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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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    An exploration of the adoption of personal nonpharmaceutical intervention measures by students at a university of technology in response to the COVID-19 pandemic
    (2024) Kell, Colette Melissa; Haffejee, Firoza; Jinabhai, Champaklal C.
    Background In March 2020 the World Health Organisation (WHO) declared coronavirus disease (COVID-19) to be a global pandemic. Due to the novel nature of the virus, there was no effective vaccine or established treatment methods, and public health officials turned to the personal non-pharmaceutical protective intervention (NPI) measures of physical distancing, hand sanitisation and the wearing of masks to interrupt disease transmission and ‘flatten’ the pandemic curve. Despite the WHO recommendation that NPIs should be included as part of any pandemic response, prior to the COVID-19 pandemic, little behavioural science research had been conducted on how to improve NPI adoption. During the COVID-19 pandemic, many Knowledge, Attitude and Practice (KAP) surveys investigated NPI compliance, but there is a dearth of qualitative literature to provide insight into the barriers and facilitators to adoption in specific populations. Over the past two decades, the South African Higher education sector has largely been transformed to accommodate students from poor and rural backgrounds. As a result, students requiring accommodation in the urban centres where universities are often based, has dramatically increased. During the COVID-19 pandemic these students effectively became mobile members of their households, returning home at various times and lockdown levels, potentially spreading the disease to relatively isolated areas. In addition, studies have consistently found that young people were more likely to be considered non adopters of the COVID-19 NPIs, partly due to the increase in risk taking behaviour associated with adolescence. In South Africa, the risk behaviour of young people is also of significant public health concern in the context of HIV/AIDS, teenage pregnancy, substance abuse and violence, this is compounded by the limited success of large research interventions. Yet, despite the acknowledgement of the need for specificity in designing youth targeted interventions, there has been little exploration of how and why South African adolescents adopt positive behaviours. Knowledge of which would be useful to better understand behaviour motivation and inform strategies for positive behaviour change. Aim This study aimed to gain an understanding of the factors influencing the adoption of the personal NPIs in response to the COVID-19 pandemic, among students at a University of Technology (UOT). Insight into these factors was used to develop guidelines to inform the design of targeted interventions to promote positive behaviour change by South African adolescents. Methodology This exploratory, qualitative study sought to understand behaviour change using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Eighteen student participants at a UOT were selected using purposive, maximum variability sampling. Each participant was interviewed individually via Microsoft Teams. Data was transcribed verbatim and analysed both deductively and inductively. Deductive analysis was guided by Theoretical Domains Framework which was developed to integrate with the COM-B model. Where possible, participant statements were coded to the appropriate domain, statements relevant to the aim of the study but did not align with the TDF domains which were inductively analysed using the Tesch approach to qualitative analysis and Braun and Clarke (2006) thematic approach. Findings This study found that NPI adoption among students evolved over time, closely aligned to the available published literature regarding NPI efficacy and WHO recommendations, but not necessarily aligned to or in compliance with government regulations. A notable exception was the reduced compliance when interacting with loved ones. In these circumstances, despite high levels of both the psychological and physical capability to perform the protective behaviours, the participants lacked the social opportunity and emotional motivation to do so. Notable factors that facilitated NPI adoption included trust in international health organisations, personal experience of COVID-19 and an altruistic desire to protect others. Factors that acted as barriers to NPI adoption included in-group trust, government distrust and social disapproval for adoption. The major themes that emerged included the need for autonomy in adolescent health decision making, the importance of social connection, the influence of social media, and the need to include young people in the development of targeted behaviour change interventions (BCIs). Conclusion This study contributes to the limited body of knowledge regarding the factors that served as barriers and facilitators to the adoption of positive health behaviours by South African adolescents in the context of the COVID-19 pandemic. These factors contributed to the development of guidelines which can be utilised by the relevant stakeholders when designing BCIs targeting this group.
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    Chiropractic and public health : a study on the perceptions and attitudes of chiropractors on health promotion and disease prevention in South Africa
    (2014-04-08) Ford, Timothy William; Korporaal, Charmaine Maria
    Background: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.
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    The influence of the workplace environment on breastfeeding practices of working mothers returning to work : a case study of two companies in KwaZulu-Natal
    (2009) Reimers, Penelope; Harris, Maureen; Searle, Ruth
    Purpose: Breastfeeding is a key child survival strategy important for the long-term health of both the mother and child. The number of women in paid employment has increased exponentially, yet very few of these women continue breastfeeding as recommended by the World Health Organisation. The purpose of this qualitative study was to identify the factors affecting breastfeeding practices in the workplace. Objectives of the study are to: 1: Describe managers’ attitudes to and knowledge about providing breastfeeding support. 2: Identify mothers’ attitudes towards breastfeeding and the workplace environment. 3: Describe the practices of the breastfeeding mothers in the workplace. 4: Identify factors that influence breastfeeding practices within the workplace environment Method The theoretical frameworks adopted were the Situation- Specific Theory of Breastfeeding and the BASNEF model. The frameworks together with the literature review provided the background which informed this study. The research was a case study of two multi -national companies in Durban, KwaZulu Natal; participants were mothers and managers in the companies. Purposive sampling was used for selecting eight women who participated in the focus groups, two follow up interviews were conducted and five managers were interviewed. Data collection techniques also included a reflexive journal and field observation. After a thorough review of the data, the main themes which emerged were used to guide the discussion and answer the objectives of the study. Results The two companies reflected a scenario of pressures in the workplace environment affecting women’s choices regarding combining work and breastfeeding; societal pressures were dictating acceptable behaviour. Breastfeeding was not a priority for employers, no breastfeeding policy existed. Breastfeeding mothers were isolated and employers and employees were not engaging on the issue. Conclusions and Recommendations Simple enabling factors within the workplace would allow mothers, their infants and employers to enjoy the benefits of supporting breastfeeding in the workplace; this would be a win-win situation. Government, non-governmental organisations and society have a responsibility to overtly protect, support and promote breastfeeding in society and in the workplace.