A Framework for Developing, Implementing, and Evaluating Adolescent Health Interventions

There are a number of frameworks that can be used to develop, implement, and evaluate adolescent health inter­ventions. However, the framework that is most compati­ble with the guiding principles set forth earlier is the Youth: Choices and Changes Model (Figure 1), which was developed by the Pan American Health Organization (Breinbauer and Maddelino, 2005).

Figure 1. The Youth: Choices and Change Model. Breinbauer C and Maddelino M (2005) Youth: Choices and Change: Promoting

According to this model, there are six stages that one should follow when developing, implementing, and evaluating interventions. These are as follows:

• identify the target group in terms of adolescent stage and gender;

• identify adolescent needs and wants, taking into account the local cultural, social, linguistic, economic, and spatial dimensions;

• identify the level(s) of intervention (individual, inter­personal, community, and public policy), bearing in mind that interventions are most likely to be effective when they address multiple levels in a mutually rein­forcing and synergistic manner;

• identify other actors’ needs and wants in a respectful and meaningful consultation process, to ensure wide­spread support and accurate information and insight in the various contexts in which adolescents exist;

• identify the theories that will support the design of the intervention, as interventions that are theory-based are more likely to be effective as pointed out above; and

• translate theory into practice, which involves identify­ing and operationalizing sets of health-promoting and health-compromising determinants.

In developing, implementing, and evaluating adolescent health interventions, it is important to bear in mind the general considerations that have been set forth in this article. A consensus has been developing about the peda­gogical features of interventions that maximize their chances of success (Table 1).

Healthy Behaviors in Adolescence. Washington, DC: Pan American Health Organization.

Conclusion. The majority of adolescents are healthy, and do not suffer from significant mental health problems or engage in risk behaviors such as unsafe sex or substance abuse. However, the onset of health problems and risk behaviors in adoles­cence, unless identified and dealt with early, may have long-term and severe adverse consequences.

Programs that provide opportunities for adolescents to access services and information, enhance their capacities to protect and promote their health, and enable them to live in safe and supportive environments, are key for helping them make the transition to successful adulthood. A coherent policy for adolescents, with clear objectives and priorities, and integrated into wider health and national policy planning and implementation mechan­isms, forms the context for successful programs.

See also: Adolescent Health; HIV/AIDS; Mental Health and Substance Abuse; Mental Illness, Historical Views of; Specific Mental Health Disorders: Child and Adolescent Mental Disorders.