Youth experiment with new lifestyles to meet certain needs they feel they are lacking. They need a voice in identifying those needs and in finding healthy ways to address them. Many traditional health promotion programs that are designed to influence young people’s behaviour have failed to give young people that voice and to involve them in the planning and implementation stages.

Early adolescence is a time when young people make important decisions related to sexuality and the use of alcohol, tobacco and other drugs. Young people who make appropriate choices have the ability to resist pressures to engage in substance misuse and abuse. They are motivated and have the skills they need to make healthy choices about regular physical activity, eating and sexual behaviour. They make constructive use of their leisure time.

In 1992, when the Health Department of Ottawa Carleton asked young people to describe their major health issues, they identified six main concerns:

  • sexuality
  • relationships with friends, parents, teachers, and police
  • alcohol use
  • stress, time pressure, and pressure to achieve
  • violence
  • body image and appearance. (153)

All of these are linked to the capacity of the home, school and community to make "the healthy choices the easy choices" for young people.

School-based health instruction is essential. Extensive evaluations of health education programs have reported that 50 hours of well-planned programs can affect changes in student’s health behaviours, attitudes and knowledge. (268) Further research has shown that these benefits are enhanced by a comprehensive approach that complements health instruction with a healthy physical and social environment in the school and collaboration with services and supports in the community. (267)

This approach, which is called "comprehensive school health", has been endorsed by more than 20 national associations in Canada as well as UNESCO and UNICEF. Comprehensive school health assumes an interdependent and dynamic relationship among three components: instruction about health, community health and social services, and healthy physical and social environments which include support from family members, peers, policy makers and the community.

Health promotion initiatives that encourage healthy lifestyle choices need to recognize gender differences in health behaviours. Studies have shown, for example, that girls may smoke for different reasons than boys, including, because of concerns about body weight and as a coping mechanism for high perceptions of stress. Programs and support need to address the underlying reasons for taking up a negative lifestyle habit and help young people find healthy alternatives to dealing with those issues.

It is also important that lifestyle education programs begin at the appropriate age. By age 16, it is too late to instruct young people about how and why to say no to smoking.

  • By grade nine, 26 percent of youth have had sexual intercourse at least once. (246)
  • Among 13 year-olds, 35 percent of boys and 31 percent of girls report having been drunk at least once (246).
  • The average age at which regular smoking begins is between 12 and 14. (246)
  • At age 11, 70 percent of boys and 53 percent of girls report exercising at least four times a week outside of school. (246)
  • At age 13, 70 percent of boys and 60 percent of girls report watching two or more hours per day of television. (246)
  • In 1992, a British Columbia survey of students in grades seven, eight and nine showed that less than 20 percent of young people always or usually wear bike helmets. Use declines with age. By grade nine, 83 percent of students report that they never or rarely used bike helmets. (263)
  • In 1990, among five to 14 year-olds, there were over 31,000 hospital admissions due to injuries. Almost two-thirds of the 10 to 14 year olds who died in 1990, did so as a result of injuries. (3)
  • In 1988 one-fifth of children between the ages of six and 12, spent time alone and unsupervised while their parents worked or studied. (3)
  • At age 11, only 29 percent of Canadian students say they eat fibre-rich foods (raw vegetables, fruits and whole wheat bread) once a day or more. (246)

Key influences on healthy, appropriate behaviour choices that affect all children at this transition include:

 
Supportive home environment
 

Role models and peer support

 

Supportive learning and living environments

 
Media

Note: These influences are also listed in the drop-down list above. Please use this menu to navigate within this page.


Supportive home environment


 

Provide support, encouragement, information and two-way communication.

  • Help your children build a strong sense of identity and self-esteem so that they can resist pressures to use drugs, to engage in sex, etc.

  • Provide your children with healthy food choices and information about healthy eating.

  • Provide your children with the opportunities and the equipment they need to be physically active. Encourage them to participate in sport and recreational activities at school and in the community, as well as alone or with friends.

  • Engage preteens and teens in straight talk about sexuality, safe sex, healthy intimate relationships, alcohol use and sex, family planning and reproductive health.

  • When children mature earlier than their peers, prepare them for dating and delaying expectations for sexual behaviour.

  • Engage your children in conversations about decision-making and lifestyle choices. Listen to their concerns and ideas. Help them learn to say no in a way that does not isolate them from their peers. The more youth feel listened to and able to negotiate with their peers, the less likely they are to end up in a peer group based primarily on opposition to conventional values that rewards smoking, substance abuse and other risk-taking behviours. (7)

  • Talk with other parents about helping adolescents make healthy choices informally or in parent support groups. Ready or Not is a community program that helps parents prevent alcohol and drug use by working things out with other parents and a qualified leader.

Set clear boundaries and supervise behaviour.

  • Set clear boundaries related to alcohol and drug use, curfews, behaviour when alone in the house, and honesty. Involve young people in setting these boundaries together.

  • Have clear, appropriate consequences for going beyond the limits that are agreed to ahead of time and enforce them.

  • Monitor students’ behaviour. Missing classes, declining participation and an inability to concentrate may be signs of substance misuse and/or alienation from school. Communicate with parents regularly about student’s health and participation in school.

 

  • Offer parenting courses and parenting support groups to help parents prevent substance abuse or premature sexual behaviours among their children. Ready or Not is one example of a well-evaluated community program for parents of preteens.

  • Offer stimulating activities for children and adolescents in their leisure time.

 

  • Offer health promotion and health education programs to employees, for example, smoking cessation and employee fitness programs so parents can adopt positive health practices and be effective role models for their children.

  • Provide family-friendly workplace policies, for example, flex time and work-at-home arrangements, so parents are able to supervise their children.

  • Offer noon hour sessions on preventing substance abuse and misuse among children and teens.

  • Sponsor family outings, for example, company picnics or family fun runs, that provide families with healthy opportunities to engage in physical activity and to enjoy healthy eating together and with work colleagues.

 

  • Support the development of materials and programs that help parents influence their children’s health behaviours in a positive way.


Role models and peer support

There is strong evidence that young people take on behaviours like those they see practiced by the role models in their lives. For example, children whose parents drink alcohol or use illegal drugs are more likely to adopt these habits than children whose parents do not (265). Older siblings, other relatives, teachers, coaches and community leaders are also important role models for young people. In addition, young girls and boys often look up to media personalities, sports stars and fashion models. They want to be like them so they emulate their behaviours.

As young people approach adolescence, peers have a great potential to influence behaviour and lifestyle choices, either in a negative or positive way. Young people who smoke, for example, are much more likely to have peers who smoke (264). In fact, risky behaviours tend to occur together among groups of friends who smoke, use alcohol and other drugs, engage in premature sexual experiences and cut classes.

On the other hand, there is a substantial body of evidence to support the effectiveness of peer teaching and peer helping when it comes to making healthy lifestyle choices (see The Peer Helping Annotated and Indexed Bibliography).



Be a good role model.

  • Do not smoke, use illegal drugs or engage in unsafe sex. Use alcohol in moderation (if at all) and do not drink and drive. Use prescription medications as advised by your doctor and do not misuse over-the-counter drugs.

  • Enjoy healthy eating and physical activity yourself and as a family.


  • Provide peer counseling/helping programs in areas such as substance abuse prevention and the prevention of eating disorders. See the Peer Helping Annotated and Indexed Bibliography for further information.

  • Invite local athletes and celebrities to serve as role models and spokespersons for positive lifestyle choices.



Supportive learning and living environments


  • Adopt a comprehensive school health approach that complements high quality health instruction with a healthy physical and social environment in the school and collaboration with services and supports in the community.

  • Provide high quality health education programs that emphasize the development of attitudes, values and behaviours, not just knowledge acquisition. Use a sequential, comprehensive approach that treats health in a holistic way, rather than a host of non-integrated instructional periods about single issues.

  • Provide a lifestyle-focussed physical education curriculum (rather than just competitive athletics) that focuses on fitness, fun and the development of lifetime activity skills.

  • Incorporate health messages into other subjects, such as science, social studies and home economics.

  • Provide teachers with in-service training on emerging health issues.

  • Facilitate meetings of the principal, school nurse, guidance counselors, social workers, police liaison officers and parent representatives.

Create healthy environments and make the healthy choices the easy choices.

  • Adopt and enforce policies prohibiting smoking or use of alcohol or other drugs on school property.

  • Provide healthy food choices in school cafeterias and vending machines.

  • Provide opportunities for healthy, fun physical activities outside of the physical education curriculum.

  • Consider offering breakfast or school lunch programs in schools where children are coming to class hungry. Collaborate with parents and community members and make the program available to all to avoid stigmatizing the participants.


Actively involve youth in decisions, policies and programs that affect their health; provide them with opportunities to develop leadership skills and take on leadership roles.

  • Encourage children and youth to define the issues that affect their health and work together to address these issues. The Kids In Action program in a disadvantaged area in Toronto is one example of how a community health centre provided this kind of opportunity. Dialogue with the Children and Youth of Ottawa-Carleton is an outstanding example of how a public health department took the lead in implementing a multisectoral dialogue with youth that led to a comprehensive collaborative plan for promoting adolescent health.

  • Encourage young people to show leadership in responding to health issues that concern them. Making A Difference For Youth in Antigonish, Nova Scotia has taken on a number of community initiatives and entrepreneurial projects related to health issues.

  • Encourage children and youth to lead activities during National Drug Awareness Week, National Nutrition Month, National Non-Smoking Week and other designated weeks and months.

Cooperate with schools to adopt a comprehensive school health approach that complements high quality health instruction with a healthy physical and social environment in the school and collaboration with services and supports in the community.

  • Work with schools to develop integrated, holistic health promotion materials and programs that fit local needs.

  • Assist in training teachers about health issues.

  • Work with schools to provide complementary services that respond to local needs. For example, studies have shown that school-based health clinics with a generic front can be effective in overcoming access barriers and in changing sexual behaviours. (270) Provide a range of services from information to support, counseling, and rehabilitation.

  • Facilitate meetings of the school principal, school nurse, guidance counselors, social workers, police liaison officers and parent representatives.

  • Provide schools with an up-to-date list of self-help groups and available health professionals and counselors.

  • Consider offering breakfast or school lunch programs in schools where children are coming to class hungry. Collaborate with parents and schools and make the program available to all to avoid stigmatizing the participants.

Assess health risks for children and youth in the community and provide appropriate services.

  • Collaborate with schools, parents and children and youth to assess local health risks and needs. Dialogue With the Children and Youth of Ottawa-Carleton describes a needs assessment process and development of an action plan for health that intimately involved young people.

  • Provide appropriate public health screening and immunization programs.

  • Provide prevention, treatment and counseling services for alcohol and drug use (including tobacco) and counseling for safe sex, sexually transmitted diseases, AIDS, sexual abuse, sexual assault and family planning at an age before young people typically get involved in these risk-taking behaviours.

Create healthy environments and make the healthy choices the easy choices.

  • Adopt and enforce policies prohibiting smoking or use of alcohol or other drugs in public places where children gather and in all community programs that include children and young people.

  • Provide healthy food choices in public places and vending machines.

  • Provide ways for children to make constructive use of their leisure time, for example through opportunities for healthy, fun physical activities for children, youth and families. The Boys and Girls Club of Canada: Active Living Initiative is one example of a program that stresses fun and leadership development.

  • Create walking and cycling paths, ski trails, skating areas, swimming areas and other incentives for spontaneous physical activity.

  • Report merchants who sell tobacco or alcohol to underage children.

  • Sponsor alcohol-free family dances and special events, for example, New Year’s Eve celebrations.

  • Implement mandatory health and physical education programs in all schools. Work with school administrators to ensure that high quality programming that meets local needs is carried out.

  • Support the teaching of healthy sexuality in schools.

  • Support the training and use of specialist teachers in health and physical education.

  • Develop policies, programs and procedures to support a comprehensive school health approach, participatory needs assessments and needed services.

  • Adopt and enforce policies prohibiting smoking or use of alcohol or other drugs in public places where children gather and in all community programs that include children and young people.

  • Enforce the law. Monitor merchants and fine those who sell tobacco or alcohol to underage children.

Media

Advertising, movies, television programming and music bombard young people with seductive messages that glamorize smoking, drinking, drug use, foods with little nutrition value and provocative sexual behaviour.

  • Restrict the kinds of media that your children are exposed to at home. Discourage them from viewing or listening to media messages and programs that glamorize unhealthy lifestyle choices.

  • Discuss with your children how advertising of adult products such as tobacco are directed toward young people in order to get them to buy the product and use it.

  • Communicate your disapproval when media that youth are attracted to portray images and messages that glamorize unhealthy lifestyle choices. Praise media that show positive lifestyle choices as attractive and fun.

  • Provide media literacy programs that teach children to critically examine how advertisements for tobacco and other products are designed to encourage young people to buy and use their products despite the known negative health effects.

  • Protest advertising of tobacco and alcohol near school properties.

  • Link health education activities with media awareness campaigns for special weeks and events, for example, National Non-Smoking Week and Weedless Wednesday.

  • Work with the media to arrange for student assignments such as preparing a public service health message or writing an article about a health issue.

  • Advocate media coverage that portrays healthy young people involved in healthy lifestyle activities.

  • Protest media coverage that glamorizes drinking, smoking, drug use and provocative sexual behaviour.

  • Encourage media personalities to act as positive role models for young people.

  • Encourage media outlets to sponsor youth sports and activities and to provide coverage of young people’s events.

  • Encourage media outlets to provide programs and ads that provide children and teens with the information they need to make healthy lifestyle choices.

  • Encourage media outlets to work with schools and community groups to arrange for young people to prepare a health message, participate in a talk show about a health issue, etc.

  • Protest advertising of tobacco or alcohol near school property or at events designed for young people and families.

  • Encourage media to inform the public about the state of children and youth well-being and the value of prevention activities.

  • Regulate the advertising of tobacco and alcohol and of gambling and lottery activities.

  • Provide guidelines for programming directed at children and youth, and encourage the development of self-regulating guidelines in the media industry.

  • Sponsor media campaigns and programs that portray youth and role models enjoying healthy lifestyles including engaging in appropriate sexual behaviour and choosing not to use alcohol, tobacco or drugs.

  • Sponsor media campaigns and programs that provide children and young teens with relevant information about healthy lifestyle choices in a way that appeals to them.

  • Provide an example of civility and integrity in all government communications.

  • Show children and young people making healthy lifestyle decisions such as wearing a bicycle helmet, engaging in physical activity and eating healthy foods.

  • Enlist media help in beginning a dialogue with politicians of all parties to inform them of children and young people's unmet needs and what they can do to improve outcomes for children and youth.


Aware of any innovative programs, legislation or initiatives that are relevant to this positive outcome?
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We are always on the lookout for specific strategies proven to be successful (or showing promise), that illustrate work done in this area. After reading this section of the site, click on the icon below and share your ideas.



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