Reducing adolescent substance use is important in South Africa, a developing nation with increasing adolescent substance use, lack of leisure/recreation opportunities, and high rates of adolescent discretionary time. Previous research suggests leisure boredom and adolescent substance use co-occur in this setting. Using longitudinal data from 2,580 SA adolescents as they progressed from the 8th to 11th grade, the current study disentangles the associations of trait and state leisure boredom with substance use, and examines how ability to restructure boring situations moderates those associations. On average, individuals with higher trait boredom used more substances, and on occasions when state boredom was high, the prototypical adolescent used more substances. Although restructuring did not moderate these associations, greater ability was associated with lower substance use independent of leisure boredom. Findings illustrated the importance of considering how trait and state aspects of leisure may contribute to adolescents’ risk behavior and addressed through preventive intervention.

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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.