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Erschienen in: Prevention Science 4/2008

01.12.2008

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

verfasst von: Edward A. Smith, Lori-Ann Palen, Linda L. Caldwell, Alan J. Flisher, John W. Graham, Catherine Mathews, Lisa Wegner, Tania Vergnani

Erschienen in: Prevention Science | Ausgabe 4/2008

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Abstract

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.
Literatur
Zurück zum Zitat Aarø, L. E., Flisher, A. J., Kaaya, S., Onya, H., Fuglesang, M., Klepp, K. I., et al. (2006). Promoting sexual and reproductive health in early adolescence in South Africa and Tanzania: Development of a theory- and evidence-based intervention programme. Scandinavian Journal of Public Health, 34, 150–158. doi:10.1080/14034940510032356.PubMedCrossRef Aarø, L. E., Flisher, A. J., Kaaya, S., Onya, H., Fuglesang, M., Klepp, K. I., et al. (2006). Promoting sexual and reproductive health in early adolescence in South Africa and Tanzania: Development of a theory- and evidence-based intervention programme. Scandinavian Journal of Public Health, 34, 150–158. doi:10.​1080/​1403494051003235​6.PubMedCrossRef
Zurück zum Zitat Caldwell, L. L. (2004). TimeWise: Taking charge of free time. Scotts Valley, CA: ETR Associates. Caldwell, L. L. (2004). TimeWise: Taking charge of free time. Scotts Valley, CA: ETR Associates.
Zurück zum Zitat Caldwell, L. L., Baldwin, C. K., Walls, T., & Smith, E. A. (2004). Preliminary effects of a leisure education program to promote healthy use of free time among middle school adolescents. Journal of Leisure Research, 36, 310–335. Caldwell, L. L., Baldwin, C. K., Walls, T., & Smith, E. A. (2004). Preliminary effects of a leisure education program to promote healthy use of free time among middle school adolescents. Journal of Leisure Research, 36, 310–335.
Zurück zum Zitat Caldwell, L. L., Smith, E. A., Wegner, L., Vergnani, T., Mpofu, E., Flisher, A. J., et al. (2004). HealthWise South Africa: Development of a life skills curriculum for young adults. World Leisure, 3, 4–17. Caldwell, L. L., Smith, E. A., Wegner, L., Vergnani, T., Mpofu, E., Flisher, A. J., et al. (2004). HealthWise South Africa: Development of a life skills curriculum for young adults. World Leisure, 3, 4–17.
Zurück zum Zitat Carnegie Council on Adolescent Development. (1992). A matter of time: Risk and opportunity in the nonschool hours. New York: Carnegie Corporation of New York. Carnegie Council on Adolescent Development. (1992). A matter of time: Risk and opportunity in the nonschool hours. New York: Carnegie Corporation of New York.
Zurück zum Zitat Coffman, D. L., Smith, E. A., & Caldwell, L. L. (2008). The effects of the HealthWise intervention on condom use knowledge. Paper presented at the 16th Annual Meeting of the Society for Prevention Research, San Francisco, CA., May Coffman, D. L., Smith, E. A., & Caldwell, L. L. (2008). The effects of the HealthWise intervention on condom use knowledge. Paper presented at the 16th Annual Meeting of the Society for Prevention Research, San Francisco, CA., May
Zurück zum Zitat Collins, L. M., Schafer, J. L., & Kam, C. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330–351.PubMedCrossRef Collins, L. M., Schafer, J. L., & Kam, C. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330–351.PubMedCrossRef
Zurück zum Zitat Darroch, J. E., Singh, S., & Frost, J. J. (2001). Differences in teenage pregnancy rates among five developed countries: The roles of sexual activity and contraceptive use. Perspectives on Sexual and Reproductive Health, 33, 244–281. Darroch, J. E., Singh, S., & Frost, J. J. (2001). Differences in teenage pregnancy rates among five developed countries: The roles of sexual activity and contraceptive use. Perspectives on Sexual and Reproductive Health, 33, 244–281.
Zurück zum Zitat Flay, B. R. (2002). Positive youth development requires comprehensive health promotion programs. American Journal of Health Behavior, 26, 407–424.PubMed Flay, B. R. (2002). Positive youth development requires comprehensive health promotion programs. American Journal of Health Behavior, 26, 407–424.PubMed
Zurück zum Zitat Flisher, A. J., Ziervogel, C. F., Chalton, D. O., Leger, P. H., & Robertson, B. A. (1996). Risk-taking behaviour of Cape Peninsula high-school students: Part IX. Evidence for a syndrome of adolescent risk behaviour. South African Medical Journal, 86, 1090–1093.PubMed Flisher, A. J., Ziervogel, C. F., Chalton, D. O., Leger, P. H., & Robertson, B. A. (1996). Risk-taking behaviour of Cape Peninsula high-school students: Part IX. Evidence for a syndrome of adolescent risk behaviour. South African Medical Journal, 86, 1090–1093.PubMed
Zurück zum Zitat Ford, D. H., & Lerner, R. M. (1992). Developmental systems theory: An integrative approach. Thousand Oaks, CA: Sage, 259. Ford, D. H., & Lerner, R. M. (1992). Developmental systems theory: An integrative approach. Thousand Oaks, CA: Sage, 259.
Zurück zum Zitat Graham, J. W. (in press). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60. Graham, J. W. (in press). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60.
Zurück zum Zitat Graham, J. W., Cumsille, P. E., & Elek-Fisk, E. (2003). Methods for handling missing data. In J. A. Schinka, & W. F. Velicer (Eds.), Research methods in psychology (pp. 87–114). Volume 2 of Handbook of Psychology (I. B. Weiner, Editor-in-Chief). New York: John Wiley & Sons. Graham, J. W., Cumsille, P. E., & Elek-Fisk, E. (2003). Methods for handling missing data. In J. A. Schinka, & W. F. Velicer (Eds.), Research methods in psychology (pp. 87–114). Volume 2 of Handbook of Psychology (I. B. Weiner, Editor-in-Chief). New York: John Wiley & Sons.
Zurück zum Zitat Guo, J., Chung, I. J., Hill, K. G., Hawkins, J., Catalano, R. F., & Abbott, R. D. (2002). Developmental relationships between adolescent substance use and risky sexual behavior in young adulthood. The Journal of Adolescent Health, 31, 354–362. doi:10.1016/S1054-139X(02)00402-0.PubMedCrossRef Guo, J., Chung, I. J., Hill, K. G., Hawkins, J., Catalano, R. F., & Abbott, R. D. (2002). Developmental relationships between adolescent substance use and risky sexual behavior in young adulthood. The Journal of Adolescent Health, 31, 354–362. doi:10.​1016/​S1054-139X(02)00402-0.PubMedCrossRef
Zurück zum Zitat Irby, M., & Tolman, J. (2002). Rethinking leisure time: Expanding opportunities for young people and communities. Washington, DC. Irby, M., & Tolman, J. (2002). Rethinking leisure time: Expanding opportunities for young people and communities. Washington, DC.
Zurück zum Zitat Kaaya, S. F., Mukoma, W., Flisher, A. J., & Klepp, K.-I. (2002). School-based sexual health interventions in Sub-Saharan Africa: A review. Social Dynamics, 28, 64–88, & 45. Kaaya, S. F., Mukoma, W., Flisher, A. J., & Klepp, K.-I. (2002). School-based sexual health interventions in Sub-Saharan Africa: A review. Social Dynamics, 28, 64–88, & 45.
Zurück zum Zitat Kelly, K., Parker, W., & Oyosi, S. (2001). Pathways to action: HIV/AIDS prevention, children and young people in South Africa: A literature review. Save the Children. Kelly, K., Parker, W., & Oyosi, S. (2001). Pathways to action: HIV/AIDS prevention, children and young people in South Africa: A literature review. Save the Children.
Zurück zum Zitat Kirby, D. (2001). Understanding what works and what doesn’t in reducing adolescent sexual risk-taking. Family Planning Perspectives, 33, 1–14. Kirby, D. (2001). Understanding what works and what doesn’t in reducing adolescent sexual risk-taking. Family Planning Perspectives, 33, 1–14.
Zurück zum Zitat Lerner, R. M., Freund, A. M., De Stefanis, I., & Habermas, T. (2001). Understanding developmental regulation in adolescence: The use of the Selection, Optimization, and Compensation model. Human Development, 44, 29–50. doi:10.1159/000057039.CrossRef Lerner, R. M., Freund, A. M., De Stefanis, I., & Habermas, T. (2001). Understanding developmental regulation in adolescence: The use of the Selection, Optimization, and Compensation model. Human Development, 44, 29–50. doi:10.​1159/​000057039.CrossRef
Zurück zum Zitat Mukoma, W., & Flisher, A. J. (2007). A systematic review of school-based AIDS prevention programmes in South Africa. In K.-I. Klepp, A. J. Flisher, & S. Kaaya (Eds.), Promoting adolescent sexual and reproductive health in eastern and southern Africa (pp. 267–287). Uppsala, Sweden: Nordic Africa Institute. Mukoma, W., & Flisher, A. J. (2007). A systematic review of school-based AIDS prevention programmes in South Africa. In K.-I. Klepp, A. J. Flisher, & S. Kaaya (Eds.), Promoting adolescent sexual and reproductive health in eastern and southern Africa (pp. 267–287). Uppsala, Sweden: Nordic Africa Institute.
Zurück zum Zitat Palen, L., Graham, J. W., Smith, E. A., Caldwell, L. L., Mathews, C., & Flisher, A. J. (2008). Rates of missing responses in personal digital assistant (PDA) versus paper assessments. Evaluation Review, 32, 257–272. doi:10.1177/0193841X07307829.PubMedCrossRef Palen, L., Graham, J. W., Smith, E. A., Caldwell, L. L., Mathews, C., & Flisher, A. J. (2008). Rates of missing responses in personal digital assistant (PDA) versus paper assessments. Evaluation Review, 32, 257–272. doi:10.​1177/​0193841X07307829​.PubMedCrossRef
Zurück zum Zitat Patrick, M. E., Collins, L. M., Smith, E. A., Caldwell, L. L., Flisher, A. J., & Wegner, L. A. (in press). Prospective longitudinal model of substance use onset among South African adolescents. Substance Use & Misuse. Patrick, M. E., Collins, L. M., Smith, E. A., Caldwell, L. L., Flisher, A. J., & Wegner, L. A. (in press). Prospective longitudinal model of substance use onset among South African adolescents. Substance Use & Misuse.
Zurück zum Zitat Reddy, S. P., Panday, S., Swart, D., Jinabhai, C. C., Amosun, S. L., James, S., et al. (2003). Umthenthe Uhlaba Usamila: The South African Youth Risk Behaviour Survey 2002. Cape Town: South African Medical Research Council. Reddy, S. P., Panday, S., Swart, D., Jinabhai, C. C., Amosun, S. L., James, S., et al. (2003). Umthenthe Uhlaba Usamila: The South African Youth Risk Behaviour Survey 2002. Cape Town: South African Medical Research Council.
Zurück zum Zitat Sahai, H., & Khurshid, A. (1996). Statistics in epidemiology: Methods, techniques, and applications. Boca Raton 1: CRC. Sahai, H., & Khurshid, A. (1996). Statistics in epidemiology: Methods, techniques, and applications. Boca Raton 1: CRC.
Zurück zum Zitat Selvin, S. (1996). Statistical analysis of epidemiologic data. New York: Oxford University Press. Selvin, S. (1996). Statistical analysis of epidemiologic data. New York: Oxford University Press.
Zurück zum Zitat Shisana, O., Rehle, T., Simbayi, L. C., Parker, W., Zuma, K., Bhana, A., et al. (2005). South African national HIV prevalence, HIV incidence, behaviour and communication survey, 2005. Cape Town: HSRC Press. Shisana, O., Rehle, T., Simbayi, L. C., Parker, W., Zuma, K., Bhana, A., et al. (2005). South African national HIV prevalence, HIV incidence, behaviour and communication survey, 2005. Cape Town: HSRC Press.
Zurück zum Zitat Silbereisen, R. K., & Todt, E. (1994). Adolescence: A matter of context. In R. K. Silbereisen, & E. Todt (Eds.), Adolescence in context: The interplay of family, schools, peers, and work in adjustment (pp. 3–21). New York: Springer. Silbereisen, R. K., & Todt, E. (1994). Adolescence: A matter of context. In R. K. Silbereisen, & E. Todt (Eds.), Adolescence in context: The interplay of family, schools, peers, and work in adjustment (pp. 3–21). New York: Springer.
Zurück zum Zitat Singh, S., Wulf, D., Samara, R., & Cuca, Y. P. (2000). Gender differences in the timing of first intercourse: Data from 14 countries. International Family Planning Perspectives, 26, 21–28. doi:10.2307/2648286.CrossRef Singh, S., Wulf, D., Samara, R., & Cuca, Y. P. (2000). Gender differences in the timing of first intercourse: Data from 14 countries. International Family Planning Perspectives, 26, 21–28. doi:10.​2307/​2648286.CrossRef
Zurück zum Zitat Statistics South Africa. (2007). Labour force survey: March 2007. Pretoria. Statistics South Africa. (2007). Labour force survey: March 2007. Pretoria.
Zurück zum Zitat Taylor, M., Dlamini, S. B., Kagoro, H., Jinabhai, C. C., & de Vries, H. (2003). Understanding high school students’ risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa. The Journal of School Health, 73, 97–100.PubMedCrossRef Taylor, M., Dlamini, S. B., Kagoro, H., Jinabhai, C. C., & de Vries, H. (2003). Understanding high school students’ risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa. The Journal of School Health, 73, 97–100.PubMedCrossRef
Zurück zum Zitat UNAIDS. (2007). AIDS epidemic update. Geneva. UNAIDS. (2007). AIDS epidemic update. Geneva.
Zurück zum Zitat United Nations Development Programme. (2006). Human development report 2006. New York. United Nations Development Programme. (2006). Human development report 2006. New York.
Zurück zum Zitat Wegner, L., Flisher, A. J., Caldwell, L. L., Vergnani, T., & Smith, E. A. (2007). Health Wise South Africa: Cultural adaptation of a school-based risk prevention programme. Health Education Research. doi:10.1093/her/cym1064. Wegner, L., Flisher, A. J., Caldwell, L. L., Vergnani, T., & Smith, E. A. (2007). Health Wise South Africa: Cultural adaptation of a school-based risk prevention programme. Health Education Research. doi:10.​1093/​her/​cym1064.
Metadaten
Titel
Substance Use and Sexual Risk Prevention in Cape Town, South Africa: An Evaluation of the HealthWise Program
verfasst von
Edward A. Smith
Lori-Ann Palen
Linda L. Caldwell
Alan J. Flisher
John W. Graham
Catherine Mathews
Lisa Wegner
Tania Vergnani
Publikationsdatum
01.12.2008
Verlag
Springer US
Erschienen in
Prevention Science / Ausgabe 4/2008
Print ISSN: 1389-4986
Elektronische ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-008-0103-z

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