Student health advocates (SHAs) are high school students who, under the supervision of the school nurse, provide health education and health promotion activities to other students via a peer education model. This 3-year follow-up study explored how the SHA experience influences career choice and attitudes of the participants. It also examined what motivates students to become SHAs, the benefits and drawbacks of SHA participation, how SHA involvement influenced career plans, and how SHAs perceive the role of the school nurse. Study results indicate that this innovative health education/promotion experience offered an opportunity for SHAs to express their interest in health and enhanced their sense of belonging, meaningful involvement, connection to learning, and caring relationships in the school setting.