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Practice guidelines for culturally sensitive drug prevention interventions

South Africa has experienced a notable increase in adolescent drug use during the country’s transition from apartheid to democracy (Central Drug Authority [CDA], 2006). These findings are verified by epidemiological studies and two national youth risk behaviour surveys, highlighting the need for effective drug prevention interventions. Whilst drug use spans across age, gender and social strata, the rapid increase in both legal and illicit drug use among adolescents in the Northern Areas communities of Port Elizabeth has been particularly pronounced. The South African Community Epidemiology Network on Drug Use (SACENDU) statistics, which reflects on racial demographics in accordance with the Population Registration Act of 1950 (South Africa, 1950), reports that, in the year 2011, the ‘Coloured’ population constituted 62 percent of those individuals seeking treatment for drug abuse, compared to 15 percent ‘African’ treatment seekers in Port Elizabeth (Dada, Plüddemann, Parry, Bhana, Vawda & Fourie, 2012:44). Furthermore, methamphetamine use by persons under the age of 20 years in Port Elizabeth increased fivefold in a three-year period, i.e. from 7 percent in 2008 to 39 percent in 2011 (Dada et al., 2012), with the ‘Coloured’ population group accounting for the majority of methamphetamine users. These statistics reinforce a long-standing racial stereotype that associates ‘Coloured’ racial identity with an enhanced susceptibility to drug use. The National Drug Master Plan (South Africa, 2012a), and the Prevention of and Treatment for Substance Abuse Act (Act no 70 of 2008) propose that drug prevention programmes should address the values, perceptions, expectations and beliefs that the community associates with drug abuse (South Africa, 2008b). This view emphasises the importance of drug preventions interventions that are culturally sensitive and contextually relevant. The current study was guided by two conceptual frameworks, i.e. the Social Constructionist Framework and the Ecological Risk/Protective Resilience Framework, and focused on the Northern Areas of Port Elizabeth, a historically marginalised community inhabited by a predominantly ‘Coloured’ indigenous/ethnic group. The goal of the study was to enhance understanding of the socio-cultural meaning attributed to cultural identity, drug use, non-use and drug prevention in the Northern Areas of Port Elizabeth, with the view to developing guidelines for drug prevention interventions that are culturally sensitive and contextually relevant. The following objectives were formulated in order to achieve the goal of the study: • To explore adolescent narratives regarding the constructs ‘Coloured’, drug use, non-use and drug prevention programmes of three distinct groups of adolescents (drug users, non-users, and TADA peer mentors) from the Northern Areas. • To explore and describe the social service practitioners’ (social workers and social auxiliary workers’) constructions of drug use, non-use and drug abuse prevention in relation to adolescents from the Northern Areas, and how such constructions inform the drug prevention services rendered to adolescents from these communities. • To review the data collected from the adolescent narratives and the social service practitioners’ reflections on their drug prevention programmes against existing theory and models for drug prevention. • To synthesise the above information with a view to developing guidelines for culturally sensitive drug prevention programmes relevant and responsive to the specific social constructions of adolescents from the Northern Areas. A qualitative research approach, located in a narrative tradition of inquiry research design, was employed to achieve the goal of the study (Riessman, 2008). The study was conducted in two phases. The first phase involved an empirical study with the four sample groups (i.e. adolescent drug users, adolescent non-drug users, Teenagers against Drug Abuse [TADA] peer mentors and social service professionals (i.e. social workers and social auxiliary workers)). Phase two involved the co-construction of the practice guidelines for culturally sensitive and contextually relevant drug prevention interventions. Phase one started with the informal exploration of community stakeholders’ views on the identified research problem and the process of gaining access to the research population. Several gatekeepers (i.e. teachers, social workers, the Families Against Drugs [FAD] Support Group representatives, a minister of religion and a community stakeholder) were engaged to assist in recruiting participants from the four sample groups. A non-probability purposive sampling method was employed to purposively recruit 29 adolescent non-drug users and ten adolescent peer mentors (via the TADA Programme at one school). The same sampling method, followed by a snowball sampling technique, was employed to recruit the two remaining sample groups of ten adolescent drug users (in the recovery process) and nine social workers and social auxiliary workers respectively. The sample sizes were determined by the principle of data saturation.The data generation method used in respect of the non-users took the form of semi-structured written narratives, administered in a group context during school time, followed by a second round of data generation. The life-grid (Wilson, Cunningham-Burley, Bancroft, Backett-Milburn & Masters, 2007:144), a qualitative visual tool for mapping important life events, was employed to guide the co-construction of the biographical narratives generated during the individual semi-structured interviews with the sample of adolescent drug users. Focus group interviews were used to enhance an understanding of the peer mentors and social service practitioners’ views on the construct ‘Coloured’ and their existing drug prevention programmes. Each of the individual and focus group interviews was audio-recorded, transcribed and complemented by the field notes. Informal data gathering occurred through participant observation of two drug prevention programmes, attendance of a FAD Support Group meeting, and interviews with community volunteers and the South African Police Services (SAPS) Youth Development Forum. Both the content and the context of the narratives were analysed to arrive at the research themes, sub-themes and categories. The content of the narratives was analysed by employing categorical content analysis, whilst the form of the narratives (i.e. how the stories were told) was analysed by using the socio-cultural approach to narrative analysis (Grbich, 2007:130). The journey metaphor emerged from the adolescent drug users’ narratives, depicting a prototypical storyline of a drug use journey, starting with experimentation and culminating in abuse and dependence for some and an early exit from the journey for others. The conclusions that can be drawn from these findings illuminate key protective factors and processes at a multisystemic level that can be strengthened to enhance the adolescents’ resistance to drug use and/or delay the onset of use. Embedded in the participants’ narration of the drug use journey were nuances relating to internalised stereotypes of ‘White’ supremacy and ‘Coloured’ inferiority as an explanatory framework for venturing onto and prolonging the journey.The two themes that emerged during the process of content and narrative analysis of the qualitative data (from both adolescent drug users and non-users) were as follows: Constructing drug use as a ‘Coloured’ phenomenon and reconstructing ‘Coloured’ identity; Risk and protective factors located at individual, family, peer, school, community and societal domains. The four themes that emerged during the data analysis of the peer mentors and social service practitioners’ narratives were as follows: Construction of ‘Coloured’ identity; socio-cultural meaning construction about the reasons for drug use amongst adolescents from the Northern Areas; description of drug prevention services rendered in the Northern Areas; and reflection on barriers to rendering drug prevention interventions.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nmmu/vital:10005
Date January 2014
CreatorsGoliath, Veonna
PublisherNelson Mandela Metropolitan University, Faculty of Health Sciences
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis, Doctoral, DPhil
Formatxxi, 567 leaves, pdf
RightsNelson Mandela Metropolitan University

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