Tesi sul tema "Health promotion South Australia Evaluation"

This research describes the design and evaluation of an internet-based universal program for use in schools with adolescent students to prevent common mental disorders and promote mental health. The research began in response to investigations that showed that rates of mental illness in Australian children, teenagers and adults were high, that these illnesses caused significant burden to individuals and society, and that there were insufficient services to treat. When current interventions are unable to alleviate disease burden it is important to focus on prevention. Mental health prevention should target youth before disorders cause disability and restriction of life choices. A review of the mental health prevention literature supported a universal cognitive behavioural approach in schools. Internet delivery was used to maintain content integrity, enable access to people living in regional and remote areas, and to appeal to young people. Internet delivery makes universal prevention cost effective and feasible. The Intervention Mapping approach was used to direct the design of the program. A feasibility study was conducted to gain opinions from students and teaching staff. Changes were made in light of results from this study and 463 students were then exposed to the program in an effectiveness trial. The effectiveness trial was a before-after design with no control group. Results from this trial provided evidence that the program was acceptable and effective for use by teachers in the intervention schools. Also student behaviour and mood changed in beneficial ways after program administration. Specifically, student reported significantly increased knowledge about stress and coping, use of help-seeking behaviours, and life satisfaction, and significantly decreased use of avoidance behaviours, total difficulties and psychological distress. The study design allows causal inferences to be surmised concerning exposure to the intervention and changes in behaviour and mood, but further evidence is needed before firm conclusions about effectiveness can be posited and generalizations made concerning different populations, settings and times. In conclusion, this thesis provides evidence that a computerised, cognitive behavioural mental health prevention program delivered to adolescent school students by teachers can potentially change student coping behaviours and mood in beneficial ways.

The promotion Walking for Health (WFH) in South Asian communities is an invaluable tool that will help to reverse the decline of physical activity and the 40% higher death rate of South Asian adults from Coronary Heart Disease (CHD). This research forms a part of the national evaluation of the demonstration WFH projects funded by the WFH initiative via the British Heart Foundation (BHF) and Countryside Agency (CA). Leicester's Chalo Chalay (Let's Walk) project was unique in both its primary target audience and its approach to promote the health benefits of walking. A key aim for Chalo Chalay as a demonstration project was to present evidence on walking as a positive preventive mechanism against CHD and other related conditions in South Asian communities and to develop a toolkit that promoted WFH in South Asian communities. It aimed to promote higher levels of awareness of the health and social benefits of walking and to increase the participation in daily walking activity by South Asian adults through increased walking opportunities, community action and improved environments.

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

Thesis (PhD)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: Unhealthy behaviour is a key modifiable factor that underlies much of the South African (SA) burden of disease and primary care morbidity. Chronic diseases such as heart disease, type 2 diabetes, lung diseases and some cancers are linked to underlying behavioural issues such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy eating. Evidence shows that brief behaviour change counselling by primary care providers can be effective in helping patients to change risky lifestyle behaviours. However, the capacity of South African primary care providers to educate and counsel patients on lifestyle modification is generally poor. The need for primary care provider training in lifestyle counselling, is stated as a critical objective in ‘re-orientating’ the primary health care system to effectively address NCDs in the National Strategic Plan for the Prevention and Control of NCDs and their risk factors in SA. The overall aim of this research was to develop, implement and evaluate the effectiveness of a training intervention for primary care providers in the South African setting, which is based on teaching best practice, behaviour change counselling (BBCC) methods that can be used for patients with risky lifestyle behaviours associated with non-communicable diseases (NCDs). “Effectiveness” relates to the effect of the training on PCPs adoption of a patient centred approach, and skills acquisition after the training, and not the effectiveness in changing, or improving patient outcomes. The sequence of the abstracts of the four articles that were published from this research, gives an overview of the process.
AFRIKAANSE OPSOMMING: Ongesonde lewenstyl kan gekoppel word aan die meeste chroniese siektes wereldwyd, en dra grootliks by tot die las van primere sorg morbiditeit, asook in Suid Afrika. Rook, ongesonde dieet, fisiese onaktiwiteit, en alkohol misbruik word beskou as die onderliggende risiko faktore wat verantwoordelik is vir die ontwikkeling van kardiovaskulere siektes, tipe 2 diabetes, respiratoriese siektes, sowel as sommige kankers. Navorsing het bewys dat primere gesondheidsorg werkers effektief kan wees om pasiente te help om hierdie gewoontes te bekamp. Nieteenstaande hierdie bewyse, is die huidige kapasiteit van primere sorg dokters en verpleegsters in Suid-Afrika nie voldoende om sodanige diens te verskaf nie. In die Nationale Strategiese Plan vir die beheer van chroniese siektes, word opleiding vir primere gesondheidsorg werkers geprioritiseer as n kritiese uitkomste vir die beheer van chroniese siektes, en die onderliggende risiko faktore. Dit is dus duidelik dat daar n behoefte is om sodanige opleidingprogramme te ontwikkel. Die doel van hierdie navorsing was om n bewysgebaseerde opleidingsprogram te ontwikkel, te implementeer, en die effektiwiteit daarvan te evalueer in ons unieke primere gesondheidsorg sisteem in Suid-Afrika. Die opleidingsprogram moes ontwikkel word, vir beide primere sorg dokters en verpleegsters, sodat dit hulle in staat kan stel om pasiente te beraad oor enige van die vier risiko faktore.

[Truncated abstract] Indigenous Australians suffer cardiovascular disease (CVD) at a rate six times greater than the general population in Australia and while the incidence of CVD has been reduced dramatically amongst the majority of non-indigenous Australians and amongst Indigenous populations in other countries in the last 30 years, there has been little change in the figures for Aboriginal Australians, showing that heart health campaigns have little impact, for this group of people. Aims : The principal aims of this study were firstly, to determine and record the barriers to the development and delivery of CVD prevention programs amongst Indigenous Australians and secondly, to develop an alternative, effective and culturally sensitive method of delivering heart health messages. Methods and results : The study was qualitative research undertaken in three South-West towns of Western Australia where the incidence of CVD was high amongst the Aboriginal community members. The use of semi-formal interviews, informal individual consultation, observation, and focus groups were methods implemented to obtain information. The first phase of the research was to identify the barriers which affected the Aboriginal Health Workers’ ability to deliver specialist educational programs. Questionnaires and interviews with the Aboriginal Health Workers and other health professionals in the towns, and community focus groups were undertaken in this phase of the study. The second phase of the research was aimed at developing an alternative strategy for delivering heart health messages. The focus changed to adopt more traditional ways of passing on information in Indigenous communities. The idea of small gatherings of friends or family with a trusted community member presenting the health message was developed. The third phase of the research was to implement this new approach. Lay educators who had been identified within focus groups and by Aboriginal Health Workers were trained in each of the towns and a protocol involving discussions of health issues, viewing a video on CVD, produced by the National Heart Foundation, sharing in a ‘heart healthy’ lunch and partaking in a ‘heart health’ knowledge game which was developed specifically for the gatherings. Several of these gatherings were held in each of the towns and they became known as ‘HeartAware parties’.

Introduction Health problems emanating from sexual behaviour include HIV/AIDS, other sexually transmitted infections and unintended pregnancies. The prevalence of HIV/AIDS and sexually transmitted infections among adolescents are considered high in South Africa. Also, the burden of unplanned pregnancies has wider implications in society. These problems occur in spite of a number of different sexual health promotion programmes. The aim of the study was to view the perception of high school teenagers to sexual health promotions programmes as well as their response to these programmes. The objectives of the study were: 1. To explore the perceptions of local teenagers regarding the content and materials used in local health promotion programmes 2. To explore the perceptions of local teenagers regarding the communication strategies and style used in local health promotion programmes 3. To explore the perceptions of local teenagers regarding the impact of local health promotion programmes on their behaviour Method This was a qualitative study. The study population was high school teenagers from the Whittlesea townships in the Eastern Cape province of South Africa. Fourteen purposefully selected teenagers from the seven high schools were individually interviewed. Analysis was done using the framework method. Results The study showed that the content of sexual health promotion programmes to which high school teenagers in Whittlesea were exposed to composed of sexual health education and the building of life skills. Perception of the messages in these contents was influenced by lack of communication on sexual matters within individual families and religious beliefs of participants. The programmes were considered to be practical and helpful. Methods that involved teenagers’ participation or interaction were generally preferred and the communication style was perceived as facilitating behavioural/attitudinal change. Conclusion In order for adolescent sexual health promotion programmes to be effective, they should employ methods that involve participation and human interaction. The involvement of parents, role models, religious groups and community services in sexual health promotion could be helpful in promoting sexual health education and lifestyle change amongst teenagers.

Thesis ( Mnutr)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Background: The rising prevalence of non-communicable diseases (NCD) is cause for concern. Improving dietary quality is a key health promotion strategy aimed at reducing NCD morbidity and mortality. Assessments that quantify “risky” dietary behaviours are worthwhile, and may help to identify high risk individuals, that would benefit from targeted interventions. Purpose: Discovery Vitality is a wellness incentive business associated with Discovery Health medical aid in South Africa. This study developed a Dietary Behaviour Score (DBSPHR) that measured degrees of compliance of Discovery Vitality members with the “spirit of dietary guidance”. It further categorized scores and identified members who may be at risk for developing NCDs due to poor dietary compliance. Methods: The DBSPHR included proportionally weighted components related to the consumption of fruit, vegetables, low fat dairy, whole-grain foods, lean meat, chicken and discretionary fat. The study population included adult South African members of Discovery Vitality, who had completed the programme’s on-line health risk assessment (PHR) between the 1st February 2010 and 31st January 2011. Stratified random sampling was used (n=1600). Half the sample included members who participated in Vitality’s HealthyFoodTM benefit (HFB) programme. The different Vitality Status groups were equally represented, and reflect degrees of engagement with the programme. Genders were equally represented. DBSPHR data were categorized as: Poor (Score 0-18), Inadequate (18.5-22.5), Fair (23-26), Good (26.5-29), Excellent (29.5-36). DBSPHR data was analyzed for variables: Vitality status, HFB participation, smoking, physical activity, alcohol consumption, body mass index (BMI), age and gender. The relationships between continuous response variables and nominal input variables were analysed using analysis of variance (ANOVA). When ordinal response variables were compared versus a nominal input variable, non-parametric ANOVA methods were used. Further, the Mann-Whitney test or the Kruskal-Wallis test was used. A p-value of p < 0.05 was considered to represent statistical significance, and 95% confidence intervals were used to describe the estimation of unknown parameters. Results: Of the sample, 67.13% of members had DBSPHRs that were considered “poor” or “inadequate”. The mean DBSPHR of the sample was 20.47 points. Women achieved better DBSPHRs than men (p<0.01). Greater engagement with the Vitality programme was associated with better DBSPHRs (p<0.01). There was no significant difference between the mean DBSPHR of members participating in the HFB and Non-HFB members, however the HFB was not assessed as an intervention. Members with “risky” lifestyle behaviours such as; inactivity, smoking and consuming alcohol excessively, demonstrated lower DBSPHR than members without these risks. Obese members achieved significantly lower DBSPHRs than normal weight and overweight members (p<0.01). Conclusions: It is concerning that Discovery Vitality members did not perform better than the general global standard of inadequate compliance with the “spirit of dietary guidance”. Engagement with the Vitality programme seems to positively impact on dietary compliance. Members at an increased risk for NCD morbidity and mortality due to; aging, obesity, smoking, inactivity or non-compliance with alcohol consumption guidelines, demonstrated lower DBSPHRs compared to members without these risks. Targeted interventions aimed at addressing “risky” dietary and lifestyle behaviours may benefit these members.
AFRIKAANSE OPSOMMING: Agtergrond: Die styging in voorkoms van nie-oordraagbare siektes (NOS) is rede tot kommer. Verbetering van dieetkwaliteit is ‘n sleutel gesondheidsbevordering strategie gemik daarop om NOS morbiditeit en mortaliteit te verminder. Assesserings wat “riskante” dieetgedrag kwantifiseer is waardevol en mag help om hoë risiko individue te identifiseer wat sal baatvind by geteikende intervensies. Doel: Discovery Vitality is ‘n welwees motiveringsbesigheid wat geassosieer is met Discovery Health mediese fonds in Suid-Afrika. Hierdie studie het ‘n dieet-gedragstelling (“Dietary Behaviour Score - DBSPHR”) ontwikkel wat die graad van nakoming van Discovery Vitality lede gemeet het aan die “gees van leiding oor dieet”. Dit het verder tellings gekategoriseer en lede geïdentifiseer wat ‘n verhoogde risiko vir die ontwikkeling van NOS mag hê as gevolg van swak nakoming van dieet. Metodes: Die DBSPHR het proporsioneel geweegde komponente bevat, verwant aan die inname van vrugte en groente, laevet suiwelprodukte, volgraan voedsels, maer vleis, hoender en diskresionêre vet. Die studiepopulasie het volwasse Suid-Afrikaners ingesluit wat lede van die Discovery Vitality program was en wat die program se aanlyn gesondheidsrisiko assessering tussen 1 Februarie 2010 en 31 Januarie 2011 voltooi het. Gestratifiseerde, ewekansige steekproeftrekking was gebruik (n=1600). Helfte van die steekproef het lede ingesluit wat aan Vitality se HealthyFoodTM voordeel program deelgeneem het. Die verskillende Vitality Status groepe was gelyk verteenwoordig en reflekteer verskillende grade van interaksie met die program. Geslagte was gelyk verteenwoordig. DBSPHRs data was gekategoriseer as: Swak (Telling 0-18), Onvoldoende (18.5-22.5), Matig (23-26), Goed (26.5-29), Uitstekend (29.5-36). DBSPHR data was vir die volgende veranderlikes geanaliseer: Vitality status, deelname aan die HealthyFoodTM voordeel, rook, fisiese aktiwiteit, alkohol inname, liggaamsmassa indeks (LMI), ouderdom en geslag. Die verhouding tussen aaneenlopende reaksie veranderlikes en nominale inset veranderlikes was geanaliseer deur die gebruik van analise van variansies (ANOVA). Wanneer ordinale reaksie veranderlikes vergelyk was teenoor ‘n nominale inset variansie, was nie-parametriese ANOVA metodes gebruik. Verder was die Mann-Whitney toets of die Kruskal-Wallis toets gebruik. ‘n P-waarde van p < 0.05 was gesien as verteenwoordigend van statistiese beduidendheid en 95% sekerheidsintervalle was gebruik om die skatting van onbekende parameters te beskryf.Resultate: Van die studie monster het 67.13% van die lede DBSPHRs getoon wat gereken was as “swak” of “onvoldoende”. Die gemiddelde DBSPHR van die steekfproef was 20.47 punte. Vroue het beter DBSPHR as mans behaal (p<0.01). Meer interaksie met die Vitality program was geassosieer met beter DBSPHRs (p<0.01). Daar was geen beduidende verskille tussen die gemiddelde DBSPHR van lede wat aan die HealthyFoodTM voordeel program deelneem en die lede wat nie aan die program deelneem nie, alhoewel die HealthyFoodTM voordeel nie geëvalueer was as ‘n intervensie nie. Lede met “riskante” lewenstyl gedrag soos onaktiwiteit, rook en hewige alkoholinname het laer DBSPHR getoon as lede sonder hierdie risiko’s. Vetsugtige lede het laer DBSPHR behaal as normale gewig en oorgewig lede (p<0.01). Gevolgtrekking: Dit is ‘n bron van kommer dat Discovery Vitality lede nie beter vertoon het as wat blyk ‘n algemene globale standaard van gebrekkige nakoming van die “gees van leiding oor dieet” te wees nie. Interaksie met die Vitality program blyk ‘n positiewe impak te hê op dieet nakoming. Lede wat ‘n verhoogde risiko gehad het vir NOS morbiditeit en mortaliteit as gevolg van veroudering, vetsugtigheid, rook, onaktiwiteit of verontagsaming van alkohol inname riglyne het ook laer DBSPHRs getoon in vergelyking met lede sonder hierdie risiko’s. Geteikende intervensies gemik op die aanspreek van riskante dieet en lewenstyl gedrag mag tot voordeel van hierdie lede wees.

South Africa has one of the highest HIV prevalence rates globally, with nearly 2.5 million people accessing antiretroviral treatment (ART) at the end of 2013. Retaining patients on ART has become a major problem in this country. When patients no longer show up for ART for unknown reasons, they are considered lost to follow-up (LTF). LTF is the highest contributor to ART attrition. This study, guided by the health belief model, evaluated the effectiveness of a technology-based, mobile health (mHealth) appointment reminder intervention on LTF among patients accessing ART services. The study ascertained differences in 6- and 12-month LTF rates between patients enrolled in the mHealth intervention (n = 832) and those in the standard of care comparison group (n = 918). A quantitative, retrospective cohort approach was used to answer the research questions using binary logistic regression analyses. The mHealth intervention was found to be significantly linked to lower likelihood of 6- and/or 12-month LTF among patients. There were 2 other key findings: a positive correlation between pregnancy and LTF, and a positive correlation between viral load increases and LTF. This study added evidence to the existing literature on the effectiveness of using mHealth-based interventions to improve HIV/AIDS care. Based on these findings, professionals should pay special attention to pregnant women and those clients with increasing viral loads to ensure they are not LTF. Positive social change that may result from this study is better health outcomes for patients on ART due to reduced risk of HIV related complications and other illnesses. This awareness would improve the lives of the patients, and positively impact their families, communities, and ultimately the global community, by reducing the overall impact of HIV disease.

There is an escalation of HIV and AIDS among the youth in South Africa and other developing countries. Research on HIV and AIDS risk factors has tended to focus more on poverty, gender, race, illiteracy, and violence than personality factors that could influence an individual` s health-protective behaviour. Previous studies have also shown that wealth, education, race, and gender may not make an individual more or less vulnerable to HIV infection. This study argued that locus of control could influence an individual` s health-protective behaviour and that external locus of control could be a risk factor in HIV and AIDS risk reduction. The aim of this study was to investigate the efficacy of a locus of control-based training programme in reducing HIV and AIDS risk among university students. The locus of control-based variables that formed the training programme for HIV and AIDS risk reduction among university students were: social systems control, self-control, fatalism, achievement-oriented behaviour, deferment of gratification, personal values and expectancies, and social alienation. These locus of control-based variables were regarded as contexts in which individuals could exhibit health risk behaviours. A sample of 257 first-year university students participated in the study. There were (N = 170) female participants and (N = 87) male participants drawn from the University of the Witwatersrand. The study was a pretest-posttest repeated measures design. Data were analysed using t tests, correlations, multiple regression, structural equation modelling, and repeated measures tests. The results of this study showed significant differences in health risks between participants with an external locus of control and participants with an internal locus of control. There was a significant relationship between locus of control-based variables and HIV and AIDS risk. The locus of control-based training programme significantly modified personality and significantly reduced locus of control-based health risks and HIV and AIDS risk. Directions for future research on locus of control, health risks, and HIV and AIDS risk could focus on the development and implementation of various locus of control-based training programmes in South Africa. Locus of control should be targeted as a health risk factor in HIV and AIDS risk reduction training programmes.

An employee wellness programme is a programme that promotes and supports the well-being of its employees and is aimed at increasing productivity. Employee Assistance Programmes (EAPs) are used as a means of ensuring employee wellness. Employee Assistance Programme can be defined as a programme aimed at improving the quality of life of employees and their families by providing support and helping to alleviate the impact of everyday work and personal problems. EAPs are intended to help employees deal with their personal problems that might adversely impact their work performance, health and well-being. The main goal of the EAP is to enhance productivity as well as social functioning of individuals.The main objective of the study as to evaluate the Employee Assistance Programmes and the impact of Workplace Wellness on employee performance in the Eastern Cape Provincial Legislature. This was triggered by the fact that Wellness and EAPs are not visible in the ECPL and the Legislature continues to lose employees due to ill-health and resignations. The institution is characterised by a culture of “us” and “them”, us, referring to Labour and them to Management, and therefore resulting in low staff morale. This raised some concern from the researcher as there is an EAP paid for by the Legislature, but awareness, utilisation and effectiveness of the programme remain a challenge. Due to the nature of the institution’s core business, it is perhaps even more vital for the Legislature to create an organisational culture of caring and employees to be nurtured. It is believed that it is more cost effective and beneficial to both the employer and the employee to retain trained employees, than it is to lose troubled employees and hire new ones, in particular because there is no guarantee that the new ones will not, in time also show signs of problems. The researcher used applied research in this study to explore the need for the EAP as well as how best the programme can be implemented. A combination of an explanatory-descriptive design was used for this study because little is known about the phenomenon or programme. For this research, the researcher used a combination of interval/systematic and random sampling to complement each other in reducing any bias that has the potential of occurring when applying interval/systematic sampling. To get representation and precision, the researcher divided 285 employees according to their ranks. The results from this attempt were: Secretariat=25, Management=42, Administrative staff=196, General Workers=33 NEHAWU Shopstewards=10. The researcher then divided employees in each respective category by one tenth or 10% of each category to get the number of respondents from each category to be included in the sample and added up all categories to get the sample size. The sample of this study was thus, Secretariat=1, Management=4, Administrative staff=20, General workers=3 and NEHAWU Shopstewards=1 and made up a sample size of 29. Only one questionnaire was compiled for all the respondents because EAP recognise that employees start from the CEO of a company to the lowest paid employee in that company and, as such considers all employees to be equal. Research results indicated that there are some limitations in the utilisation of EAP and that employees are faced with both personal and work-related problems. Thus it became clear that the whole concept of Employee Wellness and Employee Assistance Programmes needed to be overhauled and restructured to ensure maximum benefit.

"May 2002"
Includes bibliographical references (leaves 267-289)
xvii, 290, [69] leaves : ill., plates ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Depts. of Public Health and General Practice, 2002

Includes bibliographical references (leaves 310-325).
xvi, 325 leaves : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
A study which investigates in a South Australian context: 1. What are the physical activity gaps between social groups and how do these gaps relate to health and the other benefits of physical activity? 2. What are the contraints on choices and what needs to be done to make the choices of people to increase moderate physical activity easier? 3. What is the role of the social environment in relation to moderate physical activity choices and what needs to be done to ensure supportive environments? The results show that physical activity frequently becomes the province of differents sectors of society at different times. Recent case studies demonstrate that policies about how governments organise their services lead to more fundamental changes than specific health policies.
Thesis (Ph.D.)--Adelaide University, Dept. of Public Health, 2001

Bibliography: leaves 250-267.
xx, 267, [90] leaves : ill., map ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Aims to develop a model to improve breastfeeding in a low socio-economic area through the development of health promotion strategies to create a supportive environment for breastfeeding.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000?

Objective To conduct an evaluation of the pilot implementation of the World Health Organization Health Promoting Hospitals initiative and its self-assessment tool in public hospitals in KwaZulu-Natal in 2004/2005 Study design This evaluation utilised a cross-sectional design that incorporated both qualitative and quantitative research methods. Main measures Throughout the Health Promoting Hospital pilot project the opinions and responses of those with a legitimate interest in the initiative were monitored. Data collection methods utilised in this evaluation included participant observation, the World Health Organisation metaevaluation questionnaire, records of workshops and feedback meetings and secondary analysis of all data collected by the six pilot hospitals during the implementation of the project in KwaZulu-Natal. Results Major constraints were found to be time, human and financial resources, lack of training and expertise and insufficient support for the project. The self-assessment tool was found to be insufficiently adapted and not all outcomes were found to be reliable and useful. Despite this, institutional staff found the Health Promoting Hospital project to be capacity building and morale boosting. Relationships between health service levels improved. All hospitals who participated recommended that other hospitals become Health Promoting Hospitals. Conclusion If the World Health Organisation Health Promoting Hospital initiative with its selfassessment tool is to be rolled out to the rest of KwaZulu-Natal province, then substantial changes have to be made to the process. Amongst these are: further adaptation of the selfassessment tool, improved methods of data collection, provision of sufficient resources and increased and sustained provincial support for the project. In addition it is imperative that outcome and impact evaluations be done.
Thesis (M.Med.)-University of KwaZulu-Natal, 2008.

D. Litt et Phil. (Literature and Philosophy)
Eye health promotion is an important aspect of VISION 2020 campaign that aims to eliminate unwarranted cases of avoidable blindness worldwide by the year 2020. Most developing countries, including South Africa, have a serious burden of eye diseases and unwarranted causes of visual impairment and blindness. The purpose of this research therefore was to highlight the lack of an integrated eye health promotion policy in the South African primary health care system which can play a major role in the elimination of this burden of disease and also to make proposals for eye health promotion policy development in South Africa. A combination of quantitative and qualitative research methods was used in this study. Questionnaires and interviews were conducted with all national and provincial health managers of portfolios relevant to eye care. Also, various health policy documents were requested from the National and Provincial Department of Health to ascertain claims of any existing guidelines on eye care. The policy documents and guidelines obtained had no specific reference to eye health promotion. Only 11 (23%) of the managers of provincial health directorates reported that they have integrated vision screening in their health promotion programmes as part of eye health promotion strategies. Eye care managers in the provinces reported that school visits accounted for 75% of eye health promotion programmes target areas. Also, apart from the Northern Cape Province which has no eye care manager and consequently no eye health promotion programmes, the Western Cape Province also does not have eye health promotion programmes and relies mostly on private sector for eye care services. The lack of an integrated eye health promotion policy and most probably the lack of a dedicated directorate that deals with eye health promotion issues may be a contributing factor to the overwhelming lack of integrated eye health promotion activities in South Africa. It is therefore recommended that an integrated eye health promotion model be developed and be part of the South African primary health care system.
Health Studies

Thesis (Ph.D. (Health Sciences)) -- University of Limpopo, 2021
Background: The purpose of this study was to develop, implement and evaluate a Health Promoting School (HPS) training programme for educators in the high schools of the Mankweng Circuit, Limpopo Province, South Africa. Methods: This is an explanatory mixed method study conducted among high school learners to identify risk behaviours, physical environmental and school climate factors to develop, implement and evaluate a Health Promoting School training programme for educators in the high schools of Mankweng Circuit. A structured questionnaire and a semi-structured interview guide were used to collect data. Quantitative data was collected from a total of (n=828) learners on risk behaviours, environmental and the school climate factors including curriculum and policy factors from (n=12) schools, while the key informants involved in decision making at the schools provided qualitative data on the same topics. The study highlighted potential areas for the initiation of Health Promoting Schools in Limpopo Province. Results: About 828 learners participated in this study, of which, 416 (50.2%) were males and 412 (49.8%) were females. More males than females indicate that they consumed alcohol (47% versus 24%, p<0.05), while 11% (90/840) of the learners report to have smoked cigarettes, a higher proportion of which are males rather than females (18% versus 4%, p<0.05). Quantitative results were further explored through analysis of the qualitative data from key informants who confirmed that the use of substances such as tobacco, alcohol and dagga (marijuana) is rife among school learners. Factors relevant to develop a training programme for educators were identified from the findings. The identified factors informed the development of the HPS training programme. Educators received training on HPS programme and the implementation was evaluated. Conclusion: The Health Promoting School (HPS) Training Programme improved the educator’s knowledge, understanding and skills of how schools can become Health Promoting Schools.

"February 20, 2003"
Includes bibliographical references (leaves 586-603)
xvii, 603 leaves : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Investigates the level of resident participation in decision-making in aged care hostels in South Australia.
Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2003

The study was about the process evaluation of the development of the YOUNG WORKERS CAMPAIGN (YWC) Programme to document and analyses the involvement and participation of stakeholders in the development process. The purpose of the study was on the assessment of stakeholder participation and involvement in the development of the YWC to maximise the effectiveness, acceptability and sustainability of the intended programme. Informant interviews, focus group interviews and document analysis were the primary means of collecting data for this research study. The main findings are as follows: Few of the stakeholders were involved in the conceptualisation phase of the YWC Programme and their roles in the development process were not clearly described. Stakeholder analysis was not done and their involvement in decision-making was limited. In order to address the problem of participation, YWC stakeholders should pass through a process of stakeholder analysis, that is, they should be assessed in terms of contribution and value-adding to the development process.
Sociology
M.A. (Social Behaviour Studies HIV/AIDS)

The purpose of the study was to evaluate the management of the HIV and AIDS workplace policy at Statistics South Africa (Stats SA). This entailed an assessment of the levels of awareness amongst employees, and an assessment of employees’ knowledge of the policy and its implementation. Data were collected through a structured questionnaire administered to randomly selected employees. It was found that the respondents’ level of awareness of the HIV and AIDS workplace policy at Stats SA was satisfactory. Although some differences were observed, overall it seems that Stats SA was successful in promoting general awareness of its policy and its contents. However, as far as the respondents’ attitudes and opinions relating to the implementation of the policy at Stats SA are concerned, several issues still need to be addressed.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)

The primary aim of this study is to describe and explain the extent of which school managers and primary healthcare facility managers possess knowledge and awareness of their roles in the implementation of the Integrated School Health Policy in Region C in the Gauteng Provincial Department of Basic Education. The study used a qualitative research method by which semi-structured interviews were conducted using a descriptive and explanative design. A sample of ten respondents was elected using a purposive sampling strategy and conventional or content analysis was utilised in the interpretation and analysis of data. The main findings of the study revealed that managers know their role in the implementation of the policy. Although managers are aware of their important roles; they are unable to fulfil them due to a lack of skills. Therefore, the study recommends that the Department of Health and the Department of Basic Education should ensure that managers are skilled and more knowledgeable in implementing the policy objectives.
Public Administration and Operations Management
M. Admin. (Public Admiistration)

Text in English
This study sought to evaluate the implementation of an HIV and AIDS workplace policy at Sappi-Ngodwana mill. Employing process evaluation, and adopting a qualitative approach, the study evaluated the intervention process, the perceptions of the policy implementers, the strengths and weaknesses of the policy implementation, and suggests possible strategies for addressing the challenges. A systems approach was the theoretical point of departure and guiding framework of the research study. Research data was gathered through in-depth interviews with key informants and theory-driven and data-driven inductive reasoning was adopted in analysing the data. The general findings were that although the Sappi-Ngodwana mill implements a comprehensive HIV and AIDS programme that are in line with national and international benchmarks, there were challenges identified. Recommendations are that the company redesign the HIV and AIDS policy implementation plan with a specific focus on improving the peer educators` system.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)

Against the background of evidence that HIV-AIDS has had and continues to have an enormous impact on all South African schools, a need has arisen for HIV -AIDS policies and programmes to be effectively implemented in all schools. In this study, a qualitative methodology was used to evaluate policy implementation in the North West province. Data was gathered by means of field notes, observation and interviews with management and educators. The study found that although principals and educators are knowledgeable about HIV -AIDS, there is a tendency to discriminate against infected educators, particularly in terms of educator workload. This study also revealed that educators fear being accidentally exposed to HIV -AIDS infected blood, despite the guidelines given in the National HIV -AIDS policy and the availability of emergency first aid kits. The key thought emerging from this study is that not all schools are able to deal effectively with HIV -AIDS and that schools urgently need to plan or implement their own policies in this regard. School-based HIV-AIDS policies can only be successful if they take cognisance of local contextual issues and involve the three spheres of influence in the lives of educators and learners, namely, the sphere of the school, the sphere of family life and the sphere of the community.
Sociology
M.A.(Social and Behavioural Studies in HIV-AIDS)

The problem this research seeks to address is the support educators receive in teaching HIV and AIDS topics in the classroom. The reason for the choice of topic is to contribute to the revival of HIV and AIDS education in all schools in South Africa. This exploratory study uses the empowerment theory and presents the qualitative research findings based on in-depth interviews with six educators, four school managers and two parents. Thematic content analysis is used to analyse the data. The study found out that the Department of Education had in the past two years provided training workshops for principals of schools, educators and peer educators in the last two years yet the findings from the two schools under study painted a different picture all together. Findings from the interviews show that any support from the Department of Education or any other stakeholder involved in education, such as the Teacher Unions, happened some years ago. Some of the respondents were not very comfortable on this topic as to most of them HIV and AIDS education is not really being taught as it used to years ago. Finally, the research made some recommendations to these two schools on what could be done as a way of reviving HIV and AIDS education to help children and youths to grow up better able to challenge HIV and AIDS. This is in line with the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEC) 2011 report that the education sector has a critical role to play in terms of the delivery of effective HIV and AIDS prevention and awareness programmes. The findings were important as they highlighted the need for the Department of Education to monitor and evaluate the implementation of HIV and AIDS policies in all public schools. They also they gave recommendations on the way forward on HIV and AIDS education in primary schools.
Health Studies
M.A. (Social Behaviour Studies in HIV and AIDS)