Stakeholders’ Perceptions of Health Risk Behaviour Engagement among Grades 4-7 Learners in South Africa

Health-risk behaviours such as tobacco smoking and alcohol are now identified among adolescents in most of the secondary schools of South Africa. The study investigated the prevalence of smoking and alcohol use as health risk behaviours among secondary school learners in Thembisile Hani municipality of Mpumalanga province in South Africa. A quantitative descriptive research design was used for the study. A simple random sampling was employed in the selection of schools and proportional stratified sampling was used to select learners from each school according to grades. Closed-ended questionnaires were used to collect data from learners in their schools. Data were analysed using SPSS version 26.0. Out of 385 learners, 64.4% have drank alcohol whilst 64.7% have smoked cigarette in the school premises. The socio-economic status of many learners such as the employment and income of the family was found to be one of the factors exposing them to alcohol and tobacco use. There was high prevalence of alcohol use and smoking among learners in secondary schools. Excessive use of alcohol and smoking could affect the health of learners in their late life and therefore community collaboration to curb the problem is crucial.

Most analyses of oral reading fluency (ORF) are based on L1 reading, and the norms that have been developed in English are based on first language reading data. This is problematic for developing countries where many children are learning in English as a second language. The aim of the present study is to model the relationship between English reading fluency and comprehension among rural English-second-language learners (ESL) in South Africa. We use data collected in 2013 by the National Education and Evaluation Development Unit in South Africa. This survey tested 4697 Grade 5 students from 214 schools across rural areas in South Africa. A sub-sample—1772 students—were selected for an ORF test. For these students there exist data on both reading comprehension and reading fluency. Although a number of studies have analyzed the relationship between fluency and comprehension, none have been conducted on a large-scale for ESL learners in a developing country such as South Africa. The present research contributes to the literature by analysing the size, significance and uniformity of this relationship for ESL learners in South Africa. Preliminary findings indicate a threshold at 70 words-read-correct-per-minute which is lower than the typically used threshold of 90 words-read-correct-per-minute of English first language readers.

Adolescents frequently experience symptoms of mental disorders (SOMD) and engage in health risk behaviors (HRB), both of which significantly contribute to global disability and mortality. Despite this, data on these issues remain limited in low- and middle-income countries (LMICs), including Vietnam. This study aims to estimate the prevalence of SOMD and HRB and examine their associations among high school students in Vietnam. A cross-sectional survey was conducted with 3,025 students from four high schools and four continuing education centers across Ho Chi Minh City. Participants completed a self-administered questionnaire capturing demographic information, HRB (using the YBRS scale), and SOMD (using the DASS-21 screening scale). SOMD assessments focused on symptoms of depression, anxiety, and stress rather than clinical diagnoses, while HRB covered substance use, risk-taking, physical fighting, suicidal ideation, unsafe sexual behaviors, unhealthy diet, physical inactivity, and sleep deprivation. Of the 2,631 students included in the analysis, prevalence rates were 42.6% for symptoms of depression, 50.3% for symptoms of anxiety, and 31.1% for symptoms of stress. Engagement in HRB varied widely, from 4.0% for unsafe sexual behaviors to 79.9% for physical inactivity, with 91.6% reporting involvement in multiple HRB. Students experiencing SOMD were significantly more likely to engage in HRB compared to those without SOMD, with odds ratios ranging from 1.24 to 4.64. SOMD and HRB represent dual and interrelated challenges among Vietnamese adolescents, underscored by their high prevalence. These findings emphasize the critical need for integrated interventions addressing both mental health symptoms and health risk behaviors, especially in resource-constrained LMIC settings.

Gang youth have been a perennial issue with criminologists for nearly a century. Much evidence suggests that something about participation within a gang leads youth to commit more crime when compared to non-gang youth. Gang youth are at an increased risk of arrest and incarceration for serious offences in comparison to other delinquent youth. Gang youth also are more likely to report participation in what are described as ‘health risk behaviors’, which include substance use, violence, and unsafe sexual practices. Consequently, gang youth are at an elevated risk of exposure to the negative health outcomes related to such behaviors, including addiction, overdose, infection, injury, disability, and death. This chapter offers data gathered in three cities over a 20-year period to provide a descriptive epidemiology of substance use, violence and unsafe sexual practices among gang-identified youth. We conclude with a discussion on how public health approaches towards other high-risk categories of youth could compliment current criminal justice efforts aimed at curbing the influence or impact of youth gangs.

BackgroundTeenage pregnancy still remains high in low and middle-income countries (LMIC), as well as in high-income countries (HIC). It is a major contributor to maternal and child morbidity and mortality rates. Furthermore, it has social consequences, such as perpetuating the cycle of poverty including early school dropout by the pregnant adolescent, especially in sub-Saharan Africa (SSA). Few studies in SSA have investigated the trends in teenage pregnancy and the associated factors, while this is critical in fully understanding teenage pregnancy and for promotion of reproductive health among adolescents at large in SSA.MethodsTo examine the trends in teenage pregnancy and to identify associations with other health risk behaviours in South Africa (SA), a total of 31 816 South African school-going adolescents between 11 to 19 years of age were interviewed in three cross-sectional surveys. Data from the first (2002, n = 10 549), second (2008, n = 10 270) and the third (2011, n = 10 997) nationally representative South African youth risk behaviour surveys (YRBS) were used for this study.ResultsThe overall prevalence of having ever been pregnant among the combined 3-survey sample was self-reported to be 11.0 % and stable across the three surveys. Sexual intercourse among adolescents in SA has decreased from 41.9 % in 2002 to 36.9 % in 2011. However, pregnancy among girls who ever had sex increased from 17.3 % (95 % CI: 0.16–0.19) in 2002, to 23.6 % (95 % CI: 0.21–0.26) in 2008 and decreased to 21.3 % (95 % CI: 0.19–0.23) in 2011. The odds for ever been pregnant were higher for girls who had 2 or more sexual partners (OR: 1.250, 95 % CI: 1.039–1.503), girls who ever used alcohol before sex (OR: 1.373, 95 % CI: 1.004–1.878), practised binge-drinking during the last month (OR: 0.624, 95 % CI: 0.503–0.774), and girls who used mandrax (OR: 1.968, 95 % CI: 1,243–3.117). The odds for never been pregnant were lower for those who used condoms (OR: 0.462, 95 % CI: 0.309–0.691).ConclusionsGirls continue to become pregnant at unacceptably high rates in SA. Sexual intercourse among adolescents in SA has decreased slightly. However, among those who are sexually active pregnancy prevalence rates have increased. More over, this is in the context of high prevalence of HIV and other STI. There is a need to address adolescents’ sexual and reproductive health, and several health risk behaviours, including substance use, that are associated with teenage pregnancy in SA.

This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.

WHAT IS KNOWN ON THE SUBJECT?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently. Multiple HRBs might threaten adolescents' future health in adulthood. Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently. Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs. Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs. Population-based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. ABSTRACT: Introduction There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods This cross-sectional study was conducted using the 2016 Korea Youth Risk Behavior Web-based Survey (N=65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR=1.43-4.47, 95% CI=1.37-1.49 to 3.23-6.20) and/or who had suicidal ideation (OR=1.33-3.19, 95% CI=1.25-1.42 to 2.25-4.51) were more likely to engage in multiple HRBs. Discussion A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self-reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs.

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

In response to the multiple and often contradictory demands on higher education, increased attention is being given to service learning (SL) in South Africa. This article reviews the debate regarding the desirability of theory for SL and considers the need for locally-grounded theory. Grounded theory is advocated as a research method which appears well-suited to the diversity which characterises SL. Based upon a constructivist paradigm of knowledge creation and employing primarily qualitative methodologies, grounded theory comprises concepts, categories and propositions which emerge from, and are verified through the experiences of the multiple stakeholders in SL. Although analysis is not structured by existing theoretical frameworks, a preliminary literature review is recommended to locate potentially relevant literature and to sensitise the researcher to themes which may surface in the study. The article concludes with such a review of the sources and nature of the literature and research, particularly that emanating from the South African higher education sector.

Absenteeism is a significant issue in South African education, particularly among marginalized communities in rural and impoverished areas. Despite policy efforts to improve access to education, learners in these regions face challenges that limit their regular attendance and participation. This paper explores the cultural and socio-economic factors that contribute to absenteeism, with a focus on language barriers, traditional gender roles, and poverty. The use of English as the main language of instruction alienates learners who speak indigenous languages, leading to disengagement and persistent absenteeism. Traditional gender roles in rural areas often prioritize household duties and income-generating tasks over education, disproportionately affecting girls. Socio-economic issues, such as poverty, lack of transportation, and inadequate educational resources, further worsen absenteeism. Grounded in Paulo Freire’s theory of Critical Pedagogy, this paper emphasizes the need for culturally sensitive strategies to address absenteeism and promote educational equity. Through a qualitative approach, involving semi-structured interviews with learners, teachers, and community leaders, the paper seeks to uncover the underlying cultural and socio-economic factors that contribute to absenteeism. The findings aim to provide effective solutions to reduce absenteeism and improve educational outcomes for marginalized learners in South Africa, helping to break the cycle of poverty and inequality. The paper recommended that culturally sensitive educational policies and community-based interventions be implemented to reduce absenteeism and improve educational access for marginalized learners in rural South Africa. Keywords: Absenteeism; Educational equity; Socio-economic barriers; Cultural barriers; Marginalised learners.

BackgroundHealth risk behaviour among South African youth is a significant public health concern. Despite a societal mind shift to educating the public on the prevention of health risk behaviour, behavioural change is not progressing at the rate needed to influence health risk behaviour positively. The project aims to explore behavioural trends and willingness to engage in risky behaviour among senior primary school children. Secondly, to design a health risk behaviour prevention program which adequately equips senior primary school children with the necessary life skills to alter risk behaviour engagement.MethodsThe study will make use of an intervention mapping framework and a sequential, explanatory mixed methods design. Stratified random probability sampling will be used to select three primary schools in the region. Nonprobability purposive sampling will be used to select the stakeholders participating in the focus group sessions. Data collection consists of five phases with the results of each stage informing the structure and application of the next. Phase 1 - baseline data collection (needs analysis) using the child health risk behaviour survey. Phase 2 - focus group interviews. Phase 3 - a systematic review of the literature for result analysis triangulation. Phase 4 – the development of the child risk behaviour prevention program based on the outcomes of phases 1,2 and 3. Phase 5 - implementation of the program. Descriptive statistics will be used to analyse the quantitative data. Chi-square, ANOVA and multiple regression analyses will be used to predict health risk behaviour engagement. Thematic analysis will be used to analyse qualitative data.DiscussionTo our knowledge, this is the first study that would attempt to establish a health risk behaviour prevention program in youth and young people in South Africa. Overwhelming evidence exists that adolescents engage in risky health behaviour which may potentially negatively impact their lives. This study provides an opportunity to address a gap in the current strategy by developing a prevention program for young people which could later be supported by further booster programs through their adolescents. This project would serve as a baseline prevention program that could assist in the reduction of risky health behaviour among various communities.

The imperatives for lifelong learning in South Africa are driven by its reinsertion into the global economy and by the social and political necessities of equity and redress after the years of colonialism, segregation and apartheid. It is therefore not surprising to find the discourse of lifelong learning infused into new policy documents. Utilizing Belanger's framework, which argues that lifelong learning is not a norm to prescribe but an empirical reality to analyze and reconstruct, the contexts for lifelong learning in South Africa are surveyed by focusing in on the state of initial education, adult education, and the learning environments. The framework, which acknowledges the daily lived realities of women and men, is a helpful way of retaining an holistic and integrated vision of lifelong learning and its humanistic, democratic goals. For lifelong learning in South Africa to deepen for more than a small group of well-educated, mainly urban, formally employed people, the author concludes that initial education, adult education and the learning environments of all the people will have to be improved. If this does not happen, then at least two polarized 'lifelong educations' will result.

Introduction Four Virginia communities participated in a community services enhancement pilot to centralize intake and referral for childbearing women eligible for home visiting support through the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. Methods As an aspect of the study, project-trained intake workers administered behavioral health and psychosocial risk screening (including emotional health, substance use, interpersonal violence, and smoking) during intake eligibility assessment. Participants identified as at-risk were referred for community intervention concurrently with referral to MIECHV services. Results In the study sample (N=1515), emotional health was identified as the most common single risk factor (n=326, 21.5%) and clusters of 2 or more behavioral health risks were identified for 223 (14.7%) of women. Among those with two or more behavioral health risks, smoking was significantly related to all other areas of behavioral health risk. Conclusion Findings from this multi-site pilot emphasize concomitant behavioral health and psychosocial risks in childbearing women and reinforce the importance of embedding comprehensive public health interventions in community systems of care.

Suicide completion has increased in the United States among 15- to 24-year-olds from 4.5 per 100 000 (1950) to 13.2 per 100 000 (1990). Suicide attempts have been found to be associated with depression, substance use, overall number of life stressors, gender, and impulsive behaviors. We hypothesized that suicide attempt is associated with many other health risk behaviors. To evaluate this hypothesis, we analyzed the data from the 1993 Massachusetts Youth Risk Behavior Survey from a representative sample of students in grades 9 through 12 in public and private high schools. We examined the relationships between ever attempting suicide and engaging in other health risk or problem behaviors (eg, sexual activity, substance use, violence, and seat belt nonuse). The 3054 students were distributed among the 9th to 12th grades; 50.7% were female, 77.7% white, 6.7% black, 5.9% Hispanic, 4. 6% Asian, .8% Native American, and 4.4% other; and the mean age was 16 +/- 1.2 years. Based on logistic regression analysis, ever attempting suicide was associated with physical fights in the past 12 months (odds ratio [OR] = 1.3[95% confidence interval (CI), 1. 22-1.44]), regular cigarette use in the past 30 days (2.0[1.41-2. 97]), female gender (3.2[2.21-4.71]), lack of seat belt use (1.3[1. 21-1.34]), gun carrying in the past 30 days (1.4[1.12-1.70]), substance use before last sexual activity (1.4[1.09-1.84]), Native American or other (2.4[1.21-4.71]), and lifetime use of other drugs (1.2[1.04-1.40]). The full model correctly assigned 92% of the youth. There were small differences in models for males, females, and sexually active youth. Same gender sexual experiences for sexually active youth did not significantly improve the model (partial r = .0, OR = .87 [95% CI, .33-2.30]) and fewer (88%) of the youth were correctly assigned by the model. Ever attempting suicide is associated with other problem behaviors. This research proposes an empirical model of the relationship between suicide attempts and other health risk behaviors. Identifying which adolescents are at risk for suicide attempts from the presence of accompanying risk behaviors will help clinicians to evaluate suicide risk when other problem behaviors are identified, thus enabling the design of possible prevention strategies.

Extreme weather events pose major risks to human health and have a greater psychological impact on women and parents, but little is known about how they affect health risk behaviors. This study evaluated how disaster-related experiences before, during, and after Hurricane Irma were associated with mothers' health-risk behaviors, and the extent to which posttraumatic stress symptoms (PTSS) and depressive symptoms potentially mediated these relationships. Mothers (N = 534; 33% underrepresented minorities) residing in Southern Florida completed an online survey about their evacuation experiences before and hurricane experiences during and after Irma. Mothers also completed measures of PTSS, depressive symptoms, and health risk behaviors (i.e., substance use, sedentary behaviors, and difficulty falling or staying asleep). Confirmatory factor analysis assessed the fit of the health-risk behavior indicators on a latent factor. Structural equation modeling evaluated relationships between variables. A one-factor model for health risk behaviors fit the data well. After controlling for income, loss and disruption after the storm and depressive symptoms were directly associated with mothers' health risk behaviors. Before-the-storm evacuation stressors, actual life-threatening events during the storm, and loss and disruption after the storm were related to mothers' PTSS and depressive symptoms and also associated with health risk behaviors indirectly via depressive symptoms. Stressful experiences before, during, and after hurricanes are associated with mothers' health-risk behaviors via postevent emotional distress. Health interventions should include strategies that help parents cope with the impact of extreme weather events, both before and after such events occur. Mothers' distress potentially could affect child health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).