Peer Reviewed Research


Youth Advocacy Programs: Lessons From YEAH! Adult Leaders Evaluation Study


Nisha Botchwey1, L. Katie OConnell1, Kim Bryan2, Tonya Ricks3


1 Georgia Institute of Technology, Atlanta, Georgia


2 Glades Middle School, Miramar, Florida


3 Drew Charter School, Atlanta, Georgia



Disparities in youth obesity continue despite an increasing number of programs designed to address this challenge. Policy, systems, and environmental (PSE) changes hold promise. Youth Engagement & Action for Health! (YEAH!) is a youth advocacy curriculum for PSE change that promotes healthy behaviors. From 2017–2019, 18 youth-serving organizations hosted YEAH! clubs serving 237 middle school youth from low-income communities. Study data include YEAH! adult leader surveys and interviews. Data were coded on themes of youth advocacy action, youth retention, and opportunities and threats to program success. After coding, the data were organized into four categories for validation by representative adult leaders. This study found that positive outcomes were facilitated by adult leaders who had previous engagement with the youth, who showed enthusiasm for youth advocacy, and who had access to resources to motivate group cohesion, participation, and commitment. Best practices highlighted from this study offer tested strategies for adult leaders of youth advocacy groups.

Keywords: youth advocacy, community engagement, health disparities, community-based participatory research


     Advocacy can take many forms, from letter writing to direct community action, all with the same end goal—to persuade a person or entity to act (D’Andrea & Daniels, 1999). Typically, adults are expected to advocate for themselves and their communities (Hunter & Milofsky, 2007) whereas youth are rarely ascribed this role (Camino & Zeldin, 2002) and, often, youth of color and immigrant youth are excluded (Fine et al., 2004; Seif, 2011, Christens & Zeldin, 2016). When youth are trained to be advocates, there are many positive changes. Youth advocacy groups have increased positive outcomes when they partner with one or more committed adults (Botchwey et al., 2019). The characteristics of successful youth groups and their leaders have been explored (Evans et al., 2004), but questions remain about the role of adult group leaders in youth advocacy for obesity prevention.


     Adult leaders who lead or facilitate youth advocacy programs generally are not assessed for the quality of their work, and their characteristics and related contributions to this work are understudied. The limited literature on this subject shows that programs with positive outcomes are led by adult leaders who share decision-making with youth while also mentoring and giving instruction (Zeldin et al., 2013). Effective adult leaders facilitate youth meetings (Zeldin et al., 2008; Zeldin et al., 2014) while improving group cohesion and acting as mediators when necessary (Bozsik et al., 2018). Adult leaders can support youth against practicing unhealthy behaviors, like smoking (Beier et al., 2000), as well as act as mentors for both academic and non-academic success by supporting career and personal goals (McPartland & Nettles, 1991). Adults are also reported to support youth psychological empowerment processes (Krauss et al., 2014; Zeldin et al., 2014) and improve social integration (Cargo et al., 2003).

Benefits of Youth Advocacy

     For youth, taking an advocacy role has added advantages beyond advancing the immediate target of the action. When youth are involved in advocacy, they build long-term civic engagement practices as they become adults (Clement et al., 2014), which has far-reaching implications for civil society (Camino & Zeldin, 2002). Youth advocacy can build community capacity (Berman et al., 2018; Bunnell et al., 2012) and shift social norms (Dombrowski et al., 2013). These societal implications center around policy, systems, and environmental changes that can create national and international participatory youth-led movements like the 2018 March for Our Lives and the Global Climate Strike, as well as local actions to shape municipal public policy (Checkoway et al., 2005) and community planning (Ross & Coleman, 2000).

     Youth advocacy research focuses primarily on the impacts of these efforts on the youth involved. These impacts include a measured increase in youth abilities to influence adults (Botchwey, Jones-Bynes, et al., 2020) which builds youth confidence (Checkoway et al., 2011). Youth advocacy training increases youth skills, improves their knowledge base, and expands their understanding of issues (Andrade et al., 2015; Arnold et al., 2016; Millstein et al., 2016). Youth advocacy also has health impacts including reduced tobacco usage among youth (Holden et al., 2004; Kulbok et al., 2008; Ribisl et al., 2004) and improved physical activity and nutrition (Millstein et al., 2016; Botchwey, Jones-Bynes, et al., 2020). While these many benefits to youth are highly encouraging, additional research is needed to understand what makes the programs successful from adult leadership and contextual perspectives.

     Studies show that programs aimed at individual behavior modification intended to improve physical activity and nutrition may not have lasting impacts (Fialkowski et al., 2014; Summerbell et al., 2005). Instead, those that focus on policies, systems, and the environment improve long-term health outcomes because they support individuals while also changing behavior (Summerbell et al., 2005). Thus, the goal of the Youth Engagement and Action for Health (YEAH!) program is to teach youth how to advocate for PSE changes that lead to improvements in physical activity and healthy eating. Critical to the success of youth programs, and in this case YEAH!, is the engagement and training of the adult group leader (Linton et al., 2014).

Youth Engagement and Action for Health (YEAH!) Program Description

     YEAH! is a 10–12 week youth advocacy program that empowers youth to advocate for healthier options in their communities. The YEAH! study design employed community-based participatory research with a focus on a sustained collaboration with adult leaders from program design to dissemination (Israel et al., 2013). This paper gives voice to adult leaders in documenting best practices for leading youth advocacy that addresses health inequities in their communities (Wallerstein et al., 2011). In so doing, adult leaders engage in reflective practice and offer lessons learned for successful youth advocacy programs that fill gaps in previous work.

Study Purpose

     This study focused on YEAH! adult leaders and their experiences leading youth advocacy clubs aimed at PSE changes that improve physical activity and healthy eating. Understanding how YEAH! adult leaders facilitated these youth groups helps researchers develop strategies to help future club leaders to guide youth through the YEAH! curriculum and other youth advocacy projects. Specifically, the paper highlights best practices around leader characteristics, group characteristics, catalysts, and barriers.


Conceptual Framework

     Figure 1 describes the conceptual model by which the role of the adult group leaders may be influencing individual, community, and PSE changes. The YEAH! guidebook, curriculum delivery resources, youth recruitment, staff training, and meeting space are inputs that are all necessary for the YEAH! curriculum to be implemented. Adult leaders and youth engage members of the community (Botchwey, Jones-Bynes, et al., 2020). Adult leaders facilitate youth presentations of evidence-based recommendations for PSE change to decision makers (see Figure 1). Both the community and decision makers give feedback to adult leaders and youth. As reported elsewhere, program evaluation found eight short-term and four long-term outcomes for participating youth (Botchwey, Jones-Bynes, et al., 2020). Adult leaders experience short-term outcomes in scaffolding youth agency, which leads to the adult leader including advocacy in future group activities. Community members and decision makers realize a short-term outcome in awareness of advocacy that leads them to include advocacy in future group activities as well as to implement the change requested by youth.







Figure 1. YEAH! Conceptual Model: Adult Contributions Emphasized


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YEAH! Program

     For this study, the research team adapted the YEAH! curriculum originally designed by the San Diego County Childhood Obesity Initiative (Linton et al., 2014). The current study re-designed the original YEAH! curriculum from a 10-week program delivered in one county and expanded it to a 10–12 week offering with 18 clubs located across the United States in urban, suburban, and rural California, Florida, Georgia, Hawaii, Maine, Maryland, Virginia, and Washington, DC, communities that served low income, minority youth (Botchwey, Conway, et al., 2020). YEAH! clubs included Boys and Girls Clubs, Big Brothers and Big Sisters, YMCAs, schools, and after-school programs (Kim, A. et al. 2021). Each club received a $1,500 stipend that was paid upon completion of the program (Botchwey, Jones-Bynes et al., 2020). Most groups completed one session each week while some groups accelerated the delivery with two sessions per week.

     The final sample of youth participants in the study (n=137) included 59 boys and 78 girls; five race/ethnic groups: African American/Black (n = 43), Latinx (n = 19), Asian American, Pacific Islander/ Native Hawaiian (n = 33), multiracial (n = 25), and non-identified (no race/ethnic response or prefer not to answer) (n = 17) (Botchwey, Jones-Bynes, et al., 2020). All youth participants received a $50 gift card as an incentive for completion of pre- and post-assessments.

Recruitment and Training of Adult Group Leaders

     Clubs were led by 18 adult leaders who were employed by or volunteered in the participating youth-serving organizations. Club types included after-school programs focused on physical activity (n = 8), schools (n = 4), after-school programs focused on homework (n = 3), community groups (n = 2) and a church youth group (n = 1). Before starting the program, adult leaders participated in a three-hour in-person or synchronous online training session. Delivery of the YEAH! curriculum was integrated into adult leaders’ normal workload. As an incentive to ensure all final program components were complete, researchers updated the study protocol to include $50 for adult leaders.

     Clubs included a range of one to four adult leaders per group, and all groups had at least one paid leader. Some leaders oversaw more than one club. Eleven groups had leaders who had worked with their youth group before the YEAH! program. Adult leaders had varying levels of physical activity and nutrition knowledge. Five clubs had at least one leader with physical activity or nutrition experience, eight clubs had at least one leader with experience in policy education or neighborhood design, and four had at least one leader with previous experience in youth advocacy (see Table 1).


Table 1. Group and Leader Characteristics

Characteristic of Groups and Leaders


Number of leaders per group, range

1–4 (median=1)

Groups that had at least 1 paid leader


Leader experience among groups

Groups had worked with leader previously


Groups with at least 1 leader experienced in physical activity and nutrition


Groups with at least 1 leader with experience in fields of policy education, or neighborhood design


Groups with at least 1 leader with previous experience in youth advocacy




     The survey and interview guides were developed based on the YEAH! San Diego study. The post-assessment survey used in this analysis was an online survey of 68 multiple choice and open-ended questions. This survey was completed one week after the YEAH! club activities ended. Eleven adult leaders completed the post-assessment survey. This study focused on twelve open-ended post-assessment survey questions that describe the youth advocacy action, insights into youth retention, and opportunities and threats to program success (Table 2).

Table 2. Open-Ended Post-Assessment Questions Relevant to Analysis



Description of youth advocacy action

1.      Describe the outcome(s) of your group’s advocacy efforts?

2.      More specifically, have you seen any results of your group’s advocacy efforts to date? Check all that apply.

3.      For each of the boxes you checked in the previous question, please describe.

Youth retention

4.      If one or more youth stopped participating before the end, what do you think the reasons were?

5.      For those youth that continued participation to the end, what do you think their primary motivators were? Check all that apply. (Check all that apply)

Opportunities and threats to program success

6.      What are the most important ingredients for a YEAH! project?

7.      What are the most important characteristics of successful YEAH! adult leaders? You can list up to five.

8.      Did your group consult outside experts or professionals in conducting this project? Please explain.

9.      What do you think was the most significant impact of participating in this project-on the youth in your group?

10.    What do you think was the most significant impact of participating in this project—on you as an adult leader?

11.    What barriers did you encounter in leading your group? Did you overcome them? If so, how?

12.    If you were going to repeat the process of leading this group, is there anything you would change? Please describe.


     The research team conducted adult leader interviews by phone with each interview lasting between 15 and 45 minutes. The adult leader interview took place one to three weeks after completion of the YEAH! program with 10 open-ended questions (Table 3). These questions followed the survey’s themes of youth advocacy action, opportunities, and threats to program success. The goal of this series of questions was to give the adult leaders a chance to further describe their experience with the YEAH! program and the potential for future actions around the youth’s advocacy action. There was also a six-month follow-up interview with adult leaders that included two open-ended questions to document outcomes from the youth’s presentation to the decision makers and projected continuation of youth group advocacy work.


Table 3. Adult Post-Completion Interview Questions



1–3 week post completion interview questions

Youth advocacy action

1.      Tell me about your group.

2.      Who was the decision maker the youth presented to?

3.      What did the youth present?

4.      How do you think the presentation went? 

5.      Do you believe the youth’s request will happen? Why or why not?

Opportunities and threats to program success

6.      Overall, what went well with the YEAH! Program? 

7.      What did not go well? 

8.      How could the curriculum be changed for better outcomes? 

9.      What would you have done differently? 


6-month follow-up interview questions


1.      Have you seen any changes over the past six months, due to the youth’s advocacy work?

2.      Have the youth continued to do advocacy projects?


Data Analysis

     This study used a multi-method qualitative approach with three phases of data collection and analysis—surveys, interviews, and adult leader representatives. This stepwise, iterative analysis validated the outcomes with expert interpretation by the adult leader validation group. Surveys were completed online through a digital platform. To ensure adult leaders felt comfortable to speak freely, the interviewer took detailed notes rather than recording the interviews. The same person interviewed all adult leaders to ensure consistency between questions and notes.

     Upon completion of all surveys and interviews, two members of the team immersed themselves in the data. The researchers first aggregated survey data with short answers which were coded based on responses associated with three predetermined themes—youth advocacy action, youth retention, and opportunities and threats to program success. After organizing survey responses, the researchers confirmed initial codes then used the three-theme framework to combine survey responses with interview responses into four categories for validation by representative adult leaders.

     In the final validation session, the researchers presented the categories to the four YEAH! adult leaders, representative from the full group of adult club leaders. The participants clarified and honed the labeling and characterization of the presented categories. The results section presents this synthesized material organized according to themes.


Description of Youth Advocacy Action

     Seven clubs completed physical activity community assessments, six completed school assessments, and five completed park assessments. In response to the survey question Have you seen any results of your group’s advocacy efforts to date?, all adult leaders chose “no change for now, but decision makers have indicated greater understanding, and change may be possible in the future.” At the follow-up interview, some clubs saw changes based on the youth’s advocacy work. For example, a club in Hawaii presented to their county council regarding park updates. At the time of the survey, the adult leader noted, “County council put it on record to further improve the park” and by the six-month post-interview follow-up, the group received confirmation that the mayor and county council budgeted $80,000 for a park study. At a school in Florida, the youth presented to the administrators the challenge of water fountains consistently containing trash, which made it difficult for students to drink from the fountain and stay hydrated. At the time of the survey, immediately after completion of the YEAH! curriculum, no changes had taken place. However, at the first interview, one to three weeks later, the adult leader described the administration’s efforts with the custodial staff to ensure consistent upkeep of the fountains.

Youth Retention

     When asked If one or more youth stopped participating before the end of the program, what do you think the reasons were?, most adult leaders noted time challenges such as “scheduling conflicts,” “school and sports,” and “academics.” A few noted that students were not interested, or their friends were not part of the YEAH! club.

     When asked For those youth that continued participation to the end, what do you think their primary motivators were?, respondents were given a set of eight options. The top response was “incentives—gifts, prizes, stipend.” During the interview, several adult leaders stated the gift cards were a crucial part to keep the youth returning each week. At the same time, several adult leaders noted that students at the start of the program were enthusiastic about the financial incentive ($50 gift cards), yet by the end, youth were more excited about the advocacy work. Students also received YEAH! T-shirts which some adult leaders point to as creating a sense of exclusiveness, bonding the group as an identifiable team. Adult leaders strongly encouraged the youth participants to wear their YEAH! T-shirts for meetings, school, and community project events to aid in promoting the YEAH! club’s project. One adult leader stated, “I encourage the youth participants to wear the shirts for every YEAH! meeting and service event. As everyone in the school and community started to notice our T-shirts, the participants became more united as a group. Additionally, this pride compelled the group to work even harder to make a positive change for the community.”

Opportunities and Threats to Program Success

     When asked What are the most important ingredients for a YEAH! project?, three general themes emerged—time, youth commitment, and adult support. Regarding time, the challenge of “enough time” was reiterated in interviews. For youth, several adult leaders noted that youth needed to be committed not just to the program but also to the broad goal of advocacy. For example, one leader noted the YEAH! project needs “youth that actually care and are willing to advocate for a change” while another described this target as “willing students who would like to see changes in their community.” While youth commitment to change was important for some leaders, other leaders saw the responsibility falling on the adults to inspire youth. One leader noted in the survey it was important for the adult leader to “come up with a project that students are excited about and whose objective has the potential to be realized if presented well to policy and decision makers.” During the interviews, it was noted by several adult leaders that institutional buy-in was important. For example, the adult leaders were excited to start the YEAH! program at a school in Florida but were delayed by required institutional approvals. This pushed the program start date back, which interfered with academic testing and further delayed the program. Other programs were unable to set up meetings with decision makers who did not see the value of the program. One host organization had internal disagreement between adult leaders who saw the value in youth advocacy with the executive director who was worried about the club participating in advocacy work. Students could not advocate outside of the club and instead had to present their ideas directly to the executive director. This narrowed the students’ focus to the club rather than the full community.

     When asked What are the most important characteristics of successful YEAH! adult leaders?, respondents gave a range of answers, with most noting the importance of patience and communication. Other survey answers included “charisma—keeping youth engaged” and a focus on enthusiasm. In the interviews, the lack of enthusiasm came up as a barrier. For example, an adult leader for a club in Georgia, when interviewed at the end of the program, said he did not understand the point of the program and had just been told to do it. Club leadership decided to do the YEAH! program but the adult leader did not have the same enthusiasm for the program. Other survey responses included flexibility, ability to motivate, organizational skills, creativity, calm, caring, giving, and direction. Not mentioned in the surveys but discussed during the interviews was the importance for adult leaders to know their students before starting the program. Leaders who did not know their students spent the first several weeks learning names rather than focusing on the program.

     When asked Did your group consult with outside experts or professionals in conducting this project?, four groups consulted outside experts, with two of the groups partnering with their state’s public health institute, one group partnering with both the state public health institute and the planning department, and one group working with a local chef. For example, a club in Hawaii partnered with the local planning office where a former teacher was employed. At the time, the YEAH! curriculum did not include a student-facing presentation. The former teacher created a weekly presentation that included an identification game for the students to use in learning about the members of their county council. The same group worked with an expert from the public health institute who used her professional network to schedule a student presentation to the mayor. Another group of clubs in Hawaii had support from the state public health agency. During the adult leader interview, the addition of this professional background combined with the adult leader’s relationship with the kids helped create a “strong dynamic and allowed the team to shift gears when not engaging well.”

     When asked What do you think was the most significant impact of participating in this project-on the youth in your group?, the respondents focused on two major themes—skills and youth agency. The skills included tangible skills like how important it is to be prepared for a presentation and the impacts of first impressions. They also practiced and successfully executed public speaking skills to adults. During follow-up interviews with adult leaders and decision makers, many expressed surprise and excitement at the caliber of the YEAH! advocacy presentations while also seeing changes in confidence levels and increased leadership skills. One teacher commented that a member of the school’s administration team stated “I’m impressed that you could get him to participate” in response to seeing a particular student present at the end of the program. The YEAH! adult leader noted that the student wanted to present because he was proud of what we had done. Several leaders celebrated the YEAH! curriculum for the opportunity it presented for youth to work together and to develop their leadership skills. Regarding youth agency, survey respondents recognized the importance of “showing the youth they have a voice and say in the world” while another commended the students for “gaining confidence in the abilities to make a change and present their concerns to decision makers.” In follow-up interviews, one after-school program noted that students transitioned their advocacy focus from physical activity to mental health by assessing the mental health resources within their school and community. In another after-school program, the students used their newly gained skills to advocate for the school curriculum to better reflect the Asian American population it served. The students conducted assessments of the curriculum and presented recommendations to the school and the associated school board.

     During follow-up interviews, an adult leader from a Hawaii club reported that “kids seem to walk away with knowledge and a positive shift of attitudes.” Several adult leaders noted in interviews that they saw youth attitudes toward food shift throughout the process. A YEAH! Hawaii club leader stated, “I saw a collective shift in attitude. At the start of the program, the students wanted sugary muffins, and by the end, they were enjoying the healthy food. [I] saw this with the whole class.” He goes on to say, “Knowing the kids’ knowledge and baseline, they gained useful new knowledge on nutritional information. How to read nutrition labels, how to make good comparison choice, make better informed decisions.” At a school in Georgia, students enjoyed participating in a kale salad food demo. The teacher noted that one club member expressed the sentiment of the club by saying, “I would never have thought of doing it. This is simple. This is something I could make.”

     When asked What do you think was the most significant impact of participating in this project—on you as an adult leader?, all survey respondents described the youth. Some leaders were most impacted by the change in the youth. For example, one leader noted “watching the students evolve and discover areas of improvement/change that they otherwise would not have noticed.” Others found they were most impacted by seeing the youth as advocates. One respondent’s significant impact was “Having the youth get a chance to voice themselves in front of the county council.” Another said, “encouraging kids to become advocates of their own neighborhoods was an empowering and humbling experience.”

     When asked What barriers did you encounter in leading your group?, several respondents focused on youth’s time constraints. Some leaders used general attendance as a challenge while others gave specific examples like “sports and school” or “standardized testing.” During an interview, an adult leader noted several rural students lacked reliable transportation, which led to high levels of absentees at the program. The lack of regular attendance required leaders “to update and repeat what [was] already covered. It was difficult trying to move forward.” Food was a challenge as well as a solution. For example, one leader noted “the only time we could do was directly after school, and some kids didn’t have much to eat all day and so energy was low” while another noted they used food to get students’ attention. This was reiterated during the follow-up interviews. According to an adult leader from a school in Florida, “after the dissemination of snacks, participants worked even harder with each session. Youth participants eventually wanted to prepare and administer healthy snacks. Healthy eating awareness was enlightening for me as the adult leader and the youth participants as we decided on snack options to prepare for the group sessions.” Youth participants became more conscious of other group members’ dietary restraints, thereby learning another lesson about healthy eating options.

     When asked If you were going to repeat the process of leading this group, is there anything you would change?, several survey respondents identified an extended timeline that would improve the outcomes. This was reiterated in interviews. One club leader stated the program “deserved more time. We felt like we were rushing through.” For clubs located in schools, there were delays in starting programs due to internal IRB requirements. After clubs started, many were delayed or interrupted for mandatory testing. This extended the time required to complete the program. Time was also a factor in meeting with decision makers. In the survey, one respondent noted it “was hard to schedule with the principal” and in the future they would try to schedule earlier. Several clubs ultimately were unable to present to the appropriate decision maker. Those students ended up presenting to club leadership rather than an external person, so student requests went unfulfilled. One survey respondent found their large group size to be a challenge because they were unable to keep students focused. Other groups were challenged by too few students, which created a burden on other students when one student was absent. Several respondents focused on the role of the adult as the leader. One respondent suggested “clearer lines of communications and expectations” while another need expressed was to “find ways to make them [the youth] feel more accountable.”


     The YEAH! program gives youth an opportunity to participate in shaping public policy (Checkoway et al., 2005) and community planning (Ross & Coleman, 2000). Critical to the success of youth programs is the engagement and training of the adult group leader, as well as partnerships with youth-serving organizations (Linton et al., 2014). Within youth-serving organizations, adult leaders play a vital role in supporting youth by facilitating meetings and acting as mentors. To ensure adult leaders get the full support they need to be successful in facilitating youth advocacy clubs, it is important to understand the characteristics of successful adult leaders as well as what catalysts, and barriers work together to motivate group cohesion, participation, and commitment for youth.

Best Practices

     The adult leader validation group crafted a set of best practices based on the results of the surveys and interviews to benefit future clubs working on PSE programming (Table 4). The adult leader validation group organized best practices into (a) adult leader characteristics, (b) catalysts, and (c) barriers. These findings support and expand upon the baseline lessons from Linton et al. (2014), which found YEAH! programs needed close partnerships, committed adult leaders, and expert support.


Table 4. Best Practices to Support Adult Leaders


Best practices

Adult leader characteristics

Adult leader enthusiasm

Be selective on adult leaders and work with those that have enthusiasm for the program

Curriculum familiarity

Train adult leaders well

PSE/Physical Activity knowledge not necessary

Partner with local advocates that can support adult leaders that need guidance on PSE/PA/advocacy

Group characteristics

Knowing students in advance

Work with clubs that already have a relationship with students

Group size

Recommend clubs are between 10–15 students



Have funds available for the clubs to participate as well as funds for adult leader participation


Have funds available so food can be available at each club meeting


Have T-shirts for the students at the start of the program


Adult leader buy-in

Recruit/screen leaders who see the value in advocacy work

Get skeptical leaders excited about the potential of advocacy work

Ensure there is a match between institutional and adult leader enthusiasm

Institutional buy-in

Make a pitch to institutional leaders that match their value system

Youth commitment


Work with clubs that have consistent attendance (like schools)

Provide transportation

Lack of resources

Have funds and supplies available for participating club

Have additional funds available for final presentation needs

Lack of time

Include time for non-project challenges like IRB, academic testing

Anticipate and schedule decision maker meetings at the start of the study


Adult Leader Characteristics

     Effective adult leaders facilitate youth meetings (Zeldin et al., 2008; Zeldin et al., 2014), and part of being an effective leader is to motivate and inspire youth—which requires enthusiasm. Enthusiasm has the potential to help youth see the program beyond the 10-week curriculum and to build long-term civic engagement practices (Clement et al., 2014). To set clubs up for a successful program, the adult leader steering committee recommends being selective with adult leader participants and working primarily with those who show enthusiasm for the program. They can help motivate youth by creating fun and interactive sessions that go beyond a standard school curriculum.

     Familiarity with the curriculum was key to moving the YEAH! program forward. While each adult leader received training before starting the program, some leaders did not fully grasp the purpose of the program. The inability to convey this to students had the potential to reduce interest for both the youth and the adult leaders. To create successful clubs, it is recommended that adult leaders have ample time to complete training at the start of the program, especially around the importance of youth advocacy. Providing consistent check-ins and resources throughout the YEAH! program helps reinforce the program purpose and effective delivery. Besides ensuring a smooth program, well-designed training will build their enthusiasm for the program.

     Many of the adult leaders did not have prior knowledge around PSE changes for physical activity or nutrition, but the adult validation group found this was not a necessary component. While neither PSE knowledge nor physical activity knowledge was necessary, it was helpful for groups to have members of the community who acted as outside advisors to support the groups’ advocacy activities. The outside advisors can help expand youth’s knowledge base and understanding of issues (Andrade et al., 2015; Arnold et al., 2016; Millstein et al., 2016) in ways their regular adult leaders cannot. The adult leader validation group recommends connecting adult leaders with local advocates who can provide guidance and can ensure the most influential decision makers are present for the final presentation.

Group Characteristics

     Adult leaders act as mentors (McPartland & Nettles, 1991), which requires long-term relationships. When looking at the broader group structure, the adult leader validation group found it was helpful for the adult leaders to have prior experience with the students. Most of our adult leaders had previously worked with their students, but some of our clubs recruited students solely for the YEAH! club. Because the YEAH! program timeline was tight at only 10 weeks, the adult leaders who did not have preexisting experience with the youth were burdened with building rapport with participants while understanding and delivering the curriculum. It is recommended that clubs have an established relationship with their students prior to taking on the program.

     The group size was an important factor for successful clubs, with the optimal number between 10 and 15 students per group. Too few students created a burden of responsibility, especially if a student was absent. It also reduced brainstorming capabilities. Too many students were hard to keep focused, with a few students being heavily involved while others participated on the periphery.


     Financial incentives played a major role in conducting the YEAH! study, with clubs receiving stipends and students receiving gift cards. Few clubs would have participated without the organization-level incentive, but the provision of gift cards for individual youth participants showed mixed results on youth retention.

     Food was another method for improving participation. Adult leaders noted that healthy snacks at meetings were a great way to ensure youth participants’ promptness. At the same time, some clubs noted they saw youth attitudes toward healthy food change throughout the program. This demonstrates the potential for long-term PSE changes around nutrition (Summerbell et al., 2005). Access to healthy food options can be especially challenging for low-income youth, suggesting that funds be set aside to ensure snacks are available for each meeting.


     Some of the clubs lacked interest in the YEAH! program from adult leaders. This lack of buy-in to the program resulted from institutional leaders requiring adult leaders to oversee the project without the adult leaders fully understanding the purpose of the program. This led to a dissonance of desires between adult leaders and institutional leaders. For the clubs that require their adult leaders to participate, it is important to take extra time with these leaders to demonstrate the value of youth advocacy. Finally, a lesson learned is to work with both institutional leaders and adult leaders to ensure there is a match between institutional and adult leader enthusiasm.

     At the same time, other clubs were burdened by an opposite challenge—adult leader enthusiasm with a lack of buy-in by institutional leaders. Study teams are encouraged to ensure buy-in comes from all levels within a club before the start. Another important reason for multilevel buy-in is the high frequency of turnover at youth-serving organizations. The YEAH! research team did not anticipate this turnover concern from staff changes, often followed by clubs dropping out of the program. It is important to set up multiple contacts within a club, from adult leaders through executive leadership, and prepare to assist clubs as they transition between leadership.

     Several of the clubs were challenged by a commitment of youth participants to complete the program or consistently attend weekly meetings. To ensure consistent participation, study teams are recommended to emphasize steady student involvement in the recruitment phase and weekly.

     All YEAH! clubs were in low-income communities, so technology and resource availability created a large barrier to success. The study team provided the clubs with a startup package with materials to aid in program delivery, but some clubs needed additional resources. It is important when working within low-income communities to identify support for unexpected supply and final presentation needs.

     One of the largest barriers was the lack of time for individual programs, as well as getting on the calendar of decision makers. Be sure to consider non-project time challenges such as K–12 school academic testing and IRB review. When initiating a YEAH! club, adult leaders are encouraged to plan out the calendar of activities well in advance of desired meetings and to schedule those as early as possible.


     The YEAH! study was conducted with a small sample size, making it difficult to do detailed statistical analysis of survey data. This reduces the generalizability of the study and limits the study team’s ability to analyze data based on specific demographics like race, gender, or club location. To ensure scientific rigor, the research team followed strict data collection and interview methods. The team worked with a panel of adult leaders for validation to more accurately denote the optimal characteristics of leaders and groups, as well as the barriers and catalysts to youth advocacy programs.



     The YEAH! program is designed to allow for flexibility based on club location needs, but there are several ways to set the club up for positive outcomes. For adult leaders, it is best to work with leaders who show enthusiasm for the program and are well trained on the YEAH! program. They don’t need to have PSE/Physical Activity knowledge, but it is helpful if they partner with a local advocate who can supplement this knowledge. It is recommended that clubs have a well-established relationship between the adult leader and the youth to ensure time is spent on the program and not on building rapport. The optimal club size is 10 to 15 students. Clubs should have access to funds to support the adult leader for their time as well as for supplemental supplies, including food and T-shirts. It is recommended that there be buy-in at all levels, from the adult leader through the administration, to ensure support. For consistency, clubs work best with students who have consistent attendance. Finally, from the start of the program, it is recommended that adult leaders anticipate time challenges that may fall outside of the normal YEAH! program. While it is impossible to anticipate all challenges, following these best practices, as designed by a panel of experts, will set up YEAH! clubs and other youth advocacy programs for success.

Corresponding Author:

Nisha Botchwey, PhD, MCRP, MPH

Associate Professor

Georgia Institute of Technology

School of City and Regional Planning

245 4thStreet, NW

Atlanta, GA 30313


Nisha Botchwey

L. Katie OConnell


This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License.


Suggested citation (APA 7th edition): Botchwey N., L. OConnell, L.K., Bryan, K. & Ricks, T. (2021).  Youth Advocacy Programs: Lessons From YEAH! Adult Leaders Evaluation Study. Journal of Healthy Eating and Active Living, 1(2), 41-52.


Author Contributions

Conceptualization, N.B. and L.K.O.; Methodology, N.B. and L.K.O.; Investigation, N.B. and L.K.O.; Writing—Original Draft, N.B., L.K.O., K.B., T.R.; Writing—Review & Editing, N.B., L.K.O., K.B., T.R., Funding Acquisition, N.B.; Resources, N.B.; Supervision, N.B.


We would like to acknowledge and thank all of the adult leaders and youth participants who completed the YEAH! program.


This work was supported by a grant from the Robert Wood Johnson Foundation as part of the Physical Activity Research Center (PARC). The funder had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Human Subjects

The Institutional Review Board at the Georgia Institute of Technology approved this study, Protocol H16465.



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