable communities.

Footnotes

Acknowledgements

The authors would like to thank the peer educators who gave their time to the research.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this work was supported by the Massey-Lincoln and Agricultural Industry Trust.

ORCID iDs

Amanda Hay

Nicky Stanley-Clarke

Chris Andrews

Notes

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Benefits for peer educators in delivering wellbeing education to agricultural students

Abstract

Background:

Design:

Findings:

Conclusions:

Keywords

Introduction

Peer educator learning and development

Methodology and methods

Results and discussion

Finding value

Sharing information

Sharing experiences

Peer leadership

Improved mental health knowledge

Workshop presentation and leadership skills

Feeling supported

Conclusion

Limitations and future directions

Footnotes

Acknowledgements

Funding

ORCID iDs

Notes

References