Private and public promoters with main public funding and different human resources

The 67 Portuguese peer education projects characterized have been promoted by either private or public entities. There was a slightly higher number of private entities (n = 37) - such as civil society associations (for example, NGOs). The next biggest group was educational establishments (n = 16), public health institutions (n = 8), and other public entities, such as municipalities (n = 6). In general, the project promoters benefit from partnerships with other similar actors, especially from the public sector, including less predictable partners - such as the police force or private companies. The majority of the projects have more than one partnership, an inter-institutional work that often results from the forms (and requirements) of external financing and the necessity for promoters to collaborate with other intervention actors. Also within peer education we have found major expression of networking and cooperation, which characterizes the contemporary (^{Giddens, 1992}). Third sector organizations, which have boomed since 1980, seem to have seized the field of non-formal education (^{Fernandes and Garcia, 2019}) as well as of peer education.

Most of the projects (n = 57) received public funding, mainly from the central and regional administration (especially from the Ministry of Health and Ministry of Education). Some of the projects also received funds from the European Union (such as the European Social Fund); and support from local public bodies, such as municipalities. Several projects (n = 38) also received private funding from their promoters or partners, usually as a complement to public funding, which is more significant overall. Finally, it should be noted that some projects (n = 9) did not receive any specific funding. We didn’t aim to answer persistent questions about whether or not peer education interventions are more cost effective than other traditional interventions (^{Bagnall et al., 2015}; ^{Tolli, 2012}), because this would depend heavily on the projects’ characteristics, but the results indicate that it is possible to develop peer education projects without funding. This makes this strategy useful for actors with fewer economic resources who are willing to intervene socially. Despite the marginality associated with non-formal education, resulting from the legitimacy and validation that traditional education has achieved (^{Fernandes and Garcia, 2019}; ^{La Belle, 1982}), the results show that peer education, directly or indirectly, has received public investment. This funding, which is not comparable to that for traditional education, cannot be neglected in the promotion of peer education. On the other hand, state funding of non-formal education conducted by third sector organizations has been linked to neoliberal socio-economic policies, which use private actors to develop functions that some commentators consider should be a public responsibility (educational and social intervention functions) (^{Fernandes and Garcia, 2019}).

The majority of project managers are from the field of psychology (n = 21), followed by teachers (n = 16), especially higher education professors. There is a slightly lower number of social work specialists (n = 11) and health specialists, such as nurses or physicians (n = 6), among other professions. The vast majority of project managers have a high level of academic qualifications. Mobilization of these different expert fields enhances confidence in peer education (^{Giddens, 1992}). In terms of the other human resources that complement these teams, almost half of the projects (n = 32) include volunteers, especially young people, mostly students, and also some professionals, such as teachers or psycho-social technicians, who worked on a pro-bono basis, usually part-time (approximately 340 volunteer students and approximately 140 volunteer professionals were indicated). It seems to us that the indicator on voluntary work may have been under-reported in some cases, but we can nonetheless perceive that most of the human resources assigned to these projects are volunteers. The great majority of projects (n = 60) declared that they also have employees, whose professional categories are similar to those of the project managers (psychologists, teachers, social workers, etc.). There were approximately 270 professionals indicated, even though a significant part also works part-time. It is interesting to note that nine of the 67 characterized projects stated that their teams hired peer educators, such as psycho-social technicians, monitors or others, given the lack of legal framework for this activity. This denotes the importance of these actors in certain community organizations, with the aim of reaching certain groups (e.g. “drug” users) (^{Bagnall et al., 2015}; ^{Parkin and McKeganey, 2000}; ^{Turner and Sheperd, 1999}). So, should the profession of peer educators be created? This is an option to considered since overuse of volunteers can contribute to the problem of precarious employment.

Few years duration, within health/social areas of intervention and themes

Most of the Portuguese peer education projects in which we conducted interviews began after 2000. The duration of most of the 67 peer education projects was 1-2 years (n = 25). This period seems to be the most common, followed by the projects lasting between 6-8 years (n = 13), and between 3-5 years (n = 11), wherein the others were of varied duration. It should be noted that the shortest project was conducted in a few days, while the longest project was developed systematically for almost 30 years, since the 1980s. This does not mean an uninterrupted duration of peer education interventions, since such interventions tend to be developed on a cyclical basis, generally for periods lasting a few months, or over an academic year, in the case of actions targeting students. Is this sufficient time to resolve the identified problems? In a context of acceleration, interventions also tend to be rapid and non-formal education and peer education enable greater flexibility and malleability, which is viewed positively within the current social context of globalization.

The projects operate in two main fields of intervention: above all the health field (n = 39) and the socio-community context (n = 28). In the first field there are interventions addressed to the problem of consumption of psychoactive substances, followed by prevention of risk behaviour in general, and finally, the promotion of health in the context of other specific problems, such as sexual health and sexually transmitted infections (STI). In the second field there are interventions that aim to promote activism and social change, as well as those working in the context of social support, that aim to promote, for example, the inclusion of minorities. There are also interventions that promote school learning, and those that seek development of personal, social or professional skills.

The issues addressed demonstrate that the power of social action is an active and mobilizing force to generate answers to current problems facing Portuguese society. Peer education is being used to respond to contemporary challenges, such as health risks or integration difficulties in the context of migration.

While school education is overwhelmed by the traditional syllabus, non-formal education seems to be one of the most viable responses to social education goals. However, and while most of the characterized peer education interventions target social “problems,” we also find projects that foster development of professional skills among peers. Although at a smaller scale, peer education is also used to work on issues that are less socially “problematic”. However, regarding the school content, there is no doubt that formal education is still the privileged option (cf. ^{La Belle, 1982}), wherein non-formal education or strategies such as peer education playing mostly a complementary role.

Target groups primarily address young people

Peer education has been mainly directed at groups of young people (Brito and ^{Mendes, 2012}; ^{Parkin and McKeganey, 2000}; ^{Silva and Matos, 2014}), given the importance and influence of peers in this stage of life (^{Bandura, 1977}; ^{Tajfel and Turner, 1986}). Interventions with young people follow a prevention and awareness line for the problems addressed. As expected, two thirds of the projects reported that young people were their target groups. They were mainly secondary school students, followed by pre-secondary school pupils and then by higher education students. Many peer educators appear to have been chosen from the areas of health studies, followed by psychology and the social sciences. This seems to be consistent with the areas of intervention addressed and helps increase trust in the expert systems (^{Giddens, 1992}) associated with these interventions.

However, peer education strategies are also being extended to other groups, and approximately one-third of the projects seek to intervene with adults. These correspond mainly to discriminated minorities, but not only, since we also found some projects that intend to promote health or develop professional skills with adults without social inclusion problems. Residually, we also found some projects that work with children for prevention or improvement of learning, and the elderly, especially in order to promote life quality or social inclusion. Once again, these results tend to dissociate the use of peer education or non-formal education from working with disempowered or stigmatized groups (^{Fernandes and Garcia, 2019}; ^{La Belle, 1982}) and highlight their versatility.

Concerning the role of peer educators, only two projects stated that this role is given to senior citizens and in only one project was this role performed by children. However, when we look at the target peer groups of the 67 projects characterized, these include a much higher number of senior citizens and children. We know that age group has been one of the most used and relevant criteria, but not the only, in defining “peer” identity (^{McDonald et al., 2003}). But in these projects other criteria must necessarily have been used for this definition (for example other group and socio-cultural characteristics), to avoid undermining social identification mechanisms, that are important in peer education processes (^{McDonald et al., 2003}; ^{Shiner, 1999}).

There is a rough balance between males and females involved in peer education projects, although there seems to be a slightly higher presence of females in the peer educator groups and a slightly higher presence of males in the target audiences. It appears that women are more likely to volunteer for such actions, such as ^{Strange, Forrest and Oakley (2002}a) have suggested. In socio-economic terms, both in peer educators and their target audiences, there is a predominance of heterogeneous situations, following groups that present a precarious socio-economic situation and, finally, those who have a socio-economic favoured situation. However, focusing solely on target peer groups, in general these records heterogeneous or precarious, but no favoured, situations, which suggests that individuals who volunteer, or that are recruited, as peer educators, have a better socio-economic situation than the target audience. This is something that has also been observed previously (^{Strange, Forrest and Oakley, 2002a}) and that we recommend should be analysed in further detail. This can foster some form of peer educator compensation when involving low-income participants. Again, marked differences in socio-economic status can undermine the identification processes that are important for peer education (^{McDonald et al., 2003}; ^{Shiner 1999}).

(Two-phase) methodologies, (mostly with) training and (in)formal implementation contexts

Most projects form a group of individual volunteers, who will subsequently intervene with the target audience, usually in a team, over a specific period of time. However, we also found a small set of projects that included one or more peer educators in their working teams, as paid professionals. In these projects, no initial training period was given due to the experience of these individuals.

The training that a large part of the participants must perform in an initial phase to become peer educators is primarily constituted by specific contexts and spaces that tend to be formal, i.e., wherein the roles and social positions are clearly demarcated (n = 61). Thus, a significant number of courses were performed in classrooms or other school spaces, followed by courses that were held in conference rooms or offices of other private entities, such as social institutions. Only a very small number of projects indicated that the courses occurred in contexts considered to be informal, such as outdoor spaces (n = 6).

However, this difference is attenuated in relation to the implementation contexts of peer education. Although the formal contexts described above continue to be expressive (n = 40), informal contexts are now more numerous (n = 27). Some projects use both contexts, e.g. festive contexts (nightlife, academic festivities) or everyday social and informal relations. If some form of participants’ empowerment is sought, it is important to think about using more informal contexts, in which individuals feel less constrained by traditional power relationships (^{Campbell and MacPhail, 2002}; ^{Shiner, 1999}; ^{Strange, Forrest and Oakley, 2002}b). In fact, more horizontal, democratic and interactive learning underpins the rationale of peer education (^{Shiner, 1999}).

Objectives and results - skills, behaviour and knowledge, a need to improve evaluations

The projects characterized often had more than one goal. In this context, the objectives that were most mentioned relate to the acquisition or development of personal, social, educational or professional skills (n = 34); the promotion of health through adoption of less risky behaviour (n = 32); the increase of knowledge, in particular in the health field (n = 28) and, finally, the promotion of social and community inclusion (n = 24) and the provision of socio-health support services (n = 15). There were fewer references than might be expected (n = 6) to the promotion of participation and empowerment objectives, although these processes have often been associated with peer education (^{Campbell, 2005}; ^{Klein et al., 2014}; ^{Parkin and McKeganey, 2000}; ^{Turner and Sheperd, 1999}). From a sociological perspective, attention must be paid to the people who sets goals and how they are pursued. As noted, peer education can be a tool for emancipation (^{Freire, 1975}) or social control (^{Foucault, 2013}), and therefore issues of power, ethics, and participation need to be addressed at an early stage in the planning.

It was not easy to collect data about the results of final evaluations of the peer education projects that we characterized. Some projects experienced some difficulties in providing such data, for example, due to weak evaluations or excessive attention to process indicators, since some of them just have collected process indicators. This could be related to evaluation failures and/or lack of resources for final evaluations. Often the bureaucratic and financing system is more demanding with the process indicators, which condition the transfer of financial tranches. However, the projects that presented their results indicated positive effects, such as increased knowledge about the themes developed (n = 26); acquisition and development of skills (n = 20); increased adherence to support services (social, health, etc.) (n = 10); the reduction and modification of risk behaviours (n = 9) and improved access to hard-to-reach groups or hidden phenomena (n = 9). Nevertheless, as noted above, the fact that projects demonstrate positive results or are effective does not mean that they respect cultural differences or ethical principles, or even the participation of those involved. This interpretation should therefore be made carefully from a sociological perspective.

Only about half of the projects that provided us with their results broke them down in function of the two main groups involved - the peer educators and the target audience, with slightly better results recorded for the peer educators group, predominantly in terms of increased knowledge and skills development, while in the target audience the results indicated increased adherence to support services. This is an important distinction that should be clarified in projects, and that has already been criticized (^{Parkin and McKeganey, 2000}) because the target groups can be both peer educators and target audience, which is sometimes not specified by the projects. The first group may present better results by becoming more involved (they usually receive training), are closer to the project managers, and therefore more accessible for evaluation, but they may not be considered to be target groups by the projects (^{Winter, 2013}). On the other hand, analysis of the target audience is often the main objective, but it may be more difficult to achieve and assess this group. Hence, the results of peer education projects should contain a qualitative assessment that analyses the objectives, intended changes and the outcomes observed in the different groups and participants.

Typology of the peer education projects: school and community; health and social integration; young people and adults; volunteer peers and hired peers

The characterization performed enabled us to build a summary and representative typology of Portuguese peer education practice. This corresponds, in descending order of frequency to:

1) health/learning/social inclusion promotion projects fully developed in a school context with young student volunteers;

2) health/social support/learning promotion projects developed with young or adult volunteers in a community context (e.g. civic associations; NGOs);

3) health/social inclusion promotion projects that recruit student volunteers in the school context, but whose intervention is developed in a community context (e.g. young recreational settings);

4) health/social support promotion projects, in general targeting adults, with peer employees, developed in a community context (e.g. civic associations; NGOs).

In short, peer education practice continues to be dominated by projects developed with young volunteers, in the school context, in the health promotion field (Brito and ^{Mendes, 2012}; ^{Parkin and McKeganey, 2000}; ^{Shiner, 1999}; ^{Turner and Sheperd, 1999}). However, we also found less expected projects that use peer education to develop professional skills among work colleagues, or disseminate community gardens and a healthier diet among adult groups. Some projects target less common groups - such as children or the elderly and some already hired peer educators, which suggests a growth and diversification of this practice.