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RESEARCH ARTICLE

Stakeholders’ Perceptions of Health Risk Behaviour Engagement among Grades 4-7 Learners in South Africa

The Open Public Health Journal 10 Mar 2026 RESEARCH ARTICLE DOI: 10.2174/0118749445375708250307050529

Abstract

Background

Health Risk Behaviour (HRB) is an ever-growing concern globally, as well as in countries like South Africa, because of its contribution to disease incidence and premature death. This study explored the perceptions of HRB engagement among Grades 4-7 learners and key stakeholders in Paarl, South Africa, to inform the development of an evidence-based behavioural modification programme.

Methods

A qualitative, exploratory design was employed, and data were collected from school principals, nurses, and learners through seven semi-structured interviews conducted between October 2021 and July 2022. An inductive thematic analysis identified key HRBs, including substance use, bullying, and early sexual curiosity, as well as the environmental influences of family dysfunction, community violence, and gang culture.

Results

Six major themes emerged, highlighting the multifaceted nature of HRB and the need for targeted interventions. Results suggest that stakeholders perceive a critical need for programmes incorporating parental education, school-based mental health support, and community-driven initiatives, such as after-school activities, to address these behaviours.

Conclusion

These findings contribute to the theoretical underpinnings of intervention mapping and emphasise the importance of engaging stakeholders in designing culturally relevant and context-specific prevention strategies.

Keywords: Health risk behaviour, Risky behaviour, Stakeholder, Perceptions, Prevention, Youth, Gang culture, Community violence, After-school activities.
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