Interventions to Promote Rehabilitation Programmes for Youth with Violent Behaviours in Limpopo Province: A Systematic Literature Review

: Background: A rehabilitation strategy aims to reshape the individual and prepare them to enter society with a different state of mind and start a new life after incarceration. Objective: The purpose of this systematic literature review was to identify and describe the intervention strategies to promote rehabilitation programmes for youth with violent behaviours, guided by Rodger’s evolutionary concept analysis framework. Methods: A comprehensive database search was conducted from 2010 to 2020. The review focused on quantitative and qualitative studies and reports obtained from GOOGLE SCHOLAR, SABINET, SAGE, EBSCO-HOST, and SCIENCE DIRECT. Keywords and search strategies were also taken into consideration. The researchers systematically reviewed the literature, and 250 articles and 25 reports were obtained; their content was screened for relevance, and 50 articles and 11 reports were found to be suitable and relevant; these were then reviewed. A thematic analysis was performed to identify antecedents, attributes, and consequences of rehabilitation on youth with violent behaviours. The study findings were then used to inform the development of the conceptual framework. Results: The results show that antecedents of these rehabilitation strategies on violent youth behaviours include family structure, increased bullying due to gangs, and gender and environmental factors. The identified attributes were motivation, contextual differences, transformation, opportunity, and ineffective rehabilitation programmes in addressing violent behaviours in youths. Conclusion: high percentage of the population. As a result, it is always vital to protect them.


INTRODUCTION
Youth violence is a significant public health problem that affects thousands of young people each day, and in turn, their families, schools, and communities. David-Ferdon et al. [1] report that youth violence occurs when young people between such as rehabilitation strategies that play a major role in addressing youth violence. However, despite the availability of those strategies, violent youth behaviours continue to increase. Rehabilitation is defined as a process or a set of processes that are planned and are limited in time, having well-defined goals and means, of which professionals or services co-operate in assisting the individual user in their efforts to achieve the best possible functioning and coping capabilities and promoting independence and participation in society [2].
In literature, statistical data in many countries show that delinquency is essentially a group phenomenon. Between twothirds and three-quarters of all offences committed by young people are committed by members of gangs or groups, which can vary from highly structured criminal organisations to less structured street gangs. It is further reported that even those young people who commit offences alone are more likely to be associated with groups. Youth violence is regarded as a severe challenge to the family, public safety, the lives of young people themselves, and law enforcement agencies [3]. Therefore, strategies are defined as plans designed and implemented to attain goals or objectives to achieve a long-term aim [4].
The Limpopo Province of South Africa is a largely rural province, with more than 87% of people in the province living in rural areas [5]. Limpopo is one of the provinces with a high rate of unemployment among young people. It is one of the most underdeveloped areas in South Africa; the province is made up of five district municipalities and 25 local municipalities [5]. The reasons for the increase in unemployment in this province are numerous. Still, the main one is that the formal sector of the economy has not been able to create enough job opportunities for its growing labour force.
Approximately 17% of the inhabitants of the province do not have a formal education. Inhabitants of Limpopo are employed by public sector institutions and the mining, trade, and agricultural sectors [5]. This study included two child and youth care centres (Bosasa-Mavambe) in the Vhembe District and (Bosasa-Polokwane) in the Capricorn District. The study was conducted to develop strategies to promote the implementation of rehabilitation programmes for youth in child and youth care centres in the Limpopo Province.

PURPOSE
The purpose of this systematic literature review is to identify and describe the interventions and strategies to promote rehabilitation programmes for youth with violent behaviours, guided by Rodger's evolutionary concept analysis framework. The study further aims to develop a Conceptual framework (CF) that would guide research on interventions to promote rehabilitation programmes for youth with violent behaviours in the Limpopo province.
The study was conducted based on the assumptions that dysfunctional families, the influence of delinquent peers, substance misuse, and gangsterism may influence the involvement of youth towards violent behaviours. This study seeks to add to the literature on the intervention strategies meant to promote the rehabilitation programmes for youth with violent behaviours in the Limpopo Province. Thus, it will pay attention to the factors to prevent youth offences and the factors that will improve positive outcomes of rehabilitation programmes. Moreover, the study will enlighten the youth's parents/guardians to take their full responsibility towards raising and providing for the basic needs of their children.

Rodger's Concept Analysis Framework
Rodger's evolutionary concept analysis framework will guide this study. Rodger highlights that concepts develop over time and are influenced by the context in which they are used [6,7]. He further argues that these concepts are constantly undergoing dynamic development, which redefines the analysis of a concept and related terms such as antecedents, attributes, and consequences. Antecedents are events that occur prior to a concept and influence the evolution of that concept; attributes are defined as characteristics of that specific concept in terms of addressing its intended issue; and consequences are the results of the concepts, which help in clarifying them more clearly [8,9].
Most of the studies (n=45) utilised a quantitative design, followed by some (n=16) that used a qualitative design. The majority (n=19) of the programmes were delivered in institutions, followed by school-based programmes (n=18), community-based studies (n=17), and lastly, family-based programmes (n=07).

Inclusion Criteria
In this systematic review, studies were included if they met the following criteria.
Time period: All studies from 2010 to 2020 were included in this study. Other data All studies on rehabilitation programmes implemented from 2010 to 2020 that targeted young people meant to prevent violent behaviours were included.
The selected articles and reports had to pass the quality assessment criteria described in Table 1. Quasi-experimental study -The study suggests that the risk factors for adolescents in conflict with the law include poor sociodemographic status and psychological impacts of divorced parents. Negative peer group pressure was also a risk factor for incarcerated adolescents. These agreed with several studies that have found a consistent relationship between involvement in delinquent behaviours among girls and socio-economic background. It suggests that the factors need to be addressed in efforts to understand and address delinquency in girls.

Study
Setting & Country in their curricula and provide good counselling departments and assistance to the less privileged students. -The communities should be encouraged to provide recreational facilities for the youths and encourage the youths to join social clubs and associations. The governments should train and equip the police, court, and reformatory homes to meet international standards to handle the juvenile justice system.

Yes
Prior to conducting the literature review, a review protocol was developed.

Was there duplicate study selection and data extraction?
There should be at least two independent data extractors, and a consensus procedure for disagreements should be in place.

Yes
The researcher and her two supervisors reviewed the articles and reports, and a straightforward procedure was followed to reach a consensus.
3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Keywords and/or MESH terms must be stated, and the search strategy should be provided where feasible. All searches should be supplemented by consulting current contents, reviews, textbooks, specialised registers, or experts in the field of study and reviewing the references in the studies found.

Yes
The review focused on quantitative and qualitative studies and reports obtained from GOOGLE SCHOLAR, SABINET, SAGE, EBSCO, and SCIENCE DIRECT. Keywords and search strategy were also taken into consideration.
4. Was the status of publication (i.e., grey literature) used as an inclusion criterion?
The authors should state that they searched for reports regardless of their publication type. The authors should state whether they excluded any reports (from the systematic review) based on their publication status, language, etc.

Yes
The inclusion and exclusion criteria are fully described, and only studies written in English were included in this study.

Was a list of studies (included and excluded) provided?
A list of included and excluded studies should be provided.

No
The list is only provided for included studies but can also be available for excluded studies.
6. Were the characteristics of the included studies provided?
In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions, and outcomes. The ranges of characteristics in all the studies analysed, e.g., age, race, sex, relevant socioeconomic data, disease Yes These were summarised as (Tables 1-3) that summarised the literature contributions according to three of Rodger's characteristics: antecedents, attributes, and consequences.
7. Was the scientific quality of the included studies assessed and documented? 'A priori' assessment methods should be provided. For example, effectiveness studies, if the author(s) chose to include only randomised, double-blind, placebocontrolled studies, or allocation concealment as inclusion criteria); for other types of studies, alternative items will be relevant.

Yes
These were assessed using the 14-point quality assessment tool and Rodger's Evolutionary Conceptual Framework.
8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
The methodological rigour and scientific quality results should be considered in the analysis and the conclusions of the review and explicitly stated in formulating recommendations.

Yes
The included studies were guided and met Rodger's Evolutionary conceptual analysis framework requirements.
9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists, a random-effects model should be used and/or the clinical appropriateness of combining should be considered (i.e., is it sensible to combine?).

N/A
The review had a guiding conceptual framework; therefore, the combination of articles was guided by this framework.

Was the likelihood of publication bias assessed?
An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test).
N/A Rodger's Evolutionary Concept Analysis framework guided the review. However, limitations of this systematic review are presented.
11. Was the conflict of interest stated? Potential sources of support should be acknowledged in both the systematic review and the included studies.

Yes
The author declared that she did not have any conflict of interest.

Exclusion Criteria
In this study, the exclusion criteria are: Studies that focus on people older than the age of 35 years.
Publications not written in English. Studies published outside of the given time period. Studies that focus on the factors contributing to violent behaviours and rehabilitation programmes in other age groups.

Search Strategy
To achieve this, the researchers searched a variety of research databases on empirical and grey research literature. The review has focused on quantitative and qualitative studies and reports obtained from GOOGLE SCHOLAR, SABINET, SAGE, EBSCO-HOST, and SCIENCE DIRECT. Keywords and search strategy were also taken into consideration. Key concepts and search terms were developed to capture literature related to the rehabilitation of violent behaviours amongst the youth. The search strategy was used in collaboration with a health sciences librarian. An example of search terms used in Sabinet is: "Violent behaviours *or Deviant behaviours* AND therapy * or programmes* or interventions*" AND violence prevention and young people or adolescents." Furthermore, additional references were found by systematically examining the reference lists of relevant papers and reviews.

Methods of Review
In this study, the titles and abstracts were reviewed to identify relevant articles and reports and then included. Full texts of these articles and reports that met the inclusion criteria were also reviewed, and their findings were discussed.

Data Extraction and Synthesis
A data collection form was developed, guided by Rodger's Evolutionary Conceptual Analysis Framework, to collect data on antecedents, attributes, and consequences of Rehabilitation strategies on violent youth behaviours from the articles and reports that met the inclusion criteria. The findings from the reports and articles were then coded and thematically analysed to identify and explain the antecedents, attributes, and consequences of rehabilitation strategies on youths' violent behaviours.

RESULTS AND DISCUSSION
There were 2500 articles and 100 reports that were obtained through an electronic database search. After the screening of duplicates, 1700 articles and 70 reports were reviewed by titles and abstracts. Of these articles and reports reviewed, 1450 articles and 45 reports were excluded as they were irrelevant to the study.  -87 Articles were addressing rehabilitation programs on adults above 35 years and not the target group.
-50 Articles did not have full texts accessible online.
-10 Reports did not have full texts accessible online.
-06 Reports were addressing interpersonal and not youth violence. The 250 articles and 25 reports were then reviewed to determine if they met the inclusion criteria. After reviewing articles and reports, it was found that 50 articles and 11 reports met the inclusion criteria and were then analysed. The results are summarised on the PRISMA flow chart diagram, as displayed in Fig. (1).

Quality Assessment
In this study, a quality evaluation tool was used to assess the quality of selected studies in line with Rodger's Evolutionary Concept Analysis Framework [10]. The included reviews' methodological quality was assessed using the AMSTAR quality assessment tool (a measurement tool to assess systematic reviews). The reports and articles were assessed for clarity in presenting antecedents, attributes, and consequences of rehabilitation strategies on violent youth behaviours.
The AMSTAR tool was developed to check the quality of a systematic review and determine whether the most important elements are considered, as shown in Table 2. A Prisma checklist was also completed to ensure that the study fulfilled the expectation of the review articles.

Timeline
The literature search was performed from January 2020 to May 2020. Quality appraisal then followed in June, and data extraction, synthesis, and writing up were done between March and July 2020.

Outcome of Quality Assessment Tools
The articles selected in this systematic review were subject to a 14-point quality assessment tool and met the minimum standard required. The reports and articles were assessed for clarity in presenting antecedents, attributes, and consequences of rehabilitation strategies on violent youth behaviours.
The AMSTAR tool was developed to check a systematic review's quality and determine whether the most critical elements are reported. These findings are presented in Table 2.

DEFINITION OF VIOLENT BEHAVIOURS
Violent behaviour is defined as conduct un-approved by society, which means that such behaviours vary from one society to another. In addition, in most countries, young people constitute both the majority of perpetrators and victims of violence and offence, and violence prevention measures with a strong focus on youth have a great potential to reduce violence and offence rates across society. The prevention efforts can reduce youth's susceptibility to violence and crime by addressing the root causes of youth violence and strengthening young people's resilience to risk factors [11 -13].

Antecedents, Attributes, and Consequences of
Rehabilitation strategies with violent youth behaviour.

Antecedents
In this study, the antecedents that influence violent youth behaviours reported in the literature were: Family structure, increased bullying resulting from the gang, and gender and environmental factors. Literature sources reporting these antecedents are summarised in Table 3.

Family Structure
Family is regarded as the first institution in which an individual interacts. Most studies have found that children from broken families are more likely to deviate than intact families [14]. Violent behaviour is a likely outcome, especially when children continuously witness dysfunctional behaviour displayed by authority figures that they trust, particularly if it is not sanctioned or punished. Moreover, parenting serves the role of a root mechanism through which children learn appropriate and inappropriate behaviour as they come to understand the roles and norms of the communities [14]. Mambende et al. [15] add that family-related risk factors include poor parenting skills, family disruption, minimal attachment to parents, and parents or relatives with criminality or substance abuse problems. These findings are supported by World Youth Report, which claimed that dysfunctional family settings characterised by conflict, inadequate parental control, and weak internal linkages are closely associated with juvenile delinquency.

Increased Bullying as a Result of Gangs
Magidi et al. [16] highlight that gang presence increases the culture of violence and bullying and increases the victimisation and bullying of both learners and teachers. A report published in the New York Times supports the above statement by reporting that 4.5% to 7.5% of the students in the USA carry some weapon with them to school. The authors also confirm that using a variety of weaponry by gangsters in schools, such as guns, knives, bottles, and sharpened pencils, is used to threaten and control other learners [17].
The same authors further highlight that the availability of weapons in schools has a psychological effect on non-gang learners. As a result, they are conditioned to believe that violence is the way to resolve specific problems. In addition, these authors believe that the behaviour among gangs, such as responding to insults and offences through violence and weapons, leads to the normalisation and justification of carrying weapons by everyone, including non-gang-affiliated learners [17].

The influence of Gender and Environmental Factors
One study reported a higher frequency of physical fighting among boys than girls. This finding is in line with other studies that argued that boys' engagement in occasional fighting might be because of the potential influence of gender norms on the involvement in physical fighting. However, the same study demonstrates that girls are more likely to fight in intimate relationships, whereas boys fight with strangers [18 -21]. It is revealed that community disorganisation, economic inequality and relative deprivation, high unemployment rates, and the availability of alcohol and drugs in the neighbourhood may contribute to violent behaviour. This implies that the environment in which youth are reared can influence tendencies towards delinquency [22]. Table 3. Summary of critical antecedents, attributes, and consequences of rehabilitation programmes with violent youth behaviours.

Key Antecedents Factors Supporting literature
Family structure [14,15] Increased bullying as a result of gangs [16,17] The influence of gender and environmental factors [18 -22] Summary of critical attributes of rehabilitation programmes with violent youth behaviours

Summary of crucial consequences of rehabilitation programmes with violent youth behaviours Key Consequences Supporting literature
Incompletion of youth rehabilitation programmes [22,25,26,22] Low-income family involvement in youth programmes [27,28]

Attributes
Violent behaviour attributes obtained from the literature are motivation, contextual differences, transformation, opportunity, and ineffectiveness. Literature sources reporting these attributes are summarised in Table 3.

Motivation
Literature reports that youth with multiple characteristics are at greater risk for termination of programmes. The number one reason for this termination is non-participation in intervention services; thus, more incredible support is needed to ensure retention and successful programmes [23]. In Rehabilitation Strategies (RSs), the treatment options seem limited for violent delinquent youth, and a need exists for more research to create models of practice for working with such youth.

Contextual Differences
While the barriers and enablers to youth violent rehabilitation programmes were applicable in different societies, the literature reveals several contextual differences, including age, gender, culture, mode of delivery, financial resources, and location of services.
These contextual elements are important factors to consider when designing rehabilitation interventions in different countries [23]. Collective intervention is needed to address different societal values and differences.

Transformation
Literature also highlights that if parents can participate meaningfully in rehabilitation programs to transform their children's offending behaviour, they can learn about the contribution of specific home and family circumstances to their children, particularly in criminal activities [14].
However, it is reported that in the absence of parents/guardians to constrain this behavioural expression carefully, adolescents' deviant behaviour may progress to delinquency. Once parents are alerted about their children's behaviours by the criminal justice authorities, they take things personally instead of finding good ways of resolving conflict [14].

Opportunity
Due to high-risk behaviour in youth correctional centres, such as gang activities, inmates' affiliates to various gangs occurs to protect themselves against possible violations from other inmates. As a result, some young people continue to display antisocial behaviour even after being exposed to diversion programmes due to a shortage of staff members to monitor them in the institutions [24]. Follow-up services and tracking the young people during their reintegration into their communities would discourage young individuals from sliding back into anti-social behaviour.

Ineffectiveness
Due to different perceptions among the parents/guardians of the youth and the youth regarding the refusal of participating in family group conferencing, the programme becomes ineffective. In some cases, the parents did not seem to be ready to forgive the young offenders. Some young offenders attend rehabilitations programmes only to avoid prosecution, and such individuals have a negative attitude and are challenging to deal with [24]. Literature also highlights that it is problematic and challenging to work and achieve the intended goals with young offenders who can avoid prosecutions. As a result of these negative attitudes, the same young offenders will likely find themselves back in the centres in no time [24].

Consequences
This study reports the consequences of these antecedents and attributes in Table 3: Incompletion of youth intervention programs and low-income family intervention programmes.

Incompletion of Youth Rehabilitation Programmes
Literature reports that youth with more delinquency characteristics were less likely to complete the diversion program. It highlighted a need for a thorough assessment of family distinguishing socio-demographic and delinquency characteristics that contribute to violence and individualising treatment [25]. Diversion refers to the referral of youth offenders away from the criminal courts when appropriate, and it serves various purposes. These include encouraging the youth to take responsibility for their actions, allowing victims to express their views on the harm that the offender caused, and advocating reconciliation between the offender and the victim [26].
Studies highlight that youth with multiple delinquency characteristics are at the most significant risk for programme termination. There is a need for them to be connected to services that meet their individual needs for diversion to be successful. Terminated youth perpetrators have a history of more violent arrests, use more substances, and are more likely to skip schools than those who complete the programmes [22].
The number one reason for termination from the programme was non-participation in the intervention services. Thus, greater support is needed for those youth with multiple delinquency characteristics to ensure retention and successful completion of the programme. Treatment options seem limited for violent delinquent youth, and a need exists for more research to create models of practice for working with such youth. Furthermore, curricula and intervention components should be established based on data collected from research that examines programme participants [22].

Poor Family Involvement in Youth Programmes
According to certain studies [27,28], some types of parenting increase the likelihood of a child committing offences. Poor parental supervision is usually the strongest and most replicable predictor of offending based on the childrearing methods.
These authors further revealed that children who are not provided with support and authoritarian parents who tend to emphasise rules and harsh consequences also increase the probability of children returning to violent activities. It is paramount during the rehabilitation process that parents or guardians be involved in supporting their children at all costs. It is also essential for parents or family members to foster family cohesion, unity, and good parenting styles to combat youth violence [28].

Conceptual Framework
The conceptual framework based on the findings of this study is presented in Fig. (2) as a summarised model. In addition, the model also includes the proposed strategies found in the literature that are aimed at improving violent youth behaviours.

Behaviour Modification in Schools
According to David-Ferdon et al. [1], school violence is preventable. Learners' academic success and social well-being are a product of safe and supportive school and home environments, including healthy social relations. Since the children spend approximately half of their day at school, the schools also serve as the most crucial socialising environment after the home. Violent behaviour is associated with alcohol and cigarette consumption. Intervention in the school environment should be implemented, either in the continued preparation of teachers or in the development of curricula where these issues comprise the day-to-day lives of students. Furthermore, it was stated in the same literature that the school-based behaviour modification and intervention programmes designed with inputs from all stakeholders such as community structures, parents, educators, learners, and union representatives should be introduced in all schools and at all phases [16,29].

Reduction of Media Violence Exposure
Media violence exposure is associated with aggressive outcomes in youth and adolescents. The portrayals of violence on TV and movies are often unrealistic, associated with rewards and negative consequences, reinforcing observational learning and making youth more likely to engage in similar behaviour in real life [30]. Literature reports that using active mediation strategies such as discussion of media content to understand the values better can have a protective influence on aggression by contextualising what children watch. Zhang et al. [21] highlight that with the rapid development of the film industry, various violent movies indicated that numerous adolescents got easy access to violent movies in their daily lives. Thus, they are prone to forming aggressive cognition, attitude, and violent behaviour based on their brain plasticity from a developmental perspective. The same study suggests that media violence exposure is a significant risk factor for aggression in adolescents and operates with other risk factors. Targeted preventive interventions that help reduce exposure to violent media content, strengthen self-regulation, and promote parental monitoring could reduce adolescents' aggression and related adverse outcomes [21].

Family Planning and Adequate Socialisation
Family planning results in few children being born in families, and as a result, parents, single or married, can rear their children adequately to prevent the development of criminal personality [14]. Furthermore, family planning prevents the adherence to traditional customs encouraging most women and men to give birth with limited or few financial resources. The same author also suggests that policymakers should emphasise family planning, parenting programmes, and parental involvement in children's activities combined. These strategies will prevent violence and contribute to the financial growth of families [14].

Strengthening Youth Rehabilitation Programmes
The literature argues that diversion involves the referral of the youth offenders away from the criminal courts when appropriate, and it serves various purposes. These further include encouraging the youth to take responsibility for their actions, allowing victims to express their views on the offenders' causes, and advocating reconciliation between the offender and the victim [31]. Diversion programmes give young people a chance to avoid criminal records while at the same time teaching them to acknowledge responsibility for their actions. As a result of these programmes, the youth involved in criminal activities turn into advocates and role models of positive behaviour for other young people.
Mantey and Dzetor [4] highlight that religion appears to be an important tool in the rehabilitation of the inmates, especially in guidance and counselling. It is established that counselling is an essential tool used in bringing discipline among juvenile delinquents in the rehabilitation process. It gives them the confidence to believe that there are people who care about them. These young people play an essential role in helping to encourage and guide other young people to avoid being caught up in criminal activities. Furthermore, the resources and effective diversion programmes create an appropriate opportunity and life skills that address young people's educational, vocational and emotional needs against the law [15]. In addition, these diversion programmes play a significant role in the life of the youth in conflict with the law by transforming and giving them hope for a brighter future.
However, while the role of religion in the rehabilitation process cannot be over-emphasised, there should be some level of professionalism. This study further reported that many of the inmates perceived the process of their incarceration as a form of humiliation and societal rejection, which made them feel like criminals rather than the persons meant for reformation. It was further stated that several juvenile inmates had developed a negative attitude towards the correctional home despite the efforts by caretakers to make it as close to home as possible [4].

STRENGTHS AND LIMITATIONS OF THE STUDY
In this study, one of the strengths is that the authors were able to identify and examine all systematic reviews related to youth rehabilitation programmes from 2010 to 2020. It was possible because of the indicated online access to the relevant issues of the journals. The simplicity of the design and application of the AMSTAR tool was important because it made it quick and easy to use. The study is limited because the sampled participants were from only two child and youth care centres. Thus, the findings cannot be generalised among all the youth in other CYCC's in South Africa and worldwide.