Context: Authentic youth engagement is widely recognized as an efficacious strategy to promote adolescent health. Program: The Providers and Teens Communicating for Health (PATCH) Youth Advocacy Fellowship was created to support Wisconsin's Adolescent Health Program. It strives to bring youth voice to the forefront of adolescent health conversations while also providing young people the knowledge, skills, and opportunities to thrive into adulthood. Implementation: The Fellowship hires and trains Wisconsin youth, aged 12 to 21 years, to be a part of community-and state-based adolescent health conversations. Youth meet regularly as a team for ongoing enrichment and are provided opportunities to consult on adolescent-focused projects and initiatives. They are also responsible for independently completing an advocacy learning series, which culminates in an advocacy plan on a topic of personal interest. The Fellowship has been implemented as an extended 9-month program, as well as an expedited 8-week pilot. Evaluation: An evaluation was conducted to compare the 8-week pilot (summer 2018) with 51 youth and the sequential 9-month Fellowship (2018-2019) with 12 youth. Based on the quantitative analysis of 2 programmatic evaluations (posttraining and postprogram), both program models showed success. Yet, there were distinct differences among self-reported youth outcomes as well as depth and extent of engagement. Across all 14 domains, the 9-month cohort demonstrated consistently higher mean scores. Half of the domains (7) showed statistically significant differences. Discussion: When considering youth engagement, it is important for practitioners to determine the goals, needs, capacity, and resources of both youth and the organization. Engaging youth for shorter-term commitments may serve as an important health education strategy, providing youth important knowledge and skills. Yet, engaging youth for extended periods of time may result in more meaningful engagement, fruitful projects, and substantial changes in positive youth development.