Research Articles (Occupational Therapy)

Permanent URI for this collection

https://hdl.handle.net/10566/275

Browse

Now showing 1 - 20 of 20

Adolescent substance use: a prospective longitudinal model of substance use onset among South African adolescents
(Informa Healthcare, 2009) Patrick, Megan E.; Collins, Linda M.; Smith, Edward A.; Caldwell, Linda L.; Flisher, Alan J.; Wegner, Lisa
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 study’s limitations are noted.
Boys are victims, too: the influence of perpetrators’ age and gender in sexual coercion against boys
(SAGE Publications, 2018) Miller, Jacqueline A.; Smith, Edward A.; Caldwell, Linda L.; Mathews, Catherine; Wegner, Lisa
Sexual coercion among adolescent boys in South Africa is an underresearched topic despite the frequency of such events. Although quantitative research has illuminated the prevalence of sexual coercion toward boys, it has provided little understanding of the context of sexual coercion for adolescent boys. Given the often severe consequences of sexual coercion, it is important to further understand these experiences to inform prevention efforts. The current study aims to provide a more nuanced understanding of the context of sexual coercion. Data come from the baseline assessment for a translational research evaluation of a school-based intervention. The current study focuses on a subset of early and middle adolescent boys who reported experiencing sexual coercion (n = 223). Analyses examine boys’ reports of their perpetrators’ characteristics and details about the sexual coercion encounter. Logistic regression is used to examine how coercion tactics used by the perpetrator differs depending on the perpetrator’s age and gender. Eighth-grade boys were most likely to report that their perpetrator was a similar-aged female and that perpetrator’s age played a particularly important role in what tactics were used. Adult perpetrators were more likely to use physical force, threaten them, harass them electronically, and drink or use drugs at the time. Results provide important insight into boys’ experiences of sexual coercion that have implications for both future research and intervention efforts. Although much research is needed on the topic, intervention programs should recognize that both male and female adolescents can be victim and perpetrator.
Doing a leisure activity because there is nothing else to do: Related outcomes and intervention effects for adolescents
(Taylor & Francis, 2019) Motamedi, Mojdeh; Caldwell, Linda L.; Weybright, Elisabeth H.; Jones, Damon; Wegner, Lisa; Smith, Edward A.
This study examined whether a leisure-focused intervention, HealthWise, was related to reduced youth polysubstance use and delayed sexual debut via reducing how often youth did leisure activities because there was nothing else to do. HealthWise was compared to a no-intervention control for 5,610 high school students from eighth to tenth grades in townships near Cape Town, South Africa. Three specific leisure activities were examined: spending time with friends, playing sports, and going to parks. Among girls, spending time with friends because there was nothing else to do significantly mediated the effect of HealthWise on reducing frequent polysubstance use in the past month. For boys, spending time in parks because there was nothing else to do mediated the effect of HealthWise on delayed sexual debut. Results partially supported the HealthWise logic model of impacting risky behaviors via leisure and the value of prevention programs addressing the reasons behind leisure choices.
Healthwise South Africa: cultural adaptation of a school-based risk prevention programme
(Oxford University Press, 2008) Wegner, Lisa; Flisher, Alan J.; Caldwell, Linda L.; Vergnani, Tania; Smith, Edward A.
There is a need for effective prevention programmes aimed at reducing risk behaviour among South African adolescents. Health Wise South Africa is a school-based programme designed to reduce sexual and substance use risk behaviour, and promote positive use of leisure time among high-school learners (students). Based on successful programmes in the United States of America, Health Wise was developed for use in South Africa and pilot tested in four South African high schools. We carried out a process evaluation to establish the fidelity of implementation and make sure HealthWise was culturally relevant. Data sources comprised focus groups with educators and learners, lesson evaluations and observations, and interviews with school principals. Qualitative analysis of data highlighted pertinent cultural and contextual factors and identified areas for modifying Health Wise in order to promote better programme-consumer fit. These areas centred on time, language, and leisure. We noted a dynamic tension between the educators’ desire to adhere to plan, and to make adaptations in accordance with learners’ needs and the context. Ultimately, researchers need to find a balance between fidelity of implementation and programme adaptation to obtain effective programmes that are culturally acceptable to local consumers.
Inconsistent reports of sexual intercourse among South African high school students
(Elsevier, 2008) Palen, Lori-Ann; Smith, Edward A.; Caldwell, Linda L.; Flisher, Alan J.; Wegner, Lisa; Vergnani, Tania
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
Leisure boredom, timing of sexual debut, and co-occurring behaviors among South African adolescents
(Springer, 2021-08) Layland, Eric K.; Ram, Nilan; Caldwell, Linda L.
Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an underexplored correlate of sexual behavior that is associated with many adolescent health outcomes. We investigated if and how individual differences in leisure boredom may be associated with timing of sexual debut, and whether individuals engage in safe or risky behaviors at debut. Survival analysis, logistic regression, and Poisson regression were applied to eight-wave longitudinal data obtained from 3,088 South African adolescents (baseline Mage = 13.9 years) to examine associations between leisure boredom and cumulative hazard of sexual debut across adolescence, odds of co-occurring sexual behaviors, and incidence rate of co-occurring sexual risk behaviors at debut. Higher levels of leisure boredom were associated with elevated hazard cumulatively across adolescence. Higher levels of leisure boredom were also associated with lower odds of safe sex and higher odds of substance use during sex and transactional sex at sexual debut, but not casual sex or condom non-use at sexual debut. Although odds of singular risk behaviors were lower for girls than for boys, the association between leisure boredom and the number of risk behaviors at sexual debut was stronger for girls than boys. Higher trait leisure boredom was associated with elevated hazard of sexual debut, greater likelihood that risky behaviors accompanied sexual debut, and greater number of co-occurring risky behaviors at sexual debut. Results support leisure boredom as a potential target for preventing sexual risk behavior among South African adolescents.
Leisure constraints for adolescents in Cape Town, South Africa: a qualitative study
(Taylor and Francis, 2010) Palen, Lori-Ann; Patrick, Megan E.; Gleeson, Sarah; Caldwell, Linda L.; Smith, Edward A.; Wegner, Lisa; Flisher, Alan J.
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.
Linking Life Skills and Norms with adolescent substance use and delinquency in South Africa
(National Institute of Health, 2013) Lai, Mary H.; Graham, John W.; Caldwell, Linda L.; Smith, Edward A.; Bradley, Stephanie A.; Mathews, Catherine; Vergnani, Tania; Wegner, Lisa
We examined factors targeted in two popular prevention approaches with adolescent drug use and delinquency in South Africa. We hypothesized adolescent life skills to be inversely related, and perceived norms to be directly related to later drug use and delinquency. Multiple regression and a relative weights approach were conducted for each outcome using a sample of 714 South African adolescents ages 15 to 19 years (M = 15.8 years, 57% female). Perceived norms predicted gateway drug use. Conflict resolution skills (inversely) and perceived peer acceptability (directly) predicted harder drug use and delinquency. The “culture of violence” within some South African schools may make conflict resolution skills more salient for preventing harder drug use and delinquency.
Parenting practice, leisure experience, and substance use among South African adolescents
(Routledge, 2019) Xie, Hui; Weybright, Elizabeth H.; Caldwell, Linda L.; Wegner, Lisa; Smith, Edward A.
There is limited understanding of parents’ role in positive youth/adolescent development through leisure in developing countries. Using a sample of 6,626 eighth-grade students in South Africa, this study examined the interrelationships among parenting practice, adolescents’ leisure experience, and substance use. Results of structural equation modeling showed that parental leisure involvement was associated with less substance use, while parental leisure overcontrol was associated with greater substance use. The relationship of parental leisure involvement to substance use was mediated by healthy leisure engagement. The relationship of parental leisure overcontrol to substance use, on the other hand, was mediated by leisure boredom and healthy leisure engagement. The model path coefficients had little variation between genders and socioeconomic groups except that parental leisure overcontrol had a stronger positive relationship with leisure boredom for males than for females. Theoretical and practical implications are discussed.
Perceived parental control, restructuring ability, and leisure motivation: a cross-cultural comparison
(Taylor & Francis, 2017) Xie, Hui Jimmy; Caldwell, Linda L.; Graham, John W.; Weybright, Elizabeth H.; Wegner, Lisa; Smith, Edward A.
Leisure is viewed worldwide as an important developmental context for adolescents. As leisure research and programs are shared across nations, it is crucial to examine the cultural equivalence of leisure-related constructs and how they are related. Grounded in self-determination theory, this study explored the influence of perceived parental control and leisure restructuring ability on leisure motivation (a motivation and autonomous motivation) using samples of eighth grade adolescents in the United States and South Africa. Results of multiple-group structural equation modeling showed that the measurement model of the constructs was equivalent across the two samples, but the determinants of leisure motivation differed between the two samples. The findings provide implications for future cross-cultural research in leisure and offer insights on design and adaptation of leisure-based intervention and education programs in different cultural contexts.
Perceived parental control, restructuring ability, and leisure motivation: A cross-cultural comparison
(Taylor & Francis, 2016) Xie, Hui "Jimmy"; Caldwell, Linda L.; Graham, John W.; Weybright, Elizabeth H.; Wegner, Lisa; Smith, Edward A.
Leisure is viewedworldwide as an important developmental context for adolescents. As leisure research and programs are shared across nations, it is crucial to examine the cultural equivalence of leisure-related constructs and how they are related. Grounded in self-determination theory, this study explored the influence of perceived parental control and leisure restructuring ability on leisure motivation (amotivation and autonomous motivation) using samples of eighth grade adolescents in the United States and South Africa. Results of multiple-group structural equation modeling showed that the measurement model of the constructs was equivalent across the two samples, but the determinants of leisure motivation differed between the two samples. The findings provide implications for future cross-cultural research in leisure and offer insights on design and adaptation of leisure-based intervention and education programs in different cultural contexts.
Predicting secondary school dropout among South African adolescents: A survival analysis approach
(Education Association of South Africa, 2017) Weybright, Elizabeth H.; Caldwell, Linda L.; Xie, Hui Jimmy; Wegner, Lisa; Smith, Edward A.
Education is one of the strongest predictors of health worldwide. In South Africa, school dropout is a crisis where by Grade 12, only 52% of the age appropriate population remain enrolled. Survival analysis was used to identify the risk of dropping out of secondary school for male and female adolescents and examine the influence of substance use and leisure experience predictors while controlling for demographic and known predictors using secondary, longitudinal data. Results indicated being male, not living with one’s mother, smoking cigarettes in the past month, and lower levels of leisure-related intrinsic motivation significantly predicted dropout. Results support comprehensive prevention programmes that target risk behaviour and leisure.
Predicting substance use behavior among South African adolescents: The role of leisure experiences across time
(SAGE Publications, 2011) Sharp, Erin Hiley; Coffman, Donna; Caldwell, Linda L.; Smith, Edward A.; Wegner, Lisa; Vergnani, Tania; Mathews, Catherine
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.
Profiles of adolescent leisure motivation and substance use in the HealthWise South Africa research trial: a person-centered approach
(Routledge, 2018) Weybright, Elizabeth H.; Palen, Lori-Ann; Caldwell, Linda L.; Wegner, Lisa; Jacobs, Joachim J.; Smith, Edward
Engaging in intrinsically motivated behaviors, both within and outside of the leisure context, is associated with well-being. However, individuals can be driven by multiple types of motivation simultaneously, and the impact of constellations of leisure motivation is relatively unknown. The current study uses South African adolescents in the HealthWise South Africa efficacy trial (N¼2,204; Mage¼14.0) to identify profiles of leisure motivation, examine the association between profiles and substance use, and evaluate the impact of HealthWise on changes in motivation profiles over time. Results indicate three distinct profiles: high consistent motivation, low consistent motivation, and high intrinsic motivation. Members of the high intrinsic profile had the lowest odds of substance use. Profiles were fairly stable across all time points except for females in a high-training intervention school. Results illustrate the importance of identifying and understanding typologies of leisure motivation and health across time, which can be used to promote positive development in adolescents.
A qualitative assessment of South African adolescents’ motivations for and against substance use and sexual behavior
(Wiley-Blackwell, 2010) Patrick, Megan E.; Palen, Lori-Ann; Caldwell, Linda L.; Gleeson, Sarah; Smith, E.D.; Wegner, Lisa
Focus groups (N 5 15 groups; 8 with girls, 7 with boys) with adolescents in high schools near Cape Town, South Africa, were used to conduct a qualitative investigation of reported reasons for using and not using substances and for having and not having sex. Adolescents reported Enhancement, Negative States, Social, and Aversive Social motivations for both sub- stance use and sexual behavior. In addition, being addicted as a reason for using drugs and rape as a context for sexual behavior were frequently reported. Motivations against behaviors included Physical/Behavioral Consequences, Ethical Objections, Social Disapproval, and Incompatible Activities and Goals reasons. Preventive interventions should address existing motivations for and against substance use and sexual behavior to acknowledge adolescents’ experiences in context.
The state of methamphetamine ('tik') use among youth in the Western Cape, South Africa
(Health and Medical Publishing Group (HMPG), 2016) Weybright, Elizabeth H.; Caldwell, Linda L.; Wegner, Lisa; Smith, Edward A.; Jacobs, J. J.
BACKGROUND Methamphetamine use among youth in the Western Cape Province of South Africa has increased at alarming rates over the past decade. Although current estimates of youth use exist, they range from 2% to 12%. OBJECTIVES To identify (i) the prevalence of methamphetamine use in Western Cape youth and (ii) the association between use and known risk factors for methamphetamine use. METHODS Data were obtained from 10 000 Western Cape Province Grade 8 learners in 54 secondary schools (mean age 14.0 years). Prevalence was descriptively reported while risk factors for past-month use were modelled in a hierarchical logistic regression with demographic, socioeconomic status, substance use, sexual activity and relationship predictors. RESULTS Approximately 5% (n=496) of learners had used methamphetamine within their lifetime. Of these users, 65% (n=322) had used in the past month or week. Compared to never users, past-month users were more likely to be male, less likely to have a present or partially present mother, less likely to live in an apartment/flat/brick house, more likely to have used alcohol and tobacco and more likely to report having a same-sex partner. CONCLUSION Results replicate previously known methamphetamine risk factors and highlight the need to address methamphetamine use in comprehensive prevention initiatives.
Trajectories of adolescent substance use development and the influence of healthy leisure: a growth mixture modeling approach
(Elsevier, 2016) Weybright, Elizabeth H.; Caldwell, Linda L.; Ram, Nilam; Smith, Edward A.; Wegner, Lisa
Considerable heterogeneity exists in adolescent substance use development. To most effectively prevent use, distinct trajectories of use must be identified as well as differential associations with predictors of use, such as leisure experience. The current study used a person-centered approach to identify distinct substance use trajectories and how leisure is associated with trajectory classes. Data came from a larger efficacy trial of 2.249 South African high school students who reported substance use at any time across 8 waves. Growth mixture modeling was used to identify developmental trajectories of substance use and the influence of healthy leisure. Results identified three increasing and one stable substance use trajectory and subjective healthy leisure served to protect against use. This study is the first of its kind to focus on a sample of South African adolescents and serves to develop a richer understanding of substance use development and the role of healthy leisure.
Translational research in South Africa: evaluating implementation quality using a factorial design
(Springer Verlag, 2012) Caldwell, Linda L.; Smith, Edward A.; Collins, Linda M.; Graham, John W.; Lai, Mary H.; Wegner, Lisa; Vergnani, Tania; Mathews, Catherine; Jacobs, Joachim
Background: HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence- based substance use and sexual risk prevention program that emphasizes the positive use of leisure time. Since 2000, this program has evolved from pilot testing through an efficacy trial involving over 7,000 youth in the Cape Town area. Beginning in 2011, through 2015, we are undertaking a new study that expands HW to all schools in the Metro South Education District. Objective: This paper describes a research study designed in partnership with our South African collaborators that examines three factors hypothesized to affect the quality and fidelity of HW implementation: enhanced teacher training; teacher support, structure and supervision; and enhanced school environment. Methods: Teachers and students from 56 schools in the Cape Town area will participate in this study. Teacher observations are the primary means of collecting data on factors affecting implementation quality. These factors address the practical concerns of teachers and schools related to likelihood of use and cost-effectiveness, and are hypothesized to be "active ingredients" related to high-quality program implementation in real-world settings. An innovative factorial experimental design was chosen to enable estimation of the individual effect of each of the three factors. Results: Because this paper describes the conceptualization of our study, results are not yet available. Conclusions: The results of this study may have both substantive and methodological implications for advancing Type 2 translational research.
Understanding leisure-related program effects by using process data in the HealthWise South Africa Project
(American Academy for Park and Recreation Administration, 2008) Caldwell, Linda L.; Younker, Anita S.; Wegner, Lisa; Patrick, Megan E.; Vergnani, Tania; Smith, Edward A.; Fisher, Alan J.
As the push for evidence-based programming gathers momentum, many human services programs and interventions are under increased scrutiny to justify their effectiveness across different conditions and populations. Government agencies and the public want to be assured that their resources are being put to good use on programs that are effective and efficient. Thus, programs are increasingly based on theory and evaluated through randomized control trials using longitudinal data. Despite this progress, hypothesized outcomes are often not detected and/or their effect sizes are small. Moreover, findings may go against intuition or “gut feelings” on the part of project staff. Given the need to understand how program implementation issues relate to outcomes, this study focuses on whether process measures that focus on program implementation and fidelity can shed light on associated outcomes. In particular, we linked the process evaluation of the HealthWise motivation lesson with outcomes across four waves of data collection. We hypothesized that HealthWise would increase learners’ intrinsic and identified forms of motivation, and decrease amotivation and extrinsic motivation. We did not hypothesize a direction of effects on introjected motivation due to its conceptual ambiguity. Data came from youth in four intervention schools (n = 902, 41.1%) and five control schools (n = 1291, 58.9%) who were participating in a multi-cohort, longitudinal study. The schools were in a township near Cape Town, South Africa. For each cohort, baseline data are collected on learners as they begin grade 8. We currently have four waves of data collected on the first cohort, which is the focus of this paper. The mean age of the sample at wave 3 was 15.0 years (SD = .86) and 51% of students were female. Results suggested that there was evidence of an overall program effect of the curriculum on amotivation regardless of fidelity of implementation. Compared to the control schools, all treatment school learners reported lower levels of amotivation in wave 4 compared to wave 3, as hypothesized. Using process evaluation data to monitor implementation fi147 delity, however, we also conclude that the school with better trained teachers who also reported higher levels of program fidelity had better outcomes than the other schools. We discuss the implications of linking process data with outcome data and the associated methodological challenges in linking these data.
With a little help from my friends? A longitudinal look at the role of peers versus friends on adolescent alcohol use
(Elsevier, 2019) Weybright, Elizabeth H.; Beckmeyer, Jonathon J.; Caldwell, Linda L.; Wegner, Lisa; Smith, Edward A.
Introduction: Alcohol is the most commonly used substance by South African adolescents. Social norms play a key role in alcohol use, although distinctions are not always made between descriptive and injunctive norms and peer proximity. Additionally, little research identifies factors attenuating social norms, peer proximity, and alcohol use, such as one's ability to resist peer influence. Methods: The current study investigates the relationship between adolescent alcohol use in 9th Grade and descriptive peer and injunctive friend norms in 8th grade, the moderating role of resistance to peer influence, and sex differences. Data were from South African students (N=3592; Mage=14) participating in the HealthWise South Africa implementation quality trial. Results: Path model results indicated injunctive friend norms, but not peer norms, influenced alcohol use. Resistance to peer influence did not moderate relationships and group comparisons found no sex differences. Conclusion: Findings suggest social proximity shapes influences of alcohol use. Despite a differing cultural context, findings were consistent with those from the United States, indicating social proximity is relevant cross-culturally.

Browse

Browsing by Author "Caldwell, Linda L."

Results Per Page

Sort Options