Browsing by Author "De Man, Jeroen"

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    A qualitative process evaluation of community-based participatory research and human-centered design in the ‘let’s talk about vaccines’ approach in Mozambique and Malawi
    (BioMed Central Ltd, 2025) Shuro, Linda; De Man, Jeroen; Knight, Lucia; Tabana, Hanani; Schneider, Helen
    Background: Ensuring full coverage of childhood vaccination programmes is a persistent challenge in low- and middle-income countries. Urgent action is required to ensure catch up of missed immunisations in children, while simultaneously building trust and demand within communities to sustainably address existing immunization gaps. This paper summarizes the findings of a process evaluation of the ‘Let’s talk about vaccines’ approach by VillageReach in Mozambique and Malawi. The approach used community-based participatory research to identify the barriers to childhood vaccination faced by caregivers and healthcare workers, with human-centered design to codesign potential interventions to improve under two immunization access and uptake. Methods: To evaluate the implementation of the ‘Let’s talk about vaccines’ approach we conducted a qualitative process evaluation guided by the Reach Effectiveness Adoption Implementation Maintenance framework and Consolidated Framework for Implementation Research (CFIR). We completed a total of 76 qualitative interviews and 85 self-administered surveys among caregivers, healthcare workers, health officials and other stakeholders involved in the approach. We transcribed the interviews verbatim and analysed them using thematic analysis and constructs of the RE-AIM and CFIR frameworks. We analysed the survey results in Excel. Results: Key elements of the approach contributing to high fidelity to community-based participatory research principles in both countries, included diverse collaborative study and project teams, involvement of eight caregiver researchers, novel and traditional participatory methods, and extensive mobilization efforts. Success factors for human-centered design in the ideation and prototyping phase included fostering equal participation and empathy, value placed on each participant’s input, mitigating inherent power differences, interactive feedback processes, and extensive iterative processes leading to tangible solutions. Challenges included adjusting to new methods and contextual realities. Factors influencing the potential adoption of the approach included locally developed solutions, participant involvement, collaboration, a major advantage over alternative approaches, ease of use of the co-created interventions, alignment with government objectives, and adaptability for system-wide integration into immunization programming. The potential sustainability of the approach was supported by the involvement of health ministries, health professionals, community representatives, and capacity building of local structures. However, resource and incentive constraints posed as a potential challenge to maintaining long-term motivation and action. Conclusion: The evaluation findings from the ‘Let’s talk about vaccines’ approach highlighted key elements for applying community-based participatory research and human-centered design to collaboratively identify immunization barriers and create tangible solutions to overcome them. By integrating these approaches into routine immunization programs, it can potentially improve vaccination efforts for children under two in low and middle-income countries, leading to lasting change. Supporting policies that prioritize community involvement in research, program design and implementation and sustainable funding enhances immunization strategies, ensuring that they are tailored to local needs.
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    Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa
    (Public Library of Science, 2021) Mothupi, Mamothena Carol; De Man, Jeroen; Tabana, Hanani
    The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite index for assessing the maternal health continuum in a province in South Africa with the possibility of nationwide use.
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    Motivational determinants of physical activity in disadvantaged populations with (pre)diabetes: A cross-cultural comparison
    (Research Square, 2021) De Man, Jeroen; Kasujja, Francis Xavier; Delobelle, Peter
    Understanding motivational determinants of physical activity (PA) is essential to guide the implementation of PA at individual and population level. Knowledge about the cross-cultural generalizability of these determinants is lacking and they have mostly been studied as separate factors. This study compares a motivational process model across samples from diverse populations with, or at risk of diabetes.Measurement invariance of barrier identified regulation, barrier self-efficacy and social support was assessed in a rural Ugandan sample (n=712) and disadvantaged samples with high proportions of immigrants in urban South Africa (n=566) and Sweden (n=147). These motivational determinants were then compared through multigroup structural equation modeling.
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    Perceived healthfulness, nutrient content awareness, consumption, and intention to purchase selected ultraprocessed products among adults in South Africa
    (John Wiley and Sons Ltd, 2025) Swart, Rina; Bopape, Makoma; De Man, Jeroen
    Objective: To investigate the perceived healthfulness, nutrient content awareness, consumption, and intention to purchase selected ultraprocessed products (UPP) and their sociodemographic determinants. Design: Cross-sectional study involving secondary data analysis. Setting: This study was conducted in all nine provinces of South Africa. Participants: In total, 1951 adults (18–50 years), with 63.5% females and 66.3% from low socioeconomic group. Methods: Participants were shown A4 images of mock-branded UPP, with no nutrition information provided. Questions asked were based on the images to determine the nutrient content awareness, healthfulness perception, consumption frequency, and intention to purchase the UPP based on sociodemographic characteristics. Analysis: Descriptive statistics were conducted for nutrient content awareness, perceived healthfulness, consumption, and intention to purchase UPP. Associations with sociodemographic variables were determined using regression analyses: logistic regression for perceived healthfulness and nutrient content awareness, ordinary least square regression for UPP consumption, and intention to purchase was modeled as a latent variable in a multiple indicators multiple cause (MIMIC) model. Results: Over a third of participants (41.8%) were not aware that fruit juice is high in sugar. Only 13% of the participants perceived fruit juice as unhealthy and more than 50% showed the intention to purchase fruit juice, cereals, and yoghurt in the future. More than 50% reported consuming most UPP either daily or weekly. Perceived healthfulness was associated with gender, while UPP consumption was associated with education, age, gender, and being unemployed. Intention to purchase UPP was the only variable associated with socioeconomic status. Conclusion and Implications: Intervention strategies such as simplified front-of-pack labeling may have a role in improving nutrition awareness and discouraging UPP consumption.
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    Testing a self-determination theory model of healthy eating in a South African township
    (Frontiers Media S.A., 2020) De Man, Jeroen; Wouters, Edwin; Delobelle, Peter; Puoane, Thandi; Daivadanam, Meena; Absetz, Pilvikki; Remmen, Roy; van Olmen, Josefien
    Type 2 diabetes (T2D) is one of the leading causes of death and disability, and its prevalence has been growing rapidly in sub-Saharan Africa (International Diabetes Federation, 2017). In response to this T2D pandemic, engaging in healthy lifestyle activities such as healthy eating, can substantially reduce the risk of T2D onset and complications (International Diabetes Federation, 2017). However, maintaining a healthy diet has been shown challenging and motivation is believed to be a crucial factor, also because the benefits are often not immediately apparent (Kwasnicka et al., 2019).