Youth involvement in policy processes in public health, education, and social work—A scoping review

Summary

Introduction

Youth involvement in policy formulation may enhance its relevance, strengthen democratic practices, and contribute to youth development. This scoping review explored the nature, extent, and impact of adolescent involvement in policy processes aimed at improving adolescent health and well‐being in the public health, education, and social work sectors.

Methods

Studies of adolescent involvement in policy processes focusing on health, and well‐being, including obesity prevention were eligible. We searched seven databases, reference lists of included studies, and contacted key organizations. Standard scoping review methods were applied. The results were synthesized narratively, using descriptive statistics and visuals.

Results

We included 33 mostly qualitative studies, mainly from the public health sector in the USA and Europe, focusing on diet, physical activity, health & well‐being, or sexual and reproductive health. Adolescents were consulted or collaborated with, mostly in identifying problems or policy solutions and less often in agenda‐setting, decision‐making, and evaluation. Various facilitators were used to improve participation (e.g. training, adult facilitators, monetary compensation). Data on adolescents' experiences of involvement and the impact on policies were limited.

Conclusion

Due to a paucity of impact studies, we could not determine whether adolescent involvement increased the relevance of policies or improved adolescent development. The extent to which adolescents were meaningfully involved, and had a material effect on decision‐making, was largely unclear. Improved documentation, monitoring, and evaluation of youth involvement in policy using quantitative methods and standardized frameworks, can improve the evidence‐based, involvement practices, and decrease inequities.

1. INTRODUCTION

There are many threats to adolescent health and well‐being, such as increasingly unhealthy diets, inactive lifestyles, and mental health problems. ¹ Adolescence is a period of physical, cognitive, and social development, where youths gain increased autonomy, new social expectations, and responsibilities, and in which health‐related behaviors and habits are established. ² Public health, education, and social work policies can shape these behaviors by influencing the conditions in which adolescents live and grow.

It has been suggested that involving citizens in policy decision‐making can help to deliver more effective and relevant policies. ³ Given the limited evidence of the effectiveness of obesity‐related policies on adolescents, ⁴ it is important to explore how adolescents are involved in policy development when they are the primary policy target. There is no universally agreed definition of what constitutes a policy, ⁵ but for the purpose of this review, it is understood as: ’a set of ideas or a plan of what to do in particular situations that has been agreed to officially by a group of people, a business organization, a government, or a political party’. ²

The 1989 Convention on the Rights of the Child (UNCRC), ⁶ highlights the importance of involving children and young people in decisions that affect them. This was further elaborated on in the 2020 World Health Organization (WHO) global consensus statement on adolescent and youth engagement, ⁷ now endorsed by more than 250 organizations. ⁸ Reducing childhood obesity is one priority public health issue that may benefit from youth involvement in creating policies to support health, well‐being, and prevention. ⁹ Adolescents themselves make a strong link between their dietary behaviors and mental health ¹⁰ suggesting that obesity prevention should also consider relations to mental health and well‐being.

1.1. Meaningful youth engagement

The United Nations has proposed 11 core principles for meaningful youth participation in policy and decision‐making ¹¹ to ensure: 1. Youth are informed, and educated, about their rights and empowered to hold adults accountable; 2. Institutional mandates for youth involvement to avoid ad hoc approaches, and to ensure youth can participate throughout the policy process; 3. Designated seats for youth in various processes; 4. Adequate funding to support youth participation; 5. Transparency in how youth information and skills are shared; 6. Accessible decision‐making processes for all youth groups; 7. Voluntary participation; 8. Provision of timely, clear, diversity‐sensitive, and age‐appropriate information; 9. Transparency on how youth inputs influence outcomes; 10. Inclusiveness and diversity of youth voices; 11. Youth as equal partners in decision‐making processes, and facilitation of engagement. These principles resemble those previously suggested by the OECD ¹² and the AA‐HA! report, ¹² but include a couple of additions.

1.2. Three perspectives on youth involvement

We discern three perspectives on youth involvement in the literature: rights‐based, pragmatic, and social. The rights‐based perspective, in line with UNCRC, ⁶ presents youth involvement as a means to promote and secure children's and youths' fundamental rights, including those to be listened to, to express themselves, to have their views taken into account, to be involved, and to share power and responsibility in decision‐making, ¹³ which are directly reflected in Lundy's model of child participation. ¹⁴ Accordingly, the Organization for Economic Co‐operation and Development (OECD), distinguishes four forms of youth involvement in policy processes: informing, consulting, collaborating, and empowering, ¹⁵ reflecting several theoretical contributions describing different levels of involvement. ¹³ , ¹⁶ , ¹⁷ , ¹⁸ , ¹⁹ The pragmatic perspective explores the actual processes and methods applied to facilitate involvement (e.g. recruitment processes, duration of involvement, and specific engagement methods). Finally, the social perspective focuses on how the involvement process facilitates social processes and contexts that promote the social needs of the youths involved (e.g. the need to feel safe and recognized for their viewpoints and expressions). Youth have also reported the importance of ownership, personal benefits, and skills development when being involved in policy processes. ²⁰

1.3. Theoretical frameworks on involvement

A number of frameworks for involving youth have been described in the literature including participatory action research (PAR), ²¹ community‐based participatory research (CBPR) ²² ), and participatory research and evaluation (PRE). ²³ These frameworks all constitute so‐called ‘bottom‐up’ approaches that typically include those most affected by an issue. While their aims, focus, and mechanisms of action may differ, they are based on similar philosophies, methods, and theories. ²³ Other approaches include co‐design, co‐production, and co‐creation, ²⁴ which focus on designing programs/interventions that “fit” the target groups. There is no clear consensus regarding the key principles and practices of these approaches. ²⁵

1.4. Current research in the area

A preliminary search for evidence summaries (Jan 2022) failed to identify any reviews comprehensively covering this topic, although a few scoping reviews had a related focus. One review exploring children's and young people's level of participation in the development of health and well‐being interventions, ²⁶ and a review protocol on the utilization of youth PAR to inform health policy, ²⁷ but neither covered the education or social work sectors. Other recent scoping reviews were limited to policy processes in the UK, ²⁰ or to gray literature only. ²⁸ A recent WHO report, ¹² provides guidance on meaningful youth involvement.

This scoping review was conducted as part of Co‐Create, a research project funded by the European Union, which involves youth in the development of policy ideas relating to obesity prevention. ²⁹ The aim of the scoping review was to assess the nature, extent, and impact of adolescent involvement in policy processes aimed at improved adolescent health & well‐being in the public health, education, and social work sectors, to inform practices and improve the understanding of the effectiveness of such initiatives.

The specific research questions were:

1. What were the characteristics of the policies that involve adolescents?

2. At which stages of the policy process were adolescents involved?

3. By which means was adolescent involvement in policy processes facilitated?

4. How have adolescents described their experiences of being involved in policy work?

5. What impacts relating to health and well‐being (including obesity prevention) of adolescent involvement in policy processes have been reported in the literature?

2. METHODS

We chose a scoping review methodology, as this is a suitable approach to address explorative research questions. ³⁰ This review applies: the JBI methodology for scoping reviews, ³¹ Arksey and O′Malley's methodological framework, ³² and the PRISMA ScR extension. ³³ Youth participants in the Co‐Create project provided feedback on the protocol, which was published in Obesity Reviews. ³⁴

2.1. Eligibility criteria

Participants: Adolescents aged 10–19 years, as defined by WHO, ¹ were eligible. Concept: Youth involvement is defined according to rights‐based (see Table 1), pragmatic, and social perspectives. The terms ‘involvement’, ‘participation’, and ‘engagement’ were used interchangeably. Context: Policy‐related processes in public health, education, and social work sectors aimed at improving the health & well‐being of adolescents, at the local (schools/community), regional/district level, and national/state policy level. We employed Benson and Jordan's categories of the stages in policy processes ³⁶ : (i) problem emergence, (ii) agenda setting, (iii) consideration of policy options, (iv) decision‐making, (v) implementation, and (vi) evaluation). We defined a policy to also include programs, interventions, and strategies. Studies from any country were eligible, independently of country income classification (World Bank ³⁷ ). Studies in health care settings and involving patients were excluded.

TABLE 1.

Types and examples of youth involvement according to the OECD categorization. ³⁵

Type of youth involvement in terms of being:	Examples
(i) Informed	Open house, observation of political meetings, transparent communications from policymakers
(ii) Consulted	Through polling, survey, workshop, focus groups, meetings, hearings, and youth commissions
(iii) Collaborated with	Co‐facilitated consultations, internships in public institutions, advisory boards, members of steering committees, or collaboration in research
(iv) Empowered	Youth‐initiated and youth‐led consultations, youth parliaments, youth delegated decisions, and implementation

2.1.1. Types of sources

Included: empirical studies evaluating the nature, extent, and/or impact of youth involvement in shaping policies in public health, education, or social work that were aimed at improving the health & well‐being of adolescents.

Excluded: intervention studies (i) not linked to policies, policy‐making processes, or policy decision makers; (ii) where adolescents involvement was only one part of a multifaceted intervention, and (iii) with aggregated data (adolescents and adults) if < 60% of data emanated from adolescents, and (iv) commentaries, conference abstracts, and studies not available in full text.

2.2. Search strategy

The search strategy followed guidelines for scoping reviews. ³¹ First, a preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, Embase, APA PsycInfo, CINAHL, ERIC, Epistemonikos, and Web of Science Core collection was conducted (January 2022) to identify review articles. The words contained in titles and abstracts of relevant articles and index terms were used to develop a search strategy for MEDLINE. The full search strategy, including free and indexed terms, was piloted, revised, and finally adapted for each database (Data S1). Thereafter, the main search for literature published during the last 5 years (1 January 2018 to 1 February 2023) was conducted in MEDLINE, Embase, APA PsycInfo, CINAHL, ERIC, Web of Science Core Collection, and Sociological Abstracts. Finally, an update search was conducted in October 2023.

The main search was limited to the last 5 years due to a very large initial search yield, the limited time and resources of the project, and the authors wish to capture more current studies, that would better reflect new theories, processes, and best practices in the field of youth involvement. The search cut‐off also succeeds the publication of the OECD toolkit for Evidence‐based policymaking for youth well‐being, in 2017. ¹⁵ The search strategy was co‐designed and run by a librarian (RAT), and peer‐reviewed by another librarian (MH). There were no language restrictions.

The reference lists of included studies were screened, and key organizations (United Nations International Children's Emergency Fund, United Nations Population Fund, European Youth Parliament, European Youth Forum, Save the Children, Plan International, WHO, and OECD) were contacted to identify additional relevant studies.

2.3. Study selection

All identified citations were uploaded to EndNote X9 (Clarivate Analytics, USA) and duplicates were removed. Following pilot testing, titles, and abstracts were screened for eligibility by two or more independent reviewers using the machine learning (ML) ‘priority screening’ function of the EPPI Reviewer web. ³⁸ Screening was discontinued when 250 irrelevant articles were seen in a row. Potentially relevant citations were retrieved in full text and assessed by two independent reviewers. Citations excluded after full‐text scrutiny were documented along with reasons for exclusion. Disagreements were resolved through discussion or the use of an arbitrator. The selection process was reported using a PRISMA study flow diagram. ³³

2.4. Data extraction and analysis

Data were extracted by one reviewer, using a custom‐made piloted tool (Data S2). A second reviewer checked the accuracy of the extractions, which included details on the participants, concept (including engagement tools), context, study methods, and key findings relevant to the review questions. The data was used to populate five charting tables. Disagreements were resolved through discussion or an arbitrator. Authors of the original papers were contacted for clarifications.

We provided a narrative synthesis of the results, describing how they relate to the aim and research questions, and grouped them according to pre‐defined categories for policy processes and involvement. We defined engagement tools as those aimed at facilitating the engagement of youth in the policy processes, and categorized them in accordance with Duea et al ³⁹ We used descriptive statistics and graphics to visualize data.

3. RESULTS

3.1. Search results

The database searches yielded 11,199 unique citations, and 7195 citations were deemed ineligible by the ML automation tool. Of 4003 manually screened citations, 3874 were excluded at the title and abstract stage. We retrieved and assessed 128 potentially relevant studies in full text, of which 95 were excluded after scrutiny (Data S3). This resulted in 33 studies published between 2017 and 2022 being included. ⁴⁰ , ⁴¹ , ⁴² , ⁴³ , ⁴⁴ , ⁴⁵ , ⁴⁶ , ⁴⁷ , ⁴⁸ , ⁴⁹ , ⁵⁰ , ⁵¹ , ⁵² , ⁵³ , ⁵⁴ , ⁵⁵ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶⁰ , ⁶¹ , ⁶² , ⁶³ , ⁶⁴ , ⁶⁵ , ⁶⁶ , ⁶⁷ , ⁶⁸ , ⁶⁹ , ⁷⁰ , ⁷¹ , ⁷² See Figure 1.

FIGURE 1.

PRISMA study flow chart. ⁷³

3.1.1. Characteristics of included studies

See Data S4 and Figure 2.

FIGURE 2.

Characteristics of included studies: (A) countries, (B) country income classification, (C) study design (D) settings, (E) data collection methods, (F) outcomes.

A majority of studies (73%) were conducted in high‐income countries (HICs) in North America ⁴⁰ , ⁴¹ , ⁴³ , ⁴⁵ , ⁴⁶ , ⁴⁷ , ⁵⁰ , ⁵⁷ , ⁶⁶ , ⁶⁷ , ⁶⁸ , ⁷⁰ , ⁷¹ , ⁷² or Europe. ⁴⁴ , ⁴⁸ , ⁴⁹ , ⁵² , ⁵³ , ⁶⁰ , ⁶¹ , ⁶² , ⁶³ , ⁶⁹ Few were conducted in LMICs, ⁵¹ , ⁵⁴ , ⁵⁵ , ⁵⁶ , ⁵⁸ , ⁵⁹ , ⁶⁵ and in HICs outside the USA and Europe. ⁴² , ⁶⁴ , ⁶⁶

Most studies were qualitative (73%), set in the local community and/or in schools (82%). ⁴⁰ , ⁴¹ , ⁴² , ⁴³ , ⁴⁴ , ⁴⁵ , ⁴⁶ , ⁴⁷ , ⁴⁸ , ⁴⁹ , ⁵⁰ , ⁵¹ , ⁵² , ⁵³ , ⁵⁴ , ⁵⁵ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶¹ , ⁶³ , ⁶⁴ , ⁶⁵ , ⁶⁶ , ⁶⁷ , ⁶⁸ Artifacts, interviews, and focus group discussions (FGDs) were most frequently used to collect data. Adolescent development outcomes were most frequently reported, ⁴⁰ , ⁴¹ , ⁴⁶ , ⁴⁷ , ⁴⁹ , ⁵⁴ , ⁵⁶ , ⁶⁴ , ⁶⁷ , ⁷¹ while only one study ⁶⁰ reported on the impact of involvement on the national level. Only one study ⁵⁴ used a standardized framework ⁷⁴ to evaluate youth involvement.

3.1.2. Characteristics of adolescent participants

See Data S5 and Figure 3.

FIGURE 3.

Characteristics of participants: (A) no of youth participants, (B) age, (C) gender, (D) ethnicity (highest proportion), (E) location, (F) socioeconomic status (SES).

Around 40% of studies included ≤20 participants. ⁴² , ⁴³ , ⁴⁵ , ⁴⁷ , ⁴⁹ , ⁵⁴ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶⁷ , ⁶⁸ , ⁶⁹ , ⁷¹

Around 50% included both younger (10–14 years) and older (15–19 years) adolescents. ⁴⁰ , ⁴¹ , ⁴⁶ , ⁴⁸ , ⁴⁹ , ⁵⁰ , ⁵¹ , ⁵⁵ , ⁵⁶ , ⁵⁸ , ⁵⁹ , ⁶⁰ , ⁶¹ , ⁶³ , ⁶⁵ , ⁶⁶ , ⁶⁸ Around 40% also included an unknown proportion of non‐adolescents: < 10 years, ⁴⁴ , ⁴⁷ , ⁴⁸ , ⁵¹ , ⁵² , ⁵⁵ , ⁵⁶ , ⁶⁰ and >19 years. ⁴⁰ , ⁵⁴ , ⁵⁷ , ⁶⁴ , ⁶⁹ Around half (48%) reported a higher proportion of female than male participants, ⁴⁰ , ⁴¹ , ⁴² , ⁴⁶ , ⁴⁹ , ⁵² , ⁵⁵ , ⁵⁹ , ⁶¹ , ⁶⁴ , ⁶⁵ , ⁶⁶ , ⁶⁷ , ⁷⁰ and 42% did not report gender. Three studies included gender‐queer, gender‐nonconforming, or transgender adolescents. ⁴⁰ , ⁵⁷ , ⁶⁸ A majority of studies (61%) provided no information on ethnicity. In 55% of studies, adolescents came from urban areas, ⁴¹ , ⁴² , ⁴³ , ⁴⁴ , ⁴⁷ , ⁵⁰ , ⁵² , ⁵³ , ⁵⁵ , ⁵⁶ , ⁵⁷ , ⁶¹ , ⁶⁵ , ⁶⁷ , ⁶⁸ , ⁷¹ and in 42% of studies from low socio‐economic status (SES) households. ⁴¹ , ⁴³ , ⁴⁴ , ⁵⁰ , ⁵³ , ⁵⁵ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶¹ , ⁶⁴ , ⁶⁷ , ⁷⁰ Around 40% of studies did not report SES.

3.2. Data analysis and presentation

3.2.1. (i) What are the characteristics of the policies that have involved adolescents?

See Data S6 and Figure 4.

FIGURE 4.

Characteristics of policies and youth involvement: (A) policy areas, (B) policy level, (C) initiative takers, (E) frameworks for involvement, (F) recruitment arena; (G) sampling aim; (H) facilitators, (I) leadership, (J) duration of involvement.

Policy area and sub‐areas

A majority of studies (73%) were concerned with adolescent involvement in policy‐related processes in the public health sector. Many of these studies focused on dietary and/or physical activity (PA), ⁴² , ⁴³ , ⁴⁴ , ⁴⁵ , ⁵¹ , ⁶⁰ , ⁶¹ , ⁶⁴ general health & well‐being, ⁴⁰ , ⁵⁰ , ⁵² , ⁵⁵ , ⁶⁵ , ⁶⁸ or sexual‐ and reproductive health. ⁵³ , ⁵⁴ , ⁵⁸ , ⁶³ , ⁷² Two of the studies focused on mental health. ⁵⁶ , ⁶⁹ The few studies from the education sector, ⁴⁴ , ⁴⁷ , ⁴⁸ , ⁶² , ⁷¹ covered various issues (i.e. education justice, ⁴⁴ , ⁴⁷ education psychology services, ⁴⁸ anti‐bullying legislations, ⁶² and educational reform, ⁷¹ as did those from the social work sector ⁴¹ , ⁴⁶ , ⁵⁷ , ⁶⁷ (i.e. neighborhood problems, ⁴¹ social inequality, ⁴⁶ anti‐racist governance and planning, ⁵⁷ and mobility equity ⁶⁷ ). The specific aims and content of the policy‐related processes varied across studies.

Policy level, initiative takers

The policy level was local (school or community) in a majority of included studies. Academic researchers, alone or together with community stakeholders, were typically the initiative takers, ⁴² , ⁴⁶ , ⁴⁷ , ⁵³ , ⁵⁴ , ⁵⁵ , ⁵⁶ , ⁵⁹ , ⁶¹ , ⁶³ , ⁶⁵ , ⁶⁹ , ⁷² and rarely adolescents themselves. ⁴⁰

3.2.2. (ii) At which stages of the policy process have adolescents been involved?

See Data S7 and Table 2.

TABLE 2.

Stages of the policy‐process where youth were involved in the included studies (N = 33).

Author year	(i) Problem emergence	(ii) Agenda‐setting	(iii) Consideration of policy options	(iv) Decision‐making*	(v) Implementation	(vi) Evaluation
Aeschbach 2022 37			✓
Alegria 2022 38	✓	✓
Almughamisi 2022 39	✓		✓
Altares 2022 40	✓		✓
Anselma 2019 41	✓		✓	✓
Askelson 2019 42					✓	✓
Augsberger 2018 43					✓	✓
Bertrand 2020 44		✓
Boswell 2021 45			✓
Clark 2018 46	✓			✓		✓
Dafilou 2022 47	✓	✓
Dyke 2021 48				✓	✓	✓
Eriksson 2020 49	✓
Fisher 2022 50				✓
Fortin 2022 51			✓
Gonzalez 2022 52	✓	✓
Krishna 2022 53				✓	✓
Lin 2022 54		✓	✓	✓
Lofton 2021 55	✓		✓	✓	✓
Marco‐Crespo 2018 56						✓
Martin 2018 57	✓		✓
McQuinn 2022 58			✓	✓
Meriläinen 2022 59			✓	✓
Ponsford 2021 60				✓
Prapaveissis 2022 61						✓
Rahkshani 2018 62	✓
Ramey 2018 63						✓
Romano 2022 64	✓	✓
Sprague‐Martinez 2020 65	✓		✓
Taylor 2022 66		✓
Valdez 2019 67	✓	✓
Warren 2018 68	✓
Wilkinson 2022 69	✓		✓
TOTAL	16	8	13	10	5	7

^*Decision‐making may refer to decisions taken at various stages of the policy processes that also may vary in the degree of importance.

Adolescents were most often involved in the policy process at the (i) problem emergence stage ⁴¹ , ⁴² , ⁴³ , ⁴⁴ , ⁴⁹ , ⁵⁰ , ⁵² , ⁵⁴ , ⁵⁵ , ⁵⁸ , ⁶⁰ , ⁶⁵ , ⁶⁷ , ⁶⁸ , ⁷⁰ , ⁷¹ , ⁷² and/or the (iii) consideration of policy options stage, ⁴⁰ , ⁴² , ⁴³ , ⁴⁴ , ⁴⁸ , ⁵⁴ , ⁵⁷ , ⁵⁸ , ⁶⁰ , ⁶¹ , ⁶² , ⁶⁸ , ⁷² and less often in (ii) agenda setting, ⁴¹ , ⁴⁷ , ⁵⁰ , ⁵⁵ , ⁵⁷ , ⁶⁷ , ⁶⁹ , ⁷⁰ (iv) decision‐making, ⁴⁴ , ⁴⁹ , ⁵¹ , ⁵³ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁶¹ , ⁶² , ⁶³ (v) implementation, ⁴⁵ , ⁴⁶ , ⁵¹ , ⁵⁶ , ⁵⁸ or (vi) evaluation. ⁴⁵ , ⁴⁶ , ⁴⁹ , ⁵¹ , ⁵⁹ , ⁶⁴ , ⁶⁶ Adolescents were involved in 1 to 4 stages (median 2 stages) across studies.

Decision‐making in included studies referred to various types and levels of decisions, that were either operational (i.e. choice of research methods, outreach strategies, the content of an intervention), or strategic (e.g. budgeting/funding priorities). To what degree adolescents' input had an impact on these decisions was largely unclear.

Frameworks for participation

In included studies, adolescents were involved through PAR, ⁴³ , ⁴⁴ , ⁴⁷ , ⁴⁹ , ⁵⁰ , ⁵⁴ , ⁵⁵ , ⁵⁸ , ⁶⁴ , ⁷⁰ , ⁷¹ PRE, ⁵⁹ , ⁶⁶ CBPR, ⁶⁴ , ⁶⁷ co‐production, ⁴² , ⁴⁸ , ⁴⁹ , ⁵³ , ⁵⁶ , ⁵⁷ , ⁵⁸ , ⁶³ co‐design, ⁴⁴ , ⁵¹ , ⁶¹ , ⁶⁴ , ⁷² and co‐creation. ⁵¹ Some studies only described the use of ‘participatory methods’. ⁴¹ , ⁵² , ⁶⁰ , ⁶⁵ , ⁶⁸ The theory base varied across included studies, and included different theories for behavioral or social change, justice, and human rights (Data S7).

Youth involvement according to OECD's four forms of participation

See Data S7 and Table 3.

TABLE 3.

Level of youth involvement as categorized according to the four OECD forms of participation. ¹⁵

Author year	(i) Informing	(ii) Consulting	(iii) Collaborating	(iv) Empowering
Aeschbach et al. 2022 37			✓
Alegria et al. 2022 38		✓
Almughamisi et al.2022 39		✓
Altares et al. 2022 40			✓
Anselma et al. 2019 41			✓
Askelson et al. 2019 42			✓
Augsberger et al. 2018 43		✓
Bertrand et al. 2020 44		✓
Boswell 2021 45			✓
Clark et al. 2018 46			✓
Dafilou et al. 2022 47		✓
Dyke et al. 2021 48		✓
Eriksson et al. 2020 49		✓
Fisher et al. 2022 50		✓
Fortrin et al. 2022 51			✓
Gonzales et al. 2022 52			✓
Krishna 2022 53			✓
Lin et al. 2022 54			✓
Lofton et al. 2021 55			✓
Marco‐Crespo et al. 2018 56			✓
Martin et al. 2018 57		✓
McQuinn et al. 2022 58			✓
Meriläinen et al. 2022 59		✓
Ponsford et al. 2021 60		✓
Prapaveissis et al. 2022 61			✓
Rakhshani et al. 2018 62		✓
Ramey 2019 et al. 64		✓
Romano et al. 2022 64		✓
Sprague‐Martinez et al. 2020 65			✓
Taylor et al. 2022 66		✓
Valdez 20019 67			✓
Warren et al. 2018 68			✓
Wilkinson 2022 69			✓
Total:	0	15	18	0

In around half of the studies, adolescents were consulted, ⁴¹ , ⁴² , ⁴⁶ , ⁴⁷ , ⁵⁰ , ⁵¹ , ⁵² , ⁵³ , ⁶⁰ , ⁶² , ⁶³ , ⁶⁵ , ⁶⁶ , ⁶⁷ , ⁶⁹ and in the remaining studies adolescents were collaborated with. ⁴⁰ , ⁴³ , ⁴⁴ , ⁴⁵ , ⁴⁸ , ⁴⁹ , ⁵⁴ , ⁵⁵ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶¹ , ⁶⁴ , ⁶⁸ , ⁷⁰ , ⁷¹ , ⁷² In no study were adolescents only informed, and in no study were adolescents involved in youth initiated and youth‐driven project (empowering). When involved in data collection, adolescents used various participation modalities (e.g. FGDs, surveys, interviews, community outreach), and they also presented their research findings at conferences (Data S7).

The policy‐related processes were described as being led by youth, ⁵⁴ , ⁵⁷ , ⁵⁸ , ⁵⁹ , ⁶⁸ or by adult‐youth partnerships. ⁴¹ , ⁴⁴ , ⁴⁶ , ⁵¹ , ⁶⁶ , ⁶⁷ , ⁷⁰ Leadership was unclear in 21 studies, but presumably researchers/other adults were in the lead.

3.2.3. (iii) By which means have adolescent involvement in policy processes been facilitated?

Recruitment strategies

Many studies recruited adolescents from youth representation bodies, ⁴¹ , ⁴⁶ , ⁴⁸ , ⁵³ , ⁵⁷ , ⁵⁹ , ⁶⁰ , ⁶⁹ , ⁷⁰ and schools. ⁴² , ⁴⁴ , ⁴⁵ , ⁴⁷ , ⁴⁸ , ⁴⁹ , ⁵⁵ , ⁶¹ , ⁶³ , ⁶⁵ Sampling methods were mostly aimed at ensuring a diverse/representative sample of adolescents, ⁴² , ⁵¹ , ⁵⁴ , ⁵⁵ , ⁵⁷ , ⁶⁵ , ⁶⁷ , ⁶⁸ , ⁷¹ or on reaching vulnerable youth. ⁴³ , ⁴⁴ , ⁴⁷ , ⁵⁰ , ⁵³ , ⁵⁶ , ⁶¹ , ⁶⁹ Almost 25% of studies provided no information on recruitment.

Engagement tools

See Table 4.

TABLE 4.

Engagement tools ³⁸ used to facilitate participation in the included studies (N = 33).

Author year	1. Engagement and capacity building (e.g. community engagement studios, CBPR charettes)	2. Exploration and visioning (e.g. concept mapping, community forums, world cafes, SEED)	3. Visual and narrative (e.g. participatory mapping, photovoice, video‐voice, digital story‐ telling, participatory art)	4. Mobilization (e.g. boot camp translation, DDF, Delphi process)
Asechbach et al. 2022 37	Youth leadership council
Alegria et al. 2022 38			Photo‐voice
Almughamisi et al.2022 39		Concept mapping	Photo‐voice
Altares et al. 2022 40	Students advisory board	World cafe	Photo‐voice, street art, and poetry
Anselma et al. 2019 41			Intervention mapping
Askelson et al. 2019 42
Augsberger et al.2018 43	Youth Council
Bertrand et al. 2020 44			Video‐making, poster production
Boswell et al. 2021 45	Youth Council		Mind maps, drawings
Clark et al. 2018 46			Video‐making	Boot camp
Dafilou et al. 2022 47			Photo‐voice
Dyke et al. 2021 48				Community mobilization
Eriksson et al. 2020 49			Photo‐voice
Fisher et al. 2022 50	Advisory group & Youth Council		Video‐making
Fortin et al. 2022 51
Gonzales et al. 2022 52			Photo‐voice, audio, text narratives
Krishna et al. 2022 53
Lin et al. 2022 54	Youth Advisory council		Storytelling/narrative change, writing op‐eds
Lofton et al. 2021 55			Photo‐voice
Marco‐Crespo et al.2018 56			Participatory mapping, video, sketching, mural collage diagraming, etc.
Martin et al. 2018 57	Youth Council	World cafe, lifeline, body maps, placemats
McQuinn et al. 2022 58	Student PPI advisory board
Meriläinen et al. 2022 59
Ponsford et al. 2021 60
Prapaveissis et al. 2022 61		Participatory brain‐storming
Rakhshani et al. 2018 62
Ramey et al. 20189 63	Youth Advisory (YCRH*)
Romano et al. 2022 64	Youth panel	Online community forum	Photo‐voice
Sprague‐Martinez et al.2020 65			Photo‐voice, filmmaking, visual story‐telling, and writing exercises
Taylor et al.2022 66	Youth Advisory Group
Valdez et al. 20190 67			Photo‐voice
Warren et al.2018 68			Photo‐voice
Wilkinson et al. 2022 69		Divergent brain writing, journey maps

DDF: The Deliberative Democracy Forum; PAR: participatory action research; PRE: Participatory Research and Evaluation; SEED: the Stakeholder Engagement in question Development and prioritization; YCHR: Young Canadians Roundtable for Health.

The ‘Exploration and visioning‘ tools used in the included studies were World café, ⁴³ , ⁶⁰ concept mapping, ⁴² lifeline, body mapping, placemats, ⁶⁰ participatory brainstorming, ⁶⁴ on‐line community forum, ⁶⁷ and divergent brain writing and journey maps. ⁷²

The most commonly used ‘visual and narrative’ tools were photovoice, ⁴¹ , ⁴² , ⁴³ , ⁵⁰ , ⁵² , ⁵⁵ , ⁵⁸ , ⁶⁷ , ⁶⁸ , ⁷⁰ , ⁷¹ filmmaking, ⁴⁷ , ⁴⁹ , ⁵³ and storytelling. ⁵⁷ , ⁶⁸

The ‘mobilization’ tools used were bootcamp, ⁴⁹ and community mobilization/advocacy through community action initiatives and national or global campaigns. ⁵¹ While frameworks in 12 studies included an ‘evaluation’ component: PAR ⁴³ , ⁴⁴ , ⁴⁷ , ⁴⁹ , ⁵⁰ , ⁵⁴ , ⁵⁵ , ⁵⁸ ; PRE, ⁵⁹ , ⁶⁶ and CBPR, ⁶⁴ , ⁶⁷ none described having used a specific evaluation tool (e.g. partnership evaluation, ripple effect mapping). Ten studies used community engagement and capacity building ‘tools’ that constituted youth councils, coalitions, and advisory boards. ⁴⁰ , ⁴³ , ⁴⁶ , ⁴⁸ , ⁵³ , ⁵⁷ , ⁶¹ , ⁶⁶ , ⁶⁹

Training/education, adult facilitators, adapted language, compensation, safe space

In around a third of included studies (mostly PAR, CBPR, PRE) ⁴⁰ , ⁴⁴ , ⁴⁷ , ⁵⁴ , ⁵⁷ , ⁶⁴ , ⁶⁷ , ⁶⁸ , ⁷⁰ , ⁷¹ adolescent participation was facilitated through education and training. Adult facilitators were used in a majority of studies to engage and guide adolescents. ⁴¹ , ⁴² , ⁴³ , ⁴⁴ , ⁴⁷ , ⁴⁸ , ⁵⁰ , ⁵² , ⁵⁴ , ⁵⁵ , ⁵⁶ , ⁵⁸ , ⁶⁰ , ⁶¹ , ⁶⁴ , ⁶⁷ , ⁶⁸ , ⁷⁰ One of the 33 studies described the personal characteristics of the facilitators. ⁴⁷ Acceptability, feasibility of terminology and content of materials, ⁶³ youth‐friendly language, ⁶⁰ and multilingual communication were considered in some studies. ⁴¹ , ⁴⁷ In one study ⁵⁴ only adolescents with a sufficient level of the official language were interviewed. One study ⁷¹ intentionally used academic language, which was appreciated by the adolescents, who felt they learned a lot from it and that they were treated as equals. In two studies youth were hired, ⁴⁰ , ⁶⁸ and in other studies adolescents were compensated for their time with money and/or tokens. ⁴⁸ , ⁵³ , ⁵⁴ , ⁶⁷ , ⁶⁹ , ⁷¹ , ⁷² Two studies attempted to create a ‘safe space’ for youth participation through same‐gender sessions, ⁵⁸ separate sessions for youth and adults, ⁴² or for children and adolescents, ⁶⁰ one‐to‐one or small group meetings, ⁵³ , ⁶⁰ or by collaboratively creating a set of rules to ensure inclusiveness and equity ⁷⁰ (Data S8).

Duration of involvement

The duration of youth involvement ranged from a one‐off session, ⁴² , ⁵⁵ , ⁶⁰ , ⁶⁵ or a weekend, ⁴⁹ up to one year or longer, ⁴⁵ , ⁵⁰ , ⁵¹ , ⁵⁷ , ⁶⁷ but typically ranged between 6 weeks and 12 months in most studies. ⁴⁰ , ⁴⁹ , ⁵⁴ , ⁵⁶ , ⁵⁸ , ⁵⁹ , ⁶⁸ , ⁷¹ Eleven studies provided between 2 and 15 opportunities for involvement. ⁴¹ , ⁵¹ , ⁵² , ⁵⁸ , ⁶¹ , ⁶³ , ⁶⁴ , ⁶⁷ , ⁶⁹ , ⁷¹ , ⁷²

3.2.4. (iv) How have adolescents described their experiences of being involved in policy processes?

Few studies reported limited data on how the social needs of adolescents were met, i.e. in terms of feeling safe, ⁴⁸ valued, trusted or taken seriously as co‐researchers, ⁴⁸ , ⁵⁴ , ⁵⁵ , ⁷¹ having their views taken into account, ⁴⁸ , ⁵¹ and valuing the opportunity to express and share their views. ⁶⁹

In two of the studies, ⁴⁸ , ⁵¹ some of the adolescents felt their views had not been taken into account, or that the time for adequate training, for acquiring the knowledge needed, and/or for discussions was too limited. ⁶⁸ , ⁷¹

3.2.5. (v) What impacts of adolescent involvement in policy processes, related to health and well‐being have been reported in the literature?

Adolescents mostly reported benefits on their personal development from being involved in policy processes (Data S8). ⁴⁰ , ⁴¹ , ⁴⁶ , ⁴⁷ , ⁴⁹ , ⁵⁴ , ⁵⁶ , ⁶⁴ , ⁶⁷ , ⁷¹ A few studies reported the impact of adolescents input on wider external outcomes: concrete changes to a national obesity policy, ⁶⁰ and actualized school‐based obesity prevention interventions, ⁴³ , ⁴⁴ but it was unclear whether this translated into improved dietary and physical activity behaviors (or decreased obesity rate) among adolescents. Also, the output of many studies consisted of recommendations on how to involve adolescents, and interventions or actions proposed by adults, adolescents, or both. Results of two studies suggest a lack of concrete evidence that the views of adolescents were considered in a nutrition education curriculum, ⁵¹ and in an educational reform. ⁷¹ One study ⁶² revealed that the views of adolescents had not been considered in anti‐bullying legislation, and that the most affected youth were not part of the consultation.

4. DISCUSSION

4.1. Summary of main results

This scoping review included 33 empirical studies reporting on adolescent involvement in policy processes in the public health, education, and social work sectors, which aimed at improved health and well‐being. Most studies were qualitative, conducted in the public health sector in HICs in the US and Europe, in local communities and/or schools in urban areas, with only a handful of studies set in the context of a national policy or in LMICs. Adolescents were consulted or collaborated with, mostly in identifying problems or policy solutions and less often in agenda‐setting, decision‐making, and evaluation. Various facilitators for improved participation were used across studies. Many studies reported adolescent development outcomes, while few studies reported limited data on adolescents' experiences of participation, and studies reporting the impact on wider external outcomes were typically lacking. Recruitment inequities were reported in two studies.

• iWhat are the characteristics of the policies that involve adolescents?

Most policy‐related processes in the included studies were in the area of public health, with fewer studies in the education or social work sectors. Since health and well‐being is influenced by policies in many different sectors, multisectoral action may result in more powerful gains for adolescent well‐being. ¹² However, no study described adolescents being involved in a joint action policy approach.

The most common policy topics across studies were diet/PA, general health, and sexual and reproductive health, also highlighted by the WHO as important for adolescent's health. ¹ Results of a global public health consultation ¹² show that while sexual and reproductive health also are prioritized by adolescents, diet/PA are less so, and their top priority was to address mental health problems among their age group. However, the topic of mental health was covered by only two studies ⁵⁶ , ⁶⁹ in our review. Young people rarely participated in health and research prioritization exercises in the included studies. Involving young people early in the policy process could potentially result in policies that are more relevant to them.

Adolescents were mostly involved in policy processes at the local level, and less often at the regional or national level. The paucity of published evaluations may be explained by the ‘low level’ involvement (i.e. consultation only) at the national level, and that the process, outcome, or impact, of youth involvement is not systematically documented. ³⁵ According to the AA‐HA! Report, ¹² most countries report including youth in decisions regarding national and sub‐national priorities. However, little information was provided regarding the nature and quality of this involvement.

Few studies were conducted in LMICs, where almost 90% of the world's adolescents are located, ¹ and where the rate of obesity and diet‐related NCDs has been rapidly increasing. Involving these adolescents in policymaking to increase ‘buy‐in’, may potentially help to decrease the gap between the adoption of diet‐related policies and their implementation that has been reported in LMICs. ⁷⁵

• iiAt which stages of the policy process have adolescents been involved, and how?

Adolescents were mostly involved at the problem‐emergence stage and the considerations of policy options stage in the policy process, and less often in agenda‐setting, decision‐making, and evaluation. In studies, where adolescents were involved in decision‐making, the type and level of decisions varied e.g. from decisions related to designing a badge ⁵¹ to having a say in budgetary decisions, ⁵⁷ and it was largely unclear whether they had an actual say in decisions that matter. Further, it was typically unclear whether they were involved throughout the whole policy process, and to what degree. It was not stated whether adolescents were involved in monitoring activities, and only in two of the studies were adolescents involved in budgetary decisions. According to the youth participation models provided in the OECD ¹⁵ and the AA‐HA! Report, ¹² a truly youth‐led project should involve youth in all steps of the process and should also be initiated by youth. Only in a handful of studies were the policy processes described as youth‐led, and it was mostly adult researchers and other adults that initiated the process. In light of our findings, it appears that governments and relevant ministries that are responsible for “building adolescents' capacity and providing them with meaningful opportunities for participation in both leadership and financing decisions, and in all phases of the programming cycle” ¹² still have a long way to go to achieve this goal.

Adolescents in the included studies were involved in policy‐related processes through various participation frameworks, and youth representation bodies, and were mostly consulted or collaborated with, and rarely empowered. In a previously published review on a similar topic, Larsson et al ²⁶ youth were mostly consulted through interviews and FGDs, while adolescents in half of the studies included in our review were more active in collaborating with adults in developing, implementing, and evaluating interventions, and also, to various degrees, shared responsibilities for decision‐making.

• iiiBy which means have adolescent involvement in policy processes been facilitated?

Various frameworks have been proposed for understanding youth involvement, ⁷⁶ and as indicated by some of them, training, education, and adult facilitation are necessary first steps, to enable full participation and empowerment later on. This is in line with the fact that most policy processes were initiated by adults, and led by adults even if this was not explicit. Despite the important role of adult facilitators, their personal characteristics were rarely described. Adolescents commented on the importance of using adult facilitators with the same ethnic background as their own. ⁵⁷

The guiding core principles of meaningful youth involvement state that “Adequate and earmarked funding for the engagement of young people is critical to support their participation in decision‐making processes”, and that this is particularly important in LMICs. ¹² Not compensating youth for their time may act as a barrier to participation, ¹² which can lead to the exclusion of youth who are less well‐off, thereby increasing inequalities. However, only in a quarter of the included studies ⁴⁰ , ⁵³ , ⁶⁷ , ⁶⁸ , ⁶⁹ , ⁷¹ , ⁷² and in one of seven studies from LMICs, ⁵⁴ adolescents were compensated for their time.

Language may also act as a barrier to full participation. ¹² While some studies ⁴¹ , ⁴⁷ , ⁵³ , ⁷⁰ accommodated various mother tongues and/or literacy levels, one study ⁵⁴ excluded adolescents with an insufficient level of the official language from interviews. That adolescents in another study ⁷¹ appreciated that researchers used academic language in their communication, underscores the need to accommodate the various needs and preferences of adolescents.

Various engagement tools (e.g. photovoice, placemats) were used across studies to facilitate participation. For evaluation (and participation) purposes, WHO has suggested dividing adolescents into younger (10–14 years) and older (15–19 years) age groups, due to large differences in development and maturity, which was only done in one study. ⁶⁰ Many studies that included both younger and older adolescents, did not appear to have adapted participation methods or materials to the different age groups. In addition, around 30% of studies also included non‐adolescents (i.e. younger children or young adults), which may obscure adolescents' particular needs and experiences.

It is recommended that youth participation in policy should be accompanied by the collection of empirical data («on how policy aspirations are implemented in practice, who they have reached, with what effect»), and evaluation against set clear objectives, and benchmarks for participation (ref essentials of policy report). This would enable learning from mistakes or successes of previous studies, and provide information on what change that may be needed for effective participation. However, little or no information on data collection and monitoring of youth involvement was provided in the included studies, and only one study used a standardized evaluation framework to assess youth involvement. Only one study used a standardized evaluation framework to assess youth involvement.

In around 25% of studies, adolescents were recruited from various youth representation bodies, which has the benefit of providing continuity over time. It may, however, pose a problem for diversity, as inequities in recruitment into youth councils have been reported (e.g. poor representation of youth from non‐academic schools, and overrepresentation of white, males). ⁴⁶ Other reported inequities include the non‐representation of youth from lower SES in national policy projects, ⁵⁴ and of youth experiencing bullying in consultations regarding anti‐bullying legislations. ⁶² Utilizing diverse recruitment strategies, such as snowball sampling, targeted recruitment within specific educational institutions or communities, and leveraging social media platforms, could potentially facilitate a more comprehensive representation.

• ivHow have adolescents described their experiences of being involved in policy work?

Most included studies applied a rights‐based or pragmatic perspective on youth involvement, and only a few studies, ⁴⁸ , ⁵¹ , ⁵⁴ , ⁶⁹ reported limited data from a social perspective. We therefore cannot determine whether the adolescents overall felt that their social needs were accommodated for. In some studies, some participants expressed that their views had not been taken into account, ⁴⁸ , ⁵¹ or that the time for proper engagement was too limited. ⁶⁸ The frequently used ‘bottom‐up approaches’ (PAR, CBPR, PRE), have been suggested to create a sense of ‘ownership’, ⁷⁷ but we found little evidence for this.

• vWhat impacts relating to the health and well‐being of adolescent involvement in policy processes have been reported in the literature?

Involving youth in policy processes that affect them has been suggested to lead to more effective and relevant policies, improved democratic processes, and improved youth development. ⁷⁴ However, while the results of many qualitative studies suggested improved youth development outcomes, the actual impact on the policy in question was rarely reported. This is in line with findings in the literature, in particular, regarding the results of PAR projects. i.e. that “the transformational aspect of the work is typically seen in the individual youth and not necessarily in the policies”, and the finding that youth conveying research‐based recommendations, rarely oblige decision‐makers to act. ⁷⁸ Bertrand et al also disclose that in some YPAR projects the intention was never to instigate policy change in the first place, but only youth development in preparation for adult life. ⁷⁸ There may be many reasons why policymakers and public authorities do not always commit to youth involvement in policy work, ¹⁵ e.g. lack of political and institutional support (incl. insufficiently trained policymakers), unclear purpose of involving youth, or potentially wrong level or form of participation.

Regarding the studies related to obesity prevention, ⁴² , ⁴³ , ⁴⁴ , ⁴⁵ , ⁵¹ , ⁶⁰ , ⁶¹ , ⁶⁴ , ⁶⁵ the policy level was mostly local, but national in two studies. ⁵¹ , ⁶⁰ None of the policy processes were initiated by youth, and few were led by youth. ⁵¹ One study ⁶⁰ reported how involving youth had impacted on the development of a new national obesity policy. This was the only study that reported providing the participants with advance information on the purpose of the consultation, and how the data would be used. The artifacts (i.e. the written notes, and drawings) were subjected to thematic analysis and interpreted by the adults. No included study reported on changes in dietary or PA behaviors, or in the obesity rate among adolescents.

4.2. Strengths and limitations of the review

Strengths of our review were that youth provided feedback on the protocol for increased relevance, ³⁴ that the review followed standardized conduct/reporting standards, ³² , ³³ the use of established frameworks for extracting data, and the comprehensive, iterative literature searches. Also, that bias was minimized through duplicate screening and data extraction. One potential limitation was the limited search period. While providing information related to the current status of youth involvement in policy, the restricted search period prevented a deeper understanding of how youth involvement has evolved after the adoption of the 1989 UNCRC and up to now. Second, differences in terminology and indexation across databases, the ambiguity of the policy concept, and the use of the ML function in EPPI (heuristic stopping criteria), may have resulted in some eligible studies being missed. ⁷⁹

4.3. Implications for policy, and practice

Policy‐ and decision‐makers should aim to include adolescents, throughout the whole process, in developing actionable and sustainable policies for equitable health and well‐being, ⁸⁰ , ⁸¹ especially in LMICs. Following the OECD toolkit guidance to ensure a favorable environment for youth participation, could potentially increase the chance of the voice of youth being considered in decision‐making processes. Sufficient information should be provided about the purpose of involvement, what adolescents can expect from being involved, and on how their data will be used. Documentation and monitoring of youth involvement should be improved, especially at the national policy level. Participation and evaluation may benefit from separating younger and older adolescents. Recruitment should aim to ensure the representation of adolescents of different gender, ethnicity, from non‐academic schools, and outside the school system, and youth should be compensated for their time. More consideration should be given to the social aspect of involvement to ensure that adolescents feel safe, respected, and listened to. Diversity among adult facilitators should also be considered.

4.4. Implications for research

To ensure that the views of adolescents are considered in policies that affect them, ¹² monitoring, documentation, and evaluation of the impact of adolescent involvement using quantitative methods and standardized evaluation frameworks, e.g. the EU Youth Test ⁸² should be put in place. Such frameworks can bring attention to weaknesses in how youth are involved and ensure that all aspects of participation are covered. Conducting longitudinal studies of youth involvement in policy can provide insight into the long‐term impact on the health and well‐being of adolescents.

5. CONCLUSIONS

Due to a paucity of impact studies, we could not determine whether adolescent involvement increased the relevance of policies or influenced their personal development. The extent to which adolescents were meaningfully involved and had a material effect on decision‐making that matter, was largely unclear. There is a need for Improved documentation, monitoring, and evaluation of youth involvement in policy, using quantitative methods and standardized frameworks, to improve the evidence‐base, the recruitment and involvement practices, and decrease inequities. Despite the absence of evidence for the impact of involvement, allowing adolescents to articulate their perspectives and ensuring that their voices are heard in the formulation of policies designed to address their specific needs, is of value in itself.

AUTHOR CONTRIBUTIONS

Conception or design of the work (AH, GMF, KIK), Data collection (AH, GMF, AS, ASF, LB), Data analysis and interpretation (GMF, AH), Drafting the article (GMF). All authors (AH, AS, ASF, LB, HR, KIK) read and provided feedback on the final draft of the report.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest relating to this project.

FUNDING OF STUDIES INCLUDED IN THIS SCOPING REVIEW

Information on funding, role of funders, and conflict of interest in the included studies can be found in Data S9. Authors in around 73% reported no conflicts of interest (CoI), and authors in the other did not report CoI.

DIFFERENCES BETWEEN PROTOCOL AND REVIEW

We had initially considered including studies from 1989, i.e., from the year when the UN adopted the UNCRC, but chose instead to include studies published during the last five years only. It was assumed that this would more accurately reflect the current status of youth involvement. We used an EPPI reviewer for the screening, instead of Rayyan as initially planned. We also mentioned in the protocol that we would use Hart's definitions of nonparticipation, but we found no study in which youth were non‐participating.

ROLE OF FUNDERS

The content of this article only reflects the authors' views, and the European Union is not liable for any use that may be made of the information it contains. The funding source had no role in designing the study; collecting, analyzing, or interpreting the data; writing the manuscript; or deciding to submit it for publication.

Supporting information

Data S1. Full search strategies

Data S2. Data extraction form

Data.S3. List of excluded studies

Data S4. Characteristics of included studies

Data S5. Characteristics of included participants

Data S6. Characteristics of policies and policy‐processes

Data S7. Characteristics of youth involvement

Data S8. Output/outcomes

Data S9. Funders, role of funders, conflict of interest

Flodgren G, Helleve A, Selstø A, et al. Youth involvement in policy processes in public health, education, and social work—A scoping review. Obesity Reviews. 2025;26(4):e13874. doi: 10.1111/obr.13874