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Introduction
Resilience and the at risk paradigm are both widely used frameworks that help address health issues in youth. Both have been used to help youth with addressing the issues found in sexual health. Therefore, the purpose of this essay will be to define the two paradigms, explain how they link to health, compare the main ideas, explain the shift towards resilience, focus on a health promotion program and trend and how it uses the resilience paradigm.
Define the paradigms
The at risk paradigm Is referred to as the risk and protective framework (Hanewald, 2011). This paradigm uses risk factors as the main source to make prevention strategies (France, Freiberg & Homel, 2010). Therefore, the paradigm aims to reduce the risks and future problems in youth as barriers to achievement of good health (France, Freiberg & Homel, 2010). At risk students can have poor school performance which can cause disadvantaged students to not receive the proper education regarding health (Schonert-Reichl, 2000). Hanewald (2011) study found that failing boys in school had risk factors such as coming from low income homes, larger families, and having criminal parents. This study meant that to address issues they needed to find intervention to limit the risks the boys were having on their academic success. The risk factors of having poor academic success and higher dropout rates can influence youths future employment. Poor education can lead to unattainable employment which then influences socioeconomic status, knowledge of health issue, and access to services Furthermore, resulting in disadvantages towards their health due to having higher risk factors in comparison to their peers. Resilience in youth means they can bounce back and recover from disruptive change and misfortune (Hanewald, 2011). Resilience uses strengths and skill to provide individuals with the strategies to adapt from risk factors. The difference between the two paradigms are that instead of focusing on the risk and limiting them, the resilience paradigm uses those factors to promote resilience outcomes to promote positive development (Lee, Kwong Cheung, Ungar & Cheung, 2010 as cited in Hanewald, 2011). Moreover, identifying those risk factors and using them as means to create resiliency rather than trying to limit those factors can be more effective. For example, a positive teacher who can help with academic success for those who come from disadvantaged homes can promote resiliency instead of using their poor home life as barrier to better academics. Using interventions to promote resilience can help manage youth exposure to risks through coping strategies and skills. Both paradigms main ideas are to promote health in youth by identifying the risk factors that cause youth to be disadvantaged. The at-risk paradigm does this by reducing these risk and placing interventions in too limit the risk factors, while the resilience paradigm instead uses the risk factors to give the students the skill to become resilient so they can bounce back and continue having positive development.
The shift towards the resilience paradigm
Over the years, the at risk paradigm was the popular framework used to improve health in youth. Farringtion, (2002); Hawkins et al., (2002) as cited in France, Freiberg & Homel (2010) study found that during the 1990s that youth have multiple risk factors which influence health which led to new prevention research being completed. The at risk paradigms uses early intervention has its key policy, in comparison to the resilience framework which is adapted off the at risk paradigm and uses risk factors to promote resilience and strengthen youth by providing knowledge and skill (Schonert-Reichl, 2000). The shift from the at risk paradigm is seen through the risk factors and protective factors of youth health. The resilience framework aims to use risk factors as way to develop health in youth. Therefore, risk factors influence how youth adapt and become resilient to adversity rather than limiting the risk (Schonert-Reichl, 2000). This framework also allows for all youth to be focused on instead of just the youth who are considered at risk. This shifts the focus from the at risk paradigm which focuses on disadvantaged youth to the resilience paradigm which indicates that all youth experience risk factors but can be used to positively influence their health (Schonert-Reichl, 2000). Resilience builds on individuals strengths and is an essential feature to address risks. This can be done through multiple ways such as through the individual, school, and family context. The individual can get resilience through life skills and self-efficacy (Zollkoski, & Bullock, 2012). They are multiple programs that help foster resilience at an individual level by promoting life skills through training programs (Botvin & griffin 2002 as cited in Zollkoski & Bullock, 2012). School based environments help to reduce the risk factors with academic success. Youth spend a lot of time at school; therefore, teachers should promote resilience strategies by having supportive peers, positive teacher influences and opportunities for success (Zollkoski, & Bullock, 2012). Finally, family situations can also influence youth resilience such as poverty, teenage pregnancies, and single parent homes (France, Freiberg & Homel, 2010). Therefore, families need to create positive parent and child attachment that promotes warmth and encouragement to face these risk factors and help foster resilience in youth. There are many programs that help youth and parents develop communication skills so they can adapt to risk factors that may influence their health negatively and create resilience to these issues.
Analysing the chosen youth health program
The positive adolescent sexual health conference known as PASH is a conference held in North Coast of NSW. Sex education is the primary strategy used to teach youth about sexual health but 50% of students found to be dissatisfied with the curriculum. Therefore, PASH was introduced to close the gap in sexual health education. PASH program is to addresses the gaps to increase sexual knowledge and providing skills to youth will help foster resilience. This health program is annual conference help to improve sexual health in youth based on health promotion models and the positive youth development model (Crocker, Pit, Hansen, John-Leader, & Wright, 2019). Its aim is to help youth over the age of 15 to adopt resilience strategies that promote and build their confidence, skills, and knowledge for sex, sexuality, and sexual health services (Crocker et al., 2019). The conference helps youth gain these skills by having young people involved along with parents, teachers, community, and sexual health professionals. Crocker et al. (2019) found that 13% of youth reported using no protection during sex, 15% using the withdrawal method and over half of the students who reported being sexually active using a condom. Therefore, this means education in sex needs to be more in depth to promote positive sexual health behaviours and foster resilience. PASH incorporates this through promoting supportive environments, strengthen school and family relationships, building skills and empowering youth. They apply this by using a positive approach that will strengthen youths sexual health literacy and allow for open discussions about sexually transmitted infections and contraception (Crocker et al., 2019). The program applies this through workshops, open discussion, information, and practical activities. Crocker et al. (2019) states that workshops and open discussions were done through peer and youth led groups and sexual health professional which provided normalisation of the topic of sex and breaking down the barriers and risks. The involvement of teachers and parents was included in workshops so they could gain an understanding of youth experiences of sexual health to gain a better understanding and knowledge on the poor health issues youth face (Crocker et al., 2019).The success of this health promotion can be seen through an increase of sexual health literacy in different ways. The program providing supportive and open environments improved youth engagement by receiving information through sexual health professionals (Crocker et al., 2019). Empowering youth can be seen in multiple studies as effective way to improve sexual health literacy, build awareness, confidence, and skills (Crocker et al., 2019). Furthermore, having support systems to help foster resilience through providing workshops for not only youth but for the teacher and parents promotes increased knowledge of the outcomes in sexual health. The health promotion program has shown success but has stated that it is too early on to determine how effective the program is long term.
The at risk paradigm health program.
Shafii (2019) conducted a study on 14-24-year-old s who had unprotected vaginal sex in the last 2 months. This study used the at risk paradigm through an interactive computer intervention to reduce the risk of unprotected sex, sexually transmitted infections, and unwanted pregnancy. The program aims to target protective interventions such as condom use, sexually transmitted infections prevention, birth control and pregnancy prevention (Shafii, 2019). The program is to identify the risk factors and provide interventions to limit the risks for the individual. The computer program used risk and protective factors that were influenced off the individuals response to the question. This then influenced the feedback that was provided to the individual such as suggesting the use of condoms when having unprotected sex. Furthermore, this program only focused on providing youth with interventions strategies to limit the risk instead of educating them on the risks to adapt and become resilient. The program ran for 3 month and had found to be little significant difference in unprotected sex, number of partners, sexually transmitted infections, and unintended pregnancy (Shafii, 2019). The program had also found to have engagement levels drop with some individuals not returning for follow up session (Shafii, 2019).
Comparing the success
The use of resilience helps youth increase their sexual health knowledge and skills when it comes to the risks. Rather then focusing on the risk factors and how to limit them. Educating youth and providing them with the skills to bounce back from these risk events can help positively improve their health. Youth being educated on the risks such as sexually transmitted infections and by providing them with tools and skills to use in their future will prevent them from becoming at risk of these issues. An example of this is providing them with resources to seek help and educate them to get tested and the symptoms of sexually transmitted infections as seen in the PASH conference. The program that adapted resilience had shown to increase knowledge and awareness around sexual health (Crocker et al., 2019) In comparison to the at risk program which showed little change to the risk behaviours and only gave the interventions to the risk rather then educating them on why they should adopt these interventions.
Conclusion
To conclude, 50% of students expressed dissatisfaction in the sex education curriculum (Crocker et al., 2019). The resilience program has shown that to increase sexual health knowledge it should be provided through engaging supportive environments that empower youth through community involvement. PASH address this through workshops, discussion and activities that are held by youth groups and sexual health professional that have sessions for school youth, teachers, and parents (Crocker et al., 2019). Therefore, addressing the gaps in sex education that schools or parents are unable to provide to promote resilience rather than just limiting the risks. Crocker et al. (2019) study found there had been increase in sexual health literacy among youth through the program. Furthermore, resilience has shown to be a more effective framework that positively influences and strengths youth knowledge and health. Resilience paradigm Is important to ensure youth across all stages of life are given the right strategies too protect and allow for them to adapt to disadvantages in life. Moreover, the resilience paradigm should be adopted in more health promotion programs as an effective strategy to engage and promote health in youth to provide them with the skills to bounce back from risks rather then limiting their risks. Therefore, proving that the resilience paradigm is a better framework to assess and promote good sexual health in youth but instead of eliminating risk factors use them to become resilient adults.
References
- Crocker, B.C.S, Pit, S.W., Hansen, V., John-Leader, F., & Wright, M.L. (2019). A positive approach to adolescent sexual health promotion: a qualitative evaluation of key stake holder perceptions of the Australian positive adolescent sexual health (PASH) conference. BMC Public Health, 19(1).
- France, A., Freiberg, K., & Homel, R. (2010). Beyond Risk Factors: Towards a Holistic Prevention Paradigm for Children and Young People. British Journal of Social Work, 119.
- Hanewald, R. (2011). Reviewing the literature on At- Risk and resilient children and young people. Australian Journal of Teacher Education, 36(2).
- Schonert-Reichl, K.A. (2000). Children and youth at risk: Some conceptual considerations. In Children and Youth at Risk. Ottawa, Canada: Pan-Canadian Education Research Agenda Symposium.
- Shafii, T., Benson S.K., Morrison D.M., Hughes J.P., Golden M.R., & Holmes K.K. (2019) Results from e-KISS: electronic-KIOSK Intervention for Safer Sex: A pilot randomized controlled trial of an interactive computer-based intervention for sexual health in adolescents and young adults. PLoS ONE, 14(1).
- Zollkoski, S, M., & Bullock, L.M. (2012). Resilience in children and youth: a review. Children and Youth Services Review, 34(12), 2295-2303.
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