DOI: 10.4103/jehp.jehp_470_26 ISSN: 2277-9531

Effect of a peer-facilitated education program on disease knowledge among adolescents with sickle cell disease: A randomized controlled trial in Kenya

Alloysius Luambo Omoto, Alfred Owino Odongo, Dominic Mogere, Nahashon Mwirigi
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BACKGROUND:

Sickle cell disease (SCD) is a major public health challenge in sub-Saharan Africa, characterized by chronic anemia, recurrent vaso-occlusive crises, and significant morbidity. Adolescents and young adults increasingly assume responsibility for disease self-management; however, limited disease knowledge may hinder effective self-care and contribute to preventable complications. This study evaluated the effect of a structured youth support group education program on disease knowledge among adolescents and young adults living with SCD in Kenya.

MATERIALS AND METHODS:

A two-arm parallel randomized controlled trial was conducted among 104 adolescents and young adults aged between 13 and 24 years with confirmed SCD attending outpatient follow-up in Nairobi County, Kenya. Participants were randomly assigned in a 1:1 ratio to a peer-facilitated youth support group education program ( n = 52) or routine clinical care ( n = 52). The intervention consisted of four structured sessions delivered over two months using a standardized manual covering disease understanding, complications, infection prevention, pain management, medication adherence, healthy living, and reproductive health. Disease knowledge was assessed at baseline and postintervention using a structured questionnaire. Intervention effects were estimated using difference-in-differences regression analysis.

RESULTS:

A total of 100 participants completed the study (intervention: n = 50; control: n = 50). Knowledge improved in both groups; however, greater gains were observed in the intervention group. The largest improvement was observed in knowledge of SCD complications, with mean scores increasing from 48.54 to 83.87 in the intervention group compared with 48.07–62.96 in the control group. Difference-in-differences analysis demonstrated a statistically significant intervention effect ( β = 20.44, P < 0.001). Improvements were also observed in basic disease knowledge ( β = 9.87, P = 0.056) and medical management knowledge ( β = 8.70, P = 0.133), although these did not reach statistical significance.

DISCUSSION:

The findings demonstrate that structured peer-facilitated education can significantly improve disease knowledge among adolescents and young adults with SCD, particularly in recognizing and managing complications. The limited effect observed in domains, such as genetics and medical management, suggests that more complex concepts may require reinforced or alternative teaching approaches. These results highlight the value of integrating youth-friendly educational interventions into routine care to strengthen self-management capacity in resource-limited settings.

CONCLUSION:

A structured peer-facilitated youth support group education program significantly improves knowledge of SCD complications among adolescents and young adults. Integration of such interventions into routine SCD care may enhance disease self-management and improve health outcomes in resource-limited settings.

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