Physical Activity and Nutrition

Given the decrease in teen smoking, drug use, unintended pregnancy and motor vehicle mortality, the adolescents entering the new millennium might be the healthiest ever, with one big exception: their eating habits. The increase in overweight and obesity among U.S. children and adolescents has been called America’s newest epidemic. Overweight and obese teens face immediate health problems, such as high cholesterol, hypertension, Type 2 diabetes, insulin resistance, polycystic ovary syndrome, as well as emotional issues. Excess weight in adolescence carried into adulthood also predisposes youth for serious adult health risks such as coronary heart disease, stroke, gall bladder disease, some types of cancer and osteoarthritis of the weight-bearing joints. The flip side of obesity is anorexia and eating disorders, which have their onset in adolescence.

BEST PRACTICES

Nutrition

1. Parents - Family knowledge and habits regarding a healthy diet are the earliest steps to preventing adolescent overweight and obesity. Teens and parents need more consumer awareness about reasonable food and beverage portion sizes. Pregnant and parenting teens need education about the potentially protective effect of breastfeeding against the development of later obesity in their infants.
2. Schools - Schools can promote healthful dietary patterns by ensuring that school lunches are healthy and attractive to teens and by providing healthier snack options.
3. Communities - Communities can seek demonstration grants to address the lack of access to and availability of healthy affordable foods in inner cities.

Physical Activity

1. Parents - Parents and older siblings can model participation in physical activity and/or support their teen’s pursuit of athletic activity.
2. Schools - Where it has been cut, schools can restore physical education to the daily schedule. Where physical education classes are still available, schools can devote more class time to actual participation and increase the levels of intensity.
3. Communities - Communities can support youth sports and recreation programs that offer a range of activities that are accessible and attractive to teens. Communities can be creative in zoning and transportation planning to make it convenient, safe and attractive for teens to walk and ride bicycles.

Helpful Links:

Colorado Health Foundation
LiveWell Colorado
Colorado Best Practices Website
Colorado Coalition for Healthy Schools
Kaiser Permanente Educational Theatre Program

Positive Youth Development

Positive youth development (PYD) is an approach, not a program, that guides communities in the way they organize services, opportunities and supports so that young people can be engaged and reach their full potential.

PYD is characterized by the following principles:

1) Strengths-Based: A positive focus on physical and mental health, education, social, vocational, creative, spiritual and civic outcomes for youth

2) Youth Engagement: Youth are connected to themselves and positive peers, adults and communities

3) Youth-Adult Partnerships: Youth work with adults to make decisions for program and policy planning, implementation and evaluation.

4) Culturally Responsive: People recognize and respond proactively to variations in backgrounds/cultures, including but not limited to ethnic, racial, linguistic, learning and physical abilities, sexual orientation, socioeconomic status and geographic location to ensure inclusivity and equity.

5) Includes ALL youth not just youth in risky environments or exhibiting risky behaviors

6) Collaboration: Private and public agencies; state and local; and the community, including families, work together to support youth

7) Sustainability: Long-term planning through funding, capacity building, professional development, and evaluation exist for ongoing support of youth

So, what does this have to do with prevention?

The goals of primary prevention are consistent with those of the PYD approach. Both aim to reduce the increase or number of new cases of an undesirable condition. In fact, the Journal of Public Health Management and Practice, November 2006 Supplement, “Improving Public Health Through Youth Development” recently outlined the need to use a PYD approach to address youth issues. Download the journal.

In addition, in April 2008, the Association of Maternal and Child Health Programs (AMCHP) released their newsletter, the AMCHP Pulse, that urged states to focus their adolescent health efforts on positive youth development. Read the entire piece.

The Colorado Department of Public Health and Environment’s Child, Adolescent and School Health Unit has embraced the positive youth development approach in addressing adolescent health issues.

Examples of positive youth development frameworks include:

• 40 Developmental Assets
• Building Assets
• Risk and Protective Factors
• America’s Promise
• Resiliency

Teen Driving Safety

Motor vehicle crashes are the leading cause of death for 15-19 year olds, most likely due to a combination of inexperience, overconfidence, risk-taking behavior and greater risk exposure. Young people have less experience behind the wheel than older drivers. Young people are less likely to wear seatbelts than older drivers. And, young people are more likely to drive at night, with other young people as passengers, thus increasing the risks of distraction and the influence of peer pressure. Recently, Colorado passed a comprehensive Graduated Driver’s Licensing Law to address this problem. For details on the law, download a brochure at www.coteendriver.com They are available in both English and Spanish.

Sexual Health and Development

As youth enter puberty, defining their own sexual identity is at the forefront of normal developmental challenges. Part of normal development for a healthy adolescent is to explore his or her own sexuality and learn to live responsibly with it. Sexual activity can be as innocent as holding hands or as dangerous as unprotected intercourse with multiple partners. Health advocates are particularly concerned with early initiation of sexual intercourse, teen pregnancy, and sexually transmitted infections. Risky sexual behavior can lead to serious health consequences. Risky sexual behavior includes sexual intercourse initiated at an early age, unprotected sexual intercourse, sex with multiple partners, inconsistent or absent contraceptive practices and combining sexual activity with other risk behaviors such as use of alcohol or other drugs. Health-compromising results of risky sexual activity include unwanted pregnancy, too early childbearing, sexually transmitted infections and negative effects on the adolescent’s social and psychological development.

Research on adolescent sexual behavior has typically concentrated on vaginal intercourse. However, adolescents who are virgins, defined as never having had vaginal intercourse, may still be sexually active and may behave in ways that put them at risk for sexually transmitted infection. Other risk behaviors may include oral and anal intercourse.