Many adolescents are at risk of injury as a result of lifestyle, with high morbidity and mortality rates primarily affected by engagement in risk-taking behaviour (AIHW, 2004b). The study aimed to reduce injury through the design, implementation and evaluation of an intervention to affect risk-taking behaviour. The intervention was guided by theory and selectively focused on increasing protective behaviour toward friends. To meet the aim, the intervention focused on the following risk-taking behaviours: alcohol use, interpersonal violence, being a passenger of, and own risky use of a motor vehicle or bicycle. The average age of participants of the study was fourteen. The program of research was divided into three stages that, as a whole, met the aim of designing and evaluating an intervention to reduce risk-taking behaviour among adolescents. The aim of the first stage was to provide the detail required for the program design (Stage 2). Stage 1 comprised a number of research processes including (i) a comprehensive literature review. The literature review included the rationale for reducing injury and risk-taking behaviour among adolescents, examination of the friendship relationship and assessing key issues and components of previously evaluated behaviour change programs. Stage 1 also included (ii) an assessment and operationalisation of the theoretical design (Theory of Planned Behavior and cognitive behavioural strategies). It was also found, in this Study 1, that the constructs of the TPB could explain friends' protective behaviour. Further, Stage 1 included (iii) Study 2, a qualitative evaluation of injury, risk-taking behaviour and key risk and protective factors for risk-taking behaviour from the perspective of young people conducted through focus groups. The information gathered in Stage 1 was used to develop the design of the program which comprised Stage 2. The next stage (Stage 3) involved an impact evaluation of the program. Firstly, in Study 3, a qualitative study was conducted to assess intervention participants' and teachers' perceptions of the program and adolescents' change in behaviour and attitudes. Intervention participants felt that they reduced their risk-taking behaviour and increased their protective behaviour toward their friends. Overall, adolescents and teachers viewed the program favourably. Secondly, in Study 4, a quantitative evaluation was conducted. Preliminary investigations found significant differences in change and behaviours among individuals from different ethnic backgrounds and, as such, analyses were conducted with the majority, Caucasian group only. The results indicated a reduction in risk-taking behaviours from baseline to follow-up in the intervention group and an increase in the comparison group. There was no support for the prediction that intervention students would increase their protective behaviour relative to the control group. Overall, the findings indicated challenges associated with designing and implementing an effective program to reduce risk-taking behaviour among adolescents. (Author/publisher)
Samenvatting