Health Promotion

1. Health
Promotion of
Adolescents
(12 to 20 years)
By: Annabelle Evans

2. “The chief symptom of adolescence is a state of expectation, a tendency
towards creative work, and a need for the strengthening of self-
confidence. Suddenly, the child becomes very sensitive to the rudeness
and humiliations which he had previously suffered with patient
indifference. These reactions, bitter rebellious feelings, sometimes give
rise to characters that are morally abnormal.”
-Maria Montessori
(Sutton, 2007)

3. Psychosocial Development
Erikson: identity vs. role confusion
• Adolescents recognize they are unique individuals and begin to develop a
sense of personal identity
• Group identity: building psychological connections with peers and identifying
as part of a group resulting in influential behavior
• Erikson’s theory suggests that those
who remain unsure of their beliefs,
sexuality, roles, and desires will
remain insecure and confused about
themselves, their role in society and
the future. This is known as role
confusion. This can also cause
significant delays in establishing
meaningful and healthy relationships
(Mcleod, 2017)

4. Sexual Identity
• Begins with close, same-sex friendships. This may lead to sexual
exploration and experimentation driven by curiosity.
• Another form of exploration is self exploration through
masturbation
• Eventually, friendships (same sex or opposite sex) transition into
intimate relationships
• All of these experiences, emotions, and ability to understand
them form the adolescents perception of self in regards to
sexuality.
Body Image
• Base their own perception on comparisons
• This image is typically sustained throughout their lifetime
(Wisemann, 2015)

5. Health Perception
Adolescents can view themselves as invincible and are higher risk
for risky behavior
(Wisemann, 2015)

6. Nursing Diagnosis
Risk prone health behavior related to low self efficacy as evident by increase in
violence, suicide, substance abuse, and unsafe sexual practices.
Assessment
• According to the CDC, suicide among adolescent girls has increased by 45% since 1999 and 16% in
adolescent boys. (Curtins, 2016)
• Nationwide, 16.2% of students had carried a weapon (e.g., gun, knife, or club)
• Nationwide, 4.1% of students had carried a weapon (e.g., a gun, knife, or club) on school property
• Nationwide, 22.6% of students had been in a physical fight one or more times
• Nationwide, 6.0% of students had been threatened or injured with a weapon (e.g., a gun, knife, or club) on
school property
• Nationwide, 20.2% of students had been bullied on school property
• 29.9% of students nationwide had felt so sad or hopeless almost every day for 2 or more weeks in a row
that they stopped doing some usual activities
• Nationwide, 17.7% of students had seriously considered attempting suicide
• 14.6% of students nationwide had made a plan about how they would attempt suicide
• Nationwide, 21.7% of students had used marijuana one or more times
• Nationwide, 16.8% of students had taken prescription drugs (e.g., Oxycontin, Percocet, Vicodin, codeine,
Adderall, Ritalin, or Xanax) without a doctor’s prescription one or more times during their life
• Among the 30.1% of currently sexually active students nationwide, 56.9% reported that either they or their
partner had used a condom during last sexual intercourse
• Among the 30.1% of currently sexually active students nationwide, 20.6% had drunk alcohol or used drugs
before last sexual intercourse
• Nationwide, 63.2% of students had had at least one drink of alcohol on at least 1 day during their life. (CDC,
2016)
• Since Sandy Hook in 2012, there have been at least 239 school shootings nationwide. In those episodes,
438 people were shot, 138 of whom were killed. (Patel, 2018)

7. (Patel, 2018)

8. 2018 School Shootings
(Every Town, 2018)

9. The leading causes of illness and death among AYAs are largely preventable, and
health outcomes are frequently both behaviorally mediated and linked to
multiple social factors.
• Family
• School
• Neighborhoods
• Media exposure
Emerging Issues
• Increasing ethnic diversity especially in Latino and Asian American youth
which will require cultural responsiveness to health care needs and focused
attention to disparate health, academic, and economic outcomes
• Increasing suicide rates and violence stemming from trauma related to
adverse childhood experiences. About 50% of lifelong mental disorders
begin by age 14 and 75% begin by age 24. Suicide is now the leading cause of
death in AYAs
Goal of Healthy People 2020: Improve the healthy
development, health, safety, and well-being of adolescents
and young adults (AYAs).
(Adolescent Health, 2018)

10. Interventions
• Youth.gov has Positive Youth Development program and research
• “PYD is an intentional, prosocial approach that engages youth within their
communities, schools, organizations, peer groups, and families in a manner that is
productive and constructive; recognizes, utilizes, and enhances young people’s
strengths; and promotes positive outcomes for young people by providing
opportunities, fostering positive relationships, and furnishing the support needed
to build on their leadership strengths.” (PYD, 2018)
• Americorps
• 4-H After School
• CDC has STRYVE Striving To Reduce Violence Everywhere
• STRYVE offers online tools, training resources, and multiple activities that help
“increase public health leadership in preventing youth violence, promote the use
of evidence-based prevention approaches, and achieve national reductions in
youth violence.” (CDC, 2018)
• You can find more information @ vetoviolence.cdc.gov

11. Conclusion
What can nurses do to promote health in the adolescent
population?
• Assess, Notice, Listen
• Educate
• Care
• Advocate

12. References
Mcleod, S. (2017). Erikson's Psychosocial Stages of Development. Retrieved from
https://www.simplypsychology.org/Erik-Erikson.html
Curtin, S., Warner, M., & Hedegaard, H. (2016). Suicide Rates for Females and Males by Race and
Ethnicity: United States, 1999 and 2014. Retrieved from
https://www.cdc.gov/nchs/data/hestat/suicide/rates_1999_2014.htm
CDC. (2018). STRYVE | VetoViolence. Retrieved from https://vetoviolence.cdc.gov/stryve
Adolescent Health. (2018). Healthy People 2020. Retrieved from
https://www.healthypeople.gov/2020/topics-objectives/topic/Adolescent-Health
Patel, J. K. (2018, February 15). After Sandy Hook, More Than 400 People Have Been Shot in Over
200 School Shootings. Retrieved from
https://www.nytimes.com/interactive/2018/02/15/us/school-shootings-sandy-hook-
parkland.html
Every Town. (2018, February 16). Retrieved from https://everytownresearch.org/school-shootings/
CDC (2016) Youth risk behavior surveillance. MMWR. Retrieved from
https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2015/ss6506_updated.pdf
Wissman, J., & Knippa, A. (2015). Registered nurse nursing care of children review module. Stilwell,
KS: Assessment Technologies Institute.
Sutton, A. (2007) Building Success into Your Montessori Middle School Program. Research Gate.
Retrieved from:
https://www.researchgate.net/publication/234569752_Building_Success_into_Your_M
ontessori_Middle_School_Program