Young People and Health

Travelling with young people on the road to good health

When we are on a bus, we hope it is going somewhere we want to go at a steady and safe pace. This bus takes young people on a journey along the road to good health. The road will have its twists and turns and lumps and bumps so the bus needs to be well maintained, all four wheels need to be in good shape AND they have to be turning at the same time! What is it that helps the young people on this bus make this journey and get them closer to good health with each turn of its wheels?

The four wheels are the key elements of anything that seeks to inspire improvements or changes in young people’s health be this at a family, school or community level.

We call these four elements:
• Information;
• Life Skills (ability to act);
• Inspiration; and a
• Supportive Environment.

1. The Information Wheel

The information wheel is often the strongest wheel in traditional health education campaigns. Plenty of resources are spent creating information leaflets books, manuals etc. Many of these are of high quality, they are written by highly experienced and well qualified people. At times the information wheel seems pumped up to bursting point! Creating information for people is an easy, safe, measurable response to a health issue or problem that needs solving. There is an overwhelming amount of information and resources to set you up for a great journey!

But does information do its job? How far can information take you? It’s a key factor but it won’t do much of the work for you. We do not want to be without information but we want the right information. We want it delivered to us when we need it and at the right time and in the right way. In this information age, it is easy to get information overload and to feel overwhelmed by the diversity of right answers to choose from to solve our problems. And beware! Information and the search for it is good at stalling the journey! It can undermine our confidence and our belief that we have good solutions ourselves.

2. The Life Skills wheel

When we are well informed on a health issue or problem does this mean that our behaviour or attitudes are affected? No! There is no guarantee that good information influences our lives or behaviours, let alone changes them. People may believe that they are in a situation which they cannot change or that they do not have the resources to follow helpful guidelines. Think about the following messages. Is the key message or even the facts you know to be true behind the messages enough to change behaviour?
Don’t smoke!
Don’t drink!
Don’t do drugs!
Don’t carry knives!
Wear a condom!
Don’t have sex before you are married!

Most people will have good reasons for doing the things they do. The benefits they get from it outweigh the perceived risks. So changing behaviour involves interplay between what people need to know about and what they need to do in order to be healthy and safe.

This second wheel focuses on an ability to act, a life skill. Not the type that make you good at balancing the budget but the deeper skills that govern behaviour and attitudes! The World Health Organisation came up with this definition….

Life skills are abilities that help us to adapt and behave positively so that we
can deal effectively with the challenges of everyday life.

Using this definition, we can separate life skills from other types of skills, like this:
• Livelihood skills: Time management, getting a job, interview, computer, cooking, driving, etc
• Learning skills: Reading, reporting, numeracy etc
• Technical/health skills: Cleaning teeth, using a condom, road safety, giving oral rehydration etc
• Outcomes of life skills: Teamwork, self-esteem, learning from each other, confidence etc

The core life skills are grouped into five related areas:

1. Decision-making and Problem-solving
A group of young people decide to give up smoking and help others do the same. They set goals to encourage themselves and each other and try to think what problems and benefits may happen.

A group of older boys shout at and threaten two girls. The girls suspect they may have knives. The girls work out whose help to seek if this happens again.

2. Critical and Creative thinking
A girl assesses the risks involved in accepting an invitation from a male stranger for a lift across the town.

A young person is able to think about future job options and to think how to work towards these options.

3. Communication & Interpersonal relationships
A young person is able to discuss problems with parents or an appropriate adult.

A young person is able to resist peer pressure when his friends ridicule his refusal to drink alcohol.

4. Self-awareness and Empathy
A young woman develops an awareness of her sexual feelings and how these feelings can ‘take over’ sensible decisions. This awareness helps her avoid situations where she might risk unsafe sex.

A group of young people think about how they can help young children improve their communication skills.

5. Coping with Stress & Emotion
A young person learns how to cope with the conflicting pressures of needing to work and wanting to study

A boy learns to cope with the anger he feels towards his abusive father

Life skills can help young people in the following ways:

• Many young people live in circumstances that make them especially vulnerable and limits their choices and future potential.
• Life skills learning does not change events, but helps young people to cope better with these events and enrich the world they live in.
• Life skills learning should help young people become more aware of:
- what they are doing
- how they are doing things
- how they obtain information
- how they think, feel and behave.
• With better understanding about themselves and others, they can make better choices.
• A sensitive educator can help young people look deep inside themselves, discover causes for problems and develop positive behaviour.
The problem is that even with the right information and the life skills to take action, this is not enough…we are only half way there!

3. The Inspiration Wheel

Even if a young person has the necessary information and the skills to implement the information, they need to feel inspired make choices to improve their own or others health. Inspiration comes from feeling connected, having fun, feeling you are making an impact, praise and recognition. Self-motivation is also important. Self-motivated children and young people have confidence and a sense of self worth. They have goals and a sense of the effect of certain behaviours on these goals. A sense of the spiritual or feeling a connection to a higher purpose or being also helps with self-motivation.

So far, we have a three-wheeled bus taking us up the road to good health! It is driven by young people having good information delivered at the right time and in the right way. It is driven by young people who have the skills to do so. They can identify problems, make decisions, create appropriate solutions, they feel empathy with others, have good relationships. As they take the wheel, they feel inspired to put all this into practice. On the face of it, this looks like a good deal! However, it is still not enough.

The final and the wheel with the most complex construction driving our bus forward is what is in place to help things along from the social and cultural environment.

4. The Supportive Environment Wheel

This fourth wheel is constructed from what these three groups bring to the mix:
1. The closest environment around the young people composed of family, friends and the immediate community;
2. The local school and the wider community; and
3. Society as a whole, cultural and religious influences, media, government policy and law

How well this wheel works profoundly effects the working of the other wheels. After all young people live in a complex web of social and cultural interactions that frame their decisions and actions. Not everything needs to be perfect and in place but it helps if all these components are in reasonably good health! A certain amount of servicing, repair work and even wheel changes need to happen on the road as on many long journeys!

Different factors within the social and cultural environment can support, delay or block progress for young people on their journey to good health. For example, while you would think that most policy is created to enhance health and well being, sometimes it does not achieve this. More confusingly, sometimes it does but the policy is not borne out in practice.

In some cases where there is an inadequate policy areas, young people can campaign to make changes. Take the Health Messengers of Bucharest – whose Healthy Hospitals Campaign in the 1990’s saw the end of medical doctors smoking on wards and an advertising ban on tobacco products in the media. Here they are getting ready for one of their regular marches outside and in the hospital! Success was partly due to other aspects of the social and cultural environment also being ready for this change.

If you want to learn more about involving young people in the design and development of effective health education, visit my blog

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