Skip to main content

Advertisement

SpringerLink
Log in

Girls Just Want to Know Where to Have Fun: Preventing Substance Use Initiation in an Under-Resourced Community in South Africa Through HealthWise

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

This study examined how the perception of the availability of leisure opportunities may prevent substance use initiation through HealthWise, a school-based program focused on reducing risky behavior. In this study, we specifically focused on whether HealthWise increased student perceptions of leisure opportunities between 8th grade and 10th grade (N = 5610) in an under-resourced community in South Africa. Path analyses were used to test hypotheses. Given gender differences in substance use patterns, societal norms, and leisure opportunities in under-resourced communities, such as the townships of Cape Town, South Africa, it was especially important to examine associations within each gender. Results suggested that HealthWise directly reduced the likelihood of initiating alcohol and cigarette use and increased the amount of perceived leisure opportunities among girls but not boys. Perceived leisure opportunities mediated the effect of HealthWise on reducing the initiation of alcohol and cigarette use directly, and marijuana use indirectly, among girls but not boys. This is the first study to demonstrate how experimentally targeting leisure through an intervention can increase perceived leisure opportunities and thereby prevent early substance use initiation for a specific population. The importance of considering the context of gender, age, and location is discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Ackerman, S., Zuroff, D. C., & Moskowitz, D. S. (2000). Generativity in midlife and young adults: Links to agency, communion, and subjective well-being. International Journal of Aging and Human Development, 50, 17–41.

    Article  CAS  PubMed  Google Scholar 

  • Barnett, L. A. (2005). Measuring the ABCs of leisure experience: Awareness, boredom, challenge, distress. Leisure Sciences: An Interdisciplinary Journal, 27, 131–155.

    Article  Google Scholar 

  • Barnett, L. A., & Klitzing, S. W. (2006). Boredom in free time: Relationships with personality, affect, and motivation for different gender, racial and ethnic student groups. Leisure Sciences, 28, 223–244.

    Article  Google Scholar 

  • Botvin, G. J., & Griffin, K. W. (2004). Life skills training: Empirical findings and future directions. Journal of Primary Prevention, 25, 211–232.

    Article  Google Scholar 

  • Caldwell, L. L. (2004). TimeWise: Taking charge of leisure time. Scotts Valley: ETR.

    Google Scholar 

  • Caldwell, L. L. (2005). Recreation and youth development. In P. Witt & L. Caldwell (Eds.), Recreation and youth development (pp. 169–189). State College: Venture.

    Google Scholar 

  • Caldwell, L. L., & Baldwin, C. K. (2005). A developmental approach to understanding constraints to leisure. In E. L. Jackson (Ed.), Constraints to leisure (pp. 75–88). State College: Venture Publishing.

    Google Scholar 

  • Caldwell, L. L., & Smith, E. A. (2006). Leisure as a context for youth development and delinquency prevention. Australian and New Zealand Journal of Criminology, 39, 398–418.

    Article  Google Scholar 

  • Caldwell, L. L., Darling, N., Payne, L., & Dowdy, B. (1999). “Why are you bored?” An examination of psychological and social control causes of boredom among adolescents. Journal of Leisure Research, 31, 103–121.

    Google Scholar 

  • 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.

    Google Scholar 

  • Caldwell, L. L., Patrick, M. E., Smith, E. A., Palen, L., & Wegner, L. (2010). Influencing adolescent leisure motivation: Intervention effects of HealthWise South Africa. Journal of Leisure Research, 42, 203–220.

    PubMed  PubMed Central  Google Scholar 

  • Carnegie Council on Adolescent Development. (1992). A matter of time: Risk and opportunity in the nonschool hours. New York: Carnegie Corporation of New York. Report of the Task Force on Youth Development and Community Programs.

    Google Scholar 

  • Chassin, L., Hussong, A., Barrera, M., Molina, B. S. G., Trim, R., & Ritter, J. (2004). Adolescent substance use. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology (2nd ed., pp. 665–696). New York: Wiley.

    Google Scholar 

  • Collins, L. M., Schafer, J. L., & Kam, C. M. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330–351.

    Article  CAS  PubMed  Google Scholar 

  • Csikszentmihalyi, M. (2014). Flow and the foundations of positive psychology: The collected works of Mihaly Csikszentmihalyi. Dordrecht: Springer. ISBN 978-94-017-9087-1.

    Book  Google Scholar 

  • Dahl, R. (2004). Adolescent brain development: A period of vulnerabilities and opportunities. Annals of the New York Academy of Sciences, 1021, 1–22.

    Article  PubMed  Google Scholar 

  • Damon, W. (2004). What is positive youth development? The Annals of the American Academy of Political and Social Science, 591, 13–24.

    Article  Google Scholar 

  • Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum Press.

    Book  Google Scholar 

  • Erikson, E. (1968). Identity: Youth and crisis. New York: Norton.

    Google Scholar 

  • Gefou-Madianou, D. (Ed.). (1992). Alcohol, gender and culture. London: Routledge.

    Google Scholar 

  • Gleeson, S. L. (2008). Gender differences in leisure motivation, participation, and constraints for South African adolescents (Unpublished master’s thesis). The Pennsylvania State University, University Park.

  • Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549–576.

    Article  PubMed  Google Scholar 

  • Graham, J. W., Palen, L. A., Smith, E. A., & Caldwell, L. L. (2008). Attrition: MAR and MNAR missingness and estimation bias. San Francisco: Poster presented at the 16th Annual Meetings of the Society for Prevention Research.

    Google Scholar 

  • Grant, B. F., & Dawson, D. A. (1997). Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, 9, 103–110.

    Article  CAS  PubMed  Google Scholar 

  • Haugaard, J. J. (2001). Problematic behaviors during adolescence. New York: McGraw-Hill.

    Google Scholar 

  • Hedeker, D., Kandel, D. B., Yamaguchi, K., & Chen, K. (1992). Stages of progression in drug involvement from adolescence to adulthood: Further evidence for the gateway theory. Journal of Studies on Alcohol, 53, 447–457.

    Article  Google Scholar 

  • Iso-Ahola, S. E., & Weissinger, E. (1990). Perceptions of boredom in leisure: Conceptualization, reliability, and validity of the leisure boredom scale. Journal of Leisure Research, 22, 1–17.

    Google Scholar 

  • Jones, G. W. (1992). Rural girls and cars: The phenomena of “Blockies”. Rural Society, 2, 4–7.

    Article  Google Scholar 

  • Kaufman, C. E., Clark, S., Manzini, N., & May, J. (2002). How community structures of time and opportunity shape adolescent sexual behavior in South Africa. New York: Population Council.

    Google Scholar 

  • Kling, J., & Liebman, J. (2004). Experimental analysis of neighborhood effects on youth. Princeton: Princeton IRS. Working Paper 483.

    Google Scholar 

  • Kumpfer, K. L., & Alvarado, R. (2003). Family-strengthening approaches for the prevention of youth problem behaviors. The American Psychologist, 58, 457–465.

    Article  PubMed  Google Scholar 

  • Larson, R. W., & Verma, S. (1999). How children and adolescents spend time across the world: Work, play, and developmental opportunities. Psychological Bulletin, 125, 701–736.

    Article  CAS  PubMed  Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7, 83.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mahoney, J. L., Larson, R. W., & Eccles, J. S. (Eds.). (2005). Organized activities as contexts of development: Extracurricular activities, after school and community programs. Mahwah: Lawrence Erlbaum Associates.

    Google Scholar 

  • Marsiglia, F., & Hecht, M. (2005). Keepin’ it REAL: Drug resistance strategies teacher guide. Scotts Valley: ETR Associates.

    Google Scholar 

  • Møller, V. (1991). Lost generation found: Black youth at leisure. Youth Centre Project and Indicator Project, Indicator South Africa Issue Focus, 1–63.

  • Muthén, L. K., & Muthén, B. O. (2010). Mplus user’s guide (6th ed.). Los Angeles: Muthén & Muthén.

    Google Scholar 

  • Palen, L. A., Smith, E. A., Flisher, A. J., Caldwell, L. L., & Mpofu, E. (2006). Substance use and sexual risk behavior among South African eighth grade students. The Journal of Adolescent Health, 39, 761–763.

    Article  PubMed  Google Scholar 

  • Palen, L. A., Smith, E. A., Caldwell, L. L., Matthews, C., & Vergnani, T. (2009). Transitions to substance use and sexual intercourse among South African high school students. Substance Use & Misuse, 44, 1872–1887.

    Article  Google Scholar 

  • Palen, L. A., Patrick, M. E., Gleeson, S. L., Caldwell, L. L., Smith, E. A., Wegner, L., & Flisher, A. J. (2010). Leisure constraints for adolescents in Cape Town, South Africa: A qualitative study. Leisure Sciences, 32, 434–452.

    Article  Google Scholar 

  • Patrick, M. E., Collins, L. M., Smith, E. A., Caldwell, L. A., Flisher, A., & Wegner, L. (2009). A prospective longitudinal model of substance use onset among South African adolescents. Substance Use & Misuse, 44, 646–661.

    Article  Google Scholar 

  • Patrick, M. E., Caldwell, L., Gleeson, S., Smith, E., & Wegner, L. (2010). A qualitative assessment of South African adolescents’ motivations for and against substance use and sexual behavior. Journal of Research on Adolescence, 20, 456–481.

    Article  PubMed  PubMed Central  Google Scholar 

  • Patterson, I., Pegg, S., & Dobson-Patterson, R. (2000). Exploring the links between leisure boredom and alcohol use among youth in rural and urban areas of Australia. Journal of Park and Recreation Administration, 18, 53–75.

    Google Scholar 

  • Raymore, L. A., Godbey, G. C., & Crawford, D. W. (1994). Self-esteem, gender, and socioeconomic status: Their relation to perceptions of constraint on leisure among adolescents. Journal of Leisure Research, 26, 99–118.

    Google Scholar 

  • Reddy, S. P., James, S., Sewpaul, R., Koopman, F., Funanl, N. I., Slfunda, S., & Omardien, R. G. (2010). Umthente uhlaba usamila—The second South African youth risk behavior survey 2008. Cape Town: South Africa Medical Research Council.

    Google Scholar 

  • Schwartz, S. J., Zamboanga, B. L., Weisskirch, R. S., & Rodriguez, L. (2009). The relationships of personal and ethnic identity exploration to indices of adaptive and maladaptive psychosocial functioning. International Journal of Behavioral Development, 33, 131–144.

    Article  Google Scholar 

  • Sharp, E., Caldwell, L., Graham, J., & Ridenour, T. (2006). Individual motivation and parental influence on adolescents’ experiences of interest in free time: A longitudinal examination. Journal of Youth and Adolescence, 35, 340–353.

    Article  Google Scholar 

  • Sharp, E. H., Coffman, D. L., Caldwell, L. L., Smith, E. A., Wegner, L., Vergnani, T., & Mathews, C. (2011). Predicting substance use behavior among South African adolescents: The role of leisure experiences across time. International Journal of Behavioral Development, 35, 343–351.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shaw, S. M., Caldwell, L. L., & Kleiber, D. K. (1996). Boredom, stress and social control in the daily activities of adolescents. Journal of Leisure Research, 28, 274–292.

    Google Scholar 

  • Smith, E. A., Palen, L., Caldwell, L. L., Flisher, A. J., Graham, J. W., Mathews, C., & Vergnani, T. (2008). Substance use and sexual risk prevention in Cape Town, South Africa: An evaluation of the HealthWise program. Prevention Science, 9, 311–321.

    Article  PubMed  Google Scholar 

  • Statistics South Africa. (2007). Labour force survey March 2007. Pretoria: Statistics South Africa.

    Google Scholar 

  • Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental Review, 28, 78–106.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sutherland, I., & Shepherd, J. P. (2001). Social dimensions of adolescent substance use. Addiction, 96, 445–458.

    Article  CAS  PubMed  Google Scholar 

  • Tibbits, M. K., Caldwell, L. L., Smith, E. A., & Wegner, L. (2009). The relation between leisure activity participation profiles and substance use among South African youth. World Leisure Journal, 51, 150–159.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tibbits, M. K., Smith, E. A., Caldwell, L. L., & Flisher, A. J. (2011). Impact of HealthWise South Africa on polydrug use and high-risk sexual behavior. Health Education Research, 26, 653–663.

    Article  PubMed  PubMed Central  Google Scholar 

  • Townsend, L., Flisher, A. J., Chikobvu, P., Lombard, C., & King, G. (2008). The relationship between bullying behaviours and high school dropout in Cape Town, South Africa. South Africa Journal of Psychology, 38, 21–32.

    Article  Google Scholar 

  • Wegner, L., Flisher, A., Muller, M., & Lombard, C. (2006). Leisure boredom and substance use among high school students in South Africa. Journal of Leisure Research, 38, 249–266.

    Google Scholar 

  • Wegner, L., Flisher, A. J., Caldwell, L. L., Vergnani, T., & Smith, E. A. (2008). Healthwise South Africa: Cultural adaptation of a school-based risk prevention programme. Health Education Research, 23, 1085–1096.

    Article  CAS  PubMed  Google Scholar 

  • Weybright, E. H., Caldwell, L. L., Ram, N., Smith, E., & Jacobs, J. (2014). The dynamic association between healthy leisure and substance use in South African adolescents: A state and trait perspective. World Leisure Journal, 56, 99–109.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weybright, E. H., Caldwell, L. L., Ram, N., Smith, E. A., & Wegner, L. (2015). Boredom prone or nothing to do? Distinguishing between state and trait leisure boredom and its association with substance use in South African adolescents. Leisure Sciences, 37, 311–331.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilson, D. M., Gottfredson, D., Cross, A., Rorie, M., & Connell, N. (2010). Youth development in after-school leisure activities. The Journal of Early Adolescence, 30, 668–690.

    Article  Google Scholar 

  • Windle, M., & Windle, R. C. (2001). Depressive symptoms and cigarette smoking among middle adolescents: Prospective associations and intrapersonal and interpersonal influences. Journal of Consulting and Clinical Psychology, 69, 215–226.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Appreciation is expressed to the HealthWise project staff and the schools, teachers, and youth who participated in this project. We also appreciate the reviewers’ comments, which made the paper substantially better. This research was supported by the National Institute on Drug Abuse R01 DA01749. The first author was supported by the Institute of Education Sciences grant R305B090007 and by the National Institute on Drug Abuse from Award Numbers T32 DA017629, P50 DA10075, and P50 DA039838. The views expressed in this article are ours and do not necessarily represent the official views of granting agencies.

Author information

Authors and Affiliations

  1. Pennsylvania State University, State College, PA, USA

    Mojdeh Motamedi, Linda Caldwell, Edward Smith & Damon Jones

  2. University of the Western Cape, Bellville, Cape Town, South Africa

    Lisa Wegner

Authors
  1. Mojdeh Motamedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linda Caldwell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lisa Wegner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edward Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Damon Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mojdeh Motamedi.

Ethics declarations

Funding

This research was supported by the National Institute on Drug Abuse R01 DA01749. The first author was supported by the Institute of Education Sciences grant R305B090007 and by the National Institute on Drug Abuse from Award Numbers T32 DA017629, P50 DA10075, and P50 DA039838. The views expressed in this article are ours and do not necessarily represent the official views of granting agencies.

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

The research was conducted in full compliance with the APA standards for ethical practice in research, under the review of the Pennsylvania State University and the University of the Western Cape Institutional Review Board. These findings have not been published in any form nor submitted for consideration elsewhere.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all nine schools included in the study. All participating students provided assent and passive/opt out parental consent to be in the study. Passive/opt out parental consents were such that legal guardians had to return a form stating they did not want their child to participate as delineated in forms mailed to the students’ addresses and a second copy students took home with them from school.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Motamedi, M., Caldwell, L., Wegner, L. et al. Girls Just Want to Know Where to Have Fun: Preventing Substance Use Initiation in an Under-Resourced Community in South Africa Through HealthWise. Prev Sci 17, 700–709 (2016). https://doi.org/10.1007/s11121-016-0654-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-016-0654-3

Keywords

Search

Navigation