Youth Empowerment to Achieve Patient Engagement

Youth (defined as those aged 10–24 years) [1] must be systemically engaged if we hope to reach a level of patient engagement where the experience of care is improved, patient health is improved, and health care costs are lowered. Young people such as myself represent 20% of the population, and we bring a variety of perspectives and backgrounds to patient engagement work because we represent a diverse, cross-sectional group. Additionally, young people are consumers in the health care system. Therefore any health system design or redesign should be inclusive of the thoughts and unique needs of youth. When we have opportunities to exercise our role as stakeholders in the health care system, we are able to work alongside public health workers and medical providers to achieve more effective levels of patient engagement.

The YES! Youth Empowerment Model is based on providing youth with opportunities to create positive community change. The model can be applied, and is being applied, to the work of public health and health care systems alike, as young people are catalysts in the process of creating patient-centered care. This model provides youth with critical awareness to understand health care systems, health disparities, and the role that health equity plays in each. The model also builds advocacy and decision-making skills in order to help youth effectively engage in addressing social determinants of health. As a young person, I know that youth are capable of advocating for positive change around issues that affect us, such as having equitable access to health care. By engaging youth in the health care system as both stakeholders and patients, youth empowerment equips young people to successfully navigate the health care system and to advocate for our care.

The YES! model is one example of a framework that empowers youth at the highest level. Distinct from youth development, which is centered on “developing the capacity of the individual youth” [2], youth empowerment is focused on “creating greater community change, that, in its methods, relies on the development of individual capacity” [2]. Youth empowerment work can be defined by the degree to which youth are engaged in changing systems, environments, and policies.

Much of this work begins with obtaining a higher level of health literacy. The health care system is changing rapidly, and both the health and educational systems have struggled for years to provide adequate health literacy to youth. YES! develops health literacy by exposing youth to information and promoting skills associated with health system navigation. Not only do these trainings prepare youth to be informed and effective in doing patient engagement work, they also enable youth to have successful health care experiences and better health outcomes by being advocates for their own care.

The YES! model has produced strong outcomes in Montefiore Medical Center in the Bronx, New York. Here students have developed youth councils within their network of primary care clinics located on school campuses. These school-based health centers primarily serve uninsured and underserved students and provide a point of access for youth who may not otherwise have a medical home. The youth councils provide those who are served by the centers with an opportunity to represent the health needs of themselves and their peers. As a health care system, they are designing innovative structures to support a deep and comprehensive level of patient engagement. Montefiore Medical Center has been consulting with YES! for more than a year on how to implement this model in their setting.

Collaborative processes and intentional design of youth-adult partnerships have been necessary in order to sustain an equal investment from both youths and adults in their patient engagement work and to provide youths with maximum exposure to opportunities to impact change. Without opportunities, investment, and intentionality, there is no platform for youth input when making decisions about issues on which to focus and work that should be done to achieve a target, whether that be changing a health system or changing a health plan. Ultimately, it has been my experience that the most sustainable outcomes occur when young people are equitably invested in, partnered with, and able to exercise their role as stakeholders in the health care system.

• ©2015 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.