Translational Behavioral Medicine

, Volume 6, Issue 4, pp 648–658 | Cite as

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

  • Rachel A. Millstein
  • Susan I. Woodruff
  • Leslie S. Linton
  • Christine C. Edwards
  • James F. Sallis
Original Research


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.


Childhood obesity Built environment Nutrition Physical activity Policy 



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

Compliance with ethical standards


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.


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Copyright information

© Society of Behavioral Medicine 2016

Authors and Affiliations

  • Rachel A. Millstein
    • 1
    • 2
  • Susan I. Woodruff
    • 3
  • Leslie S. Linton
    • 4
  • Christine C. Edwards
    • 4
  • James F. Sallis
    • 5
  1. 1.San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical PsychologySan DiegoUSA
  2. 2.Department of PsychiatryMassachusetts General HospitalBostonUSA
  3. 3.School of Social WorkSan Diego State UniversitySan DiegoUSA
  4. 4.Health Policy Consulting GroupSan DiegoUSA
  5. 5.Department of Family Medicine and Public HealthUniversity of California, San DiegoSan DiegoUSA

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