B1-3 Public health workers’ experiences of co-creating health promoting measures with adolescents in five municipalities in Norway

Findings from this study implicate that more long term and systematic approaches are needed to secure involvement of adolescents in public health measures in municipalities.

Background: There is an increasing focus on the importance of involving adolescents when planning and implementing public health measures targeting and affecting them. Co-creation and involving end-users and other stakeholders in developing and implementing public health measures have been promoted to ensure better tailored and more sustainable solutions. However, what the involvement should entail is rarely specified, and it is often up to the public health workers to choose how to involve the adolescents. The aim of this study was to investigate how public health workers experience involving adolescents in the planning and implementation of public health measures aiming to promote good mental health in this group.

Methods: A qualitative research design was used to achieve the aim of the study. Semi-structured interviews were conducted with 15 public health workers (project leaders, members of project groups and teachers) involved in planning and implementing public health measures in five municipalities participating in the national programme for public health work. In addition, participatory observations of selected project activities were conducted in the municipalities. Data were collected during 2021. Reflexive thematic analysis was used to analyse data.

Results: The public health workers experienced several challenges that inhibited the involvement of the adolescents. These inhibitors can be divided into four main themes: time, adolescents as the target group, competence and resources in the project group, knowledge and awareness among the adolescents. To work around some of these obstacles, the public health workers utilised a variety of means and methods to engage the target groups. They used already established infrastructures and networks to obtain access and build relationships with the adolescents. In addition, they implemented the measures in several steps so that the adolescents would see the result of their own involvement.

Conclusions: Municipalities are instructed by the Local Government Act to involve adolescents in the planning and implementation of public health measures. Even though the municipalities in this study planned and implemented co-creation processes during the COVID-19 pandemic, which led to more ad hoc solutions than would otherwise be the case, the study indicates that the municipalities have not integrated co-creation at the operational and strategic levels in ways that ensure a fulfilment of this demand. Co-creation in public health work is left much to the individual public health worker.