Student Essay Prize

The Young Persons Health Special Interest Group (YPHSIG) launched a new essay competition for medical students this year to better understand what thoughts and feelings medical students have about adolescent health in the UK.

Prize winners

We are delighted to announce the winner of the YPHSIG Student Essay prize 2020 is Jessica O'Logbon.

Jessica is a 2nd year medical student at Kings College London, UK . Her essay "‘How should adolescent health services change by 2040 to better accommodate young people?" impressed our panel of judges with its ideas for patient participation in healthcare. We will share an abridged version of the winning essay shorty and Jessica will be invited to collect her prize at the RCPCH conference once a rescheduled date is available.

Congratulations also to runners up: Daisy Lu (University College London) and Triya Chakravo (University of Oxford) who both showed great insight in their reflections on young people's healthcare.

YPHSIG Student Essay Prize Winner 2020

Jessica O'Logbon

"I am particularly passionate about improving the quality and accessibility of adolescent healthcare as adolescence is a critical period during which the health habits that we will carry with us into adulthood are developing."

Message from the YPHSIG student link representatives

It has been a pleasure to organise the first YPHSIG Student Essay Prize. We received such a high standard of entries from medical students across the UK. It was a joy to read their insightful and innovative views on different aspects of adolescent health. Our entries varied from incredibly thoughtful reflections on a specific case that impacted the author to broad ranging and inspiring ideas on what adolescent healthcare might look like in 2040.

The YPHSIG student essay prize has allowed us to explore what thoughts and perceptions medical students have about adolescent health. The engagement of medical students nationally has demonstrated that they are engaging with adolescent health at an early stage in their careers. We hope that this annual essay prize and other future YPHSIG student events can continue to encourage medical students to get involved in adolescent healthcare and develop their interest.

Robbie Bain and Francesca Neale

YPHSIG student link representatives

Winning Essay 2020 (Click to expand/collapse)

How should adolescent health services change by 2040 to better accommodate young people?

INTRODUCTION

Adolescence is a period of increasing freedom, personal autonomy and risk-taking behaviours that lead to preventable morbidity and mortality [1]. This makes it a critical time for engaging this population in their health. Until recently, adolescents were seen as being relatively healthy and were not considered to be a priority in terms of health service delivery [2]. A number of factors have now changed this perception. The rate of mortality in adolescents is declining much slower than other age groups with increasing morbidity [3]. It is also of great concern that there has been no reduction in rates of deaths from intentional injury among 10-18-year olds in three decades with suicide rates rising [4, 5]. This highlights important contributors to morbidity such as mental health and substance abuse [6]. Literature review, focus groups and workshops have sought the views of children and adolescents in regard to what they felt was important for their health and well-being. Key areas emerged such as being more informed and involved in decisions about health services; for schools to play a greater role in their health and better access to age-appropriate services when needed [7]. This essay explores innovative ways that adolescent health services can improve in these areas to better accommodate young people in the next 20 years.

INVOLVING ADOLESCENTS IN HEALTH

“Adolescents and youth should be supported and empowered to contribute to designing, implementing and assessing policies, programs and systems that contribute to their health and wellbeing” was considered the single most important theme by youth advocates across the world [8]. Working with young people, youth workers and other professionals can achieve more accessible, appropriate services. This can be improved further by fostering close relationships with voluntary and community sectors. NHS trusts should open a dialogue with youth organisations like the UK Youth Parliament to take account of young people’s concerns and ideas regarding health matters, with a particular focus on barriers to access.

There is a much higher rate of success where use of resources or services has been planned jointly with young people [9] and The GP Champions Project is an example of this. The project aimed to find unique ways of improving the health of young people aged 10 to 24 years. Some of these included weekly pop-up GP services for students attending Lewisham Southwark College and supporting young people to produce their own leaflets for every GP in Sheffield and Cornwall. Additionally, young people have created training materials such as videos on young people’s needs around mental health and wellbeing for GPs, pharmacists and reception staff [10]. These initiatives empower adolescents to take control of their care and allow professionals to form a deeper understanding of young people’s thoughts and feelings when accessing services. Similar videos have been used in the e-learning Adolescent Health Programme which is available for free to all health professionals working within the NHS, but more awareness needs to be raised amongst staff about undertaking this programme and its importance in practice.

Establishing systems for the training, mentoring and participation of youth health advocates has the potential to transform traditional models of healthcare delivery to create adolescent-responsive health systems [8]. This is particularly important for marginalised adolescents such as those who are homeless, looked after by the state, young offenders or LGBTQ+ and who often experience inequalities in health. As these groups are less able to access health services in any event, there is an even greater urgency in ensuring their unique needs are identified and met [2]. This can only be known through dialogue and more effort must be made in order to listen to and consult with young people about the effectiveness and suitability of adolescent health services [11].

BRINGING HEALTH SERVICES CLOSER TO ADOLESCENTS

Adolescents spend most of their time in education, employment or at home. They are often surrounded by their peers and family members and the majority of teenagers have access to the Internet and are using it daily. This presents a range of opportunities to increase accessibility.

Many young people would like health services to be provided within their school [12]. Health drop-ins in schools are easy to access and enable young people to attend without the knowledge of their parents. This is particularly important for young people from rural areas [13. It can also appear less stigmatising than a ‘problem specific’ service. School health drop-ins can reduce unnecessary delays and deliver basic care, especially for sexual, reproductive and mental health concerns with a clearer understanding of young people’s needs in ways that work better for them [14]. Most services are held during the lunch break to avoid young people missing teaching time, but this results in short consultations when many students attend. Therefore, clinic opening hours before or after school should be made available and this should also be applied to primary care opening times to make them more adolescent-friendly.

In addition to this, adolescents’ wide use of technology can pave the way for the integration of technology into their health care. Teens are comfortable on the Internet and use it for a variety of reasons such as social and emotional support, relationship creation and maintenance, entertainment and information seeking [15]. They can investigate topics they consider embarrassing or that might arouse their parents' suspicions without adult interference or supervision. Adolescents are attracted to customisation, interactivity and multimedia formats such as games, quizzes, and personalised health check tools so health care providers can utilise these methods to ensure health information is reaching them.

Digital health interventions are a promising way to intervene early and promote health and wellness among adolescents. They are most effective when they focus on an adolescent’s strengths and their online peer interactions [16]. Evidence suggests that adolescents would like to use technology-based communication tools with their health care providers [17]. To streamline this process, collaborating with adolescents to provide the patient perspective is vital, such as establishing a young people’s panel to advise on ways in which digital technologies might be used to provide health information, improve access to services and encourage engagement and participation. With health experts to inform content, technological experts to develop software and research teams to measure effectiveness with data collection tools built into media platforms, teens and young adults can begin using evidence-based, secure and seamlessly integrated social media sites to prepare for their upcoming doctor's visit – and then tell their friends to use it too [18].

ENHANCING HEALTH LITERACY IN ADOLESCENTS AND THOSE AROUND THEM

Limited health literacy can reduce opportunities for young people to develop the capabilities needed to be actively involved in decisions about their health and care.

Peer and parent influences are especially relevant for youth. Families provide the primary structure within which children are born, grow, and develop, and from which adolescents transition to adult lives. Considering the complexity and variety of UK health services available, it can be difficult for adults to navigate through the health care system let alone adolescents. Consequently, many parents themselves have only basic health literacy skills and find it difficult to guide their children about health matters. Public Health England reports that 42% of working-age adults (aged 16-65 years) in England are unable to understand and make use of everyday health information, rising to 61% when numeracy skills are also required for comprehension [19]. Therefore, it is crucial that parents as well as children are informed about health services.

Alternative ways to disseminate information such as open engagement events held at hospitals or local GPs, similar to parent-teacher association meetings held at schools, can foster active engagement from parents and break down barriers to navigating through the healthcare system. School, community and family-based interventions to promote health literacy have shown promising results. For example, the Adult Education Trust’s ‘Talk about Alcohol’ intervention, delivered in UK secondary schools, has reported a statistically significant delay in the age young people start drinking alcohol, as well as increased knowledge about the effects of alcohol [20].

Peer education is also an effective tool for promoting healthy behaviours and teaching skills among adolescents [21]. Adolescents who have been through the healthcare system themselves and students who understand how it works and the services available (e.g. healthcare students) means that there is already a reserve of accumulated experience and knowledge which can be shared with others. Embracing this new concept can help the way adolescents view healthcare and address their worries about accessing it.

CONCLUSION

The most powerful actions to improve adolescent health arise from directly learning from adolescents as individuals. More time spent understanding what they need and want from healthcare services can be scaled-up with funding and support given to youth health initiatives to create more adolescent-responsive healthcare services. Ensuring that there are high-quality health services provided in UK schools and better educational strategies to raise health literacy can reduce barriers to accessibility. Technology provides an exceptional opportunity for coordinating actions between health services as well as bringing them closer to adolescents.


REFERENCES 1. El Achhab, Y., El Ammari, A., El Kazdouh, H. et al. Health risk behaviours amongst school adolescents: protocol for a mixed methods study. BMC Public Health 16, 1209 (2016). https://doi.org/10.1186/s12889-016-3873-42. Coleman J. Meeting the health needs of young people. Journal of Epidemiology & Community Health 2001;55:532-533.3. Wolfe I, Macfarlane A, Donkin A, Marmot M, Viner R. Why children die: death in infants, children and young people in the UK. Part A. May 2014 (On Behalf Of: Royal College of Paediatrics and Child Health, National Children’s Bureau and British Association for child and adolescent public health)4. Royal College of Paediatrics and Child Health & University College London. Child Health Research UK – Clinical outcomes review programme. Overview of child deaths in four UK countries. 2013. London. RCPCH5. Bould H., Mars B., Moran P., Biddle L., Gunnell D. Rising suicide rates among adolescents in England and Wales, The Lancet, Volume 394, Issue 10193, 2019, Pages 116-117, https://doi.org/10.1016/S0140-6736(19)31102-X6. Lawrence RS, Appleton Gootman J, Sim LJ. Adolescent Health Services: Missing Opportunities. Washington (DC): National Academies Press (US); 2009. 7. Annual report of the Chief Medical Officer 2012, our children deserve better: prevention pays. Department of Health, London20138. Patton GC, Sawyer SM, Santelli JS, et al. Our future: A Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423–2478. doi:10.1016/S0140-6736(16)00579-19. Street C., Warner-Gale F., Sedgewick J., Roberson J., Anderson Y. Taking on the Challenge: Shaping Health Services Through Young People’s Participation10. Association for Young People’s Health (AYPH), Royal College of General Practitioners, Youth Access to Information & Advice and Counselling (YIACS) GP Champions for Youth Health: Toolkit for General Practice 2015. 11. Milne AC., Chesson R., Health services can be cool: partnership with adolescents in primary care, Family Practice, Volume 17, Issue 4, August 2000, Pages 305–308, https://doi.org/10.1093/fampra/17.4.30512. Department of Health (2012) Getting it right for children, young people and families. London: Department of Health.13. Miller B., Baptist J., Johannes E. Health needs and challenges of rural adolescents.14. Mason-Jones, A.J., Crisp, C., Momberg, M. et al. A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health. Syst Rev 1, 49 (2012) doi:10.1186/2046-4053-1-4915. Elaine N. Skopelja, Elizabeth C. Whipple & Peggy Richwine (2008) Reaching and Teaching Teens: Adolescent Health Literacy and the Internet, Journal of Consumer Health on the Internet, 12:2, 105-118.16. Aschbrenner KA, Naslund JA, Tomlinson EF, Kinney A, Pratt SI, Brunette MF. Adolescents' Use of Digital Technologies and Preferences for Mobile Health Coaching in Public Mental Health Settings. Front Public Health. 2019;7:178. Published 2019 Jul 2. doi:10.3389/fpubh.2019.0017817. Radovic A, McCarty CA, Katzman K, Richardson LP. Adolescents' Perspectives on Using Technology for Health: Qualitative Study. JMIR Pediatr Parent. 2018;1(1):e2. doi:10.2196/pediatrics.867718. Wong CA, Merchant RM, Moreno MA. Using social media to engage adolescents and young adults with their health. Healthc (Amst). 2014;2(4):220–224. doi:10.1016/j.hjdsi.2014.10.00519. Aarendonk D., Akinwale B., Berry J., Cabe J., Connolly A., Gann B. Local action on health inequalities Improving health literacy to reduce health inequalities20. Martin, K., Nelson, J. and Lynch, S. (2013). Effectiveness of School-Based Life-Skills and Alcohol Education Programmes: A Review of the Literature. Slough: NFER21. Abdi F, Simbar M. The Peer Education Approach in Adolescents- Narrative Review Article. Iran J Public Health. 2013;42(11):1200–1206.

(Abridged version of winning essay) Updated 09/07/2020

Essay competition details

The essay competition had three categories:

1. What are the social, psychological and medical challenges facing adolescents in the UK? (1500 words)

The formation of new relationships and an increase in risk taking behaviours are but a few factors which makes healthcare challenging for adolescent patients. Discuss how factors such as these create challenges in medical practice.


2. Case study: the patient that changed my outlook on adolescent healthcare. (1500 words)

Think about a young person you have seen within adolescent healthcare services. What impact did the young person have on you and how did it change your outlook on young people in healthcare?

3. How should adolescent health services change by 2040 to better accommodate young people? (1500 words)

The adolescent period is a time challenging for patients. With ever-growing evidence that adolescent patients are a distinct patient group in their own right, with unique developmental and social needs, how should health services adapt in the next 20 years to facilitate this development?

Participants were invited to enter once for one category.

Deadline for the essay submission was the 27th of January 2020 at 23:59 GMT.

Entries are now closed.


Prizes for this competition are as follows:

  • First place- £100 cash prize, a ticket to the RCPCH 2020 annual conference and a certificate presentation at this event
  • Two runner up prizes- £25 prize and certificates (delivered by post).

Full terms and conditions are available below. If you have any queries, please feel free to contact yphsigstudent@gmail.com.

Essay Prize 2020 Terms and Conditions (Click to expand/collapse)

Guidance and Regulations

1. Eligibility

1.1 The competition is open to all those currently enrolled at a UK Medical School at the time of submission.

1.1.1 Entrants must detail their medical school and course year in their submission email.

1.2 Entries are invited one of the following essay titles:

· What are the social, psychological and medical challenges facing adolescents in the UK? (1500 words)

· Case study: the patient that changed my outlook on adolescent healthcare. (1500 words)

· How should adolescent health services change by 2040 to better accommodate young people? (1500 words)

2. Essay submission

2.1 Candidates must nominate themselves for entry by submitting a short essay on the specified topic to the judging panel.

2.2 Entries must be made to the following email address: yphsigstudent@gmail.com

2.3 Only essays that are submitted via email, in Word format to the published email address will be accepted.

2.4 Entries in PDF format will not be accepted

2.5 The deadline for submission is 23.59 GMT on Monday 27 January 2020.Submissions after this time will not be accepted.

2.6 Essays must be up to 1500 words. Entries over the word limit will not be accepted.

2.6.1 The word limit does not include the title or references.

2.6.2 References should be presented as footnotes and endnotes; references presented in alternative formats may be considered to be part of the limit.


3. Judges and judging criteria

3.1 Essays will marked by both senior members of YPHSIG and the YPHSIG student representatives.

3.2 The panel will mark essays against the following criteria:

  • Style of writing
  • Punctuation, spelling and grammar
  • Content/understanding
  • Originality

3.3 It is the entrant’s responsibility to ensure submission has been received by YPHSIG. The student representatives will email to confirm receipt of applications within 5 working days of submission.

3.4 The judge’s decision is final.


4. The Prize

4.1 The 1stplace winner will receive a prize of £100 and free entry to the Royal College of Paediatrics and Child Health (RCPCH) Annual Conference (28th-30thApril 2020) in Liverpool. The winner will receive a certificate during the YPHSIG organised session at the conference. The winning essay will be published on the YPHSIG website.

4.1.1 The conference ticket itself is non-redeemable or exchangeable with no cash alternative. Individuals are expected to cover the cost of their own travel and accommodation during the conference.

4.2 The winners of 2ndand 3rdplace will each receive a prize of £25 and a certificate by post.


Updated 17/12/19

Francesca NealeYPHSIG Student Link Representative
Robbie BainYPHSIG Student Link Representative