Adolescent-led Our Voice method to promote healthy and active lifestyles and environments in South Africa

Abstract

Adolescents' immediate environments, including their homes, schools, and neighbourhoods, have a significant impact on their behaviour, health and development. Fostering adolescents' agency and empowerment can drive environmental and behavioural changes that can lead to improved health outcomes and reduced disparities in current and future generations. The objective of the study was to pilot and evaluate the implementation of a "by the people" citizen science method (the Our Voice method), engaging adolescent high school learners in Cape Town, Western Cape, South Africa in promoting healthy and active lifestyles and environments. Sixty-six high school adolescents of both genders between the ages of 13-18 years old were purposively recruited from 6 high schools in Cape Town, located in places of low or middle/high socioeconomic areas (SEA), as citizen scientists. The citizen scientists and some caregivers were interviewed via telephone. Citizen scientists also used a mobile application to collect data in their immediate environments to identify barriers to healthy eating, physical activity, hygiene, and safety. Data were audio-recorded, downloaded, and transcribed. In facilitated workshops, citizen scientists analysed the data and proffered solutions to the barriers, advocated change, and thereafter implemented relevant health promoting changes. Demographic characteristics and anthropometric measurements of the adolescents were also collected. Overall, similar barriers were experienced by adolescents regardless of SEA. However, lower socioeconomic status areas were a significant contributor of barriers to physical inactivity and unhealthy eating, safety, and hygiene. The buy-in and participation of adolescents and the school authority in the intervention to promote healthy lifestyles and environments is imperative. The Our Voice method was found to be a promising multi-layered tool for empowering adolescents as advocates in promoting feasible healthy and active lifestyle and environmental changes.