{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:02:47Z","timestamp":1789646567945,"version":"4.0.0"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001322","name":"south african medical research council","doi-asserted-by":"publisher","award":["Grant MAT 3765"],"award-info":[{"award-number":["Grant MAT 3765"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use: Research and Treatment"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Adolescent alcohol and other drug use represents a growing public health challenge in South Africa, particularly in the Western Cape, with early onset and high prevalence rates. Despite the urgent need for prevention and treatment programmes (aligned with SDG 3.5), a substantial treatment gap exists, with many young people failing to seek or receive adequate prevention and treatment services. Understanding perceived factors influencing help-seeking among a heterogenous group of adolescents is essential for developing youth-friendly prevention and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This research aimed to explore secondary school learners\u2019 perspectives on factors that facilitate or hinder health-seeking behaviours in the Western Cape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A qualitative methodology was adopted, semi-structured interviews were conducted with 84 learners from 11 purposively sampled schools across 7 community clusters in Cape Town. Inductive thematic data analysis was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The findings highlighted perceived facilitators and barriers at individual and service levels. Facilitators and barriers reflected both the perspective of adolescents with lived experience of substance use, and general perceptions of services and adolescent help-seeking. User-level facilitators included self-determination and a desire for change, insight to seek professional help, strong preference for informal help-seeking (especially from parents), and peer encouragement and support. User-level barriers comprised self-stigma, reluctance to stop using substances, lack of knowledge of available services (among adolescents and parents), and fear of parental rejection or punishment. Service-level barriers included access constraints (geographic, financial, programme availability), unappealing and ineffective services, stigma and perceived judgement from educators and fear of confidentiality breaches within schools<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>To address the treatment gap, interventions should leverage existing trust relationships (parents, peers) and develop clear pathways to professional services, be it preventative or targeted treatment. Schools must shift from punitive to supportive environments that address confidentiality and stigma concerns. Future research should examine help-seeking behaviours among adolescents with documented substance use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29768357261425063","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:59:31Z","timestamp":1774933171000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceived Factors Influencing Health-Seeking for Substance Use Among Secondary School Learners in the Western Cape, South Africa"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5200-137X","authenticated-orcid":false,"given":"Gadija","family":"Khan","sequence":"first","affiliation":[{"name":"Developmental, Capable and Ethical State (DCES), Human Sciences Research Council, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gcina","family":"Malandela","sequence":"additional","affiliation":[{"name":"Developmental, Capable and Ethical State (DCES), Human Sciences Research Council, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Daniels","sequence":"additional","affiliation":[{"name":"Public Health Societies and Belonging (PHSB), Human Sciences Research Council, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-987X","authenticated-orcid":false,"given":"Zaino","family":"Petersen","sequence":"additional","affiliation":[{"name":"Public Health Societies and Belonging (PHSB), Human Sciences Research Council, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"1139","article-title":"Drug use among youth and adults in a population-based survey in South Africa","volume":"24","author":"Peltzer K","year":"2018","unstructured":"Peltzer K, Phaswana-Mafuya N. Drug use among youth and adults in a population-based survey in South Africa. S Afr J Psychiatr. 2018;24:1139.","journal-title":"S Afr J Psychiatr"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874944502114010435"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.4102\/safp.v62i1.5122"},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","unstructured":"Dada S Burnhams NH Erasmus J et al. Monitoring alcohol tobacco and other drug use trends in South Africa. October 2018 | Phase 43. S Afr Fam Pract. 2018;46(5). http:\/\/doi.org\/10.1080\/20786204.2004.10873081","DOI":"10.1080\/20786204.2004.10873081"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-023-02590-4"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.969053"},{"issue":"2","key":"e_1_3_3_8_2","first-page":"234","article-title":"Substance use services conceptualised on a continuum","volume":"14","author":"Latimore A","year":"2023","unstructured":"Latimore A, Smith M, Reardon L, et al. Substance use services conceptualised on a continuum. Int J Public Health. 2023;14(2):234-245.","journal-title":"Int J Public Health"},{"issue":"1","key":"e_1_3_3_9_2","first-page":"15","article-title":"Rethinking prevention and treatment for adolescent substance use disorders","volume":"331","author":"Volkow N","year":"2024","unstructured":"Volkow N, Gordon M, Lee M. Rethinking prevention and treatment for adolescent substance use disorders. JAMA. 2024;331(1):15-16.","journal-title":"JAMA"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-022-00491-w"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2021.1963110"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-019-01469-4"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/28324765.2023.2298918"},{"key":"e_1_3_3_14_2","doi-asserted-by":"crossref","unstructured":"Sotardi VA. Four pillars of help-seeking attitudes: emotional societal cognitive and relational insights from New Zealand youth. J Adolesc Res. 2024. Published online October 24 2024. http:\/\/doi.org\/10.1177\/07435584241291165","DOI":"10.1177\/07435584241291165"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/pxac117"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v8.25670"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2020.1775992"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.4236\/health.2014.614203"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.12688\/gatesopenres.13588.2"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.2147\/OAJC.S411924"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v13i1.2654"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-18714-4"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.52634\/mier\/2013\/v3\/i1\/1554"},{"issue":"1","key":"e_1_3_3_24_2","first-page":"74","article-title":"Qualitative research paradigm: a design for distance education researchers","volume":"6","author":"Shava GN","year":"2019","unstructured":"Shava GN, Nkengbeza D. Qualitative research paradigm: a design for distance education researchers. Namibia CPD J Educ. 2019;6(1):74-87.","journal-title":"Namibia CPD J Educ"},{"key":"e_1_3_3_25_2","unstructured":"TIMSS South Africa. What is the poverty index and quintile categorisation of schools? TIMSS SA website. Published 2023. Accessed October 24 2025. https:\/\/www.timss-sa.org\/faq\/what-is-the-poverty-index-and-quintile-categorisation-of-schools"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1080\/1743727X.2020.1755248"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23636"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.51.3.390"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.01.015"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16111934"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2024.152469"},{"key":"e_1_3_3_32_2","first-page":"2650","article-title":"Adolescent girls\u2019 sexual and reproductive health information needs and barriers in Cape Town","volume":"29","author":"Holtman N","year":"2024","unstructured":"Holtman N, Bimerew M, Mthimunye K. Adolescent girls\u2019 sexual and reproductive health information needs and barriers in Cape Town. Health SA. 2024;29:2650.","journal-title":"Health SA"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/eip.12402"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-01930-1"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-022-00501-2"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.3390\/children10030552"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/13575279.2018.1448258"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-020-01707-0"}],"updated-by":[{"DOI":"10.1177\/29768357261474602","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000}}],"container-title":["Substance Use: Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768357261425063","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29768357261425063","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768357261425063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:32:16Z","timestamp":1787124736000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29768357261425063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":37,"alternative-id":["10.1177\/29768357261425063"],"URL":"https:\/\/doi.org\/10.1177\/29768357261425063","relation":{},"ISSN":["2976-8357","2976-8357"],"issn-type":[{"value":"2976-8357","type":"print"},{"value":"2976-8357","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"article-number":"29768357261425063"}}