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Health Education Research Advance Access published online on October 22, 2007
Health Education Research, doi:10.1093/her/cym064
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions{at}oxfordjournals.org

Healthwise South Africa: cultural adaptation of a school-based risk prevention programme

L. Wegner1,2,3,*, A. J. Flisher2,3,4, L. L. Caldwell5, T. Vergnani1 and E. A. Smith6

1 HIV/AIDS Programme, University of the Western Cape, Bellville 7535, South Africa
2 Adolescent Health Research Institute, University of Cape Town, Red Cross Children's Hospital, Klipfontein Road, Rondebosch 7700, South Africa
3 Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory 7925, South Africa
4 Research Centre for Health Promotion, University of Bergen, Bergen, Norway
5 Recreation, Park and Tourism Management and Human Development and Family Studies, The Pennsylvania State University, 201 Mateer Building, Penn State University, University Park, PA 16802, USA
6 Prevention Research Centre, The Pennsylvania State University, 105-G South Henderson, University Park, PA 16802, USA

Correspondence to: * Correspondence to: L. Wegner. E-mail: lwegner{at}uwc.ac.za

There is a need for effective prevention programmes aimed at reducing risk behaviour among South African adolescents. HealthWise South Africa is a school-based programme designed to reduce sexual and substance use risk behaviour, and promote positive use of leisure time among high-school learners (students). Based on successful programmes in the United States of America, HealthWise was developed for use in South Africa and pilot tested in four South African high schools. We carried out a process evaluation to establish the fidelity of implementation and make sure HealthWise was culturally relevant. Data sources comprised focus groups with educators and learners, lesson evaluations and observations, and interviews with school principals. Qualitative analysis of data highlighted pertinent cultural and contextual factors and identified areas for modifying HealthWise in order to promote better programme-consumer fit. These areas centred on time, language, and leisure. We noted a dynamic tension between the educators' desire to adhere to plan, and to make adaptations in accordance with learners' needs and the context. Ultimately, researchers need to find a balance between fidelity of implementation and programme adaptation to obtain effective programmes that are culturally acceptable to local consumers.

Received on September 12, 2006; accepted on August 2, 2007


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