The adaptation of an evidence-based brief intervention for substance-using adolescents and their caregivers.

Objective: Adolescent substance use is prevalent and associated with additional risk behaviours. Research shows that evidence-based brief interventions with adolescents and their main caregiver may mitigate the progression of substance use. Method: We used the ADAPT-ITT framework to develop a needs-based, culturally-sensitive intervention. Five focus groups with adolescents (n = 30), three focus groups with separate main caregivers of adolescents who use substances (n = 21), key informant interviews and an expert meeting, were conducted. Results: Adolescents described the need to decrease risk behaviours, while adolescents and caregivers requested additional support. The core components of the original intervention were retained, with some additions. The newly adapted RAD-PAL intervention was viewed as acceptable. Conclusion: Despite apparent acceptability, we need to test feasibility and efficacy in a trial.

Building a mental hospital in apartheid South Africa.

In April 1962, a new mental hospital was inaugurated in Belville, a town near Cape Town, South Africa. Stikland Mental Hospital was planned as mental health care was changing with the introduction of psychotropic drugs and renewed debates about deinstitutionalization-and as the South African legislature formalized the system known as "apartheid." This article focuses on this hospital, which embodied many global ideas about treatment and management of the mentally ill but which also incorporated the local politics of strict racial segregation. It had been planned in response to overcrowded mental hospitals in the 1950s, but by the time it opened, new forms of treatment had produced a surplus of beds for White patients. Architecturally, the hospital was conceived with the general principles of the villa plan in mind, although utilitarian aspects, such as patient and staff numbers, gardens, and budgets, dominated the design of the buildings. The public relations exercises undertaken highlight the negotiations involved in building a mental hospital in 1960s South Africa, but the example of Stikland also showcases new plans for research and training in mental health professions in the 1960s and 1970s. Disciplines such as clinical psychology benefited from the professional training opportunities provided. Overall, Stikland Mental Hospital therefore provides an important perspective on deinstitutionalization outside its familiar settings and historical accounts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Public Representations of Loss in Death Announcements, 1912 to 2002.

This work presents a historical analysis of death announcements ( N = 1,443) posted in the New York Times between 1912 and 2002. Announcements were coded according to two main categories: the genre of the announcement and the presence of emotion words. Four distinct main genres emerged: death notices, memorials, recognition postings by organizations, and recognition postings by nonorganizational parties (friends and family). The proportion of death notices declined steadily from 1912 to 2002, while the proportion of announcements paying tribute to the deceased increased. The announcements were also analyzed in terms of emotion words used, and it is argued that the increasing frequency of emotion words used in the death announcements reflects a progressive emotionalization and psychologization of grief and loss.

When There Are Only Minorities: Identity and In-Group / Out-Group Orientations of Emerging Adults in Four South African Ethnocultural Groups.

Intergroup relation perspectives stem from research in Western contexts with clear distinctions between the dominant and nondominant groups. In South Africa, with at least 13 different cultural groups and 11 official languages, no group is dominant in all life spheres. We examine the relationship between identity and in-/out-group orientation across Black-Zulu, Coloured (mixed racial ancestry), Indian, and White-Afrikaans emerging adults (N = 390; 75% females, Mage = 19.97 years, SD = 2.44). Results indicate that personal identity for all groups and ethnic identity for Black-Zulu, Indian, and White-Afrikaans emerging adults were important for intergroup relations. Black-Zulu, Coloured, and Indian emerging adults distinguish themselves less from others, whereas White-Afrikaans emerging adults are less open to others. Ultimately, the complexity of intergroup relations in South Africa has implications for the effective transformation interventions needed to counter experiences of threat and make group boundaries more flexible for emerging adults.

Developing Intervention Strategies to Optimise Body Composition in Early Childhood in South Africa.

Purpose. The purpose of this research was to collect data to inform intervention strategies to optimise body composition in South African preschool children. Methods. Data were collected in urban and rural settings. Weight status, physical activity, and gross motor skill assessments were conducted with 341 3-6-year-old children, and 55 teachers and parents/caregivers participated in focus groups. Results. Overweight and obesity were a concern in low-income urban settings (14%), but levels of physical activity and gross motor skills were adequate across all settings. Focus group findings from urban and rural settings indicated that teachers would welcome input on leading activities to promote physical activity and gross motor skill development. Teachers and parents/caregivers were also positive about young children being physically active. Recommendations for potential intervention strategies include a teacher-training component, parent/child activity mornings, and a home-based component for parents/caregivers. Conclusion. The findings suggest that an intervention focussed on increasing physical activity and improving gross motor skills per se is largely not required but that contextually relevant physical activity and gross motor skills may still be useful for promoting healthy weight and a vehicle for engaging with teachers and parents/caregivers for promoting other child outcomes, such as cognitive development.

Brief school-based interventions and behavioural outcomes for substance-using adolescents.

BACKGROUND: Adolescent substance use is a major problem in and of itself, and because it acts as a risk factor for other problem behaviours. As substance use during adolescence can lead to adverse and often long-term health and social consequences, it is important to intervene early in order to prevent progression to more severe problems. Brief interventions have been shown to reduce problematic substance use among adolescents and are especially useful for individuals who have moderately risky patterns of substance use. Such interventions can be conducted in school settings. This review set out to evaluate the effectiveness of brief school-based interventions for adolescent substance use. OBJECTIVES: To evaluate the effectiveness of brief school-based interventions in reducing substance use and other behavioural outcomes among adolescents compared to another intervention or assessment-only conditions. SEARCH METHODS: We conducted the original literature search in March 2013 and performed the search update to February 2015. For both review stages (original and update), we searched 10 electronic databases and six websites on evidence-based interventions, and the reference lists of included studies and reviews, from 1966 to February 2015. We also contacted authors and organisations to identify any additional studies. SELECTION CRITERIA: We included randomised controlled trials that evaluated the effects of brief school-based interventions for substance-using adolescents.The primary outcomes were reduction or cessation of substance use. The secondary outcomes were engagement in criminal activity and engagement in delinquent or problem behaviours related to substance use. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures outlined by The Cochrane Collaboration, including the GRADE approach for evaluating the quality of evidence. MAIN RESULTS: We included six trials with 1176 adolescents that measured outcomes at different follow-up periods in this review. Three studies with 732 adolescents compared brief interventions (Bls) with information provision only, and three studies with 444 adolescents compared Bls with assessment only. Reasons for downgrading the quality of evidence included risk of bias of the included studies, imprecision, and inconsistency. For outcomes that concern substance abuse, the retrieved studies only assessed alcohol and cannabis. We generally found moderate-quality evidence that, compared to information provision only, BIs did not have a significant effect on any of the substance use outcomes at short-, medium-, or long-term follow-up. They also did not have a significant effect on delinquent-type behaviour outcomes among adolescents. When compared to assessment-only controls, we found low- or very low-quality evidence that BIs reduced cannabis frequency at short-term follow-up in one study (standardised mean difference (SMD) -0.83; 95% confidence interval (CI) -1.14 to -0.53, n = 269). BIs also significantly reduced frequency of alcohol use (SMD -0.91; 95% CI -1.21 to -0.61, n = 242), alcohol abuse (SMD -0.38; 95% CI -0.7 to -0.07, n = 190) and dependence (SMD -0.58; 95% CI -0.9 to -0.26, n = 190), and cannabis abuse (SMD -0.34; 95% CI -0.65 to -0.02, n = 190) at medium-term follow-up in one study. At long-term follow-up, BIs also reduced alcohol abuse (SMD -0.72; 95% CI -1.05 to -0.40, n = 181), cannabis frequency (SMD -0.56; 95% CI -0.75 to -0.36, n = 181), abuse (SMD -0.62; 95% CI -0.95 to -0.29, n = 181), and dependence (SMD -0.96; 95% CI -1.30 to -0.63, n = 181) in one study. However, the evidence from studies that compared brief interventions to assessment-only conditions was generally of low quality. Brief interventions also had mixed effects on adolescents' delinquent or problem behaviours, although the effect at long-term follow-up on these outcomes in the assessment-only comparison was significant (SMD -0.78; 95% CI -1.11 to -0.45). AUTHORS' CONCLUSIONS: We found low- or very low-quality evidence that brief school-based interventions may be more effective in reducing alcohol and cannabis use than the assessment-only condition and that these reductions were sustained at long-term follow-up. We found moderate-quality evidence that, when compared to information provision, brief interventions probably did not have a significant effect on substance use outcomes. It is premature to make definitive statements about the effectiveness of brief school-based interventions for reducing adolescent substance use. Further high-quality studies examining the relative effectiveness of BIs for substance use and other problem behaviours need to be conducted, particularly in low- and middle-income countries.

Reliability of the GAIN-SS, CRAFTT and PESQ screening instruments for substance use among South African adolescents.

INTRODUCTION: Screening for adolescent substance use can assist with the early identification of substance-related problems and guide the provision of appropriate services. As such, psychometrically sound screening tools are needed. The aim of this study was to compare the reliability of the CRAFFT, Global Appraisal of Individual Needs-Short Screener (GAIN-SS) substance use subscale and Personal Experience Screening Questionnaire (PESQ) among adolescents from disadvantaged communities in Cape Town, South Africa. METHODS: Adolescents aged 12-19 years (n = 231) completed the three screeners at two points in time. RESULTS: Findings show that all three of the screeners had adequate internal consistency (Cronbach α ≥ 0.8). Test-retest reliability was similar for all three screeners, with intraclass correlation coefficient values slightly higher for the PESQ (0.82, 95% CI: 0.77-0.86) than for the GAIN-SS substance use subscale (0.79, 95% CI: 0.73-0.84) and CRAFFT (0.76; 95% CI: 0.66-0.83). Kappa values indicated that the GAIN-SS substance use subscale and CRAFFT had moderate levels of agreement, while the PESQ had substantial levels of agreement for identifying those who had moderate or higher substance use risks at Time 1 and Time 2. CONCLUSION: The findings indicate that all of these short screeners seem to have acceptable reliability when used in this population. All of the three screeners are appropriately reliable when used with adolescents from disadvantaged communities in Cape Town, but the PESQ performed slightly better. Future studies should also include the assessment of validity of these screeners in this context.

Improving the counselling skills of lay counsellors in antiretroviral adherence settings: a cluster randomised controlled trial in the Western Cape, South Africa.

Little research has investigated interventions to improve the delivery of counselling in health care settings. We determined the impact of training and supervision delivered as part of the Options: Western Cape project on lay antiretroviral adherence counsellors' practice. Four NGOs employing 39 adherence counsellors in the Western Cape were randomly allocated to receive 53 h of training and supervision in Options for Health, an intervention based on the approach of Motivational Interviewing. Five NGOs employing 52 adherence counsellors were randomly allocated to the standard care control condition. Counselling observations were analysed for 23 intervention and 32 control counsellors. Intervention counsellors' practice was more consistent with a client-centred approach than control counsellors', and significantly more intervention counsellors engaged in problem-solving barriers to adherence (91 vs. 41 %). The Options: Western Cape training and supervision package enabled lay counsellors to deliver counselling for behaviour change in a manner consistent with evidence-based approaches.

Brief school-based interventions and behavioural outcomes for substance-using adolescents.

BACKGROUND: Adolescent substance use is a major problem, in and of itself and because it acts as a risk factor for other problem behaviours. As substance use during adolescence can lead to adverse and often long-term health and social consequences, it is important to intervene early on in order to prevent progression to more severe problems. Brief interventions have been shown to reduce problematic substance use among adolescents and are especially useful for individuals who have moderately risky patterns of substance use. Such interventions can be conducted in school settings. This review set out to evaluate the effectiveness of brief school-based interventions for adolescent substance use. OBJECTIVES: To evaluate the effectiveness of brief school-based interventions on reducing substance use and other behavioural outcomes among adolescents compared to another intervention or assessment-only conditions. SEARCH METHODS: We searched 10 electronic databases and six websites on evidence-based interventions, and the reference lists of included studies and reviews, from 1966 to March 2013. We also contacted authors and organisations to identify any additional studies. SELECTION CRITERIA: We included randomised controlled trials that evaluated the effects of brief school-based interventions for substance-using adolescents.The primary outcomes were reduction or cessation of substance use. The secondary outcomes were engagement in criminal activity and engagement in delinquent or problem behaviours related to substance use. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures outlined by The Cochrane Collaboration, including the GRADE approach for evaluating the quality of evidence. MAIN RESULTS: Six studies involving 1139 participants were included in this review. Overall the quality of evidence was moderate in the information provision comparison, and low or very low in the assessment only comparison. Reasons for downgrading the quality included risk of bias of the included studies, imprecision and inconsistency. Our findings suggested that compared to information provision only, brief interventions (BIs) did not have a significant effect on any substance use (three studies, 732 participants, standardised mean difference (SMD) -0.06; 95% confidence interval (CI) -0.20 to 0.09) or delinquent-type behaviour outcomes among adolescents (two studies, 531 participants, SMD -0.26; 95% CI -0.54 to 0.02). When compared to assessment-only controls, BIs had some significant effects on substance use and delinquent-type or problem behaviours, but high levels of heterogeneity existed between studies and it was not always possible to pool the results. When the comparison was with assessment-only conditions, studies of individual interventions that measured BI effectiveness reported significantly reduced substance use in general and in two studies reduced frequency of alcohol use specifically. When the data were pooled, BIs reduced cannabis frequency (SMD -0.22; 95% CI -0.45 to -0.02) across three studies (n = 407). Cannabis quantity was also reduced by BIs in comparison to assessment only (SMD -60.27; 95% CI -66.59 to -53.95) in one study (n = 179). However, the evidence for studies that compared brief interventions to assessment-only conditions was generally of low quality. Brief interventions also had mixed effects on participants' delinquent or problem behaviours. AUTHORS' CONCLUSIONS: There was limited quality evidence that brief school-based interventions were more effective in reducing substance use than the assessment-only condition, but were similar to information provision. There is some evidence for the effectiveness of BI in reducing adolescent substance use, particularly cannabis, when compared to assessment only. However, it is premature to make definitive statements about the effectiveness of brief school-based interventions for reducing adolescent substance use. Further high quality studies examining the relative effectiveness of BIs for substance use and other problem behaviours need to be conducted, particularly in low- and middle-income countries.

Lay counselors' ability to deliver counseling for behavior change.

OBJECTIVE: Options for Health is an evidence-based sexual risk reduction intervention based on motivational interviewing (MI). Thirty-nine antiretroviral adherence lay counselors were trained to deliver Options for Health to help their patients to optimize their antiretroviral treatment adherence. An evaluation of counselors' ability to deliver the intervention after 35 hr of training revealed that counselors struggled with elements of the 8-step Options protocol and failed to achieve proficiency in MI. The current study aimed to determine the impact of refresher training and supervision on counselors' proficiency in the intervention. METHOD: Audio-recordings of counseling sessions were collected for 22 of 39 counselors after 18 hr of refresher training and supervision had been delivered over a 12-month period. Recordings were transcribed, translated, and analyzed for fidelity to the Options protocol and the MI approach. Analysis was conducted using the Motivational Interviewing Treatment Integrity Tool and an instrument developed by the researchers. Results were compared to findings from an evaluation of counselors' performance immediately following the initial 35-hr training. RESULTS: Counselors improved their delivery of some intervention steps, but not others; their use of micro-counseling skills and therapeutic approach improved to such an extent that they closely approximated the MI approach. CONCLUSIONS: This study contributes evidence for the positive impact of ongoing training and supervision on lay health worker practice. Although counselors did not achieve complete proficiency in the Options protocol, refresher training and supervision improved counselors' basic counseling communication skills and therapeutic approach, enabling them to deliver better quality counseling for behavior change.

From research to practice: lay adherence counsellors' fidelity to an evidence-based intervention for promoting adherence to antiretroviral treatment in the Western cape, South Africa.

In the Western Cape, lay counsellors are tasked with supporting antiretroviral (ARV) adherence in public healthcare clinics. Thirty-nine counsellors in 21 Cape Town clinics were trained in Options for Health (Options), an evidence-based intervention based on motivational interviewing (MI). We evaluated counsellors' ability to deliver Options for addressing poor adherence following 5 days training. Audio-recordings of counselling sessions collected following training were transcribed and translated into English. Thirty-five transcripts of sessions conducted by 35 counsellors were analysed for fidelity to the Options protocol, and using the Motivational Interviewing Treatment and Integrity (MITI) code. Counsellors struggled with some of the strategies associated with MI, such as assessing readiness-to-change and facilitating change talk. Overall, counsellors failed to achieve proficiency in the approach of MI according to the MITI. Counsellors were able to negotiate realistic plans for addressing patients' barriers to adherence. Further efforts aimed at strengthening the ARV adherence counselling programme are needed.

The relationship between substance use and delinquency among high-school students in Cape Town, South Africa.

Research has shown a positive relationship between substance use and delinquent-type behaviours among adolescents. The aim of this study is to explore the temporal relationships between these outcomes through secondary data analysis of a longitudinal study of high-school students' risk behaviours. Two regression models were compared and gender, socioeconomic status and repeating a grade were found to be consistent predictors of delinquent-type behaviour. Alcohol (OR: 1.26, CI: 1.02-1.55, p = 0.03) and drug use (OR: 1.10, CI: 1.03-1.16, p = 0.002) in the ordinal regression models were significantly associated with delinquent-type behaviours at Time 2 only. A transition model use was then used to measure delinquent-type behaviours as predicted by the previous time period, and results indicated that gender and delinquency were predictive of delinquency. Smoking also significantly interacted with delinquent-type behaviour to increase future risk of this behaviour. The findings point to the need for intervening early with adolescents who show delinquent-type behaviour.

Developing program theory for purveyor programs.

BACKGROUND: Frequently, social interventions produce less for the intended beneficiaries than was initially planned. One possible reason is that ideas embodied in interventions are not self-executing and require careful and systematic translation to put into practice. The capacity of implementers to deliver interventions is thus paramount. Purveyor organizations provide external support to implementers to develop that capacity and to encourage high-fidelity implementation behavior. Literature on the theory underlying this type of program is not plentiful. Research shows that detailed, explicit, and agreed-upon program theory contributes to and encourages high-fidelity implementation behavior. The process of developing and depicting program theory is flexible and leaves the researcher with what might be seen as an overwhelming number of options. METHODS: This study was designed to develop and depict the program theory underlying the support services delivered by a South African purveyor. The purveyor supports seventeen local organizations in delivering a peer education program to young people as an HIV/AIDS prevention intervention. Purposive sampling was employed to identify and select study participants. An iterative process that involved site visits, a desktop review of program documentation, one-on-one unstructured interviews, and a subsequent verification process, was used to develop a comprehensive program logic model. RESULTS: The study resulted in a formalized logic model of how the specific purveyor is supposed to function; that model was accepted by all study participants. CONCLUSION: The study serves as an example of how program theory of a 'real life' program can be developed and depicted. It highlights the strengths and weakness of this evaluation approach, and provides direction and recommendations for future research on programs that employ the purveyor method to disseminate interventions.

Meaning-making after neonatal death: narratives of Xhosa-speaking women in South Africa.

The death of a neonate can be traumatic for mothers, resulting in profound grief which ruptures their sense of coherence and identity. A narrative approach was used to explore how six Xhosa-speaking women tell stories about the death of their baby to help them understand the significance of the loss. They struggled to establish a sense of their baby as a person to be mourned, to redefine their own identity, and to find reasons for the death. Their meaning-making was influenced by the baby's father, older women in their community, and the context of deprivation in which they live.

Inequitable access to substance abuse treatment services in Cape Town, South Africa.

BACKGROUND: Despite high levels of substance use disorders in Cape Town, substance abuse treatment utilization is low among people from disadvantaged communities in Cape Town, South Africa. To improve substance abuse treatment utilization, it is important to identify any potential barriers to treatment initiation so that interventions to reduce these barriers can be implemented. To date, substance abuse research has not examined the factors associated with substance abuse treatment utilization within developing countries. Using the Behavioural Model of Health Services Utilization as an analytic framework, this study aimed to redress this gap by examining whether access to substance abuse treatment is equitable and the profile of variables associated with treatment utilization for people from poor communities in Cape Town, South Africa. METHODS: This study used a case-control design to compare 434 individuals with substance use disorders from disadvantaged communities who had accessed treatment with 555 controls who had not accessed treatment on a range of predisposing, treatment need and enabling/restricting variables thought to be associated with treatment utilization. A hierarchical logistic regression was conducted to assess the unique contribution that the need for treatment, predisposing and enabling/restricting variable blocks made on substance abuse treatment utilization. RESULTS: Findings revealed that non-need enabling/restricting variables accounted for almost equal proportions of the variance in service utilization as the need for treatment variables. These enabling/restricting variables also attenuated the influence of the treatment need and predisposing variables domains on chances of treatment utilization. Several enabling/restricting variables emerged as powerful partial predictors of utilization including competing financial priorities, geographic access barriers and awareness of treatment services. Perceived severity of drug use, a need for treatment variable) was also a partial predictor of utilization. CONCLUSIONS: Findings point to inequitable access to substance abuse treatment services among people from poor South African communities, with non-need factors being significant determinants of treatment utilization. In these communities, treatment utilization can be enhanced by (i) expanding the existing repertoire of services to include low threshold services that target individuals with less severe problems; (ii) providing food and transport vouchers as part of contingency management efforts, thereby reducing some of the financial and geographic access barriers; (iii) introducing community-based mobile outpatient treatment services that are geographically accessible; and (iv) employing community-based outreach workers that focus on improving awareness of where, when and how to access existing treatment services.

Exploring high school learners' perceptions of bullying.

OBJECTIVE: Learners' perceptions of aspects of school life that are sufficiently serious to interfere with their schoolwork were investigated. Bullying was a form of behaviour that was singled out for inclusion and further exploration in the study. METHOD: Learners from three coeducational Western Cape Education Department schools were surveyed: 414 Grade 8 and 474 Grade 9 learners completed an anonymous, voluntary self-report questionnaire. RESULTS: Factors identified as most frequently interfering with their schoolwork included classmates not listening in class, feeling overwhelmed by schoolwork, teacher absenteeism, and verbal fighting. When asked specifically about bullying, 40% of learners indicated that they frequently experienced bullying at school-although they ranked it as much lower when compared to other potentially problematic school experiences. Furthermore, although the majority of learners indicated they thought teachers considered bullying a problem, few felt there was anything that school staff could do to counteract bullying effectively. CONCLUSIONS: These findings suggest that learners perceive bullying as an unavoidable part of school experience and have normalised this aggressive behaviour.

A citation analysis of Henri Tajfel's work on intergroup relations.

The late Henri Tajfel (1919-1982) is one of the central figures who shaped the development of post-war European social psychology. His contributions range from the establishment of an infrastructure for a European social psychology, and the start of a new intellectual movement within social psychology, to the formulation of a set of concepts addressing intergroup relations that were finally integrated into Social Identity Theory. The present study provides an empirical examination of Tajfel's contribution to intergroup research over the last 30 years via a citation analysis of five journals: the Journal of Personality and Social Psychology, the British Journal of Social Psychology, the European Journal of Social Psychology, the South African Journal of Psychology, and the German Journal of Social Psychology (Zeitschrift für Sozialpsychologie). The results indicate that Tajfel's work on intergroup relations is increasingly cited, especially since the 1990s, and the international recognition of his work is substantial. Three possible reasons for the recognition his work still enjoys are proposed: its potential to generate theoretical and empirical controversies; its explanatory power; and the extent to which his work is used as a referential framework.

The feminization of psychology: data from South Africa.

In many countries, women outnumber men in psychology, both as students and as professionals. Much of this information is drawn from Europe and the USA, and the information available about the situation in developing countries is a lot less detailed. The steady increase in the presence of women in psychology in South Africa is examined, via access to two large national databases and telephone interviews. These sources are the most reliable available, and are comprehensive enough to give a very good snapshot of women in psychology in this country over the last 12 years. The data indicate that psychology as a profession in South Africa is dominated by women. Although the applied practical aspects of the discipline attract women disproportionally, women are also over-represented in research psychology and academia (except at the professorial level). The racial composition of the profession remains skewed, with white psychologists in the majority. Although the data in this regard are incomplete, approximately 5% of registered psychologists are black. An examination of student enrolments suggests that this situation will continue in future, as women (and white students) enrol in much greater numbers for both undergraduate and postgraduate degrees. In 2002, 74% of psychology majors were women, and 78% of all Master's degrees in psychology were awarded to women. Thus it would appear that the feminization of psychology in this country is further advanced than in Europe and the USA. It is not a question of men abandoning the profession, but rather that women entered the profession at a much higher rate in recent years.

Time-on-task, technology and mathematics achievement.

Information and communication technologies hold much promise for use in education in developing countries. This study reports on an evaluation conducted on the introduction of computers in the delivery of the mathematics curriculum in one of the provinces of South Africa. Although the request was for an outcome evaluation very early in the implementation of the program, it was tailored in such a way as to fulfill a more formative role. Despite substantial variability in implementation, and in most cases with very weak exposure of the learners to the intervention, sufficient evidence emerged to indicate that this mode of curriculum delivery may be effective. Improvement in mathematics performance was related to a range of variables: some concerned classroom teaching practices, some referred to social differences between the learners, and some to the specific intervention. The strongest of these predictors in the sample was the strength of the intervention: the more time learners spent on using the software to study mathematics, the more improvement they showed from 1 year to the next in their performance in the subject.

Characteristics of mentoring relationships.

OBJECTIVE: Mentoring programmes offer an increasingly popular solution to the problem of youth 'at-risk'. While positive outcomes of these programmes are widely documented, there has been little research into the operant processes. The aim of this study was to provide in-depth qualitative information about relationship processes in the Big Brothers Big Sisters of South Africa programme. METHOD: The sample consisted of mentors and youth in eight relationships. Semi-structured interviews were conducted with the participants and were analysed making use of the narrative method. RESULTS: Relationships were classified into two groups, namely those constructed in terms of their purpose to help the mentees, and those constructed as friendship for their own sakes. These relationships displayed the qualities previously associated with negative and positive relationships, respectively. The results of the study further extend previous findings, revealing the interaction of these overt qualities with underlying constructions of relationships. CONCLUSION: The study highlights the influence of the programme and broader social context on the mentoring relationships. It indicates the importance of the partners' ability to move beyond the constraints of contextually available narratives of their relationships, and to establish more personal connections, based on the value of the relationship itself, rather than on the programme's ultimate goals.