This project aimed to develop a digital web and mobile phone intervention for reducing Estonian adolescent and young adult alcohol and tobacco consumption. A systematic review was conducted, including a meta-analysis based on 32 randomised controlled trials, to investigate the associations with effectiveness of digital interventions in reducing adolescent and young adult alcohol and tobacco consumption. Digital interventions reduced adolescent and young adult weekly drinking (mean difference = -0.55, 95% CI (-1.04, -0.05), I2=93%) and monthly binge drinking (mean difference = -0.30, 95% CI (-0.55, -0.05), I2 = 75%). Digital interventions increased smoking cessation (risk ratio = 1.70, 95% CI (1.37, 2.11), I2= 35%). A qualitative focus group study with Estonian adolescents and young adults (N=22) indicated a lack of knowledge regarding effects of alcohol and tobacco consumption early in life and a recognition of the difficulty to change alcohol and tobacco consumption. A web and mobile phone based intervention programme was appealing to the focus group participants. The development of the first individually tailored web and mobile phone intervention targeting Estonian adolescent and young adult alcohol and tobacco consumption was undertaken. The content of this intervention was informed by the systematic review and meta-analysis, focus group study, psychological theory, and participatory design. The intervention, called MyOwnMe, is a tailored web program linked to a daily mobile phone text-messaging program. A pilot study with Estonian adolescents and young adults (N=22) indicated feasibility of implementation in Estonia and acceptability of intervention content. No difference was found between the intervention and control group in alcohol (mean difference = -0.2 95% CI (-0.9, 0.6), p = 0.62) or tobacco consumption (30-day abstinence from cigarette smoking RR = 1.25, 95% CI (0.81, 1.94)) after the 8-week study period. Results of this pilot study will be used for recommendations in this thesis on the development of individually tailored web and mobile phone interventions for Estonian adolescents and young adults.

Several researchers have indicated that the emphasis placed by young people on body shape and appearance has been greatly shaped by the media. The aim of this research was to investigate this notion specifically with regard to televised media. It was hypothesised that there would be a relationship between media images, eating attitudes and dietary behaviours, particularly for teenagers with body-image self-schemas who were conscious of their appearance. Nine hundred and sixty five senior secondary school students, from 33 country and metropolitan, state and independent, co-educational and single-sex South Australian high schools were surveyed. Fifty-six percent of the sample were adolescent girls and the average age of participants was 16.1 years. The questionnaire included sections on television usage, dieting behaviours, eating restraint and eating habits, as well as attitudes to foods, gender and appearance. Cluster analysis procedures indicated that it was possible to cluster television viewers into four distinct groups, "Telephiliacs", "Telephobics", "Modellers" and a "Relaxation/Information" group. These groups were classified according to television usage. Telephiliacs made the mose use of television, using it to gain information, for relaxation and entertainment and as a resource for body image and appearance standards; Modellers used it as a guide on which to model their appearance and behaviour; the Relaxation/Information group used it to relax and to gain information; and Telephobics did not watch much television and made the least use of it. The results of discriminant analyses confirmed that these cluster groups were different and that they could be distinguished by attitudes to appearance, dieting behaviours and foods consumed. The findings support the notion that the adolescent television audience is an active one and that television usage is dependent upon the needs of the individual. Television usage varied amongst adolescents and it was more likely to be used as a source of reference for body image standards by teenagers who were conscious of their appearance. These teenagers were also more likely to diet. Any outcomes related to television usage were accentuated if teenagers believed that television was "real". The findings suggest that television perpetuates an image of the thin body ideal and acts as a source of reference for adolescents with body-image self-schemas. / Thesis (M.Ed.)--Department of Education, 1996.

Several researchers have indicated that the emphasis placed by young people on body shape and appearance has been greatly shaped by the media. The aim of this research was to investigate this notion specifically with regard to televised media. It was hypothesised that there would be a relationship between media images, eating attitudes and dietary behaviours, particularly for teenagers with body-image self-schemas who were conscious of their appearance. Nine hundred and sixty five senior secondary school students, from 33 country and metropolitan, state and independent, co-educational and single-sex South Australian high schools were surveyed. Fifty-six percent of the sample were adolescent girls and the average age of participants was 16.1 years. The questionnaire included sections on television usage, dieting behaviours, eating restraint and eating habits, as well as attitudes to foods, gender and appearance. Cluster analysis procedures indicated that it was possible to cluster television viewers into four distinct groups, "Telephiliacs", "Telephobics", "Modellers" and a "Relaxation/Information" group. These groups were classified according to television usage. Telephiliacs made the mose use of television, using it to gain information, for relaxation and entertainment and as a resource for body image and appearance standards; Modellers used it as a guide on which to model their appearance and behaviour; the Relaxation/Information group used it to relax and to gain information; and Telephobics did not watch much television and made the least use of it. The results of discriminant analyses confirmed that these cluster groups were different and that they could be distinguished by attitudes to appearance, dieting behaviours and foods consumed. The findings support the notion that the adolescent television audience is an active one and that television usage is dependent upon the needs of the individual. Television usage varied amongst adolescents and it was more likely to be used as a source of reference for body image standards by teenagers who were conscious of their appearance. These teenagers were also more likely to diet. Any outcomes related to television usage were accentuated if teenagers believed that television was "real". The findings suggest that television perpetuates an image of the thin body ideal and acts as a source of reference for adolescents with body-image self-schemas. / Thesis (M.Ed.)--Department of Education, 1996.

Thesis (MA (Psychology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: With the growing HIV/AIDS epidemic in South Africa, it is important to understand the sexual behaviours that place youth at risk of HIV/AIDS, other sexually transmitted diseases (STDs) and unwanted pregnancies in order to develop and implement appropriate health-promoting interventions. Parents are in a unique position to help adolescents to have responsible attitudes and behaviour towards sex, and to educate adolescents into healthy sexual adults. The study aimed to investigate parent-adolescent communication and adolescents’ sexual risk-taking behaviour, and the relationship between them. An exploratory, descriptive research design and a quantitative methodological approach were used. One biographical questionnaire, three measuring scales of parent-adolescent communication and one questionnaire about adolescent sexual risk-taking behaviour were used as measuring instruments. Data from 95 female adolescents who were attending the family planning facilities of two clinics in the Metropole Region of the Western Cape were employed for the study. The collected data were analysed using descriptive statistics, Spearman’s correlations, analyses of variance and multiple regression analysis. The findings revealed a high prevalence of sexual risk-taking behaviours among adolescents in the Western Cape. Family environment characteristics, especially the parents’ marital status, play a significant role in both parent-adolescent communication and sexual risk-taking behaviour. Unexpected findings were some significant correlations that were found between different factors of both general and sexual parent-adolescent communication. Spearman’s correlations and best subsets multiple regression analysis were performed on the data to ascertain which factors are significantly correlated or associated with adolescent sexual risk-taking behaviour. In both statistical analyses, the amount of parent-adolescent communication about sexual issues was the most important. A significant negative correlation between adolescents’ sexual risk-taking behaviours and the amount of parent-adolescent communication about sexual issues illustrates the positive influence of amount of parent-adolescent sexual communication on adolescents’ sexual risk-taking behaviour. / AFRIKAANSE OPSOMMING: Met die groeiende MIV/VIGS epidemie in Suid-Afrika is dit belangrik om te verstaan watter gedrag jong mense in gevaar stel om MIV of ander seksueel oordraagbare siektes op te doen of om ongewens swanger te word om daardeur programme wat hierdie gedrag verminder, te kan ontwikkel en implementeer. Ouers is in ‘n unieke posisie om te verseker dat hulle adolessente kinders verantwoordelike houdings en optrede teenoor seks ontwikkel en om hulle op te voed tot volwassenes wat ‘n gesonde houding tot seks het. Die doel van hierdie studie was om die verhouding tussen ouer-adolessente kommunikasie en die seksuele waaggedrag van jong mense te ondersoek en die verhouding tussen hulle te bepaal. ‘n Ondersoekende, beskrywende navorsingsontwerp en ‘n kwantitatiewe metodologiese benadering is gebruik. ‘n Biografiese vraelys, drie vraelyste oor ouer-adolessente kommunikasie en een vraelys oor die seksuele waaggedrag van jong mense is deur 95 adolessente meisies voltooi wat die gesinsbeplanningsfasiliteite by twee klinieke in die Wes-Kaapse metropool besoek het. Die data is ontleed deur die berekening van Spearman (Rho)-korrelasies, variansieontleding, meervoudige regressie-analise en beskrywende statistiek. Die bevindings dui op ‘n hoë voorkoms van seksuele waaggedrag onder adolessente in die Wes-Kaap. Gesinsomstandighede, veral die ouers se huwelikstatus, speel ‘n belangrike rol in ouer-adolessente kommunikasie en seksuele waaggedrag. Onvoorsiene bevindings was die beduidende korrelasies tussen verskillende faktore van beide algemene en seksuele ouer-adolessente kommunikasie. Spearman-korrelasies en best subsets meervoudige regressie-analise is op die data uitgevoer om te bepaal watter faktore betekenisvol met adolessente waaggedrag korreleer of daarmee geassosieer is. In beide statistiese analises is gevind dat die hoeveelheid ouer-adolessente kommunikasie oor seksuele kwessies die belangrikste was. Daar was ‘n statisties beduidende negatiewe korrelasie tussen die adolessent se seksuele waaggedrag en die hoeveelheid kommunikasie tussen die ouer en adolessent oor seks, wat beteken dat adolessente minder seksuele waaggedrag sal vertoon indien hulle ouers meer met hulle oor seksuele sake sal praat.

Magister Public Health - MPH / Background: Alcohol consumption among adolescents is increasing due to the general availability of alcohol in many community settings. Binge drinking (defined as drinking 5 or more drinks per occasion) (Parry, 2000) is considered the most common type of harmful alcohol consumption among young people. The United States Youth Risk Behaviour Surveillance report proposes that patterns of health risk behaviours are established during youth (Centre for Disease Control and Prevention,2006). The abovementioned report highlights behaviours such as alcohol misuse, drug use and risky sexual behaviour that have the potential to undermine the health and development of youth. Adolescent developmental theories recognise risk behaviours as central to normal adolescent development but there are complex predisposing risk factors that can cause these behaviours to compromise the healthy development of our youth. In order to design and implement effective intervention schemes, we need to understand the dynamics of alcohol use among local youth better, as these play out in their specific social environmental and personal contexts.Aim: The aim of this study was to gain an understanding of what influences the patterns of alcohol use among adolescents in a peri-urban historically disadvantaged community in the Western Cape. The study identified some of the factors that promote and inhibit drinking within the study community from the perspective of the adolescents themselves and a few of the adults who work with adolescents. The study also determined some of the harmful consequences to drinking as described by the adolescents.Method: This was an exploratory study using qualitative research methods. Four focus group discussions were conducted with adolescents aged between 14 and 19 years that were both attending and not attending school. Three key informant interviews with adults who were involved with the youth were conducted.Convenience sampling was used for the non-school attending participants and snowball sampling was used for the school attending youth. The adults in the study were purposively sampled. The study was conducted within the study setting during March and April 2009. Thematic and content analysis was used to interpret the data.The descriptive data was coded and categorised according to themes that emerged during analysis.Results: In general the youth of this study are drinking on weekends. They spend their time on the streets and access alcohol from the many illegal taverns in their neighbourhood. Some of the reasons why adolescents drink include just for the fun of it and because their friends drink and to cope with stress or boredom (risk factors for problem behaviour). Those who don’t drink generally have strong parental role models, have observed some of the harmful effects of alcohol use and seem able to resist peer pressure (protective factors for problem behaviour). There were no significant differences between the perceptions of male and female adolescents regarding alcohol consumption. The black adolescents in general appeared to be more affected by poverty than the coloured adolescents, a factor that influenced their choices around alcohol use. Risky sexual behaviour, rape and fighting seem to be some of the harmful consequences to drinking that are described by the youth of this study. The social environment in which the adolescents of this study live seemed to play a significant role in their attitudes toward drinking. Factors such as a lack of infrastructure for leisure, poverty and a tolerance for public drunkenness are community factors that affect these adolescents but over which they have little or no control.Conclusion: The potential for problem behaviour as perceived by the participants is determined by the balance of risk and protective factors that emanate from their social environment, the community itself and their own personality. Those fortunate enough to have cohesive families with interested adults around them are more likely to be protected from problem behaviour due to drinking.Recommendations: Recommendations from this study include engaging with the youth directly when designing intervention programmes; using peer-led programmes to effect change and to help adolescents to clarify their values; equip them with skills to plan for the future in order to develop their self-efficacy to make the right choices when it comes to alcohol consumption. It is also recommended that intervention programmes address relationships within the community itself such as strengthening parent-child communication; building positive adult role models and empowering community members to challenge issues such as illegal tavern owners serving alcohol to minors.

Cette étude vise à examiner la relation entre les pratiques parentales utilisées durant la période de l'enfance et les dimensions principales du du trouble déficitaire de l'attention avec hyperactivité (TDAH) à l'adolescence, soit l’inattention, l’hyperactivité et l’impulsivité. Les pratiques spécifiques parentales (engagement, pratiques parentales appropriée, supervision, punitions corporelles, discipline appropriée, discipline sévère et incohérente, discipline verbale positive, félicitations et récompenses, et les attentes claires) et les aspects du fonctionnement familial (communication, résolution de problèmes, rôles dans la famille, sensibilité affective, engagement affectif, contrôle comportemental) ont été examinés par rapport à l'inattention et d'hyperactivité. Trente-six enfants de 6 à 9 ans et leurs parents ont participé à une étude longitudinale de 5 ans. Il y a un manque d'études longitudinales dans ce domaine et cette étude vise à combler cette lacune. Les résultats ne montrent pas de résultats significatifs dans la relation entre les pratiques parentales utilisées dans l'enfance et les symptômes principaux de l'hyperactivité et l'inattention à l'adolescence. Les études futures devraient se concentrer sur la relation entre la psychopathologie parentale et les principaux symptômes du TDAH de l'enfance à l'adolescence, ainsi que l'impact des pratiques parentales sur ces principaux symptômes. / This study aims to examine the relationship between parenting practices used in childhood on one hand and the core symptoms of Attention deficit hyperactivity disorder (ADHD) in adolescence on the other hand. Specific parenting practices ( involvement, positive parenting, monitoring/supervision, corporal punishment, appropriate discipline, harsh and inconsistent discipline, positive verbal discipline, praise and incentives and clear expectations) and aspects of family functioning were examined ( communication, problem solving, roles, affective responsiveness, affective involvement, behavioural control and general functioning) in relation to inattention and hyperactivity. The sample consisted of 36 participants involved in a 5 year study from childhood (6 to 9 years old) to adolescence (11 to 14 years old). The results do not show significant results in the relationship between parenting practices used in childhood and the core symptoms of hyperactivity and inattention in adolescence. There is a lack of longitudinal studies in this area and this study attempts to fill in this gap. However despite a lack of significant results, past research suggests an important relationship between parental psychopathology, which has been linked with ineffective parenting practices and the persistence of ADHD from childhood to adolescence. Future studies should focus on the relationship between parental psychopathology and the core symptoms of ADHD from childhood to adolescence, as well as the impact of parenting practices on these core symptoms.