Getting It Right!
Models of Better Practice in Youth Health
Joan Silk, September 1999

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TABLE OF CONTENTS

ACKNOWLEDGMENTS

EXECUTIVE SUMMARY

KEY FINDINGS AND RECOMMENDATIONS

Recommendation 1: Increased Funding

Recommendation 2: Partnerships with Social Research Bodies

Recommendation 3: Resourcing

Recommendation 4: Research in the Social Determinants of Health

Recommendation 5: Developing Prevention Initiatives

Recommendation 6: Training

INTRODUCTION

SECTION A - HISTORY AND INFLUENCES

Chapter 1: Theoretical and historical background to the youth health movement in NSW
  • 1.1 Youth health services
  • 1.2 Health promotion and the community health model
  • 1.3 Social context
  • 1.4 The move away from individuals
  • 1.5 The WHO declaration on health
  • 1.6 Social class and poverty
  • 1.7 Social class and issues of control
  • 1.8 Gender
  • 1.9 Youth and issues of control over one's life
  • 1.10 Health issues are political issues
  • 1.11 Role of youth health services
SECTION B - PROCESSES OF BETTER PRACTICE AND THEIR COMPONENTS

Chapter 2: Addressing inequalities
  • 2.1 Social class and inequality
  • 2.2 "Disadvantaged groups" and inequality
  • 2.3 Inequality - who's responsible?
  • 2.4 Individual responsibility
  • 2.5 Deficit theory
  • 2.6 Freire's theories
  • 2.7 Problems with seeing social disadvantage as originating within the individual - "Blaming the victim"
  • 2.8 Problems with seeing social disadvantage as originating within the individual - "Changing their mentality"
  • 2.9 Problems with seeing social disadvantage as originating within the individual - "Saving them" and cultivating dependency
  • 2.10 Problems with seeing social disadvantage as originating within the individual - "Keeping them off the streets"
  • 2.11 Implications for practice
  • 2.12 Some approaches to addressing inequality - advocacy
  • 2.13 Does advocacy foster dependency and "welfarism?"
  • 2.14 Advocating for groups
  • 2.15 Empowerment - Concepts of personal empowerment
  • 2.16 Concepts of collective empowerment
  • 2.17 A synthesis
  • 2.18 Social connectedness
  • 2.19 Community participation and competency
Checklist (Chapter 2): Addressing Inequalities

Chapter 3: Access and participation
  • 3.1 Who participates and how?
  • 3.2 Making the service accessible
  • 3.3 Achieving "youth-friendliness"
  • 3.4 Premises
  • 3.5 Physical access and outreach
  • 3.6 Making the centre look "youth-friendly"
  • 3.7 First impressions are important
  • 3.8 Programs and services that can enhance access
  • 3.9 Developing access through diversity, cultural understanding and sensitivity
  • 3.10 Confidentiality
  • 3.11 Promoting health literacy to increase access and participation
  • 3.12 Monitoring of young people's views about the service
  • 3.13 Complaints procedures
  • 3.14 Establishing participation in a youth health service
  • 3.15 Countering misinformation can challenge prejudice and increase access and participation
  • 3.16 Building a profile in the community
  • 3.17 Types of participation in management
  • 3.18 Participation in health programs - peer programs
  • 3.19 Why peer education?
  • 3.20 Developing a peer program
Checklist (Chapter 3): Access and Participation

Chapter 4: Building supportive environments
  • 4.1 What is a supportive environments approach?
  • 4.2 A supportive environments approach to prevention
  • 4.3 Supportive environments in road safety
  • 4.4 The Haddon Matrix
  • 4.5 Passive interventions
  • 4.6 Building a supportive environment for addressing Injecting Drug Use, (IDU) issues
  • 4.7 Legislative change
  • 4.8 A supportive environment is multi-faceted
  • 4.9 The need to lobby
Checklist (Chapter 4): Building Supportive Environments

Chapter 5: A balanced approach
  • 5.1 The Ottawa Charter
  • 5.2 Balancing individual and population approaches
  • 5.3 What is a population-based approach?
  • 5.4 The population approach to suicide prevention
  • 5.5 Balance between an individual and group focus and a population focus
  • 5.6 Needs and requirements
Checklist (Chapter 5): A Balanced Approach

Chapter 6: Coordination
  • 6.1 Multi-dimensional nature of youth health
  • 6.2 Joint programs and promotions
  • 6.3 "Spelling it out"
  • 6.4 Teamwork
  • 6.5 Multi-disciplines - A team is an entity that is more than its individual parts
  • 6.6 Referrals
  • 6.7 Need for network development
  • 6.8 Regular representation on and contact with important networks around a core of issues
  • 6.9 Working with other parts of the health system
  • 6.10 Promotion of the service
Checklist (Chapter 6): Coordination

Chapter 7: Collaboration
  • 7.1 What is collaboration?
  • 7.2 "Getting them in" - accessing young people
  • 7.3 "Going into their territory"
  • 7.4 The good, the bad and the youth health workers!
  • 7.5 Co-location
  • 7.6 Approaches to working with schools
  • 7.7 Clinical services
  • 7.8 Issues-based services - health education
  • 7.9 Issues with information-based health education
  • 7.10 A rationale for health education sessions in schools - health educators do it better?!
  • 7.11 Another rationale for health education sessions in schools - "promoting the service"
  • 7.12 Settings-based school programs
Checklist (Chapter 7): Collaboration

Chapter 8: Building the infrastructure
  • 8.1 Need for linkages between research and practice
  • 8.2 Resourcing services to take time out from direct work
  • 8.3 Training
  • 8.4 Planning
  • 8.5 Youth health work is high stress
  • 8.6 Policy development and documentation
Checklist (Chapter 8): Building the infrastructure

GLOSSARY

LIST OF ABBREVIATIONS

APPENDIX 1 - PROFILE OF YOUTH HEALTH SERVICES

APPENDIX 2 - THE AUGUST CONSULTATION MATERIAL
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