Youth: choices and change



Peter Byass

Umeå International School of Public Health, Umeå, SE-90185, Sweden (email:



Authors: Cecilia Breinbauer & Matilde Maddaleno
Publisher: Pan American Health Organization, Washington, DC, USA, 2005
ISBN: 92 75 11594 X; softcover, 392 pages; price CHF 50 (in developing countries CHF 35)

Having tried to parent adolescents over the last decade or so, I was interested to read this almost 400-page compendium, which brings together a broad range of issues around adolescent development. Its subtitle, "Promoting healthy behaviours in adolescents", firmly sets the context of its health-based agenda, as would be expected from its publisher, the Pan American Health Organization, but what is impressive about the text is its holistic approach. Clearly, adolescence is about a huge mixture of interrelated and changing factors, biological, cognitive and socioemotional. The authors have done an excellent job in dealing with these complex issues. How choices for positive lifestyles and health can be facilitated and supported is a hugely difficult area for public health planners worldwide.

But this brings me to an important question: who will read and use this book? In the Preface it is hoped that local health promoters and others who play significant roles in adolescents' lives will find it useful — and no doubt some will. These people, though, tend to be busy and under-resourced, and getting to grips with a heavy volume like this that approaches adolescence from an academic perspective may be too much to expect of them. If I were responsible for a local adolescent health programme with limited resources, I would need to know how to design and implement activities locally that might maximize the impact of the programme among the target population. Should it be a clinic with health professionals offering condoms and safe-sex messages — or a café to chill out in, with peer support? Unfortunately I am not sure that I would really be able to find a lot of help with making these kinds of policy decisions within this book.

On a more positive note, it is a well-researched and compiled text that will certainly be of use to another potential readership — the academic and research communities who study the needs of adolescents and design and evaluate interventions for promoting adolescent health. At least half of the book deals with theories and models for health promotion and behaviour change among adolescents, and this systematic approach will certainly be helpful to those approaching these issues from a more theoretical perspective.

At a practical level, there are some niggles about the book. Although it has a good list of references and web resources, there is no index! For a huge and complex work like this, it is frustrating to have to search the whole volume for a particular topic. Also, for some reason the chapter running heads and page numbers have been set in extremely small type and printed, not as is conventional, along the top and bottom edge, respectively, but rather on the vertical edge of the page; artistic maybe, but not conducive to easily finding one's way around the book.

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