Youth Participation as a Protective Factor

1. Youth Participation as a Protective Factor Michele Kelley & Christine Bozlak with Myrtis Sullivan & Michael Rodríguez-Muñiz UIC Great Cities Institute September 11, 2007 (Rev.9/11/2007) Implications For ImprovingAdolescent Well-being & Community Capacity for Health

2. 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.

3. 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)

4. 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

5. 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)

6. 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.

7. 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)

8. 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

9. 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.

10. 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)

11. 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)

12. “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)

13. 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

14. 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)

15. 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

16. 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)

17. 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

18. 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

19. Developmental Outcomes Associated with Youth Participation

20. Developmental Outcomes Associated with Youth Participation

21. Hart’s Ladder of Youth Participation(Hart, 1992, as cited by the Free Child Project, 2007)

22. Local Examples of Youth Participation • The Empowered FeFes: Youth with disabilities serving as advocates • Beyond Media • Street Level Youth Media • Project FOCUS • Batey Urbano

23. 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

24. 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

25. 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)

26. 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.

27. 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.

28. 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.

29. 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

30. 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

31. 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)

32. 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

34. 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?

35. Morsillo & Prilleltensky, 2007, p.729

36. Examples of Concepts and Domains for Evaluation

37. Morsillo & Prilleltensky, 2007, p.737

38. Evans & Prilleltensky, 2007, p.683

39. Components of the Code of Informality (Adpated from Kahane & Rapoport, 1997, p.26 as cited in .Morsillo, 2007, p.49)

40. Table continued

41. 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

42. 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

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

44. 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.

45. Overview of Services (cont’d) 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.

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

47. 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

48. Applying Youth Development to Public Health

49. Maternal and Child Health Bureau (HRSA) • Healthy People 2010, 2020 • 21 Critical Objectives for Adolescents

50. DCHP’s Developmental Approach To Services • Reproductive Health and Early Childhood • Child and Adolescent Health • Volunteerism and Community Service • Domestic Violence • Adult and Senior Health