Communication strategies for dietary change in a worksite peer educator intervention.

At the heart of peer health education programs is the assumption that tapping social networks increases adoption of behavior change, yet the communication strategies used by peer educators have not been previously documented to assess the use of social networks in promotion of health messages. Our program in public worksites trained peer health educators to utilize their social networks along with individual persuasive strategies to promote the 5 a Day for Better Health message (i.e. eat five or more servings of fruits and vegetables every day). Communication strategies utilized by the peer health educators were tracked via monthly focus groups over a 9 month intervention in 40 social networks of labor and trades employees. Audiotapes were transcribed and content analyzed to identify 10 communication strategies used by peer educators. Strategies were rated as enacted in an individual or a group (collective) context. Peer health educators were more likely to implement 'creating context' and 'role modeling' as group context change strategies, and 'encouragement' and 'responding to employee needs' as individual change strategies. Strategies used most frequently by males were 'mock competition', 'giving materials' and 'encouragement', while females used 'creating context' and 'keeping 5 a Day visible' most frequently. Hispanic peer health educators were more likely to use individual change strategies than their non-Hispanic counterparts. Documentation of the creative approaches utilized by lay educators among their peers can inform public health professionals on (1) how to better train outreach workers within various cultural, gender and social contexts, and (2) how to maximize social network effects.