A pilot study evaluating the effects of a youth advocacy program on youth readiness to advocate for environment and policy changes for obesity prevention


Youth advocacy for obesity prevention is a promising but under-evaluated intervention. The aims of this study are to evaluate a youth advocacy program’s outcomes related to youth perceptions and behaviors, develop an index of youth advocacy readiness, and assess potential predictors of advocacy readiness. Youth ages 9–22 in an advocacy training program (n = 92 matched pairs) completed surveys before and after training. Youth outcomes and potential predictors of advocacy readiness were assessed with evaluated scales. All 20 groups who completed the evaluation study presented their advocacy projects to a decision maker. Two of six perception subscales increased following participation in the advocacy program: self-efficacy for advocacy behaviors (p < .001) and participation in advocacy (p < .01). Four of five knowledge and skills subscales increased: assertiveness (p < .01), health advocacy history (p < .001), knowledge of resources (p < .01), and social support for health behaviors (p < .001). Youth increased days of meeting physical activity recommendations (p < .05). In a mixed regression model, four subscales were associated with the advocacy readiness index: optimism for change (B = 1.46, 95 % CI = .49–2.44), sports and physical activity enjoyment (B = .55, 95 % CI = .05–1.05), roles and participation (B = 1.81, 95 % CI = .60–3.02), and advocacy activities (B = 1.49, 95 % CI = .64–2.32). The youth advocacy readiness index is a novel way to determine the effects of multiple correlates of advocacy readiness. Childhood obesity-related advocacy training appeared to improve youths’ readiness for advocacy and physical activity.

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Evaluation was performed at San Diego State University. Program funding for YEAH! is provided by The California Endowment and Kaiser Permanente.

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Corresponding author

Correspondence to Rachel A. Millstein PhD, MHS.

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This paper was supported by a grant (# 68508) from the Active Living Research program of the Robert Wood Johnson Foundation.

Conflicts of interest

Authors Millstein, Woodruff, Linton, and Edwards declare that they have no conflicts of interest. Author Sallis has received grants from the National Institutes of Health, Robert Wood Johnson Foundation (Active Living Research), Centers for Disease Control and Prevention, Nike Inc., and the California Endowment. He is also a part owner of Santech, Inc., and has a consulting relationship with the University of North Carolina, Greensboro, on an NIH grant.

Additional information


Practice: Youth advocacy training for obesity-related environment and policy change has preliminary evidence of effectiveness and should be further developed for use in practice.

Policy: Youth advocacy is a promising strategy for engaging more people in the policy change process for improving health environments.

Research: The present evaluation documents positive short-term outcomes of youth advocacy training on youth participants, justifying more rigorous and longer-term evaluations.

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Millstein, R.A., Woodruff, S.I., Linton, L. et al. A pilot study evaluating the effects of a youth advocacy program on youth readiness to advocate for environment and policy changes for obesity prevention. Behav. Med. Pract. Policy Res. 6, 648–658 (2016). https://doi.org/10.1007/s13142-016-0408-6

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  • Childhood obesity
  • Built environment
  • Nutrition
  • Physical activity
  • Policy