Adolescents and health policy: Getting them on board!
Adolescence is a time of developmental transitions of high relevance to health policy. Growing decision-making capacity, separation from families, integration into peer groups and development of identity mean that adolescents are increasingly making health-related decisions. Parents, providers, and policy makers struggle as the obligation to protect comes into conflict with adolescents’ developmental need to make decisions, make mistakes and move forward. Our experiences with the Indiana State Plan for Adolescent Health demonstrated that adolescent involvement in health policy can both meet developmental needs and be good health policy.
The state plan was the product of the Indiana Coalition to Improve Adolescent Health (ICIAH), a group of youth serving agencies, government departments, healthcare providers, and educators (ICIAH and ISDH, 2009). Its goal was to provide a blueprint for policymakers, specifying adolescent health priorities and metrics to measure progress. However, as the plan progressed, it became clear that missing from the coalition were the voices and agency of adolescents.
To capture youth perspectives, we conducted focus groups across Indiana, speaking with adolescents about the aspects of health and health promotion most important to them (Ott et al., 2011). We met with adolescents with diverse life experiences, conducting focus groups in different regions, with adolescents of different ethnicities and genders, and from different socio-economic contexts. Groups met in the state capital, rural areas, an aging industrial city, and a college campus.
Even with our broad-based sampling, groups were more similar than different, with discussions focusing on cross-cutting developmental issues. Our findings, corroborating WHO recommendations (Wallerstein , 2006), answered a first question and begged a second: (1) What is the added value of involving adolescents in health policy? And, given this added value, (2) what is the most efficient and developmentally targeted way to involve adolescents?
Why Involve Adolescents in the Policy-making process?
How to involve youth?
The benefits of youth involvement beg the question of why we would consider making policies, creating programs, or doing research without involving youth. The answers are not surprising – cost and efficiency. To do meaningful work with youth, it requires staff and time to recruit and train youth (Klindera and Menderweld, 2001). Unfortunately, policy and research frequently have very limited lead time and budget. However, with some creativity and forethought, it is often possible to involve youth. Tips include the following:
All of these approaches are built upon a view of youth not as a liability, or even as a future asset, but as a here-and-now resource. If those of us who work closely for and with youth can make this philosophical shift, youth involvement will necessarily follow.
|Author :||Dr Mary Ott
Associate Professor of Pediatrics
Indiana University School of Medicine
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Indiana Coalition to Improve Adolescent Health and Indiana State Department of Health Adolescent Health Program (2009). Picturing a Healthier Future: A State Strategic Plan for Indiana’s Adolescents. 5 April
Klindera, K., Menderweld, J. (2001). Youth Involvement in Prevention Programming. Advocates for Youth: Washington, D.C.
Kuther, T.L., Posada, M. (2004). Children and adolescents’ capacity to provide informed consent for participation in research. Adv Psychol Res, 32: 163-73.
Ott, M.A., Rosenberger, J.G., McBride, K.R., Woodcox, S.G. (2011). How do adolescents view health? Implications for state health policy. J Adolesc Health, 48 (4): 398-403.
Wallerstein, N. (2006). What is the evidence on effectiveness of empowerment to improve health? in Health Evidence Network Report, WHO Regional Office for Europe: Copenhagen.