Young people's lifestyles

World Health • 50th Year, No. 3, May- June 1997 21 Young people's lifestyles Diane Levin he importance of adolescent health behaviour has been well documented globally. This is partly because health habits that are established during those years are often risky, and many are resistant to change during the adult years . Tobacco, alcohol and drug abuse, unsafe sex, sun exposure, poor nutri- tion and even reckless driving all take root during adolescence. In general, a shift has been wit- nessed towards empowerment in health promotion, yet not enough has been achieved to incorporate this concept in programmes for adoles- cents. In order for programmes to be successful, adolescents must be involved in planning them and putting them into practice, as well as helping to set the national and local agenda. The health behaviour oflsraeli adolescents has been investigated as part of WHO 's Health Behaviour of Schoolchildren study. Excessive dieting occurred among girls, more than in any country in Europe, while smoking rates at the age of 15 were low compared with those in European countries. As we witness a steep rise of melanoma (skin cancer) in Israel, we cannot overlook the risk behaviour involved, including many hours of exposure to the sun and the inadequate use of protective clothing and sunscreens. Israel has a low rate of HIV infection, but it is obvious that this situation will last only as long as a high level of awareness is maintained, through opportunities to acquire reliable information, develop skills and have access to health services and products such as con- doms. All this provided the foundation for a national strategy for adolescent health promotion in Israel, based on the Kupat Holim Clalit Health Insurance Institution. Kupat Holim is a national body which provides about 65% of Israel's population, three and a half million people, with comprehensive health care ranging from preventive services to major university-status hospitals. The institution has more than 300 com- munity clinics, but only 15 of them are oriented specifically to offering appropriate health care to adoles- cents. Beginning in 1996, a three- year strategy was developed and funded by the Ministry of Health's Committee for Health Promotion, targeted at adolescents between 12 and 18 years of age. The topics and strategies of this initiative include the following: • workshops on nutrition : promot- ing healthy eating habits and preventing eating disorders among teenagers in schools; • "Lite-Line", a nutrition hotline for teenagers, their parents and teachers provided on a routine basis, four days a week; • workshops on sun exposure for schoolteachers, students and their parents, promoting habits that protect against the adverse effects of exposure to the sun; • peer education for preventing sexually transmitted diseases: training adolescents to be educa- tors by promoting increased awareness about high-risk behav- iour while developing communi- cation and education skills; • workshops for parents on under- standing health needs during adolescence: understanding and coping with the physiological, social, emotional and cognitive changes that occur during adoles- cence, with emphasis on the improvement of communication with teenagers; • a health promotion newsletter for teenagers; an interactive mass- media tool which emphasizes such aspects as nutrition, sun exposure, smoking, AIDS prevention and other topics; teenagers take an equal part in the editorial board, as well as sharing in the journalism. Intersectoral teams which are re- sponsible for programme develop- ment and activities comprise health education specialists, nutritionists, physicians, nurses, social workers and psychologists. Each topic and respective strat- egy has its own built-in quality assessment strategy under which needs are determined locally, using tools that have been established for use on a national basis. Formative and impact evaluation, actively involving teenagers, is carried out on a regular basis. We have already witnessed such changes as an improvement in inten- tion to diet, a willingness to seek professional help when dieting, greater awareness regarding safer sex, and more willingness to avoid excessive exposure to the sun . Thanks to the use of quality assessment tools for programme development, execution and evalua- tion, this new strategy has proved the value of making an appropriate investment in health promotion for youth. Because only a few years are spent in adolescence, a constant . effort must be made to involve teenagers and their parents in the programmes as early as possible. And since so many programmes are short-lived, it is clear that this in- vestment must be made on an inter- sectoral level in order for it to be inclusive and sustainable. In the words of 16-year-old Natalie: "We can study physics and chemistry at any time of our lives, but these programmes can save our lives." • Diane Levin is Director of the Department of Health Education, Kupat Halim Clalit Health Insurance Institution, 10 1 Arlozorov Street, 62098 Israel.