The effect of peer education based on adolescent health education on the resilience of children and adolescents: A cluster randomized controlled trial

RESEARCH ARTICLE The effect of peer education based on adolescent health education on the resilience of children and adolescents: A cluster randomized controlled trial Yinshuang Tang☯, Hua Diao☯, Feng Jin‡, Yang Pu‡, Hong WangID* School of Public Health and Management, Chongqing Medical University, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China ☯ These authors contributed equally to this work. ‡ FJ and YP also contributed equally to this work. YT and HD are co-first authors. * wangh111111@aliyun.com Abstract Background An increasing number of children and adolescents have reported mental health problems, and resilience is a protective factor against these problems. Therefore, the aim of the study is to verify the effect of peer education based on adolescent health education on adolescent resilience. Method A cluster randomized controlled trial was conducted including 1,613 students who were divided into an intervention group (19 classes, 732 participants) and a control group (24 classes, 881 participants). One-year peer education was performed in the intervention group, and the control group had no interventions. The Resilience Scale for Chinese Adoles- cents by Yueqin Hu and a self-designed basic information questionnaire were used to collect data. Chi-square test and rank-sum test were used to compare the differences of demo- graphic characteristics between the two groups. A linear mixed model was used to compare

the changes of resilience between the two groups after intervention, and the intra-cluster correlation coefficient (ICC) was calculated. A generalized linear mixed model (GLMM) was used to verify the effect of peer education on adolescent resilience. The significance was set at P < 0.05. Results After intervention, compared with the control group, the intervention group showed signifi- cant improvement in target focus, emotion adjustment, interpersonal assistance and total resilience (P < 0.05). The ICC range was 0.003 to 0.034. The GLMM results indicated that peer education based on adolescent health education had significant effects on PLOS ONE PLOS ONE | https://doi.org/10.1371/journal.pone.0263012 February 2, 2022 1 / 18 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Tang Y, Diao H, Jin F, Pu Y, Wang H (2022) The effect of peer education based on adolescent health education on the resilience of children and adolescents: A cluster randomized controlled trial. PLoS ONE 17(2): e0263012. https://doi.org/10.1371/journal.pone.0263012 Editor: Enamul Kabir, University of Southern Queensland, AUSTRALIA Received: July 1, 2021 Accepted: January 10, 2022 Published: February 2, 2022 Copyright: © 2022 Tang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting information

files. Funding: The study was supported by Social and Humanities Sciences Research Planning Fund Project from Ministry of Education (17YJA840015) and Research Special Fund for Public Welfare Industry of Health(No.201202010). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.