2.2 Risk and protective factors: concepts

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En provenance du cours de The University of Melbourne

Global Adolescent Health

41 notes

The University of Melbourne

Global Adolescent Health

41 notes

This course will explore the dynamic factors affecting the health and wellbeing of young people around the world, and how important it is for individuals, communities and nations that we improve the health and life chances of this important population group. With over 25% of the world’s population aged between 10 and 24 years, today’s generation of young people is the largest in human history. As the future leaders and drivers of growth, productivity and innovation, young people are our greatest assets, and investment in their health and wellbeing has social, economic and other benefits that continue across the lifespan and into the next generation. In this course we will adopt a life-course framework to take a holistic view of youth health and wellbeing. We will explore changing patterns of adolescent health and development, including why adolescence is starting earlier and ending later; how puberty and adolescent brain development may shape future health; and how what happens in adolescence can affect the start to life for the next generation. We’ll also look at the major health and social issues affecting young people and ways of addressing these through policy, practice and programming. COURSE FORMAT: This course comprises short video lectures and interviews, required and recommended readings, online discussion, quizzes and written assignments. There is no required text for this course and all readings are provided. DO I HAVE TO PAY FOR THIS COURSE? No- you may access 100% of material in this course for free. You are also welcome to do as much or as little of the course as you like, including all (or none!) of the assessment tasks- it all depends on your learning goals. The option to pay for this course is there for those who wish to receive a Course Certificate as evidence of completion (which does require you to attempt and successfully pass the assessment tasks). WHO IS THIS COURSE FOR? This course will be relevant for anyone with an interest in the health and wellbeing of young people. You do not need to be of any particular personal or professional background to benefit from this course, but having some basic undergraduate study experience will be helpful to your learning (particularly if in a health related field). WHAT IS THE MOST INTERESTING THING I'LL LEARN IF I TAKE THIS COURSE? You’ll learn how so much of what happens during adolescence can impact not only the future health of individuals, but the health of the next generation as well. You’ll develop a greater understanding of the key factors impacting upon youth health and learn how to be a better advocate for the health and wellbeing of young people. View the MOOC promotional video here: http://tinyurl.com/z5l4mod

À partir de la leçon

Week 2 - Introduction to adolescent health: developmental and ecological perspectives (Part II)

This week we return to our conceptual framework and unpack the key concepts of social determinants of health and risk and protective factors. We explore what these terms mean and how they influence and shape adolescent health and development. We also begin to apply this knowledge at a practical level in terms of the interventions and actions we can take to improve or maintain health and wellbeing during the adolescent and young adult years, or prevent problems from happening in the first place.

2.1 Revisiting the framework6:43

2.2 Risk and protective factors: concepts9:43

2.3 Risk and protective factors: implementation11:57

2.4 Risk and protective factors: peer relationships6:04

2.5 Risk and protective factors: families, education and communities8:10

2.6 Social determinants of adolescent health: economic factors8:16

2.7 Social determinants of adolescent health: human rights and gender13:58

2.8 Social determinants of adolescent health: population displacement8:42

2.9 Social determinants of adolescent health: advertising and marketing9:33

2.10 Socially disadvantaged adolescents5:27

Interview with Prof Craig Jeffrey (UK/Aus) 22:40

Interview with Prof Rima Afifi (Lebanon/USA) 22:47

Interview with Baroness Susan Greenfield (UK) 21:06

Rencontrer les enseignants

Professor Susan Sawyer
Chair of Adolescent Health
Department of Paediatrics
Professor George Patton
Professorial Fellow
Adolescent Health Research

The idea of risk and protective factors derives from the field of public health.

We've understood from the times of ancient Greece that lifestyle is

related to health and disease.

We now know that tobacco increases risks for later life diseases,

such as lung cancer, emphysema, heart attacks and stroke.

We therefore, refer to it as a risk factor for these later health problems.

So too heavy alcohol consumption is a risk factor for cirrhosis of the liver.

Obesity for type two diabetes and

low physical activity for cardiovascular disease.

We also know that social circumstances are associated

with particular patterns of disease.

Low socioeconomic statuses, for example,

associated with higher rates of cardiovascular disease.

These ideas have been adapted to thinking about the scope for

promoting healthy child and adolescent development.

In this context, risk factors are a little different to those used in public health.

Risk factors are more social influences, perhaps from the family or

community context that predict greater health problems or

perhaps social adversity during the adolescent years.

Protective factors are by contrast, positive influences on development.

These may be nurturing and supportive relationships.

Connection with institutions that promote healthy development.

All the acquisition of skills, values and emotional resources

that promote positive development across all aspects of life.

These ideas about the broader social context,

as well as more specific risk and predictive factors have been included

in the conceptual framework that Susan presented in an earlier lecture.

There is first, the broader.

Social, cultural and economic contexts in which adolescents grow up.

These include the overall economic development of the country, but

also where in their country a young person may be growing up.

In many large, middle income countries, the influence on health and

development of a young person in an urban setting are quite different

from those of an adolescent growing up in a poorer rural setting.

Cultural and religious values, similarly have a great influence

on identity, on health and the values that underpin health.

Secondly, there are risk and protective factors that more typically

relate either to attributes of the individual or the social context.

One example of an individual attribute would be sensation seeking.

It's a personality characteristic that heightens the likelihood

of experimentation with sex, tobacco use, illicit drug use.

Conversely, intelligence is an individual factor that is protective.

Positive relationships with others that are also very protective.

Positive connection with family, a connection with school and

education that we discussed in the previous lecture and a connection and

engagement with local community and

peers who have a positive set of values and outlook on life.

These are all protective.

One common way of looking at this is to adapt the model of Urie Bronfenbrenner,

one of the most influential developmental psychologists of the post-war years.

His ecological systems theory proposes various levels of influence

on the development of the individual through childhood and adolescence.

Macro factors relate to the cultural values and

attitudes that tend to persist over time within countries.

At the next level down, there is the political, economic and

service system environment in which development occurs.

These macro factors in turn influence what happens at the next levels down.

The more immediate influences on the young person's health and

development are what happens in the community in the school in the families in

which a young person is growing up.

And ultimately, it is those a young person comes into contact with on a daily basis

in these settings that have the greatest influence on their health and development.

So why does this matter so much in adolescence?

Looking at this slide of brain development during the adolescent years,

we are increasingly coming to a view that adolescence is a phase in

which the balance between emotion and

emotional controls differs from that in other life phases.

Good evidence of when our vulnerability for health and social problems and

it is the quality of the social scaffolding during this period between

these yellow lines, that influences whether or not young people develop many

of the major health problems that emerge during the adolescent years and whether

young people are able to achieve their full potential as they approach adulthood.

So what does this social scaffolding look like in adolescence and how does it work?

One useful perspective is the social development model of David Hawkins and

Richard Catalano.

It integrates a number of understandings about how social contexts

influence health and development across childhood and adolescents.

Social and emotional connections lie at the centre of this model of development.

It is these relationships that an adolescent has with his family,

her peer group, the school and the local community that lie centrally.

Those connections fasted by the creation of opportunities

to engage in those contexts and having the interpersonal and

emotional skills to be able to engage.

In a school setting, it's not only the skills of the young person that matter,

but also those of the teachers.

In the family settings, that's equally true of the skills that

parents need in addition to those that the young person has acquired.

Lastly, young people need to have the respect and

recognition in those settings for the contributions that they're making.

This is true at home, it's true at school.

It's also true in the local community.

Promoting greater connection by creating opportunities for

engagement by teaching young people and they carry the skills to engage and

insuring that young people are recognised for the achievements they make and

the contributions they make are essential elements of the social scaffold for

the adolescent years.

Clearly, young people didn't bring different assets social emotional physical

to their adolescent years.

But getting all this right will mean that young people have a much greater

likelihood of growing up with health promoting values and attitudes,

your health risks behaviours and fewer health problems.

Lastly, I want to take a look at how the social scaffold for health and

development changes across these developmental years.

So in this slide, adapted from the work of Neal Halfon,

a US-based community paediatrician, I've tried to illustrate how the social

contexts that influences the individual changes across childhood and adolescents.

In very early life, family influences dominate.

Later with the entry into education, the preschool and

school met much more for the individual.

The individual here acquires a set of capabilities

that bring increasing independence.

Community influences grow through childhood and

adolescence as this independence also increases.

But this pattern of development is likely to be quite different in low income

settings, particularly in rural settings.

Here the influence of family is likely to be much greater at all points in

the life course, including the adolescent years.

The influence of education is likely to be briefer and

less pervasive in settings where retention is not so high.

And the local village community is likely to have much greater influences

on all aspects of health and health risk during the adolescent years.

So during this lecture, I've tried to introduce a number of ideas about how

the social context influences health and development during childhood and

adolescents and how this changes over time.

In the next lecture, I'll about the strategies to health action and

the process for incorporating and understanding of risk and

protective factors into health programs at levels from the national to

the state to the district and to the local neighbourhood or village.

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