Adolescent Friendly Study Materials

Adolescents in Research Toolkit uses the WHO’s expanded definition of ‘young people’ as persons of 10 to 24 years of age1 and focuses on what is primarily called ‘the second decade of life’.

The adolescent age span (10 — 24-year-old) covers 14 years. A period during which adolescents experience rapid physical, cognitive and psychosocial growth. These rapid changes affect how they feel, think, make decisions, and interact with the world around them. It is an intense developmental period that will have a long lasting impact on their futures.

Typical reading and understanding skills of each group

Reading and comprehension skills differs from country to country, language ability as well as whether the language is first, second or third language, and schooling level reached according to the quality of general schooling in the region.

10 – 14-year-old group:

  • 10 – 14-year-old are transitioning from learning to read to reading to learn.
  • Able to Identify and summarize the sequence of events in a story
  • Make inferences (“read between the lines”) by using clues from the text and prior knowledge
  • Understand similes, metaphors, and other descriptive devices
  • Able to refer to evidence from the text when answering questions about it
  • Able to compare and contrast information from different texts

15 – 19-year-old group:

  • Keep expanding vocabulary and reading more complex texts
  • Able to analyse how characters develop, interact with each other, and advance the plot
  • Able to determine themes and analyse how they develop over the course of the text
  • Able to use evidence from the text to support analysis of the text
  • Identify imagery and symbolism in the text
  • Able to analyse, synthesize, and evaluate ideas from the text
  • Able to understand satire, sarcasm, irony, and understatement

20 – 24-year-old group:

  • Vocabulary more extensive that the 15-19 group.
  • Greater depth to understanding of concepts and comprehension of the reading material.

Providing information and study material to adolescents

WHO recommends that Informational materials that are relevant to the health of adolescents provided by the point of health service delivery are available in different formats (e.g. posters, booklets and leaflets), and that Informational material should be presented in familiar language, easy to understand and be eye-catching. However, this is not a homogenous group, their information requirements differ, their language skills differ, their cognitive development is at different levels. Therefore, you cannot prepare information or study material for them as if they are ALL the same.

Writing for adolescents – in terms of presentation and language.

If you are only able to produce a single informational material for all adolescent age groups

  • Structure the information into three separate levels

First level (at the beginning)

  • A simple summary containing the most important information on top.
  • This summary is aimed at the 10–14-year-old group so language should be simple and easy to understand.
  • The sentences should be short and in active voice (subject, verb, object).
  • It should contain only pertinent information and no long explanations.

Second level (in the middle)

  • Each paragraph in this section should be structured and contain a single idea, followed by an example and an explanation.
  • The structured paragraph is aimed at the 15–19-year-old group and explains the points made in the summary.
  • The paragraphs are logically arranged so that the information is easy to absorb and understand.
  • Language should be as simple as possible without being patronising.

Third level (towards the end)

  • This section should provide motivation (why & how), rationale (what) and consequences of choices (then) with regard to the topic at hand.
  • This is the persuasive part of the communication and should be framed according to what works best with adolescents, for example:
  • Gain-and loss-framed messages are differently persuasive.
  • If a behaviour leads to a certain outcome, gain-framed messages work well.
  • If a behaviour leads to a more uncertain outcome, then loss-framed messages more effective.
  • Gain-framed messages can be more persuasive than loss-framed messages
  • Adolescents (and adults) are more sensitive to minor losses than to minor gains.
  • Intense feelings (whether positive or negative) reduces the effect of loss framing on risk-taking.
  • When we experience positive feelings, the effect of gain framing on risk aversion also subsides.
  • In general, everyone prefers certain alternatives (predictable) to uncertain alternatives.

Other things to consider:

Hard reduction approach

A harm reduction approach: Normalises behaviour (without medicalisation) whilst reducing risk.

Example: I am prepared for whatever’s next. I am not defined by what others my think but by the choices I make. This is my moment, I am PrEPPed.

Youth messaging and marketing – Reducing Stigma = Improved Adherence

  • Reduced initiation and retention on PrEP or treatment due to:
  • Fear of unintentional disclosure
  • Fear of stigma
  • Fear of PrEP being mistaken for ART
  • How the medication is packaged and marketed could make a huge difference: medicalisation vs. empowering & youth friendly

Unplanned social behaviour is age appropriate but there are always consequences

Lessons learnt from getting young women onto contraceptives: 80 000 unplanned pregnancies annually in SA – but only 40% of adolescent girls are on contraception

  • Adolescents do not plan social encounters
  • The Imagined Audience – fear & embarrassment
  • Need for the construction of an entry point into the health system
  • Risk perception
  • Influential relationships – excluding medical health professionals

Taking this into account, we now need to build an evidence-base of what will work for other adolescent interventions.

BY YOLISWA NTSEPE (MA, PhD)
ADOLESCENT PROGRAMMES MANAGER

UPDATED NOV 22, 2023

TABLE OF CONTENTS:

REFERENCES & ADDITIONAL RESOURCES:

WHO 2012 Making health services adolescent friendly: developing national quality standards for adolescent friendly health services. https://apps.who.int/iris/bitstream/handle/10665/75217/9789241503594_eng.pdf

WHO 2009 Quality Assessment Guidebook: A guide to assessing health services for adolescent clients. https://apps.who.int/iris/handle/10665/44240

WHO 2009 Strengthening the health sector’s response to adolescent health and development. https://www.who.int/publications/i/item/WHO-FCH-CAH-10-01