Abstract
Research Objective
The new adolescent brain science is telling us how the natural course of adolescent neurodevelopment creates emotional, psychological, and social challenges, and that adolescence is a unique and critical developmental period. While mental health promotion has been encouraged, teens are not flourishing psychologically, socially, and emotionally, and policymakers are hesitant to implement strategies where success is uncertain. Accordingly, we aimed to develop a prioritized set of evidence‐informed policy recommendations that would result in advanced flourishing for U.S. teens.
Study Design
We used a stepwise approach, guided by a National Expert Panel, with four components: rapid evidence review (RER); scan of existing policy recommendations; key informant interviews; and a modified Delphi process for prioritizing final recommendations.
Population Studied
High‐school‐aged teens (13‐18 years).
Principal Findings
Our review of systematic reviews (aka RER) outlined the evidence base supporting interventions that advance teen flourishing. Though a diverse set of interventions was identified, the quality of the available research demands that any new implementation be accompanied by rigorous evaluation. Similarly, our policy scan surfaced an extensive array of policies, mostly from other nations, that we cross‐referenced with the evidence base from the RER to help populate a starting list of policy recommendations to increase adolescent flourishing. Our key informant interviews identified compelling visions for teen‐friendly social, cultural, and built environments that further helped us frame and organize our starting list of policies. To set the stage for prioritizing evidence‐informed policy recommendations, we identified a framework of two broad domains: Broad Cultural Change and Systems of Caring. Within the Broad Cultural Change domain, we identified three subdomains: (a) teens; (b) mental health; and (c) systemic discrimination. For example, a more comprehensive definition of mental health, to include wellbeing in addition to mental disorders and risky behaviors, would help make teen flourishing a mental health policy goal. The systemic “isms” that affect teens on a daily basis (e.g., racism, sexism, homophobia) must be dramatically ameliorated for teens to flourish. Systems of Caring included (a) education; (b) social media; (c) health and healthcare; (d) violence prevention and criminal justice; (e) child welfare; (f) families; (g) extracurricular, recreational, sport, and employment; and (h) the cross‐cutting areas of research, measurement, governance, and funding. For example, social media policy options could include penalizing companies that harm teens; engaging adults and teens in building more socially productive digital platforms; and using challenge awards to accelerate creation of an ecosystem that reshapes social technologies to support teen wellbeing. Policy recommendations underwent three rounds of prioritization to arrive at a final concise set of evidence‐informed policy recommendations across two domains and 11 subdomains.
Conclusions
Our comprehensive, structured, and systematic approach developed a concise, ranked set of policy recommendations to advance wellbeing for U.S. teens.
Implications for Policy or Practice
Despite deep concerns about the nation’s adolescents, this age group is typically left out of policy and program initiatives. The needs of adolescents are unique, and the landscape of their development is evolving. This work ensures that the unique needs of adolescents are addressed in a policy agenda focused on advancing their psychological, social, and emotional wellbeing.
Primary Funding Source
Well Being Trust.
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Dougherty D, LeBlanc N, Armstrong P, Wittenberg R, Cope E. Teen Psychological, Social, and Emotional Wellbeing: Moving Upstream with Evidence‐Informed Policies. Health Serv Res. 2020;55: 10.1111/1475-6773.13360