Evidence-based interventions

Evidence-based interventions for adolescent health and well-being take many forms, depending on:

• the determinants or conditions of interest (for example, promoting mental health or better hygiene practices),
• the target population (for example, general population or adolescents only),
• the context (for example, humanitarian or high-income contexts),
• the ecological level (for example, targeting individuals or institutions) and
• the lead sector (for example, health sector or education sector). 

In this section we describe interventions that fall into three categories: 

1. Adolescent-specific interventions.

Many effective interventions to address major adolescent conditions are specifically for adolescents, that is, they are directed exclusively, or mostly, to adolescents. Examples include HPV immunization, provision of school health services (SHS) and comprehensive sexuality education (CSE). 

2. Interventions with wider impacts but particular benefits for adolescents.

Adolescents will benefit substantially from many interventions that address wider age groups or the population as a whole. For example, reducing urban air pollution contributes significantly to healthier urban environments, from which all will benefit. However, because of children and adolescents’ greater vulnerability to air pollution, the impacts for them will be particularly powerful. 

3. Interventions with wider impacts that need age-appropriate design to be effective for adolescents.

Many organizational interventions (for example, improving the quality of primary care facilities) and structural interventions (for example, limiting the promotion and availability of alcohol) need to be designed with adolescents in mind; otherwise, while being effective for adults or other population groups, they will be less effective for adolescents. For example, limiting access to alcohol and protecting against its marketing should take into account where adolescents meet and their particular susceptibility to online marketing. Similarly, improving the quality of care requires education and training of providers in adolescent-responsive care. Many individual-level interventions also need age-appropriate adaptation (such as adolescent-friendly adherence and disclosure support to adolescents living with HIV). 

This chapter summarizes all three types of interventions.

It aims to make the adolescent-specific aspects of the interventions clear and highlights the importance of addressing the special needs of adolescents in the design and implementation of interventions at any level of the ecological framework, from structural or environmental to individual.

At the structural and environmental levels, we describe interventions that operate in the macro-environment. Interventions at this level largely take the form of policies or legislation.

At the organizational level, interventions involve systems-level responses in health but also in other sectors.

At the level of the community or interpersonal environment, we describe interventions that operate in communities or families or with peers or partners.

At the individual level, we describe interventions addressed to adolescents themselves, recognizing that they may require support to access and benefit from that intervention.

Some interventions operate across multiple ecological levels (for example, adolescent participation). In each intervention area, example interventions are provided. The presentation here of examples of interventions is not exhaustive.