Enhancing cooperation between youth and adults to improve healthcare has been central to the YHP since it began in 2010, and a recently published peer-reviewed study1 of the YHP-supported Young Canadians Roundtable on Health (YCRH) demonstrates some of the benefits and potential pitfalls of this approach.
The YCRH was created in 2013 to be Canada’s youth voice on health and operates across the country to develop youth engagement in designing and improving interventions for youth services. Its approach is based upon research demonstrating that youth engagement can improve the effectiveness of interventions in healthy eating, smoking reduction, obesity prevention, sexual health and in other areas. Evidence from such youth engagement in public health actually happening is quite scarce.
The Roundtable has already racked up some notable achievements, the highest profile of which has been the Youth Health Rights project (http://youthhealthrights.ca/), which addresses a major gap in the knowledge and understanding of young people about their rights and access to healthcare across Canada’s ten provinces.
This has been achieved despite the geographic challenges of operating across this huge country which means that cooperation is largely virtual, with the over 30 YCRH volunteers meeting face-to-face as working groups just once a year at the Annual Summit of the Sandbox Project (http://sandboxproject.ca/), which provides logistical support for the initiative.
The YCRH is genuinely youth-led and has its own governance structure - with a youth chair and co-chair acting as the primary points of contact for members – a long way from what one of the research interviewees saw as the more usual approach of “bounce some ideas off young people, buy them pizza, ... and then go ahead and do whatever they were going to do anyway.”
The research highlighted some of the advantages and challenges of the approach as well as its major achievements – the Youth Health Rights project and a youth perspective on the Lancet Commission on Adolescent Health and Well-Being2. In structural terms the use of an external secretariat, in this case the Sandbox Project, freed up the participants to concentrate on where they could add value, and to experiment with different topics and ideas providing “a lot of flexibility and adaptability for the youth to actually have their own say and their own determination of what’s important and what they want to work on.” Having a secretariat gave some of the stability needed for the YCRH to become and remain an ongoing platform for the youth voice on health in Canada.
There are of course challenges in working between youth and adults, which were highlighted in the study. Mutual respect and understanding are vital, with an acknowledgement that lived experience should be valued along with academic knowledge. Methods of communication vary and it is important to ensure that everyone understands what is being said. Flexibility is key, especially from the adult participants – allowing generous timeframes, agreeing on deadlines, being ‘comfortable with the ambiguity of working with youth’ and developing structure and clarity for the various roles undertaken – which of course can be challenging in a continually evolving ‘living laboratory’.
For the participants new skills emerged from, or were enhanced by, the challenges. For adults these included patience, and improved active listening, conflict resolution and project management skills, and for youth enhanced health advocacy and leadership capability.
Perhaps most importantly there were also broadened perspectives: “I had previously thought that young people were not really concerned about their health…that turns out to be wrong”, and real appreciation of the YCRH’s value as “a huge asset and a benefit for everybody across Canada”.
Currently, the Roundtable is working on a sexual health and reproductive rights project, to increase information and awareness and address barriers to healthcare access, and is building these findings into its work.
1 Ramey, H.L., Rayner, ME., Mahdy, S.S. et al. Canadian Journal of Public Health (2019) 110: 626. https://doi.org/10.17269/s41997-019-00254-9
2 The Lancet (2016) Our future: a Lancet commission on adolescent health and wellbeing. Available at https://www.thelancet.com/commissions/adolescent-health-and-wellbeing