You have been reading Lissa, a graphic narrative written by Sherine Hamdy and Coleman Nye and illustrated by Sarula Bao and Caroline Brewer; the title is a colloquial Arabic term meaning “not yet” or “there’s still time.” The book tells the story of two friends, Layla and Anna, as they confront personal medical decisions, family relations, and health inequalities in the United States and revolutionary Egypt. 

The following questions are designed to help you reflect on the major themes raised by the book.Choose 3-4 of the following questions and answer each in about 100 words each: 

Anna and Layla are both involved in making critical health-related decisions that the other doesn’t understand. Why does Layla think it’s bizarre for Anna to “treat a disease that she does not have”? Why can’t Anna understand the reluctance of Layla’s family to consider a transplant for Abu Hassan?

In one scene, a patient tells Layla that a kidney transplant doesn’t necessarily work when there are so many elements of the food, water, and air that continue to make a person sick. What are some of the factors identified in the book that produce toxic ecologies of both cancer and kidney disease?

In what is known as “Graphic Medicine,” comics are increasingly used in medical education to teach professional ethics and observational skills, to foster empathy among providers, and to reinforce how healing involves more than treating a body. Do you think Lissa is successful in achieving these goals? Why or why not? What do you think medical, nursing, or other students in the health profession could gain from reading this work?

Identify (citing a page number) and discuss a specific moment or scene in the book that you found to be memorable, frustrating, or inspiring. Why was this section significant to you?

https://drive.google.com/file/d/1xARb2_3FjwQSlycVNOLzjOWAZ-b8nYQ7/view

Concern about the growth in adolescent problem behaviours (e.g. delinquency, drug use) has led to increased interest in positive youth development, and a surge in funding for ‘after school programs.’ We evaluate the potential of youth sport programs to foster positive development, while decreasing the risk of problem behaviours. Literature on the positive and negative outcomes of youth sport is presented. We propose that youth sport programs actively work to assure positive outcomes through developmentally appropriate designs and supportive child – adult (parent/coach) relationships. We also highlight the importance of sport programs built on developmental assets (Benson, 1997) and appropriate setting features (National Research Council and Institute of Medicine, 2002) in bringing about the five ‘C’s of positive development (competence, confidence, character, connections, and compassion/caring: Lerner et al., 2000). An applied sport-programming model, which highlights the important roles of policy-makers, sport organizations, coaches and parents in fostering positive youth development is presented as a starting point for further applied and theoretical research.

Keywords: Program design; Developmental assets; Sport participation; Sport dropout; Coaches; Parents; Sport outcomes

There is growing concern about the future of today’s youth. Concerns stem from an increase in adolescent problem behaviours (delinquency, drug use), coupled with changing social forces (both parents working, single parent homes, increases in youth unsupervized time at home alone). Over the past two decades, researchers and practitioners have taken a ‘deficit reduction’ approach to youth behaviour pro- blems (Benson, 1997). Most often, a problem has been identified (e.g. obesity), and funding has been provided so that researchers could examine strategies and develop interventions to reduce or eliminate the problem. Unfortunately, this approach is costly, and intervention programs have only demonstrated moderate success (Benson, 1997). Further, Pittman (1991) has pointed out that problem-free

Physical Education and Sport Pedagogy Vol. 10, No. 1, February 2005, pp. 19 – 40

!Corresponding author: School of Physical and Health Education, Queen’s University, Kingston, ON, K7L 3N6, Canada. Email: jesslfraser@hotmail.com

ISSN 1740-8989 (print); ISSN 1742-5786 (online)=05=10019 – 22 # 2005 The Physical Education Association of the United Kingdom DOI: 10.1080=1740898042000334890

youth are not necessarily fully prepared: youth free of drugs, alcohol use and crime are not necessarily prepared to productively engage in society. Recent theoretical and applied research proposes that an ‘asset building paradigm’ hold equal weight to a ‘deficit reduction paradigm’; that focus be placed on promoting positive youth development as well as reducing problem behaviours in youth (Benson, 1997). Accompanying this paradigm shift is a vision of fully able children, eager to explore, gain competence, and make a difference in society (Damon, 2004). It has been suggested that youths’ potential needs only to be fostered appropriately for optimal development to occur (Peterson, 2004).

However, this vision may initially appear idealistic. One does not need to look far to see the inequities in today’s society. Socio-economic status, race, gender, and environmental factors can all limit youths’ opportunities. For example, youth sport programs are becoming increasingly expensive, competitive and elitist. As De Knop et al. (1996) suggest, cultures around the world are experiencing the insti- tutionalization of youth sports, which is leading programs to become increasingly inaccessible to many families. While Hellison and Cutforth (1997) emphasize the vital role youth programming can play in facilitating the healthy development of youth at risk, they suggest that organizations serving inner-city children and youth are overburdened and underfunded.

In this paper, we examine the youth sport and positive youth development bodies of literature, and propose an applied sport-programming model of positive youth development. The model emphasizes the vital role of policy-makers in assuring the accessibility of youth sport programs to all youths, regardless of socio-economic status, race, culture, ethnicity, or gender. The model also highlights the role of sport organizations in designing programs that develop better people, rather than simply skilled individuals. Finally, the model proposes the critical role of coaches in implementing programs on a day-to-day basis, and of parents in supporting their child throughout their involvement in sport programs. At both the sport programming and implementation levels the model highlights pedagogical issues in the areas of general subject matter, specific learning settings, and instructional methods.

Positive youth development

Numerous definitions of optimal youth development have emerged among research- ers. Hamilton et al. (2004) suggest that optimal development in youth ‘enables indi- viduals to lead a healthy, satisfying, and productive life as youth, and later as adults, because they gain the competence to earn a living, to engage in civic activities, to nurture others, and to participate in social relations and cultural activities’ (p. 3). It has been suggested that through optimal development, ‘good youth’ emerge. ‘Good youth’ are said to experience more positive than negative affect, to be satisfied with their life as it has been lived, to recognize what they do well and use their strengths to fulfill pursuits, and to be contributing members of society (Peterson, 2004). The question of exactly how youths’ potential is fostered through positive development, and how resulting ‘good youth’ emerge in society is only beginning to be addressed.

20 J. L. Fraser-Thomas et al.

The National Research Council and Institute of Medicine (NRCIM, 2002) has outlined four main areas of youth development: physical, intellectual, psychologi- cal/emotional, and social. For each development area, several corresponding assets are suggested, that facilitate positive youth development. For example, good health habits and good health risk management skills are assets facilitating positive physical development. Knowledge of essential life skills, vocational skills, decision-making skills, and critical reasoning skills contribute to positive intellectual development. Numerous assets contribute to youths’ psychological and emotional development including mental health, positive self-regard, coping skills, conflict resolution skills, mastery motivation, a sense of autonomy, moral character, and confidence. Finally, assets facilitating youths’ social development include connectedness with parents, peers, and other adults, a sense of a social place, an ability to navigate in diverse con- texts, and an attachment to pro-social or conventional institutions. The NRCIM (2002) outlines eight features of settings that are most likely to foster these positive developmental assets (Table 1). Hellison and Cutforth’s (1997) eleven key criteria of ‘state-of-the-art’ extended day programs are strikingly similar; however, they also highlight the importance of keeping program numbers small, focusing on the whole person, respecting individuality, empowering youth, encouraging courageous and persistent leadership, treating youth as resources to be developed, and helping youth envision their futures.

Benson and colleagues (Benson, 1997; Benson, Leffert, Scales, & Blyth, 1998; Leffert et al., 1998; Scales & Leffert, 1999; Scales et al., 2000) have also developed a list of developmental outcomes based on scientific literature and practitioners’ wisdom. The Search Institute’s 40 assets are divided into two broad categories (external and internal assets), and further divided into eight sub-categories (Table 2). Despite youths’ differing needs, interests, and environments, Benson and colleagues have found a trend towards asset depletion in all American youth (Benson, 1997). Race, ethnicity, and family income do not appear to influence asset development, while gender and family composition appear to have only a slight influence on asset development (assets are fewer in boys and in single parent families). Benson and colleagues’ research has consistently demonstrated three powerful roles of developmental assets: protection, enhancement, and resiliency. For example, developmental assets play a protective role because the more assets

Table 1. Features of positive development settings (NRCIM, 2002)

1. Physical and psychological safety 2. Appropriate structure 3. Supportive relationships 4. Opportunities to belong 5. Positive social norms 6. Support for efficacy and mattering 7. Opportunities for skill building 8. Integration of family, school, and community efforts

Positive youth development through sport 21 youth have, the less likely they are to engage in high-risk behaviours such as alcohol, tobacco, and drug use. Youth high in developmental assets are also less likely to be depressed or suicidal, and less likely to demonstrate antisocial behaviours, violence, and school problems. Second, developmental assets play an enhancement role, as youth who demonstrate more developmental assets are also more likely to ‘thrive’, meaning they are more likely to be successful in school, show leadership, volunteer