Youth Participation as a Protective Factor

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Youth Participation as a Protective Factor

• Implications For ImprovingAdolescent Well-being
  
• Community Capacity for Health

Michele Kelley Christine Bozlak with Myrtis
Sullivan Michael Rodríguez-Muñiz UIC Great
Cities Institute September 11, 2007
(Rev.9/11/2007)
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Presentation Goals

• To discuss the implications of the paradigm shift
  from a disease model to a strengths-based model
  of adolescent health within community settings.
• To review the science of youth participation and
  how the concept is defined and used in the
  literature.
• To position youth participation within a
  community health development context.

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Critical Health Objectives for Adolescents and
Young Adults

• Mortality and Morbidity
• Risk Factor Orientation
• Individual Behavior Change
• MAJOR CATEGORIES
• Unintentional Injury
• Violence
• Mental Health Substance Abuse
• Reproductive Health
• Chronic Diseases
• (Healthy People 2010 National Initiative to
  Improve Adolescent Health)

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Traditional Public Health Approach

• Adult expert providing health education
• Organization driven interventions
• Policies driven by professional decision makers
  and experts
• CONSEQUENCES
• Lost opportunities social costs incurred
• Ecological validity, psycho-political validity
  compromised
• Youth empowerment community change compromised
• Limited understanding, motivation individual
  change

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National Academy of Sciences Report 2002

• Changing landscape of family and community life
• Resources available to young people
• Societal complexity
• Continuum of learning
• Social stratification disparities
• Expand framework to positive outcomes
• (NAS Community Programs to Promote Youth
  Development, 2002)

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WHO Europe Report on Empowerment Health 2006

• increasing citizens skills, control over
  resources and access to information relevant to
  public health development
• using small group efforts, which enhance
  critical consciousness on public health issues,
  to build supportive environments and a deeper
  sense of community
• promoting community action through collective
  involvement in decision-making and participation
  in all phases of public health planning,
  implementation and evaluation, use of lay helpers
  and leaders, advocacy and leadership training and
  organizational capacity development
• being sensitive to the health care needs
  defined by community members themselves.

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WHO Europe Report on Empowerment Health 2006

• The most effective empowerment strategies are
  those that build on and reinforce authentic
  participation ensuring autonomy in
  decision-making, sense of community and local
  bonding, and psychological empowerment of the
  community members themselves.
• (Wallerstein, 2006)

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There is a better way.

• To address and prevent problem behaviors and
  health disparities
• To more fully consider social context of youth
  health and development
• To enhance youth well-being (positive development
  and positive health status)
• To foster community development

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Multiple Paradigms Concepts for Youth
Participation

• Positive Youth Development (Pittman)
• Pyschopolitical Validity (Prilletensky 2007)
• Sociopolitical Development (Watts 2007)
• Youth empowerment (Wallerstein 2006)
• Challenge to
• capture process and outcomes, relate to
  disparate sets of literatures, capture individual
  and setting level factors and the epistemic
  premise of interventions.
• Deal with the black box of implementation
• Ethnical and power issues.

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Positive Youth Development (PYD) Youth
Participation

• PYD is the umbrella term that youth participation
  falls under
• We emphasize youth participation because it is
  the practical application of PYD
• Youth participation in their community is viewed
  as critical to youth development
• Need for choice and voice. (Pittman et. al.,
  2003)

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Definition of PYD

• There are many definitions and none are
  comprehensive
• Catalano et. al. (1999, 2004) and NICHD conducted
  a review of the PYD field and determined there
  was no comprehensive definition
• Catalano created a definition that highlighted
  PYD objectives (Benson et. al., 2006)

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• PYD seeks to promote one or more of the
  following
• Bonding, resilience, social competence,
  emotional competence, cognitive competence,
  behavioral competence, moral competence,
  self-determination, spirituality, self-efficacy,
  positive identity, belief in the future,
  recognition for positive behavior, opportunities
  for prosocial development, and prosocial norms.
• (Catalano et. al., 1999, 2004 as cited in Benson
  et. al., 2006)

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Positive Youth DevelopmentBackground

• Not an entirely new concept, but new approach to
  developing programs for children and youth (NCSL,
  2007)
• A field of research and an arena of practice
  (Benson et. al., 2006)
• Interdisciplinary
• Community is a critical delivery system for PYD
  (Benson et. al., 2006)
• Overlap with public health, especially health
  promotion, and focus on protective factors and
  well-being

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Goals of PYD

• Promoting positive relationships with peers
• Emphasizing youths strengths
• Providing opportunities to learn healthy
  behaviors
• Connecting youth with caring adults
• Empowering youth to assume leadership roles in
  programs
• Challenging youth in ways that build their
  competence (NCSL, 2007)

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Recognized Leaders in PYD

• Karen Pittman (Forum for Youth Investment)
  Being problem-free is not being fully-prepared.
• Peter Benson, Search Institute
• Reed Larson, UIUC
• Richard Lerner, Tufts University
• Journals Applied Developmental Science New
  Directions in Youth Development
• Other countries due to the U.N. Convention on the
  Rights of the Child

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What PYD Can Be

• A field of interdisciplinary research
• A policy approach
• A philosophy
• An academic major
• A program description
• A professional identity
• (Benson et. al., 2006)

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Types of Youth Participation

• Service learning/community service
• Religious participation
• School participation
• Extracurricular activities (i.e. clubs, etc.)
• Sports participation
• Artistic expression (i.e. theaters, media)
• Civic engagement

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Theoretical Underpinnings for PYD and Youth
Participation

• Three Theoretical Strands
• Human Development
• Community Organization and Development
• Social and Community Change (Benson et. al.,
  2006)
• The field is influenced by Paulo Freire and John
  Dewey

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Developmental Outcomes Associated with Youth
Participation
Youth-serving Organizations Develop social responsibility, social competence, form community and personal identity, increase cognitive development, sense of belonging, safe space, connect with caring adults, decrease problem behavior and health risks, enhance school engagement and academic achievement (Studies cited Hart, 1997 Johnston Nicholson et. al., 2004 Hobbs, 1999 Anderson-Butcher, 2003).
Religious Participation Increase in educational outcomes, emotional health, family cohesion, voluntarism less likely to initiate drug use (Studies cited Sikkink Hernandez, 2003 Regnerus, 2000 Johnson et. al., 1996)
School Participation Less substance use school nurse visits less likelihood in early sexual activity less engagement in violence (Studies cited Bonny et. al., 2000 McNeely et. al., 2002)
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Developmental Outcomes Associated with Youth
Participation
Sports Participation Less likely to report mental, general health, eating problems, suicide behavior increase in school attachment. Concern for U-curve. (Studies cited Pate et. al., 2000 Steiner et. al., 2000 Eccles et. al., 2003 Peretti-Watel et. al., 2002)
Civic engagement Impacts long-term citizenship behavior (i.e. voting) civic competence sociopolitical development psychopolitical literacy, cultural sensitivity, critical thinking skills, ability to solve conflicts non-violently (Studies cited Youniss et. al., 1997, 2002 Chavis Wandersman, 1990 Prilleltensky Fox, 2007)
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Harts Ladder of Youth Participation(Hart, 1992,
as cited by the Free Child Project, 2007)
Rung Degrees of Participation
8 Youth initiated, shared decisions w/ adults
7 Youth initiated and directed
6 Adult-initiated, shared decisions
5 Consulted and informed
4 Assigned but informed
3 Tokenism
2 Decoration
1 Manipulation
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Local Examples of Youth Participation

• The Empowered FeFes Youth with disabilities
  serving as advocates
• Beyond Media
• Street Level Youth Media
• Project FOCUS
• Batey Urbano

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Youth Participation/Health Promotion Research
Examples

• Youth participation in a local tobacco control
  campaign
• (Bozlak Kelley, manuscript under review)
• Future research on youth participation in
  wellness policy discussions

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Community Health Development

• Incorporates community capacity for health
  (Goodman et al 1998), community building
  (Kretzmann McKnight, 1993 Minkler 2004) WHO
  notion of a healthy community (Hancock and Duhl
  1986)
• Capacity for community- driven action across
  multiple sectors that effect the quality of life
  and well-being of residents
• Builds community in terms of prosocial structures
  and processes as well as enhancing built
  environment and resources the livability of
  communities (Anderson 2003)
• Fosters enculturation, sense of community
  (McMillan Chavis (1986), shared understanding,
  prosocial, positive social identities

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What is a healthy community?

• A healthy community is one that is constantly
  creating and improving those physical and social
  environments and expanding those community
  resources which enable people to mutually support
  each other in performing all the functions of
  life and in developing their maximum potential
• (Hancock Duhl, 1988)

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Healthy community healthy youth

• A healthy community strives to makes the
  connection between wellness and justice and
  recognizes the reciprocal and conditional
  relationship between the two domains.
• An effective PYD project does the same.

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Examples of Youth Participation Community
(Health) Development

• Consider Collaborative Investigation of
• Youth Health Issue
• Youth can be involved in stages of the research
  process to inform design and implementation,
  outreach strategies to other youth, endorse the
  study to potential participants, provide context
  to study findings and design creative solutions.

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Examples of Youth Participation Community
(Health) Development

• Consider Tailoring Of Messages About Critical
  Health Issues To Other Youth
• Youth can assist in designing media and content
  of message and dissemination strategies. Think of
  potential of technology youth community radio
  station as well as website for data collection
  and information.

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Other examples of youth participation

• Community gardens
• Small scale agriculture and cultural food
  production
• Youth radio
• Technology lab (photography and video action
  projects)
• Community mural
• Community assessment

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Challenges to Youth Participation

• Academic, Community and Organizational norms
  capacity
• Epistemic Premise Conflict
• - power isms age, race/ethnicity, gender,
  sexual orientation
• Ethical issues
• Reconcile tension between Building theory vs.
  Building Young Lives Communities

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Challenges to Youth Participation

• Developmentally appropriate participation
• Boundaries of participation
• Meaning of participation to youth - authenticity
• Creating space for dialogue and action
• Support sustainability
• The most effective participation may not be
  program driven with identified health outcomes
  (ESI vs. CSI)
• Empirically supported interventions vs.
  Culturally supported interventions (Wallerstein
  2007 Hall 2001)

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Next Steps - Research

• -Conceptualizing and measuring youth
  participation and process- youth viewpoint
• Capturing outcomes at individual, program,
  organizational and community levels
• Specifying under what conditions which subgroups
  of youth, organizations communities benefit
• Case Studies Mixed methods

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Study Questions

• What are the effects of youth participation in
  project XX on youth, groups, and the community?
• How did youth participation in project XX foster
  change at multiple levels?
• How was the epistemic premise of the project
  manifested in activities, interactions and
  outcomes?

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Morsillo Prilleltensky, 2007, p.729
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Examples of Concepts and Domains for Evaluation
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Morsillo Prilleltensky, 2007, p.737
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Evans Prilleltensky, 2007, p.683
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Components of the Code of Informality
(Adpated from Kahane Rapoport, 1997, p.26 as
cited in .Morsillo, 2007, p.49)
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Table continued
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Next Steps Advocacy Change

• 1. Advocate for incorporation of youth
  participation into community assessment and
  action, program design and evaluation.
• For youth designated and youth run safe spaces
  for reflection, socialization and dialogue and
  action.
• For funding streams and youth leadership training
  for sustainability
• 2. Lead by example including youth
  participatory opportunities in our own work

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Youth Programs at Illinois Department of Human
Services, Division of Community Health and
Prevention

• Dr. Myrtis Sullivan, MD, MPH
• IDPH
• Associate Director, Family Health
• Title V (MCH) Director

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CHP Mission Statement

• CHP improves the health and well-being of
  families and individuals through partnerships and
  services that build community competence.

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DCHP Partners with Communities

• Illinois' communities help by
• preventing conditions that keep children and
  families from reaching their full potential,
• providing services and supports that build toward
  truly healthy environments in which children
  develop and families live and work.

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Overview of Services (contd)

• 60 programs in the areas of
• health promotion,
• family support,
• youth development,
• substance abuse prevention,
• violence prevention and intervention for
  children, youth and families in need across
  Illinois.

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Budget

• A budget in excess of 500 million, from both
  Federal and State sources to administer all of
  its programs.

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Program Bureaus

• DCHP are managed by 7 bureaus
• Maternal and Infant Health
• Family Nutrition
• Early Intervention.
• Child and Adolescent Health
• Community-Based and Primary Prevention
• Youth Services and Delinquency Prevention
• Domestic and Sexual Violence Prevention

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Applying Youth Development to Public Health
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Maternal and Child Health Bureau (HRSA)

• Healthy People 2010, 2020
• 21 Critical Objectives for Adolescents

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DCHPs Developmental Approach To Services

• Reproductive Health and Early Childhood
• Child and Adolescent Health
• Volunteerism and Community Service
• Domestic Violence
• Adult and Senior Health

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Child and Adolescent Health

• Access to health care
• Teen Pregnancy Prevention and Support for Teen
  Parents
• Youth Services and Delinquency Prevention
• Substance Abuse Prevention

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Service Integration

• high priority on service integration
• At all levels (from local to state)
• At all stages of implementation (from planning to
  evaluation)

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Limited-English Proficiency

• partnerships with local providers.
• commitment to providing services in the
  customers mother tongue.
• linguistic and culturally-relevant service
  delivery.
• On-going Provider Training
• Staff training on serving Limited-English
  Proficient clients

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DCHP Training on Cultural Competency

• The Division, since its inception ten years ago,
  has worked to provide ongoing training to enhance
  staffs awareness and knowledge of new and
  innovative approaches to serving Limited-English
  Proficient communities.

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DCHP Training on Cultural Competency

• The Division in collaboration with The Center
  for Capacity Building on Minorities with
  Disabilities Research at the University of
  Illinois at Chicago is providing training to all
  its staff on cultural competency.

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IDHS Community Health and Prevention

• Key Child and Adolescent Programs

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Positive Youth Development (PYD)

• State and Local Collaboration Demonstration
  Project
• Address the needs of adolescents and young adults
  in communities
• Increase youth opportunities and avenues for
• positive use of time
• positive self expression
• youth participation and civic engagement
• Youth viewed as equal partners

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Access to Health Care

• School Based Health Centers (throughout the
  state)
• Promoting Enrollment in All Kids (Medicaid/Title
  IXX and S-CHIP/Title XXI Social Security Act)

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Teen Pregnancy and Teen Parents

• Primary Teen Pregnancy Prevention
• Teen Parent Services (TANF Programs)
• Life Skills Literacy
• Responsible Parenting (GED and tutoring services,
  parenting skills))
• Parents Too Soon (22 community-based providers
  statewide)
• Subsequent Pregnancy Prevention

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Youth Services and Delinquency Prevention

• Teen REACH (Responsibility, Education,
  Achievement, Caring, and Hope)
• Comprehensive Community-Based Youth Services
• Homeless Youth
• Services to youth (lt 20 years of age) to help
  with transition to independent living
• Case management, food and shelter

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Substance Abuse Prevention

• Comprehensive Projects
• Strategic Prevention Framework State Initiative
  Grant
• Community Youth Services
• Enforcing Underage Drinking Laws

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Volunteerism and Community Services

• AmeriCorps

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Domestic and Sexual Violence Prevention

• Domestic Violence Victim Services
• Domestic Violence Partner Abuse Intervention
  Program
• Sexual Assault Prevention.

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Vision For Illinois

• Partnerships with Youth and their Families
• Youth Leadership Development
• Healthy Life Styles
• Access to Quality Health Care and Services
• Assets-based indicators
• Independence and Successful Transition to
  Adulthood

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Summary Strategies for Success

• Life-Course Perspective
• Ecological Model of Human Development
• Ready by 21
• Connected Youth
• Mentorship
• Positive Youth Development
• Resilience
• Youth Empowerment
• Youth Involvement

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Contact Information

• The DHS Customer Care Line
• Voice [phone]
• TTY [phone]
• The Division of Community Health and Prevention
• Voice [phone]

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Contact Information

• IDHS on the Web
• http//www.dhs.state.il.us/
• The Division of Community Health and Prevention
• http//www.dhs.state.il.us/chp/