Acceptability and feasibility of a brief substance use intervention for adolescents in Cape Town, South Africa: A pilot study

Abstract

S ubstance use is prevalent among South African adolescents, but few interventions exist to reduce risk of harm. This study assesses the feasibility, acceptability and preliminary effects of a brief intervention for reducing adolescent substance use and other risk behaviours. This single-arm feasibility test recruited 30 substance-using adolescents and their primary caregiver. Participants received separate interventions (2 sessions for adolescents, 1 session for caregivers), with a subsample randomly selected for post-intervention interviews. Feasibility was measured by the proportion of eligible adolescents who were enrolled and retained in the study. Interviews explored acceptability, and changes in outcomes from baseline to 1-month follow-up assessed preliminary effects of the intervention. Thirty of 43 (69.8%) eligible adolescents and their caregivers were enrolled, with 29 adolescents (96.7%) and 28 caregivers (93.3%) completing the intervention. Twenty-eight adolescents (93.3%) and 29 caregivers (96.7%) were retained at follow-up. Frequency of alcohol, cannabis use and delinquent-type behaviours decreased significantly from baseline to follow-up. Participants appreciated the intervention content and delivery and felt that it facilitated behaviour change. Suggestions for improving the intervention were provided. This study found that the intervention is feasible, acceptable and had promising effects on adolescent behaviour. Efficacy must be established with a randomised controlled trial.

Socio-demographic and social support factors related to substance use in South African in-school adolescents: Insights from the Girls Achieve Power (GAP Year) trial in three peri-urban settings

“…Perceived social support also seems to have some correlation with substance use, with one family-related measure of support emerging as predictive of substance use itself, and two friend-related indicators differing by frequency of use for those who had used substances in the last year. This confirms research findings that caregivers act as a moderator or mediator for other risk factors children and adolescents may be facing (Measelle et al, 2006;Petersen et al, 2012), and that strong parental attachment relationships play a role in whether an adolescent uses substances (Brook et al, 2006). Although research exists on peer substance use influencing adolescents' substance use, there is limited knowledge about peer support, especially in a South African context.…”

“…Future studies could structure questionnaires to ask in more depth about substance use (e.g., specific symptoms of addiction) as well as a wider range of mental health variables, as the association between substance use and mental health symptoms is relatively unexplored in the South African adolescent population (Magidson et al, 2017). In addition to family support, the influence of peers is a potentially significant mediator or encourager of substance use, especially for adolescents (Brook et al, 2006), and this could be explored further.…”

“…In rural areas, prevalence of substance use may be lower than in urban samples (Tshitangano & Tosin, 2016). Studies conducted in SA have found several demographic factors to be associated with adolescent substance use, including being male, age (evidence is mixed on the direction of the relationship), friends using substances, having lower income, or a parent being unemployed (Brook et al, 2006;Magidson et al, 2017;Mohale & Mokwena, 2020;Muchiri & dos Santos, 2018;Peltzer et al, 2010). Internationally, longitudinal studies have found substance use to be associated with male gender, younger age, and the presence of common mental health disorders such as depression and anxiety (Brook et al, 2006;Lai et al, 2015).…”

Adolescent Health Series – Alcohol, tobacco, and other drug use among adolescents in sub‐Saharan Africa: A narrative review

“…We located two systematic reviews of adolescent ATOD interventions in SSA: one focused on school-based tobacco prevention [59] and the other on school-based alcohol prevention interventions [60]. Our comprehensive evidence review yielded studies of four community interventions [61][62][63][64] and four school-based interventions [33,[65][66][67][68][69]. Taken together our two search approaches yielded four community interventions and six school-based interventions for this review.…”

Take it personal! Development and modelling study of an indicated prevention programme for substance use in adolescents and young adults with mild intellectual disabilities and borderline intellectual functioning

“…Feasibility Feasibility in this study was investigated as it is pivotal to know how trainers experienced providing the intervention. This is helpful for implementation and adherence of trainers and participants to the protocol (Carney, Johnson, Carrico, & Myers, 2020). To assess feasibility, trainers were asked to complete an open-ended questionnaire after the intervention.…”