Designing their Own Story: A Meta-Ethnography of Health Promotion Among Adolescents with Parental Substance Use Problems

Aims: Children and adolescents living with parental substance use problems (PSUP) are at potential risk of developing cognitive, behavioral, psychosocial and emotional difficulties affecting their health. However, little is known about how they themselves understand and promote their own health and well-being. This meta-ethnography aims to integrate and synthesize qualitative studies that have explored - from a salutogenic health-promoting perspective - how adolescents living with PSUP express health promotion and well-being, focusing on resources for positive health. Methods: The seven iterative phases by Noblit and Hare were followed. Systematic literature searches yielded 13 articles. Results: Designing their own story" was identified as an overarching metaphor accentuated by three main themes that we named: (1) "controlling before opening up"; (2) "choosing trusted support"; and (3) "learning for life". The overarching metaphor symbolizes how adolescents living with PSUP demonstrate agency in a stressful life situation, expressing a sense of control in everyday life and actively choosing whom to involve for support. Conclusions: Supplementing protection and prevention, a different view on narrative of adolescents living with PSUP emerges in the conceptual framework of salutary health promotion. When support is offered, this can inform professionals, service providers and policymakers about the significance of acknowledging and exploring the resources within the adolescents themselves and in their environments. Further research is needed to gain a broader and deeper understanding of how to support adolescents living with PSUP in a health-promoting direction, recognizing their potential to improve their health and well-being in their stressful and challenging life situation.