Reaching Youth Worldwide: Part 1 - Reaching Young People Worldwide

Approaches for Developing Youth Programmes

Helping adolescents make decisions that will positively affect their health and future is a challenge for communicators. A variety of ways must be used to reach young people because they are different from each other and have different experiences,needs, and lifestyles. The forthcoming chapters describe various innovative approaches and programmes that effectively address the differences among youth.

Diversity: Adolescents are a diverse group. Early adolescents experiencing puberty have different needs than young people in their early twenties. Adolescence is a time of experimentation, possibilities, and deciding in which direction one wants to go in life. Because of this, adolescents [1] are not a homogeneous group that can be reached or influenced with one type of communication strategy or approach. The diversity among youth can be used advantageously by those who work with them. Lessons learned to date indicate that a variety of strategic communication approaches needs to be used to help youth understand the potential rewards and consequences of decisions they make. Communication programmes play an essential role in educating, understanding, informing, and motivating young people.

The Johns Hopkins University Center for Communication Programs (JHU/CCP) and its primary project, the Population Communication Services (JHU/PCS), worked with partners in more than 25 countries on strategic communication programmes comprising a variety of interventions designed to reach different needs. Included in this working paper are six proven effective approaches that JHU/CCP used to help young people make decisions that positively affect their health and welfare. The projects selected occurred from 1995-2000.

High-risk Behaviors: Young people between the ages of 10 and 24 years [2] make up 25 percent of the world's population, roughly 1.7 billion people. Of these, 86 percent live in developing countries. Although birth rates have declined since the 1980's, the young age structure means an overall increase in the number of people entering their reproductive years. Statistically, young people now are the healthiest, most educated, and most urbanized of any previous cohort. [3] Urbanization, however, carries a greater exposure to high-risk behavior. Complications associated are the major causes of death for women aged 15 to 19. [4] The United Nations estimates that one-half of all new HIV/AIDS cases are among 15- to 24-year-olds. Youth also face problems such as unemployment, adolescent pregnancy, and drug and alcohol abuse. Each of these issues requires different approaches to reach youth and influence their behavior.

Human Rights: From a human rights perspective, reproductive health programmes for youth are important to support. Young people are more likely to engage in risky behavior and adopt new behaviors and values than older people, because adolescents are in an information-seeking and testing phase of life. To protect themselves from unwanted pregnancy, sexually transmitted infections (STIs), and other consequences of high-behavior, young people have a basic human right to receive accurate reproductive health information and services.

Economics: From an economic perspective, the decisions that adolescents make have an impact on their adult lives, and taken collectively, affect the future of their country. For example, in some African countries, employers face a shortage of workers because of the number of youth who are sick with HIV/AIDS. Also, school-aged girls who get pregnant must often drop out of school and subsequently have limited employment options. The axiom that "An investment in youth is an investment in the future" is especially true in relation to reproductive health.

Policy Barriers: Few countries have an official policy regarding adolescent reproductive health. Many countries impose cultural and legal barriers to discourage young people from seeking reproductive health information services. The Program of Action drawn up at the International Conference on Population and Development in Cairo in 1994 urges countries to "ensure that the programmes and attitudes of health-care providers do not restrict the access of adolescents to appropriate (reproductive health) services and the information they need..." Advocating reproductive health programmes for young people continues to be an essential component of the Cairo programme as barriers to empowering youth remain at policy and health provider levels. Thus, in the absence of concrete policies and often within hostile political environments, planners must create innovative reproductive health programmes that reach adolescents.

Historically, adolescent reproductive health programmes have been small, under funded, undocumented and unmeasured for impact. Most reproductive health interventions focused on reducing the fertility rate of married couples, because they are the easiest group from which to gather data. But young married couples are only one type of youth audience; most young people are either not sexually active or sexually active and unmarried, some with children. These various audiences require different messages to encourage, educate, and motivate youth appropriately about reproductive health issues.

Behavior Change Models: Programmes for young people need to use models that can be replicated, documented, and evaluated for impact. JHU/PCS uses the behavior science models, Steps to Behavior Change (SBC) and the Ideation Framework, to develop and evaluate youth programmes. The SBC model recognizes that a person goes through the following stages: 1) increasing knowledge, 2) approving of the behavior, 3) intending to practice it, 4) practicing it, and 5) advocating the behavior. According to the Ideation Framework, behavior is the result of the joint action of cognitive, emotional, and social factors that are cumulative and influenced by communication. [5] Intervening variable and casual pathways through which communication affects behavior can be identified and evaluated. Strategies such as social learning theory and community mobilisation also play significant roles in PCS programmes.

Lessons Learned in Developing Youth Programmes


1. Work with youth to design the programme.

Designing effective programmes for young people requires an understanding of their needs and concerns. Youth need to be involved in programme development and execution to ensure the approaches used are interesting, relevant, and engaging. Effective youth programmes encourage youth to be part of the decision-making process and seek feedback from young people on a regular basis. In cases where there may be problems that adults identify as issues yet young people do not, programme managers need youth to be involved even more, because the risk is much greater of developing programmes that only satisfy adults' interests.

2. Appeal to youth with friendly centers and services.

In an era when having unprotected sex can lead to contracting a fatal disease, providing amicable services and information for youth must be a priority. Services need to be designed and branded as "youth-friendly." It is not sufficient merely to identify providers willing to serve youth. Rather, these providers must be trained to communicate effectively with youth, to respect them as clients with special needs, and to treat them accordingly.

3. Engage multiple audiences with one programme

Youth audiences comprise many different segments, including those who are married, unmarried, in and out of school, urban and rural, sexually active, and not sexually active. Some programmes have to reach all of these audiences and at the same time focus on the special needs of each. A participatory programme can reach many audiences with meaningful activities and messages.

4. Use hotlines

Telephone hotlines provide accurate, confidential, and personalized information to anyone with access to a telephone. For adolescents who have limited access to youth centers and services, a telephone hotline may be the only source on which they can rely for information and referral to a clinic that serves youth. Hotlines offer adolescents the assurance that their questions can be answered in confidence without fear of repercussions or embarrassment.

5. Entertain to educate

Entertainment-Education uses an entertaining format to transmit educational messages. Reaching adolescents with entertainment leveraged through the multimedia is a hallmark of JHU/PCS programmes. Many messages in popular culture promote unhealthy behavior. To model both positive and negative behaviors and show the consequences of them, Entertainment-Education uses credible characters in an engaging narrative. Since adolescents are experimenting with different kinds of behavior, presenting positive behavior models is important. Entertainment-Education uses mass media and folk media in popular formats such as music, serial dramas, and variety shows to present messages with an emotional appeal that can persuade and motivate young audiences to engage in healthy behaviors.

6. Involve and teach youth through technology.

Within the past five years, the use of computer technology for behavioral counseling and health education has become popular. This rise is due, in part, to the increased availability of powerful, yet low-cost, computers that make it feasible to deliver computer-based health education materials to a large number of people. Benefits of computer-based instruction for delivering health education messages vis-a-vis traditional health education interviews include being able to reach large audiences and having users learn at their own pace.

5 Cleland, J. and Wilson, C. (1987). Demand theories of the fertility transition: An iconoclastic view. Population Studies, 41(1):5-30.