1. Adolescent Health, Development & Wellbeing.docx

CRITICAL READING: CORNELL NOTES Adolescent Health, Development & Wellbeing Name: Date: 9 October 2023 Section: Lecture 1 Period: Questions/Main Ideas/Vocabulary Notes/Answers/Definitions/Examples/Sentences When Does Adolescence Occur? 1402 – Oxford Dictionary: Adolescence lasts...

CRITICAL READING: CORNELL NOTES Adolescent Health, Development & Wellbeing Name: Date: 9 October 2023 Section: Lecture 1 Period: Questions/Main Ideas/Vocabulary Notes/Answers/Definitions/Examples/Sentences When Does Adolescence Occur? 1402 – Oxford Dictionary: Adolescence lasts from 14 – 25 for men and 12 – 25 for women. 1904 – Stanley Hall: Adolescence lasts from 14 – 24 for women and men. Currently – WHO: Ages 10 – 19 represents the adolescent years. Viewing Adolescence from a Westernised Perspective Some cultures don’t recognise adolescence as a decade-long transition, but rather critical life stages are marked by formal rites of passage or ceremonial rites. What Western cultures consider appropriate, normal and healthy development is not considered as such in other cultures. Example: Western cultures become more independent from parents and family in the later years of adolescence; this is not necessarily the case in Eastern cultures. Identifying the End of Adolescence Social transitions can also mark the end of adolescence. Australia – 18 years old: Considered adults in the eyes of the law. End of formal schooling. Can legally vote in elections. Legally purchase alcohol. Responsible for giving full legal consent or refusal of medical treatment. Erik Erikson – Identity vs. Role Confusion During this stage, adolescents aim to figure out their identity. What is identity? Comprises the various qualities that make people who they are. Attributes people use to define themselves as part of a social group. Goals and values. Self-image. Erikson believes two major identities are formed during this time: sexual and occupational. At the end of the adolescent stage, adolescents should have a reintegrated sense of self, of what wants to do or be and of one’s sexuality. A lot of exploration takes place as individuals rely less on parents and more on peers. Role confusion arises if one fails to establish a sense of identity within society. Identity/Role Confusion – Media Examples Mulan: The gender expectations of her culture don’t align with who she is. Troy Bolton: Struggling between his music identity and basketball identity. Erik Erikson – Identity vs. Role Confusion Outcomes Positively resolved: Individuals create a stable identity for themselves. Negatively resolved: Individual doesn’t create a stable identity and becomes confused about who they are and their place in the world. James Marcia – Four Identity Statuses Identity diffusion: Those yet to experience the crisis without a clear set of values. Identity foreclosure: Those yet to experience the crisis, but already committed to an identity and values. Identity moratorium: Those in the crisis, wanting to establish their identity and values. Identity achievement: Those who have successfully resolved the crisis with a clear identity and set of values. Bronfenbrenner’s Ecological Model A holistic model that considers biological, social and environmental factors that can influence adolescent development, health, well-being and behaviour. We can use this framework to guide our understanding of how systems influence psychological and social changes which occurred during adolescence. Cultural differences: What can be inferred based on the Western culture can't always be applied to all situations. For example, having to share space with your siblings or family in Western cultures can potentially be considered a stressful, challenging experience. In some cultures, generations of family members live and share space so it might not be appropriate to think that an adolescent living in this environment is experiencing increased stress. As adolescence represents an important time for development and forming adaptive health and well-being behaviours, the conversation naturally goes towards the role of schools. Adolescents spend most of their time at school, so the setting becomes an ideal environment to introduce prevention and early intervention programmes to help reduce potential problematic health risk behaviours or programmes that focus on increasing well-being. The Benefit of Interventions During School Schools have long been recognised in public health agendas as important settings for health and well-being promotion and education. Promoting healthy habits and behaviours in schools not only reduces risk behaviours and increases mental health, but also can help with academic achievement. Academic achievement is also associated with improved health later in life. Two Major Reasons Why School Is an Ideal Setting Schools present an efficient method of obtaining the attention of the majority of students. Schools are the main setting in which formal education takes place. The WHO’s Health Promoting Schools Framework The WHO Health Promoting Schools Framework was developed over 25 years ago. Derived from the important role schools play in health and well-being, not only for students but for staff, families and the broader community. This framework offers an approach to developing school interventions, emphasising the importance of multi-level community health programmes and schools. The Health Promoting Schools Framework School curriculum: Health topics are promoted through formal school curriculum. School ethos/environment: Health promotion is hidden or informal – encompasses values and attitudes within the school and physical environment. Families/communities: Schools seek to engage with families and the outside community in recognition of the important role they play in student health. Application of Framework to Various Health & Wellbeing Related Outcomes Overweight/obesity. Physical activity and sedentary behaviors. Nutrition. Tobacco use. Alcohol/substance use. Sexual health. Mental health. Violence. Bullying. Body image/eating disorders. Sun safety. Oral health. Fit-4-Fun Students aged 10 – 12 from a school in NSW. Designed to build a school environment/ethos that supports physical activity, creates links between the school and home via parental and family involvement, supports teaching and learning through a health and physical education programme. Curriculum component: 60 minutes a week for eight weeks. Mix of theory and practical lessons. Outcome measures include health related fitness, cardio-respiratory fitness, muscular fitness and flexibility. Family component: Requires families to partake in 20-minute activities, three times a week for eight weeks. School component: Focuses on increasing activities at recess and lunch (when students were on breaks) for eight weeks. Methods: Treatment and control group measured at baseline and six months post intervention. Measurements: Cardio-respiratory fitness, BMI, flexibility, muscular fitness and overall physical activity levels. Results found that after six months, those who were in the intervention (treatment group) showed significant improvements in cardio-respiratory health, BMI health, flexibility and overall physical health but not muscular fitness. Students reported that parent and family involvement was difficult. Older students were less likely to participate in the activities designed to improve school ethos/environments. The Queensland School Breakfast Project Students aged 11 – 12 years. Designed with a broad focus of improving the breakfast consumption (both quality and frequency). Curriculum component: Classes had increased focus on health, nutrition and breakfast. Development of recipe books period Students delivering material related to eating healthy breakfasts. Family component: Newsletters with information given to parents/caregivers. Involvement of parents in class events. Breakfasts made available to students in the neighbouring out of school care facility. School component: Events to promote breakfast. Allocation of breakfast eating area. Change in timetable to allow for earlier snacks in the day. Trial of breakfast in tuckshop/canteen. Methods: Treatment and control group measured at baseline (term 1) and again in term 4. Intervention delivered in terms 2 and 3. Measurements: Breakfast skipping. Type of breakfast consumed (includes energy dense and micronutrient poor food or beverage choice). Although both groups reported an increase in breakfast skipping, breakfast skipping in the intervention (treatment) and group increased by 4.5% while the control group increased by 20.2%. Those in the intervention group reported a decrease in consuming energy dense and poor micronutrient breakfasts; the control group reported an increase on this measure. Girls were significantly more likely than boys to skip breakfast and term 4 than term 1, supporting other findings that suggest as girls get older, they're more likely to skip breakfast. Schools report that finding and maintaining momentum for planning and implementation was difficult; highlights a common issue of school interventions, limited resources and competing priorities. Meta-Analysis Examining the Effectiveness of Intervention using the Framework Found Varying Results Effective: Reducing BMI, smoking, incidence of bullying behaviour, physical activity, fitness, fruit and vegetable intake. Not so effective: Fat intake, alcohol use, drug use, violence, bullying perpetration and symptoms of depression. At times, there was not enough data to determine effectiveness. Authors highlight a consistent major limitation: the family/community domain was the weakest aspect of the intervention and minimal efforts were made to engage this group of people. Raises an important point on how essential the broader school and family environments are when creating and implementing health and well-being and interventions. Vaping – the Use of E-Cigarettes Prevalent in adolescent populations but is still relatively new. Vaping in adolescents can be playing a role in social maladjustments and health problems: Poor learning and academic performance. Poor sleep quality. Impaired memory and cognition. Lung injuries. Increased aggressive and impulsive behaviour. Attention deficits. Increased depressive symptoms and suicidality. Poisonings and burns. People who use E-cigarettes are also three times more likely to take up tobacco smoking. Based on previous, successful OurFutures programmes which have tackled alcohol use, cannabis, psychostimulants and emerging drugs. OurFutures programmes have shown to be effective through large randomised controlled trials across Australia with 21,000 students. OurFutures – Vaping Programme Only the protocol has been published. Methods: 230 schools in Australia were invited to participate, 42 accepted and met the inclusion criteria; 21 schools in the intervention group, 21 schools in the control group. Target population: students in years 7 and 8. Timeline for data collection: baseline, intervention (delivered over four weeks), post-intervention, follow up data at 6, 12, 24 and 36 months. Outcome measures: Primary: change over time in E-cigarette use. Secondary: mental health, knowledge about E-cigarette use, motives to use E-cigarettes, attitudes to E-cigarettes, measures on peer pressure, health related QoL and resource utilisation. The programme will be delivered in health and education classes across 4 weeks: 1 40-minute lesion each week. 20 minutes: students participate in an online cartoon scenario. 20 minutes: teach-led component. Focuses on harm minimisation and comprehensive social influence approach, providing evidence-based information about E-cigarettes, normative education to correct misconceptions use and resistance skills training. Not designed following the WHO’s guidelines of including the ‘family/community’ component.