Insufficient physical activity is associated with many non-communicable diseases (NCDs) and responsible for >5 million deaths worldwide each year. Public health guidelines recommend at least 60 minutes/day of moderate-to-vigorous physical activity for youth. An alarmingly low number of teenagers meet these public health guidelines: on a global level, only 22% of boys and 15% of girls between the age of 12-18 years. As a result, many young people have an increased risk of developing physical inactivity-related NCDs, both physical and mental.
Many interventions on improving physical activity in adolescents have had disappointing impact because they were not context-specific and implemented top-down and adult-driven, not addressing the real needs and lived experience of young people. For example, the beneficial long-term effects of regular physical activity on reducing morbidity and health-care cost are highly relevant for health professionals and policy makers, while for teenagers the more immediate benefits on wellbeing, directly or indirectly through social interaction, and having fun are relevant. In programmes that did engage young people, those selected were often already confident, articulate, and naturally identified leaders. In practice, engagement of youth growing up in vulnerable life situations (e.g. living in socially and economically underprivileged neighbourhoods, those with lower educational levels) in implementation of preventive interventions would have greater impact on closing equity gaps in health and wellbeing.
By introducing teen-centred evidence-informed co-creation, a Youth-centred Participatory Action (YoPA; formerly called YoPAAPE: A Youth-centred Preventive Action Approach towards co-created implementation of socially and Physically activating Environmental interventions) proposes an alternative approach to tackle the complex real-world societal challenges of physical inactivity and health inequalities. In this novel participatory approach, teenagers are central to the implementation and evaluation of holistic, systemic interventions tailored to their local communities. YoPA focuses on the physical and built environment as well as the social environment in light of the importance of peer influence and social networks for both physical activity and wellbeing. Through empowerment, YoPA aims to enhance personal and collective agency and perceptions of personal control, which has a direct effect on improving health outcomes.
The overall aim of YoPA is to optimally tailor, implement and evaluate social and physical environmental interventions for structural improvement in the lifestyle of teenagers (12-18 years) in vulnerable life situations to reduce their risk for NCDs.
