Minnesota youth engage in a wide variety of activities that are self-destructive and have long-term negative effects on both physical and mental health. That was the finding of a 1987 Adolescent Health Survey of over 36,000 Minnesota students conducted by the Adolescent Health Program, University of Minnesota. The survey dealt with health perceptions, behaviors, and attitudes of 7th to 12th graders.

This article reports on the results of that survey and how the Minnesota 4-H Youth Development program is responding to the issues that emerged from the survey analysis.

Here are some of the highlights of the Minnesota Adolescent Health Survey:

• 90% of males, 85% of females reported being in good or excellent health.
• Sexual activity increased from 10% for 7th graders to 64% for 12th graders.
• Average starting age for sexual intercourse was 14 years.
• Of those sexually active, about 17% NEVER used birth control.
• In decreasing order of frequency, concerns expressed were:
  1. Appearance.
  2. School performance.
  3. Being liked by others.
  4. Losing a best friend.
  5. Death of a parent.
  6. How friends treat them.
  7. Getting a job in the future.
• 12% smoked cigarettes daily.
• Over 60% of youth had used alcohol.
• Of those, 70% had been drunk in the past year.
• 24% reported drinking and driving.
• 1.4% used marijuana daily.
• 19% reported feeling depressed in the past month.
• 3% of males and 6% of females had made suicide attempts in the past year.
• 42% of females, 18% of males felt they were overweight.
• 6% of females, 9% of males actually were overweight.
• 33% of males reported seeking help from no one on contraception.
• 19% of males reported seeking help from no one when dealing with depression.

The data just highlighted provided the basis for the Minnesota 4-H response to self-destructive behavior among adolescents. The Self-Protection programs deal directly with health issues and they incorporate: (1) prevention theory, (2) youth participation, (3) adult guidance, (4) starting early, and (5) collaborative efforts of a variety of agencies at state, county, and community levels. Each of these aspects of self-protection programming is discussed below.

Prevention Theory

Whether the issue is drug and alcohol abuse, early sexual activity, teen pregnancy, stress and depression, or delinquency, the most effective prevention programs incorporate:

1. Providing information about the problem.
2. Building self-esteem.
3. Teaching and providing opportunities for practicing "life skills."

When young people are equipped to communicate effectively, cope with stress, problem solve, be assertive, and choose friends, they're better able to resist pressures to adopt unhealthy behaviors. They're able to make wise decisions about their health and their lifestyle and take responsibility for themselves.

Youth Participation

An important component of the Self-Protection programs is the involvement of youth as both recipients and providers of information and skills for prevention. Adolescents have time, energy, and skills to share. Involvement in teaching and service projects can help them understand they can contribute, receive recognition, and affect their communities. It can also challenge them to expand their knowledge and skills and to carry responsibility. Community service experiences can lead to such benefits as decreased delinquency, improved academic achievement, enhanced self-esteem, and exposure to career opportunities.

Training for teens is critical. They need to know about early adolescent development and the learning process. They need to learn appropriate methods for teaching and working with younger children. In the process of being trained to teach younger children about health issues, the teens receive information about relevant issues even as they practice skills they need to make wise decisions for themselves.

Adult Guidance

Self-protection topics can't typically be taught with a do-it-yourself manual. They need careful and sensitive planning and instruction by caring adults and/or teens who have been trained in the subject matter, as well as in educational principles and teaching strategies.

Both pre-teens and teens need opportunities to think and talk about the changes occurring as part of their physical, intellectual, sexual, and emotional maturation. They need to interact with trusted adults and peers, be part of a comfortable social group, and see positive role models. They need to learn and practice some of these decision-making skills in safe environments with the guidance of adults and other teens. Youths need to feel a sense of power, of being trusted to lead, to take responsibility, to be held accountable, and to be rewarded.

Starting Early

Dealing with health issues must begin at an early age. This includes programs in alcohol and chemicals, safety, sexuality, nutrition and eating behaviors, physical and sexual abuse, and stress and depression. Research1 shows, for example, that youth begin experimenting with alcohol at about 11. The average age at which teens begin to be sexually active is 14. Body image is an issue with youth before they even reach junior high school.

Collaborative Efforts

Comprehensive and intensive educational programs that employ networks of agencies and resources at the state, county, and community levels can provide a broad support base for youth. By working cooperatively, parents, teachers, 4-H leaders, doctors, clergy, and peers can develop programs that touch many aspects of adolescents' lives and provide them with information and resources they need. They can provide teens with consistent positive messages of support in the decisions they have to make in health and lifestyle issues. Collaborative efforts allow 4-H to offer a wider variety of health programs and materials than would otherwise be possible. They also connect 4-H with related diagnostic, counseling, clinical, medical, and religious services that other agencies can more appropriately provide. This makes it possible to offer truly comprehensive prevention programs that simultaneously support intellectual, emotional, physical, psychological, and spiritual needs of youth in the community.

Collaborative projects at the state level model for counties the advantages of networking. Advantages include expanding existing program services; efficient and economic sharing of staff, resources, and time; and support for current funding and future programming. Many state agencies and organizations have regional offices and staff who are eager to serve Extension districts across the state.

Self-Protection is the theme for comprehensive and intensive educational programs that address critical health issues and employ networks of agencies and resources at the state, county, and community levels to provide a support base for youth. The programs listed below were developed in the first phase of the Self-Protection program dealing with issues of: (1) alcohol abuse and drinking and driving; (2) stress, depression, and suicide; (3) sexuality; and (4) violence in relationships.

1. Alcohol Decisions: Teen Training Workshops use materials and resources from Cornell University and the Minnesota Prevention Resource Center to train teenagers to teach elementary age children about the effects of drinking alcohol on driving and riding.

2. Fragile Time is an educational documentary about teenage depression and suicide, produced and filmed in Minnesota. It's a 30-minute documentary in 1/2" VHS format for adult audiences. It teaches adults to recognize young people in trouble and intervene in high-risk situations.

3. Tackling Tough Stuff is a curriculum of activities and experiences to teach young people (aged 12 to 17) to recognize stress and depression and take positive steps for self-protection for themselves and their friends.

4. Project 4 Teens. Provides teenagers with information about human sexuality, relationships, and the importance of serving as positive teenage role models for their peers and younger children. The Project 4 Teens training also helps the teens develop the skills they need for wise personal choices about their own sexual health and teaches them how to teach others.

5. The Power To Choose. Minnesota 4-H joined the National Council of Jewish Women and the Minnesota Coalition of Battered Women in developing a program aimed at preventing violence in relationships. The resulting video, "The Power To Choose," designed for use with junior and senior high school students, deals with dating relationships and the proper use of power.

6. Health Choices. 4-H agents and volunteers, as well as other youth and health professionals, are being trained in use of the "Health Choices," a health issues curriculum developed by Hazelden Health Promotion Services.

7. State Fair Health/Safety Event. In 1987, Minnesota initiated a State Fair Health/Safety Event to recognize 4-H members who developed and implemented projects around relevant health issues.

8. Youth Health Conferences. Minnesota 4-H works with 13 other agencies to sponsor day-long health conferences for junior and senior high school students. Workshops, drama, music, panels, speakers, and exhibits dealing with current health issues are presented by health professionals and youth to give students ideas and encouragement to plan and implement health programs in their own schools and communities.

The Self-Protection programs developed by Minnesota 4-H deal far more with social than physical issues. The data from the Adolescent Health Survey suggest that adolescent health problems have shifted from biological to social causes. Accidents, homicides, and suicides are the three leading causes of deaths among Minnesota adolescents. All involve social factors around which individuals make personal decisions.

Health issues addressed by the Self-Protection program were identified in the Adolescent Health Survey. Program strategies are based on recent prevention theories that recommend a combination of basic information, skill development, and self-esteem building. Most of the programs also include active involvement of youth as teachers and planners of local prevention programs with heavy reliance on adults to provide support to these youth. The programs can be delivered in a variety of ways through 4-H Clubs, schools, or other community organizations.

Because it's based on critical issues, the Minnesota 4-H Self-Protection program content will change. Its mission to provide Minnesota adolescents with information and skills they need for wise personal choices about their health and their lifestyles will endure.

1. P. Benson and others,1983 Minnesota Survey on Drug Use and Drug-Related Attitudes (Minneapolis, Minnesota: Search Institute,1983).

This article is online at http://www.joe.org/joe/1989summer/a4.html.

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