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Mandoh M, Raeside R, Todd A, Redfern J, Mihrshahi S, Cheng HL, Phongsavan P, Partridge SR. Evaluating the effect of a 12-month youth advisory group on adolescent's leadership skills and perceptions related to chronic disease prevention research: a mixed-methods study. BMC Public Health 2023; 23:2344. [PMID: 38012583 PMCID: PMC10680352 DOI: 10.1186/s12889-023-17283-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Youth Advisory Groups (YAGs) represent a promising method to engage adolescents in research of relevance to them and their peers. However, YAGs are rarely implemented or evaluated in chronic disease prevention research. The aims of this study were firstly, to evaluate the effect of participation in a 12-month YAG on adolescents' leadership skills and perceptions related to chronic disease prevention research and secondly, to evaluate the process of establishing and facilitating a 12-month YAG and identify barriers and enablers to establishment and facilitation. METHODS This study was a 12-month pre-post study. Eligible participants were adolescents (13-18-years) and current members of an established YAG. Data collection involved online surveys and semi-structured interviews at baseline, six-months and 12-months follow-up. Participatory outcomes such as self-efficacy, leadership skills, and collective participation were derived from Youth Participatory Action Research Principles (YPAR), and the Lansdown-UNICEF conceptual framework for measuring outcomes of adolescent participation. Process evaluation data were captured via meeting minutes, Slack metrics and researcher logs. Quantitative data was analysed using descriptive statistics and qualitative data was thematically analysed using a reflexive thematic analysis approach. RESULTS Thirteen (13/16) YAG youth advisors consented to participate in the evaluation study (mean age 16.0 years, SD 1.3; 62% (8/13) identified as female). Survey data assessing participatory outcomes found an increase in leadership and life skills scores over 12-months (+ 8.90 points). Semi-structured interview data collected over the 12-month term revealed three key themes namely: influence, empowerment, and contribution. Comparison of pre-post themes determined a positive trend at follow-ups, demonstrating improved participatory outcomes. Process indicators revealed that at 12-month follow-up the YAG was implemented as planned. Semi-structured interview data determined barriers to YAG facilitation included time and limited face-to-face components, while enablers to YAG facilitation included flexibility, accessible delivery methods, and a supportive adult facilitator. CONCLUSION This study found that a YAG fostered positive participatory outcomes and unique opportunities for youth participants. A successful YAG based on YPAR principles requires researchers to ensure YAG establishment and facilitation is an iterative process. Taking into consideration important barriers and enablers to YAG facilitation ensures adolescent engagement in a YAG is both meaningful and impactful.
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Affiliation(s)
- Mariam Mandoh
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Rebecca Raeside
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Allyson Todd
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
- The George Institute for Global Health, The University of New South Wales, Camperdown, NSW, 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Hoi Lun Cheng
- Sydney Medical School, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Westmead, NSW, 2145, Australia
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Stephanie R Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
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Conway-Moore K, Knai C, Finegood D, Johnston L, Brinsden H, Aguiar A, Kopainsky B, Önal F, Helleve A, Klepp KI, Lien N, Luszczynska A, Rito AI, Rønnestad AM, Ulstein M, Blanchard L, Savona N, Rutter H. Co-creating obesity prevention policies with youth: Policy ideas generated through the CO-CREATE project. Obes Rev 2023; 24 Suppl 2:e13623. [PMID: 37753599 DOI: 10.1111/obr.13623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 09/28/2023]
Abstract
Despite growing recognition of the importance of applying a systems lens to action on obesity, there has only been limited analysis of the extent to which this lens has actually been applied. The CO-CREATE project used a youth-led participatory action research approach to generate policy ideas towards the reduction of adolescent overweight and obesity across Europe. In order to assess the extent to which these youth-generated policy ideas take a systems approach, we analyzed them using the Intervention Level Framework (ILF). The ILF ascribes actions to one of five system levels, from Structural Elements, the least engaged with system change, up to Paradigm, which is the system's deepest held beliefs and thus the most difficult level at which to intervene. Of the 106 policy ideas generated by young people during the CO-CREATE project, 91 (86%) were categorized at the level of Structural Elements. This emphasis on operational rather than systems level responses echoes findings from a previous study on obesity strategies. Analyzing the distribution of systems level responses using the ILF has the potential to support more effective action on obesity by allowing identification of opportunities to strengthen systems level responses overall.
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Affiliation(s)
- Kaitlin Conway-Moore
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Cécile Knai
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Diane Finegood
- Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, Canada
- Morris J. Wosk Centre for Dialogue, Simon Fraser University, Vancouver, Canada
| | - Lee Johnston
- Morris J. Wosk Centre for Dialogue, Simon Fraser University, Vancouver, Canada
| | | | - Anaely Aguiar
- System Dynamics Group, University of Bergen, Bergen, Norway
| | | | - Furkan Önal
- System Dynamics Group, University of Bergen, Bergen, Norway
| | - Arnfinn Helleve
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Ana Isabel Rito
- National Institute of Health Dr.Ricardo Jorge, Lisbon, Portugal
| | | | | | - Laurence Blanchard
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
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Samdal O, Budin-Ljøsne I, Haug E, Helland T, Kjostarova-Unkovska L, Bouillon C, Bröer C, Corell M, Cosma A, Currie D, Eriksson C, Felder-Puig R, Gaspar T, Hagquist C, Harbron J, Jåstad A, Kelly C, Knai C, Kleszczewska D, Kysnes BB, Lien N, Luszczynska A, Moerman G, Moreno-Maldonado C, NicGabhainn S, Pudule I, Rakic JG, Rito A, Rønnestad AM, Ulstein M, Rutter H, Klepp KI. Encouraging greater empowerment for adolescents in consent procedures in social science research and policy projects. Obes Rev 2023; 24 Suppl 2:e13636. [PMID: 37753605 DOI: 10.1111/obr.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 09/28/2023]
Abstract
The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged.
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Affiliation(s)
- Oddrun Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Isabelle Budin-Ljøsne
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen Haug
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Trond Helland
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | | | | | - Christian Bröer
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria Corell
- Unit for Mental Health, Children and Youth, Public Health Agency of Sweden, Stockholm, Sweden
| | - Alina Cosma
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - Dorothy Currie
- School of Medicine, St. Andrews University, St. Andrews, UK
| | - Charli Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Solna, Sweden
| | - Rosemarie Felder-Puig
- Department of Evidence and Quality Standards, Austrian National Public Health Institute, Vienna, Austria
| | - Tania Gaspar
- Psychology and health Sciences Department, Lusofona University, Lisbon, Portugal
| | - Curt Hagquist
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
| | - Janetta Harbron
- Research Centre for Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Atle Jåstad
- Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Colette Kelly
- Health Promotion Research Centre, University of Galway, Galway, Ireland
| | - Cecile Knai
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Dorota Kleszczewska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | | | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | | | - Gerben Moerman
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | - Jelena Gudelj Rakic
- Centre of Health Promotion, Institute of Public Health of Serbia, Beograd, Serbia
| | - Ana Rito
- Centre for Studies and Research in Social Dynamics and Health, Lisbon, Portugal
| | | | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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Bröer C, Ayuandini S, Baillergeau E, Moerman G, Veltkamp G, Luszczynska A, Budin-Ljøsne I, Rito AI, Stensdal M, Lien N, Klepp KI. Recruiting and engaging adolescents in creating overweight and obesity prevention policies: The CO-CREATE project. Obes Rev 2023; 24 Suppl 1:e13546. [PMID: 36623291 DOI: 10.1111/obr.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
The CO-CREATE project aims to collaborate with adolescents across Europe in developing policy ideas that contribute to overweight and obesity prevention. In this paper, we present the theoretical basis and methodological approach to recruitment and engagement in the project. The principles of youth-led participatory action research were employed to design Youth Alliances in which adolescents and adults could collaborate. These Alliances should serve to promote and support adolescent participation and to develop policy ideas that would contribute to obesity prevention. Alliance members were recruited in two local geographical areas per country with a focus on reaching out to underrepresented youth. We started with fieldwork to assess locally relevant forms of inclusion and exclusion. The methodology entailed a handbook combining existing tools which could be used flexibly, a collaborative organization, and budgets for the alliances. Engagement started in local organizations, that is, schools and scouts, and with peers. Health- and overweight-related challenges were addressed in their immediate surroundings and supported the inclusion of experiential knowledge. Adolescents were then supported to address the wider obesogenic system when designing policy ideas. The CO-CREATE Alliances provide a concrete example of how to engage youth in public health, in a manner that strives to be participatory, transformative, and inquiry based.
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Affiliation(s)
- Christian Bröer
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Evelyne Baillergeau
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerben Moerman
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerlieke Veltkamp
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Aleksandra Luszczynska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Isabelle Budin-Ljøsne
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ana Isabel Rito
- Centre for Studies and Research on Social Dynamics and Health-CEIDSS, Lisbon, Portugal
| | - Maja Stensdal
- PRESS, The Youth Organization of Save the Children Norway, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Knut-Inge Klepp
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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