Youth voices as change agents: moving beyond the medical model in school-based health center practice

This article describes a 34-week pilot project aimed at improving health care service delivery for adolescents by offering youth a distinct role as advisory board members who help shape policy, provide feedback, guidance, and direction to a school-based health center (SBHC) program in Boston. Freshmen were recruited to participate in a Youth Advisory Board Project that included weekly afterschool meetings. Adult supervision was provided by SBHC staff that included 2 clinical social workers and 1 youth empowerment specialist. Through this effort, students were (1) trained in nonprofit board development and governance structures; (2) urged to identify gaps in services; (3) taught to select, prioritize, and implement action projects; and (4) offered clinical support around personal issues. Students brought a wealth of life experiences, knowledge of teen attitudes, information regarding trends in risk-taking behaviors, and feedback about experiences in the SBHC. In addition, their increased awareness of the SBHC service elements led to identification of obstacles to youth participation in care, feedback regarding positive and negative health care experiences within the SBHC, as well as with external health care providers, and ideas about unrecognized needs leading to gaps in services. This experience demonstrated that young health care consumers, with support, can focus their attention and begin to utilize analytical thinking skills to shape health outcomes and inform service delivery.