Working with adolescents 

For researchers working in this area, it’s important to engage young people early on in their projects, not just for data collection but also to understand what topics are important to adolescents, and how research in these areas can have a positive impact on their lives.

Researchers typically engage with young people through schools, but this comes with challenges, as Dr Laura Tinner, from the University of Bristol’s Population Health Sciences Institute, explained:

“My research focus is on adolescent health inequality”, she said. “I felt that trying to engage in a school environment only really reached a particular set of young people; those who feel comfortable discussing health – a potentially sensitive topic – among their school peers.” 

Informally empowering youth 

Trying a different approach to adolescent engagement, Laura set up the Empowering Youth project*. The aim was to work with youth organisations and groups to explore different avenues for reaching young people, and different environments in which they may feel more comfortable.

“I worked with three community groups in Bristol,” said Laura. “And through the Creative Youth Network, we employed a young Artist to facilitate a series of workshops with young people. This Artist also took on some research. In this way we hoped to engage more with young people about health and behaviour.”

The resulting workshops, aimed at young people aged 12-18, used art exercises to enable a focus on inequality and health. The idea was to allow the participants to develop their creative skills, and to discuss health inequality in a more informal and indirect setting than schools might allow. 

Building confidence with creative exercises 

Workshops were held in 2021 at three youth centres in different areas of Bristol with different levels of affluence. Each workshop was split into two halves – first, creative activities led by the Artist, and second, a focus group discussion.

Laura’s aim for working with a young Artist was to have the creative exercises led by someone a similar age to the participants, and who wasn’t a researcher. It was also an opportunity to provide work experience for a young person in the community. Leading the creative elements, the Artist built rapport and encouraged group engagement. Exercises involved playful tasks like drawing with eyes closed, with the wrong hand, or drawing using negative space.  Follow-on exercises then encouraged participants to consider the upcoming focus group topics. Young people were invited to use different colours to mark against themes such as ‘exercise’, ‘drinking’, ‘eating’, ‘opportunity’, ‘inequality’ and ‘health’. They also played a word association game. 

Continuing discussion through focus groups 

These follow-on exercises were then used as a springboard for discussion in the Focus Group. Led by Laura, with input from the Artist, participants were encouraged to expand on their word associations and the colour choices they made and what they represented. The topics that came up ranged from health perceptions, inequality perspectives and other wellbeing related topics. 

“Health risk behaviours were mentioned by most of the participants as the predominant health issues related to their age group,” said Laura. “Smoking, drinking, drug use, physical inactivity, poor diet, and so on. Participants also mentioned a perceived lack of activities specifically for adolescents. There’s a sense that they feel forgotten – all of the young people spoke about the perceived inequality in relation to opportunities and education, which left them feeling unprepared for adult life, and uncertain about the future.”         

Feeding back to policy makers 

“The participants also expressed strong awareness and understanding of a variety of extremely complex issues,” said Laura. “Tobacco smoking, alcohol use and poor diet were highlighted as the key issues for young people’s health – and mental health issues were also considered important.

“Young people described themselves as ‘forgotten’, which they conceptualised through lack of age-appropriate activities and public spaces for them. All of the participants felt uncertain about their future and thought they could be better supported around education and employment decisions, especially after the events of the past few years. There is a clear need for city-wide structural and age-specific policies for adolescents, particularly in deprived areas, to support them in living a healthy life.”

Following the workshops, Laura was able to feed her results into relevant Bristol City Council organisations:

“I presented may findings at a local authority Health and Communities team meeting in the City of Bristol,” she said. “Young people’s perspectives in my research contrasted, at times, with what that team had recently uncovered in school settings, highlighting the need to engage with young people in spaces outside of school, to glean a range of more diverse perspectives and speak to those who feel marginalised. As a result of this, we hope that the findings may contribute to the ongoing Belonging Strategy in the City of Bristol. 

Setting up a project with benefits for all 

To highlight the value of their time, each participant in the project received a packed lunch and took home a pack of art equipment plus shopping vouchers. The young people involved were generally very open about their lives. They indicated that they enjoyed the art activities and were interested in having more input in local policy and research.

But as well as benefits to the participants, staff at the organisations Laura worked with reported stronger lines of communication with young people on previously un-covered topics such as mental health and alcohol use. And the Artist Laura employed gained new opportunities too – they have subsequently run other youth workshops, building on the experience gained through this project. 

Being flexible when presented with challenges 

One of the challenges that Laura and her team found when setting up community collaborations was the need to be flexible in balancing mutually contradictory timelines.

“I didn’t have any issues establishing links with different groups when developing the project,” said Laura. “But many of the plans we initially arranged didn’t come to pass – either because of timescale issues, personnel changeovers, or other problems.

She continued: “The organisations were keen to help – one group said they would be happy to host the workshops at different sites, for example – but after we’d established a funded timeline based on all the ideas that the different stakeholders had given me, new circumstances meant that we had to work with different organisations.” 

Finding learning for future community engagement 

The project gave Laura substantial insight into how best to coordinate research projects with strong community engagement elements:

“It was hugely important for us to be clear with potential community partners about who we were, what we were doing and, importantly, what we could do for them’” she said.  “Communicating enthusiasm for a project can give rise to responses in kind, and researchers are more likely to get fresh ideas, approaches or other feedback which can enrich their research. Often, the real challenge can be finding a balance between being flexible to community needs and maintaining the focus on your research question.”

She continued, “It’s also important to remember that community organisations tend to work very much in the present. They may not have the time, space or resources to focus on long-term projects and results the way that research can and often does. It’s often necessary to work towards goals which suit both ways of thinking, especially with limited funding!”

The success of co-produced, creative workshops such as this - which engage with young people on difficult topics – provides learning for researchers in the future. Positive feedback from the participants and youth workers suggested that using art in this way, as well as working with a young Artist, helped the participants to feel more at ease and open to discuss their thoughts on health and inequality. These types of engagement methods are widely used within the ‘youth work’ sector to empower young people and establish relationships, but are, as yet, less common within health research.

Laura’s Empowering Youth project shows that making the most of opportunities to try new methods to engage with the public can have a real impact. This may be in prioritisation of community-led research needs, network building, diversifying recruitment, or upskilling the community. Laura’s project shows that creative methods clearly have substantial potential when investigating the motives and opinions of young people.