Edward A. Smith

Inconsistent Reports of Sexual Intercourse Among South African High School Students

PURPOSE This study aims to describe patterns of inconsistent reports of sexual intercourse among a sample of South African adolescents. METHODS Consistency of reported lifetime sexual intercourse was assessed using five semiannual waves of data. Odds ratios related inconsistent reporting to demographic variables and potential indicators of general and risk-behavior-specific reliability problems. RESULTS Of the sexually active participants in the sample, nearly 40% reported being virgins after sexual activity had been reported at an earlier assessment. Inconsistent reporting could not be predicted by gender or race or by general indicators of poor reliability (inconsistent reporting of gender and birth year). However individuals with inconsistent reports of sexual intercourse were more likely to be inconsistent reporters of substance use. CONCLUSIONS These results suggest that researchers need to undertake efforts to deal specifically with inconsistent risk behavior data. These may include modification of data collection procedures and use of statistical methodologies that can account for response inconsistencies.

Substance Use and Sexual Risk Prevention in Cape Town, South Africa: An Evaluation of the HealthWise Program

Sexual behavior and substance use represent major threats to the health and well-being of South African adolescents, especially in light of the high prevalence of HIV infection in this population. However, there is currently a lack of evidence-based school programs designed to address health risk behaviors. The current study details the evaluation of HealthWise South Africa, a leisure, life skills, and sexuality education intervention for eighth and ninth grade students. We hypothesized that, compared to controls, HealthWise participants would have delayed sexual initiation, reduced rates of current sexual activity, increased use of and perceived access to condoms, and lower rates of lifetime and past use of multiple substances. Longitudinal data were analyzed using logistic regression of multiply imputed data. Results indicate that HealthWise was effective in increasing the perception of condom availability for both genders (OR = 1.6). As compared to HealthWise participants, control participants also had steeper increases in recent and heavy use of alcohol (OR = 1.4 [95% C.I. = 1.1–1.8], 1.6 [1.2–2.2], respectively) and recent and heavy cigarette use (OR = 1.4 [1.1–1.7], 1.4 [1.1–1.8], respectively). There were also several significant gender by treatment interactions, which are discussed. These results suggest that HealthWise is a promising approach to reducing multiple health risk behaviors among the population of school-going South African adolescents.

Leisure as a Context for Youth Development and Delinquency Prevention

This article highlights the importance of leisure as a context for human development as well as for prevention of risky behaviour, including crime and delinquency.We offer a brief review and synthesis of current criminology literature that examines leisure activity and then describe leisure research that may provide additional insight into why leisure may be an important context for understanding and preventing delinquent behaviour.We end with a brief description of an intervention that teaches youth to make healthy decisions in their leisure and describe a set of post hoc analyses from a data set from 628 rural youth in the United States used to evaluate the leisure based intervention. Although the data we report were not collected to examine delinquent behaviour, we tentatively conclude leisure-related variables can serve as risk and protective factors to property damage and by extension other delinquent behaviours. We suggest that helping youth become more intrinsically motivated by having goal-oriented leisure pursuits and decreasing levels of a motivation, learning to overcome peer pressure, and becoming more aware of leisure opportunities may reduce the risk of damaging property. Additionally, having parents who are aware of leisure interests, activities and friends is also a protective factor.We also found evidence to suggest that some form of leisure education intervention may be effective in preventing delinquent acts.

The Effect of Active Parental Consent On the Ability to Generalize the Results of an Alcohol, Tobacco, and Other Drug Prevention Trial to Rural Adolescents

The authors report the effect of active parental consent on sample bias among rural seventh graders participating in a drug abuse prevention trial. Students obtaining active consent from their parents to complete the survey were of higher academic standing, missed fewer days of school, and were less likely to participate in the special education program at their school as compared to students who did not return a parental consent form. However, students with consent were not significantly different from students whose parents actively declined. The sample obtained under active parental consent represents students less at risk for problem behaviors than would have been obtained under passive consent procedures.

Predicting substance use behavior among South African adolescents: The role of leisure experiences across time.

Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents’ substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.

Influencing adolescent leisure motivation: intervention effects of HealthWise South Africa.

Abstract This study investigates changes in self-reported motivation for leisure due to participation in Health Wise, a high school curriculum aimed at decreasing risk behavior and promoting health behavior. Participants were 2,193 mixed race adolescents (M = 14 years old) from 9 schools (4 intervention, 5 control) near Cape Town, South Africa. Students in the Health Wise school with the greatest involvement in teacher training and implementation fidelity reported increased intrinsic and identified motivation and decreased introjected motivation and amotivation compared to students in control schools. These results point to the potential for intervention programming to influence leisure motivation among adolescents in South Africa and represent a first step toward identifying leisure motivation as a mediator of program effects.

Results of a 3-Year Study of Two Methods of Delivery of Life Skills Training

Model programs and standards for substance abuse prevention have been identified by a number of federal agencies. The study reported here assessed two methods of delivery of one such program, Life Skills Training (LST), implemented in nine rural disadvantaged school districts. The results indicate that neither standard LST nor an infused LST delivery method was found effective for the entire sample, although some encouraging results were foundforthe females in the study. This study, conductedbyresearchersindependentof the LST program, is useful for school decision makers in determining what programs are most effective with which groups. It includedall studentswith parentalpermission,controllingforprioruse levels, unlike some previous LST studies. The results of the program, as implemented by regular classroom teachers, reflect many issues relevant to recruitment, training, implementation, adaptation, and institutionalization of prevention programming.

Leisure constraints for adolescents in Cape Town, South Africa: a qualitative study

This study identified leisure constraints, constraints negotiation strategies, and their relative frequencies among 114 high school students from one under-resourced area of South Africa. Through focus group discussions, participants identified intrapersonal, interpersonal, structural, and sociocultural constraints to leisure, suggesting some degree of universality in this previously documented typology. Intrapersonal constraints were mentioned most often. Whereas participants readily identified ways to overcome interpersonal and structural constraints, strategies for overcoming intrapersonal and sociocultural constraints were not mentioned frequently, suggesting a potential need to help adolescents identify and employ these types of strategies.

Effects of HealthWise South Africa on Condom Use Self-efficacy

The present study examines the impact of the HealthWise South Africa prevention intervention on condom use self-efficacy. Students from the Cape Town area were assessed at the beginning and end of each school year, beginning in the 8th grade and ending in the 11th. The intervention was delivered in 12 lessons during the 8th grade and 6 lessons during the 9th grade. Using three-level multiphase mixed-effects models, we found that HealthWise had a statistically significant positive effect on condom use self-efficacy, although effects differed for boys and girls. HealthWise had an effect during the first phase of the intervention (8th grade) for girls and during the second phase (9th grade) for boys. We speculate that the gender differences occur because the 8th grade lessons of the intervention taught skills such as discussion, decision making, and negotiation, which may be more salient to girls, and a 9th grade lesson explicitly focused on condom use within the context of sexual relationships, which may have been more salient to boys.

Was Bob Seger Right? Relation Between Boredom in Leisure and [Risky] Sex.

This article examines the association between boredom in leisure and risky sexual behaviors among South African youth (N = 1695) using longitudinal data. We hypothesized that youth who were higher on boredom in leisure at the end of ninth grade would be more likely to report engaging in risky sexual behaviors at the beginning of tenth grade. Chi-square results indicate youth, especially male youth who experience high levels of leisure boredom in ninth grade, are more likely to engage in risky sexual behaviors in tenth grade. These findings have implications for prevention programs that aim to delay sexual initiation, reduce sexual risk behaviors, and decrease the transmission of HIV and AIDS. The findings support the need for additional research on how the reduction of leisure boredom may be a potential target for reducing sexual risk among youth.