Browsing by Author "Crutzen, Rik"
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Item Adolescent Hookah pipe use: Exploring the role of basic psychological needs and motivation(SAGE, 2021) Kader, Zainab; Crutzen, Rik; Roman, Nicolette VanessaAdolescent hookah pipe use is on the rise despite it being a public health concern. Several studies focus on the external determinants of adolescent hookah pipe use but research focusing on the internal factors motivating adolescents to smoke the hookah pipe is sparse. Drawing on self-determination theory, a contemporary theory of human motivation, this study aimed to explore the basic psychological needs (BPN) and motivation of adolescent hookah pipe users and nonusers in an attempt to explore whether satisfaction or frustration of needs contributes to hookah pipe use.Item Determinants of adolescent Hookah pipe use: A systematic review(Routledge, 2019) Kader, Zainab; Roman, Nicolette Vanessa; Crutzen, RikAdolescent hookah pipe use is increasing at a rapid rate, thus posing a major public health concern globally. The hookah pipe is a gateway substance to other substances that may be more harmful. Yet, at present, little is known about why adolescents are so drawn to this mechanism. It is this gap that this study attempted to fill. This study, therefore, aimed to review the determinants of adolescent hookah pipe use. An electronic search of 12 databases identified studies investigating determinants of adolescent hookah pipe use. Twentyfive studies sampling a total of 88,988 adolescents who use the hookah pipe were included. This study found that adolescent hookah pipe use is determined by an interplay of family factors, peer/friends factors, individual factors, school factors, the actual hookah pipe mechanism, advertisements, and awareness of hookah pipe lounges or bars. Prevention and early intervention strategies aimed at reducing adolescent hookah pipe use is needed.Item Healthcare workers’ beliefs, motivations and behaviours affecting adequate provision of sexual and reproductive healthcare services to adolescents in Cape Town, South Africa: a qualitative study(BioMed Central, 2018) Jonas, Kim; Crutzen, Rik; Krumeich, Anja; Roman, Nicolette V.; van den Borne, Bart; Reddy, PriscillaBACKGROUND: Adolescents’ sexual and reproductive healthcare (SRH) needs have been prioritized globally, and they have the rights to access and utilize SRH services for their needs. However, adolescents under-utilize SRH services, especially in sub-Saharan Africa. Many factors play a role in the under-utilization of SRH services by adolescents, such as the attitude and behaviour of healthcare workers. The aim of this study therefore, was to explore and gain an in-depth understanding of healthcare workers’ beliefs, motivations and behaviours affecting adequate provision of these services to adolescents in South Africa. METHODS: Twenty-four healthcare workers in public SRH services in Cape Town, South Africa participated in this qualitative study through focus group discussions. To fulfill the aims of this study, nine focus group discussions were conducted among the SRH nurses. RESULTS: SRH nurses indicated that they are experiencing challenges with the concept and practice of termination of pregnancy. They explained that this practice contradicted their opposing beliefs and values. Some nurses felt that they had insufficient SRH skills, which hinder their provision of adequate SRH services to adolescents, while others described constraints within the health system such as not enough time to provide the necessary care. They also explained having limited access to schools where they can provide SRH education and pregnancy prevention services in the surrounding area. CONCLUSIONS: Nurses are faced with numerous challenges when providing SRH services to adolescents. Providing the nurses with training programmes that emphasize value clarification may help them to separate their personal beliefs and norms from the workplace practice. This may help them to focus on the needs of the adolescent in a way that is beneficial to them. At the health systems level, issues such as clinic operating hours need to be structured such that the time pressure and constraints upon the nurse is relieved.Item Intervention to reduce adolescent hookah pipe use and satisfy basic psychological needs(Cogent OA, 2020) Kader, Zainab; Crutzen, Rik; Roman, NicoletteBackground: Hookah pipe use is a public health concern and threat to adolescents’ health. self-determination theory asserts that satisfaction of basic psychological needs (BPN) will contribute to adolescents developing optimally. Purpose: The purpose of this study was to design an intervention to reduce adolescent hookah pipe use and satisfy their BPN. Methods: A modified delphi approach was implemented using a two-phased approach. Phase 1 included reviews and empirical research that formed part of the needs analysis. Phase 2 was the development of the intervention in collaboration with stakeholders from academia, policy and practice (n = 25). The stakeholders formed the sample for this study. Phase 1 informed phase 2. Phase 2 was implemented through a 4-hour workshop with the stakeholders. The workshop was audio recorded, transcribed verbatim and thematically analysed. Principal Results: The results indicated that a holistic four-pronged approach focusing on (1) the hookah pipe user, (2) the family, (3) after school recreation activities and (4) the teacher and community was needed as a model to intervene in adolescent hookah pipe use and satisfy their BPN. The intervention was described using the RE-AIM framework which considers reach, efficacy, adoption, implementation and maintenance of the intervention.Item An intervention to reduce adolescent Hookah pipe use and satisfy their basic psychological needs(University of Western Cape, 2020) Kader, Zainab; Roman, Nicolette V.; Crutzen, RikAdolescent hookah pipe use is a public health concern because it poses several health, environmental, and economic risks. Self-determination theory (SDT) posits that people are motivated to engage in certain behaviours in an attempt to satisfy their basic psychologicalItem An intervention to reduce adolescent Hookah pipe use and satisfy their basic psychological needs(University of Western Cape, 2020) Kader, Zainab; Roman, Nicolette V.; Crutzen, RikAdolescent hookah pipe use is a public health concern because it poses several health, environmental, and economic risks. Self-determination theory (SDT) posits that people are motivated to engage in certain behaviours in an attempt to satisfy their basic psychologicalItem Nurses' perceptions of adolescents accessing and utilizing sexual and reproductive healthcare services in Cape Town, South Africa: a qualitative study(Elsevier, 2019) Jonas, Kim; Roman, Nicolette; Reddy, Priscilla; Krumeich, Anja; van den Borne, Bart; Crutzen, RikBackground: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services. Methods: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data. Results: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents. Conclusions: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof.Item Predictors of nurses’ and midwives’ intentions to provide maternal and child healthcare services to adolescents in South Africa(Biomed Central, 2016) Jonas, Kim; Reddy, Priscilla; van den Borne, Bart; Sewpaul, Ronel; Nyembezi, Anam; Naidoo, Pamela; Crutzen, RikBACKGROUND: Adolescent mothers are at a much higher risk for maternal mortality compared to mothers aged 20 years and above. Newborns born to adolescent mothers are also more likely to have low birth weight, with the risk of long-term effects such as early onset of adult diabetes than newborns of older mothers. Few studies have investigated the determinants of adequate quality maternal and child healthcare services to pregnant adolescents. This study was conducted to gain an understanding of nurses’ and midwives’ intentions to provide maternal and child healthcare and family planning services to adolescents in South Africa. METHODS: A total of 190 nurses and midwives completed a cross-sectional survey. The survey included components on demographics, knowledge of maternal and child healthcare (MCH) and family planning (FP) services, attitude towards family planning services, subjective norms regarding maternal and child healthcare and family planning services, self-efficacy with maternal and child healthcare and family planning services, and intentions to provide maternal and child healthcare and family planning services to adolescents. Pearson’s correlation analysis was conducted to determine the association between knowledge, attitude, subjective norms, self-efficacy, and intention variables for FP and MCH services. A 2-step linear regression analysis was then conducted for both FP and MCH services to predict the intentions to provide FP and MCH services to adolescents. RESULTS: Self-efficacy to conduct MCH services (β = 0.55, p < 0.01) and years of experience as a nurse- midwife (β = 0.14, p < 0.05) were associated with stronger intentions to provide the services. Self-efficacy to provide FP services (β = 0.30, p < 0.01) was associated with stronger intentions to provide FP services. CONCLUSIONS: Self-efficacy has a strong and positive association with the intentions to provide both MCH and FP services, while there is a moderate association with attitude and norms. There is a need to improve and strengthen nurses’ and midwives’ self-efficacy in conducting both MCH and FP services in order to improve the quality and utilization of the services by adolescents in South Africa.Item Predictors of nurses’ and midwives’ intentions to provide maternal and child healthcare services to adolescents in South Africa(BioMed Central, 2016) Jonas, Kim; Reddy, Priscilla; van den Borne, Bart; Sewpaul, Ronel; Nyembezi, Anam; Naidoo, Pamela; Crutzen, RikBACKGROUND: Adolescent mothers are at a much higher risk for maternal mortality compared to mothers aged 20 years and above. Newborns born to adolescent mothers are also more likely to have low birth weight, with the risk of long-term effects such as early onset of adult diabetes than newborns of older mothers. Few studies have investigated the determinants of adequate quality maternal and child healthcare services to pregnant adolescents. This study was conducted to gain an understanding of nurses’ and midwives’ intentions to provide maternal and child healthcare and family planning services to adolescents in South Africa. METHODS: A total of 190 nurses and midwives completed a cross-sectional survey. The survey included components on demographics, knowledge of maternal and child healthcare (MCH) and family planning (FP) services, attitude towards family planning services, subjective norms regarding maternal and child healthcare and family planning services, self-efficacy with maternal and child healthcare and family planning services, and intentions to provide maternal and child healthcare and family planning services to adolescents. Pearson’s correlation analysis was conducted to determine the association between knowledge, attitude, subjective norms, self-efficacy, and intention variables for FP and MCH services. A 2-step linear regression analysis was then conducted for both FP and MCH services to predict the intentions to provide FP and MCH services to adolescents. RESULTS: Self-efficacy to conduct MCH services (β = 0.55, p < 0.01) and years of experience as a nurse- midwife (β = 0.14, p < 0.05) were associated with stronger intentions to provide the services. Self-efficacy to provide FP services (β = 0.30, p < 0.01) was associated with stronger intentions to provide FP services. CONCLUSIONS: Self-efficacy has a strong and positive association with the intentions to provide both MCH and FP services, while there is a moderate association with attitude and norms. There is a need to improve and strengthen nurses’ and midwives’ self-efficacy in conducting both MCH and FP services in order to improve the quality and utilization of the services by adolescents in South Africa.Item Teenage pregnancy rates and associations with other health risk behaviours: a threewave cross-sectional study among South African school-going adolescents(BioMed Central, 2016) Jonas, Kim; Crutzen, Rik; van den Borne, Bart; Sewpaul, Ronel; Reddy, PriscillaBACKGROUND: Teenage pregnancy still remains high in low and middle-income countries (LMIC), as well as in highincome countries (HIC). It is a major contributor to maternal and child morbidity and mortality rates. Furthermore, it has social consequences, such as perpetuating the cycle of poverty including early school dropout by the pregnant adolescent, especially in sub-Saharan Africa (SSA). Few studies in SSA have investigated the trends in teenage pregnancy and the associated factors, while this is critical in fully understanding teenage pregnancy and for promotion of reproductive health among adolescents at large in SSA. METHODS: To examine the trends in teenage pregnancy and to identify associations with other health risk behaviours in South Africa (SA), a total of 31 816 South African school-going adolescents between 11 to 19 years of age were interviewed in three cross-sectional surveys. Data from the first (2002, n = 10 549), second (2008, n = 10 270) and the third (2011, n = 10 997) nationally representative South African youth risk behaviour surveys (YRBS) were used for this study. RESULTS: The overall prevalence of having ever been pregnant among the combined 3-survey sample was selfreported to be 11.0 % and stable across the three surveys. Sexual intercourse among adolescents in SA has decreased from 41.9 % in 2002 to 36.9 % in 2011. However, pregnancy among girls who ever had sex increased from 17.3 % (95 % CI: 0.16–0.19) in 2002, to 23.6 % (95 % CI: 0.21–0.26) in 2008 and decreased to 21.3 % (95 % CI: 0.19–0.23) in 2011. The odds for ever been pregnant were higher for girls who had 2 or more sexual partners (OR: 1.250, 95 % CI: 1.039–1.503), girls who ever used alcohol before sex (OR: 1.373, 95 % CI: 1.004–1.878), practised binge-drinking during the last month (OR: 0.624, 95 % CI: 0.503–0.774), and girls who used mandrax (OR: 1.968, 95 % CI: 1,243–3.117). The odds for never been pregnant were lower for those who used condoms (OR: 0.462, 95 % CI: 0.309–0.691). CONCLUSIONS: Girls continue to become pregnant at unacceptably high rates in SA. Sexual intercourse among adolescents in SA has decreased slightly. However, among those who are sexually active pregnancy prevalence rates have increased. More over, this is in the context of high prevalence of HIV and other STI. There is a need to address adolescents’ sexual and reproductive health, and several health risk behaviours, including substance use, that are associated with teenage pregnancy in SA.