Abstract
BACKGROUND: Childhood and adolescence (0-19 years) is a critical time for laying the foundations for life-long good health and well-being. To support the development of the new World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) European Regional Strategy for Child and Adolescent Health and Well-being, we undertook a European Region-wide survey of representatives of Member States (MS), child health professionals (CHPs), and adolescents to determine priority areas for action. METHODS: Stakeholders participated via structured online questionnaires in which they rated a series of problem statements concerning child and adolescent health and well-being using a five-point scale of concern. We performed descriptive analyses and calculated a regional average rating of concern for each problem statement by stakeholder group to enable them to be ranked. RESULTS: We received responses from 40 MS representatives, 204 CHPs, and 2789 adolescents. The burden of mental health, access to mental health services, excessive screen time, problematic social media use and tobacco and nicotine product use emerged as top ten priorities across all three groups. Adolescents expressed a distinct set of priorities that nonetheless align with broader concerns, such as barriers to health care access and violence against children, including the perceived failure of health professionals to identify and act on such cases in time. Concern ratings for some problem statements varied significantly between countries, highlighting the diversity of challenges across the Region. We presented the survey findings during MS consultations to inform strategy development and ensure the content reflected the perspectives of all stakeholders. CONCLUSIONS: The inclusive consultation approach to strategy development ensured that MS priorities, the expertise of CHPs, and the voices of adolescents themselves enter into the core of ambitions to achieve 'a healthy start for a healthy life'.