Peer-led health education, physical activity, and sedentary behaviour among undergraduates in Owerri, Imo State, Nigeria: a one-group pre-test/post-test quasi-experimental study

Physical inactivity and sedentary behaviour are major contributors to the rising burden of non-communicable diseases, particularly among young adults. University students are increasingly adopting sedentary lifestyles owing to academic demands, limited opportunities for physical activity, and reduced parental oversight. Peer influence during this developmental stage offers a potential avenue for behaviour change. This study examined changes in physical activity and sedentary behaviour following a peer-led health education intervention among undergraduate students in Owerri, Imo State, Nigeria. A one-group pre-test/post-test quasi-experimental design was used, with no control or comparison group. A total of 336 sedentary undergraduate students participated in the study. This included 320 peer participants and 16 peer-nominated students who were also sedentary and were subsequently trained as peer educators took part in a structured six-week peer-led health education programme addressing physical activity and sedentary behaviour. The same WHO STEPS-adapted questionnaire was administered at baseline and one week after the intervention. Physical activity was defined as engagement in any reported physical activity rather than meeting recommended guideline levels. Data were analysed in IBM SPSS v23 using descriptive statistics, McNemar's test for paired pre/post comparisons, and binary logistic regression for predictor analysis, with significance set at 0.05. The proportion of students reporting any physical activity rose from 63.7% at baseline to 100% post-intervention, and self-reported sedentary behaviour declined from 70.9% to 43.5% ( p < 0.001). Changes in the duration of physical activity and sedentary behaviour were also observed ( p < 0.001). Logistic regression identified gender (OR = 0.431, 95% CI 0.275–0.677, p < 0.001) and accommodation status (OR = 0.745, 95% CI 0.593–0.936, p = 0.012) as significant predictors of physical activity. Pre/post changes in physical activity and sedentary behaviour were observed following the peer-led health education intervention, and the findings suggest that this approach may be a useful strategy for promoting more active lifestyles among undergraduates. However, controlled studies with longer follow-up are needed.