Adolescent Health Programming: A Systematic Review and Proposed Solution

Adolescence is a time of dramatic development emotionally, mentally, cognitively, socially, and relationally. The importance of relational and social development during adolescence and young adulthood (13-23) is a pivotal time impacting a plethora of health outcomes. However, traditional approaches to relationship skills in school-based programs have focused primarily on risky sexual behavior and partner violence neglecting the importance of whole health wellness, including emotional, relational, and mental well-being. The current study presents findings from a systematic literature review of school-based adolescent health programs. Results indicate that many programs are designed with outcomes to prevent (1) unplanned or teenage pregnancies (2) sexually transmitted diseases (3) violent or abusive relationships. While comprehensive sexual education programs during the last 20 years have shown improvements in reduced health outcomes of STIs and unplanned pregnancies; programs have wide diversity in fidelity, implementation, and success. Further, programs typically minimize and lack critical components of education and developmental support for healthy relationship skills outside of intimate relationships. Despite current Family Life Education Standards in Virginia, key outcomes such as STI prevalence, dating violence, and teen pregnancies continue to be a growing problem in Lynchburg City, Virginia. In response to the 2025-2027 Lynchburg needs assessment that indicated teen birth rates and STIs remain a significant public health problem and are an increased concern in the community; a recommendation is proposed for a new after-school program. The proposed program, Rooted, is built from the evidence-based strategies and qualities of current school-based programs that have documented success, and is supplemented with a peer-mentoring program that expands to building resilient networks during a period of radical change. The recommended program emphasizes future-oriented decision-making, building overall relationships skills, self-regulation, emotional intelligence, conflict resolution, life-skills, and personal responsibility across all forms of relationships.