LAUSR

Peer-to-peer approaches are widely used in health promotion. Peer leaders are suggested to increase credibility and identification through role modelling. We suggest that to meet the rationales of peer education, peer leaders should be able to interpret and rework their delivery, based on programme rationales. This entails a need for implementation studies to compare programme theory with the realities of implementation. The purpose of this study was therefore to conceptualise a youth-led programme and to explore how peer leaders engage with the peer leader education and subsequently implement activities. The case of study was the Danish street sport organisation, GAME. GAME educates and supports youth peer leaders (age 16-25) in providing life skills-based community sports activities for younger peers (age 8-15) in less advantaged neighbourhoods. A theory of change was developed in partnership with professionals from GAME to conceptualise their programme and its rationales. To study implementation, we observed three two-day peer leader education camps and 49 peer-led GAME activities focusing on specific elements of the theory of change. We present a theory of change to illustrate the content, rationale, expected outcomes and key assumptions of a peer-led community sport programme. We compare this conceptualisation to the implementation of peer-led activities; i.e., GAME's operationalisation of the peer leader education and peer leaders' enactment of the programme in practice, focusing on role modelling, pedagogical approaches and interactions with participating children. As expected, implementation style varied considerably across settings and thereby the ways in which delivery corresponded with the intentions described in the theory of change. The study provided insight into how youth peer leaders in community sport interpret their role and interact with peers of relevance to peer leadership research and practice. The rationales behind peer education call for programmes that allow youth peer leaders to interpret and adjust activity implementation with an ensuing need for implementation studies. Initiatives to educate and support peer leaders should be modified based on insights into peer leaders’ interpretation and implementation of peer-led activities.