Healthy Living: does “the messenger” make a difference? Evidence from an experiment of co-production with teenagers in Tuscany

Introduction/Objectives: Health is per definition co-produced: lifestyle habits in early life stages can determine health and quality of life in adulthood. The prevention of chronic diseases is especially important during adolescence. However, the prevalence of obesity among teenagers reveals that often, by communicating to young people with downstream interventions and/or appointing adults as advice delivers, public campaigns stumble in promoting health among youth. What if the adolescents become first partners, then main actors of these interventions? Can an action of lifestyle promotion based on a co-production process be effective in improving health-related behaviours of adolescents? In this paper, we present the results of working together with a group of students, involved in a large-scale participatory survey, and assigning to them the responsibility of informing their peers about healthy lifestyles. Methods: 49 16/17-year-old Tuscan students were involved in the two-phases project beFood. In the initial phase, during a mandatory training course, students actively participated in discussions with experts and peers as well as practical activities aimed at increasing their knowledge/awareness and at “learning by doing”, at identifying and improving their skills to hold and communicate healthy conducts, and at becoming partners in the activities of lifestyle promotion. The teenagers were also involved in research co-production, which included the validation of a questionnaire thought to investigate lifestyles, and in the development of a webAPP by means of which they personally conducted the survey. In the second phase, they had the responsibility of informing their peers on healthy behaviours, also delivering the questionnaire. Results: The process of co-production proved to be fruitful in two respects: a large number of responses (n=5029) was gathered in a peer-to-peer approach and, more importantly, the authors could observe how the work-together and the self-activation produced fertile terrain for the evolution of the target group into a trained class of instructors. This experience demonstrated that, if adequately supported, message recipients can become effective messengers and testimonials of health-related information. Conclusions: An effective strategy of health promotion and prevention should be based on a direct involvement, activation and empowerment of individuals, in a co-production process which sees people as main actors and partners, not as targets. Healthcare professionals should support (younger) people in actively undertaking learning processes that may lead to the adoption of healthy behaviours and to their sponsorship among peers. Finally, in the wake of this outcome, the authors suggest an approach to health promotion policy-making based on two-way communication processes, a shared definition of solution and a true participation of people in the delivery of the same strategies