Youth Perspectives On Health & Wellness: A Focus Group Study

Abstract

Purpose: Youth are often the targets of health policy, but are rarely consulted during policy formation. As part of the development of a state health plan for Indiana adolescents, we conducted focus groups to identify health issues relevant to youth and solicit their solutions. Methods: After IRB approval, six groups of 6 - 10 adolescents each were recruited from existing community groups across the state. Led by a trained moderator, focus groups lasted 1 hour and were conducted in a private room at each group's regular meeting place. The semi-structured interview guide included questions such as ‘‘What makes a teenager healthy?”, “What are teenagers’ health concerns?’’, “Who do you trust most for health information or advice?”, and “What solutions would you recommend to help solve the health issues affecting others your age?” Focus groups were audio recorded and transcribed. We developed four preliminary codes from an initial reading of the transcripts: physical health, psychological health, social support, and health communication. Preliminary codes were selected, closely read, and key concepts that spanned groups were identified. These key concepts were organized into a model. Results: Groups were recruited from five different cities or small towns across Indiana, and included an urban youth leadership group, Future Farmers of America, a Latino student group, an alternative high school group, parenting adolescents, and university freshmen. The 49 participants ranged in age from 14-24, included males (26) and females (23), and included White (32), African American (10), and Latino (7) ethnicities. Participants described three levels of health; individual, relational, and environment. Participants listed stress and fatigue, obesity, tobacco, alcohol, sexual health, and access to care as key health issues. While acknowledging an individual's responsibility for their own health behaviors, they placed these behaviors in the context of relationships and environment. Relationships with parents and other caring adults were viewed as critical supports. Supportive adults were someone they could talk with, respectful of emerging skills, and remained positive and non-judgmental. Physical environments included buildings, roads, green space, sidewalks, and violence; financial environments included family financial stressors and the need to have a job; Informational environments included access to complete and truthful health information. These environments could either support or hinder healthy decision-making. The themes of supportive relationships and environments were consistent across geographic locations, demographics, and life circumstance. Conclusions: Adolescents viewed health as a shared responsibility between adolescents and the adults in their lives. Supportive relationships and healthy physical, financial, and informational environments were viewed as necessary to healthy behaviors and outcomes.