In this study, we aimed to explore how adolescents experience co-creating health promotion measures in four municipalities in Norway. We applied a qualitative design with group interviews (n = 9) among forty-nine adolescents participating in projects related to ‘Program for Public Health Work in Municipalities’ (2017–2027). Additionally, participatory observation of project activities was performed in two municipalities. We conducted a data-driven thematic analysis to analyse the data. The most prominent finding was that the adolescents often expressed feelings of resignation and dissatisfaction. Furthermore, we identified four underlying reasons behind the resignation and dissatisfaction. These were related to long project duration, the experience of not having an influence on the outcome, promises not being kept and lack of information and continuity in their participation. Essential features for meaningful participation were not present, and the findings suggest that the municipalities had limited success in facilitating participation that adolescents perceived as meaningful. The findings indicate that despite good intentions and policies supporting children’s participation, effort placed on implementing such policies in practice is still needed. This study adds knowledge regarding important factors to consider when involving young people in co-creating measures to avoid unintended effects such as disempowering adolescents.

Aim: To explore what municipal actors consider as inhibiting and promoting adolescents’ involvement in public health measures in municipalities. Methods: A qualitative study with individual and group interviews was conducted among 15 municipal actors who were central in involving adolescents from five Norwegian municipalities participating in the National Programme for Public Health Work in Municipalities (2017–2027). In addition, participatory observation of project activities was done in two municipalities. A data-driven thematic analysis was applied to analyse data. Results: In the analysis, we developed four themes, including both inhibitors and promoters for adolescent involvement: (a) Timeframe challenges in adolescent involvement; (b) Lack of necessary knowledge and awareness among adolescents; (c) Limited competencies and resources in the project groups; and (d) Facilitators’ attitudes on and perceptions of adolescent involvement. Conclusions: This study reports factors that are important to consider when facilitating involvement processes with young people. Findings suggest that further work should be done to ensure involvement of adolescents in public health measures in municipalities, and actors involving adolescents must be provided with competence and resources to ensure such participation.

It is well-known that the social environment in which children and adolescents live and grow has an impact on their mental wellbeing, though the relative importance of different social contexts may vary. In the present study, we used data from the Young-HUNT4 survey in Norway (n = 8066, age range 13 to 19 years). Linear regression models were used to investigate the relative importance of family cohesion, school climate, and number of leisure activities on psychological distress, loneliness, and life dissatisfaction among Norwegian adolescents by investigating whether the strength of association varied across social contexts for the three outcomes. Additionally, analyses were stratified by parental education to investigate whether the relative importance of family, school, and leisure activities differed between adolescents from families with low and high parental education. We found that family cohesion showed the strongest association with all three outcomes, followed by the school climate and number of leisure activities. Generally, these associations did not vary significantly between low and high parental education. Understanding the relative importance of social contexts may be essential in developing effective public health policies and interventions in preventing mental ill health and promoting mental wellbeing in children and adolescents.

The Norwegian Public Health Act (PHA) mandates municipalities to integrate a systematic, knowledge-based, cross-sectoral approach aimed at levelling the social gradient in health. This study aimed to describe and analyse how the intentions of the PHA are addressed in municipal plans and project-planning documents. A document analysis of municipal plans and project documents extracted from four municipalities in Central Norway was employed and complemented with deductive, qualitative content analysis. Findings indicate awareness of public health work as a whole-of-municipality responsibility. Systematic knowledge-based processes that make use of relevant data in planning and decision-making processes are described across municipality projects and plans. Multisectoral working groups are set up at a project level; however, opportunities for further improvements arise in respect to the anchor of these structures and systematic knowledge-based working procedures in the wider municipal context. Public health process aims (systematic knowledge-based approach, cross-sectoral governance) receive more attention than outcome aims (health equity) in both program documents and municipal plans. Only very rarely does the document hold operationalizations of how to achieve health equity. As such, effort placed on cross-administrative levels and sectors to promote structures for health equity is still needed.