How do adolescents view health? Implications for state health policy

Objectives: Policy-makers rarely consult adolescents during development of health policies. However, perspectives of adolescents on health can inform public health policies and programs. As part of the development of an Indiana state plan for adolescent health, we used qualitative methods to describe adolescents' "emic" views of health, and discuss implications for a state health policy for youth. Patients and Methods: We conducted eight adolescent focus groups in geographically and culturally diverse regions of Indiana. Each group was audio-recorded, transcribed, and analyzed using qualitative methods. Results: Participants described health as a shared responsibility between adolescents and adults in their lives. They identified a key role for supportive adults in initiating and maintaining health behaviors. Physical, financial, and informational environments could support or hinder healthy behaviors and outcomes. Although adolescents' descriptions of physical health and risk behaviors were similar to adult formulations, they described mental health as "stress and fatigue," an interaction between the adolescent and their environment, rather than depression and anxiety which are considered to be individual pathologies. Respect for decision-making capacity, seeking adolescent input, and providing harm reduction messages were identified as particularly important. Conclusions: Adolescent's perception of health can inform policies and programs, and should be sought before the development of health policies.