The South African health system has experienced dramatic fluctuations since the abolishment of Apartheid in 1994. Despite efforts to reduce both social and economic inequality within the system, the exposure of youth from more disadvantaged socio-economic circumstances to behaviours that place them at risk of either physical or mental harm has remained a consistent problem in South Africa. Non-communicable diseases (NCD) linked to risky behaviour account for more than 50% of the global disease burden (Benziger et al. 2016). From 2007 to 2019, a decrease in the overall mortality rate was noted in South Africa (Achoki et al. 2022). However, an alarming exception to this generally positive trend is the noteworthy increase in adolescent mortality in both males and females during the same period (Achoki et al. 2022).

Although numerous interventions have been conducted to mitigate risky behaviours, young people continue to engage in unsafe sex, binge drinking, the use of illicit drugs and violent activities (Khuzwayo et al. 2020). The relative lack of change in these risky behavioural choices could be attributed to the lack of consistency and structure when developing interventions, and to the focus on adolescent intervention strategies rather than targeting a younger pre-adolescent age group. Studies focussing on intervention strategies often suffer from heterogeneous methodologies and do not report details of the interventions, making replication and application difficult for determining who may benefit and in which circumstance (Wong et al. 2023). Some programmes emphasise skills development, while others emphasise harm reduction (Pharaoh et al. 2014). In truth, most non-communicable diseases are modifiable/preventable by behavioural changes, accepting responsibility for one’s health, and adopting a healthy lifestyle (Betty et al. 2017).

Health risk behaviour prevention/intervention programmes are defined as methods, activities, or interventions that endeavour to reduce or deter specific or predictable behaviours, protect the current state of well-being, and promote desired outcomes or behaviours of an individual or community (Prinz 2016). The development of community-based youth programs should include purposeful environments encouraging positive and beneficial, sustainable relationships with both peers and adults (Perkins and Borden 2003). Thus, the active engagement of youth as a stakeholder in developing the content of intervention programmes is postulated to significantly increased buy-in, participation, and success of the intervention programme (Pharaoh et al. 2014). Previously implemented approaches to prevention programmes include school-based programmes, family/parenting-based programmes, community-based programmes, and the multi-domain approach (which involves a combination of the individual, family, school, and community elements), as well as mass-media intervention and access and marketing restrictions (Pharaoh et al. 2014).

It is evident that there is a need to establish a baseline of current literature regarding intervention/prevention programmes. Thus, the aim of this scoping review is to identify and collate recent literature focussing on health risk behaviour intervention/prevention programmes targeting adolescents, preadolescents, and youth, and to report on their effectiveness at reducing risky behaviours in that population.