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Table 2 Review findings and implementation considerations

From: Adolescents and health-related behaviour: using a framework to develop interventions to support positive behaviours

Adolescent physiological factors

Key points from systematic review results

Implementation considerations

Neurological decision-making ability

• When adolescents are in situations that involve a high level of emotion (e.g. times of great excitement), they are less likely to spend time considering the (potentially risky) consequences

• In high emotion situations (or so called ‘hot’ emotional contexts) decision-making processes may therefore be different from less charged (‘cold’ or deliberative) situations

• Interventions to support adolescents, and those who care for them, can raise awareness of this likelihood and help adolescents to identify that their ‘gut’, or immediate reaction, in such situations may put them at risk

• Knowledge of such variations may help adolescents to differentiate between their decision-making ability in a variety of situations and apply different strategies. For example, gaining the skills to recognise when a rash or unhealthy decision is likely to occur

Reward processing

• Reward processing develops across adolescence

• Interventions to support adolescents should encourage the rewards that healthy behaviours can give (for example being more active and looking/feeling healthier as a result)

• In addition, the benefits of saying ‘no’ to unhealthy behaviours can be emphasised (for example refusing cigarettes and having fresher breath, skin, and clothes as a result)

• In situations where adolescents need to concentrate intensely (for example when playing computer games), they may be more likely to accept an immediate reward without considering the consequences (for example they may be more likely to eat an unhealthy snack and lose their appetite for more nutritious food)

• An understanding of this likelihood may be helpful for both adolescents and those who care for them.

In addition, interventions that act as prompts or reminders for adolescents may be of help

Age and stage

• Many new experiences that children encounter as they develop through adolescence can impact on future health (for example, smoking)

• It is important that early interventions, at a younger age, explain the potential consequences (good or bad) in a supportive way. This early approach may help adolescents make healthier choices at a later stage (for example, turning down an offer of a cigarette for the first time)

• Younger adolescents may be less able to stop acting on impulse, due to the developing (neurological) maturation processes

• Interventions that focus on controlling impulsive action may be better suited to older adolescents

• Younger adolescents may respond better to interventions that focus on immediate rewards (for example, the immediate benefits of taking exercise, such as glowing skin, feeling energised). In contrast, older adolescents may be better able to see the longer term outcomes and anticipate those benefits (for example, having good muscle tone as a result of regular exercise)

• Interventions that are responsive to and implemented in an age and stage appropriate way may be more effective due to their acknowledgement of the physiological maturation process