Lisa Wegner

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.

Health Wise South Africa: Development of a Life Skills Curriculum for Young Adults

Abstract The purpose of this paper is to describe the development of an international collaborative effort that aims to reduce risky behavior (e.g., substance use, risky sexual behavior) that leads to outcomes such as HIV/AIDs, pregnancy, and addictions among a sample of South African youth. Because many of these risky behaviors occur in free time, a major part of the effort was leisure education to promote positive use of free time. The program described has been pilot tested and is currently underway as a larger-scale, randomized trial in the Province of the Western Cape in South Africa. This paper describes the conceptualization and revision of the HealthWise curriculum, working with the Western Cape Education Department, and the on-going randomized trial.

Leisure boredom and substance use among high school students in South Africa.

The purpose of this study was to determine the extent of leisure boredom, and investigate the relationship between leisure boredom, substance use and demographic variables among high school students in Cape Town, South Africa. 621 students from 39 high schools selected through a multistage cluster sampling procedure completed a questionnaire which measured substance use and demographic information, and included the Leisure Boredom Scale (LBS). Using generalized estimating equation models, leisure boredom was modeled on the demographic variables, and substance use indicators on leisure boredom. Although no significant association between leisure boredom and substance use was found, girls reported significantly higher leisure boredom than did boys. Also, Black and Colored students reported significantly higher leisure boredom than White students. This finding may be partly attributed to socio-economic status, as race is still a strong indicator for socio-economic status in South Africa. The findings imply that there is a need for leisure education programs for adolescents which are developmentally and socio-culturally appropriate.

A prospective longitudinal model of substance use onset among South African adolescents.

Substance use onset among Colored adolescents between eighth and ninth grades in an urban area of Cape Town, South Africa was examined using latent transition analysis. Longitudinal self-report data regarding substance use (N= 1118, 50.9% female) were collected in 2004 and 2005. Results indicated that the pattern of onset was similar across genders; adolescents first tried either alcohol or cigarettes, followed by both, then dagga (cannabis), and then inhalants. The prevalence of lifetime cigarette use was slightly greater for females; dagga (cannabis) and inhalant use were greater for males. The similarity of developmental onset in the current sample to previous international work supports the promise of adapting prevention programs across contexts. The studys limitations are noted.

Leisure boredom and adolescent risk behaviour: a systematic literature review.

There has been very little research investigating leisure boredom and risk behaviour among adolescents in South Africa. A systematic review of literature was conducted to synthesise current knowledge within the field of leisure boredom and risk behaviour among adolescents. An online and a hand search for relevant articles were conducted using keywords. This resulted in the retrieval of 25 articles that met the inclusion criteria. It was evident that the experience of leisure boredom is influenced by a variety of different factors, not least of which is the environment or context within which adolescents are situated. A key finding was how few studies have focussed on leisure boredom and risk behaviour in adolescents, particularly in the developing world. Also, gaps in the knowledge basis were identified, thus providing direction for future research. The review focuses attention on leisure boredom as a factor contributing to risk behaviour in adolescents. Expanding knowledge in this area is useful for individuals and organisations concerned with adolescent health, education and development.

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.

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.

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.