Browsing by Author "Pharaoh, Hamilton"
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Item Concept mapping: Stakeholders perceptions of what should be included in interventions programmes aimed at reducing engagement in health risk behaviour amongst youth(African Association for Health, Physical Education, Recreation, Sport and Dance (AFAHPER-SD), 2014) Pharaoh, Hamilton; Frantz, Jose M.; Smith, MarioEngagement in health risk behaviours (HRBs) amongst young people is increasing despite numerous programmes to address such behaviours. The active engagement of multiple stakeholder groups, including youth, in articulating the content of youth development programmes, is thought to significantly increase buy-in, participation and success of intervention programmes. This article reports on a modified concept mapping study that used seven interviews with five teachers and two community leaders, as well as three focus groups with 32 learners with three stakeholder groups (youth, youth community programme leaders, and teachers). The stakeholders were asked to identify the content that they believe should be included in youth development programmes in order to succeed in reducing, delaying or preventing engagement in HRBs in the South African context. The findings of a thematic content analysis indicated that programmes aimed at effectively combating HRBs amongst youth should include content on four major aspects or themes: 1) HRBs that the learners engage in; 2) perceived reasons why youth engage in HRBs; 3) places of exposure to health risk behaviour; and 4) specific content or focuses. A concept map with four subsidiary quadrants was distilled and illustrated in a visual-special network representative of concepts and relations between the concepts that create propositions of stakeholders’ perceptions of what should be included in the content of proposed programmes.Item Development, implementation and evaluation of youth development programmes to address health risk behaviour among grade 8 to grade 10 learners in selected schools in the Paarl area.(University of the Western Cape, 2014) Pharaoh, Hamilton; Jose Frantz; Smith, MarioBackground: There is consensus internationally and among South African researchers that engagement in health risk behaviours amongst the youth is a concern from a public health perspective. It is evident that much health risk behaviours are established during adolescence, and may continue into adulthood, affecting health and wellbeing in later life, and some preventable health behaviours may be contributory causes of morbidity and mortality. Research into the development t of programmes can play a major role in reducing health risk behaviour amongst the youth and also provide a key learning opportunity should this be driven with bigger impetus by the building of research knowledge. Research knowledge needs to inform all stakeholders as to the best evidence-based possibilities that can assist in creating the behavioural change that is envisaged. This study therefore aimed to design, evaluate the feasibility of, and implement, a comprehensive youth development programme that will help to equip learners with the skills to change health risk behaviour in selected schools in the Paarl area, through input from all the stakeholders. The objectives of the study were to 1) obtain baseline information of grade 8 –10 learners about the health risk behaviours they engage in, and the extent to which learners manage personal situations; 2) explore the views of stakeholders regarding the type of health risk behaviours learners engage in, and reasons for engaging; 3) To determine the content of school-based interventions reported in literature, and its effectiveness in reducing or delaying these behaviours amongst the youth; 4) To design a youth development programme based on the views of the stakeholders and literature; 5) To evaluate the feasibility of the youth development programme designed in objective 4; 6) To implement a youth development programme. Method: This study adopted Intervention Mapping as a framework that translated into a five phase study. Each phase informed the next and the findings culminated in the proposed youth development programme for grade 8-10 learners in the Paarl area. Phase 1 used a survey to obtain baseline information about the health risk behaviours that youth engage in and the extent to which learners manage personal situations. The survey was administered using the face-face method and included a demographic questionnaire, the Youth Risk Behaviour Surveillance Survey and the Life Effectiveness Questionnaire. Descriptive statistics such as Frequencies and cross tabulations were performed, as well as inferential statistics including Multiple Regression analysis and Chi-square tests. Phase 2 entailed concept mapping using focus groups and individual interviews with stakeholders to determine their perceptions of the health risks learners engage in and the reasons for their behaviours. The sample included learners, teachers, and community representatives. Thematic analysis was conducted with transcriptions of the focus groups. Phase 3 entailed a systematic review of the literature reporting on interventions aimed at delaying and or preventing engagement in health risk behaviours amongst youth. Phase 4 entailed the triangulation of the findings from the first three phases into a draft programme. Phase 5 included a Delphi study with life skill trainers and experts in the field of health risk programming for adolescents. The Delphi survey was conducted in two rounds. After the feedback in round one, revisions were made to the draft programme to develop the final programme. Results: The results in phase 1 resonated with the findings in the existing body of literature with regards to the health risk behaviours that learners engaged in. Smoking, drinking, sexual activity, drug use, physical inactivity, crime and violence were the most prominent HRBs reported by learners in this sample. Regression analyses indicated that the combination of the LEQ`s life skill domains (Time management, Achievement, Emotional control, Social competence, Active initiative, Self-confidence, Intellectual flexibility and Task leadership) significantly explained between 25% and 56% of the variance in the health risk behaviours (smoking, drinking, drug use, sexual activity). Gendered patterns in engagement with drinking, drug use and risky sexual behaviour was empirically supported by the results of Chi square tests. Drinking and drug use was significantly more prevalent with male learners whilst risky sexual behaviour was significantly more prevalent amongst female learners. Results from phase 2, represented by a concept map suggested that the development of programme content should start with contextual relevance achieved by understanding the range of HRBs youth engage in. This in turn allows for an exploration of the pathways in which engagement has come about. The second and third quadrants illustrate this through their focus on the reasons why youth engage in HRBs and the places where they are exposed to HRBs respectively Once the content has addressed what they do and why they do it, the process of skills development can commence to combat engagement in HRBs. The resultant concept map has four quadrants where each quadrant represents a concept map that corresponded to the themes identified was conceptualized as interacting with one another. During the systematic review process it was identified that effective interventions included the following elements: multi-theoretical approaches, multiple HRBs as targets, gender differentiation, and life skills. In phase 4 a concept map was created that assisted with the design of the programme. The findings from the Delphi study ratified the components included and determined that it was feasible. The recommendations included independent facilitators who have been trained in a specific skill set, avoiding the blurring of the boundary between teachers and facilitators, and a distinction between grades for the purposes of conceptualizing and presenting the programme. This resulted in the researcher augmenting the proposed programme to include independent facilitators; peer mentors; a staggered or tiered programme. These augmentations were substantial and made an immediate implementation not feasible. The scope of the revisions for developing a tiered or staggered programme was adopted as a recommendation, but was outside the scope of the present study in fulfilment of the requirements for a doctoral degree. Thus the final or revised programme only represents the initial level for grade 8 learners and the development process will continue using the same methodology in post-doctoral research. These include the development and accreditation of the training resources, selection and training of faciltators, and the clarification of the relative standing of facilitators in the school environment. Discussion: Health risk behaviour engagement, the factors influencing that engagement and the development of a diverse youth development programme to delay, reduce or prevent it is in itself very complex. Add to it the fact that the youth live in an ever-changing environment where negative role modelling and exposure to health risk behaviour is an everyday occurrence. Structures have been identified in this study that can play a vital role in designing a youth development programme, as well as build on existing programmes. This study incorporated intervention mapping as a participatory design using both quantitative and qualitative methodologies that speak to a high level of rigour and methodological coherence. The study yielded a rich data base with clear directives for future research that will make a significant contribution to the attempts to impact youth development programming and health risk behaviour amongst adolescents. Conclusion: The findings of this study suggest that a multi-theoretical approach to programming that includes gender differentiation and the targeting of multiple HRBs is likely to be more effective in the reduction, delay and prevention of health risk behaviour amongst learners in grade 8-10. The resultant programme is tiered or staggered and differentiates between grades in conceptualization and implementation of the programme. The study presented the programme for the first tier with grade 8 learners and made clear recommendations for the way forward. The study makes an important contribution in its use of participatory methodology that includes stakeholder participation to create a more robust and comprehensive programme.Item The effects of the LEQ’s life skills domains as it relates to the engagement in health risk behaviour among grade 8 learners in a selected high school in Paarl(University of the Western Cape, 2018) Marais, Janene Elizabeth; Pharaoh, HamiltonAdolescence can be understood as the transitional period between childhood and adulthood. During adolescence individuals tend to experiment and discover who they are in terms of their unique social identity and are more susceptible to health risk behaviour engagement. Health risk behaviour place individuals at risk for numerous health complications. The most common forms of health risk behaviours are smoking, drinking, illicit drug use, risky sexual behaviour, violence and physical inactivity. Life skills development has been proven to reduce many health risk behaviours in adolescents. The Life Effectiveness Questionnaire (LEQ) is a psychometric instrument which has been developed to measure life skills. Social Cognitive Theory posits that people are not driven by inner forces nor are they controlled by external stimuli, rather there is a reciprocal triadic relationship where the environment, cognition and personal factors influences learning through observation. When in the presence of their peers, adolescents are more likely to engage in health risk behaviour because of peer influence and immediate rewards. This study aimed to study the effects of the LEQs life skills domains as it relates to the engagement in health risk behaviour among Grade 8 learners in a selected high school in Paarl. This study used a quantitative methodology with a cross-sectional design employing written surveys. The sample consisted of 104 Grade 8 learners. The data was collected using self-reported questionnaires. One was the LEQ (Appendix 5 and 6) which measures life skills and the other was the Youth Risk Behaviour Surveillance Survey (YRBSS) (Appendix 7) which measures the prevalence of health risk behaviour engagement. The data was analysed using the Statistical Package for Social Sciences V24 (SPSS). The results suggested that there is still a high prevalence of health risk behaviour engagement among Grade 8 learners with increases evident in some of the health risk behaviours.Item HIV/AIDS education in South Africa: knowledge, attitudes and beliefs of high school learners in Paarl and Wellington(University of the Western Cape, 2007) Pharaoh, Hamilton; Frantz, Jose M.; Rhoda, AntheaINTRODUCTION: In South Africa about 1500 people become HIV infected every day. More than half of these new infections occur in young people. HIV/AIDS programmes have been implemented to combat the disease, but yet the incidences are still on the increase. AIM: The aim of this study was to determine the knowledge, attitudes and beliefs of high school learners about HIV/AIDS in the Paarl and Wellington area. Methodology: This study made use of a quantitative study design, by means of a self-administered questionnaire in order to reflect the knowledge, attitudes and beliefs of high school learners in the Paarl and Wellington areas regarding HIV/AIDS. Convenient sampling was used to obtain a large enough sample size to represent the learner population represented by the high schools in Paarl and Wellington. Data analysis was done using the SPSS version 10.0 to obtain frequencies, means and percentages. Cross-tabulations were done to determine relationships between variables. RESULTS: This study confirms that the learners have basic knowledge regarding HIV/AIDS. The learners make use of this knowledge during some stages of their decision-making but a lack of more in-depth knowledge in certain areas may put them at risk of becoming HIV infected. They might not perceive themselves to be at risk. Their beliefs and attitudes in some instances did afford them the opportunity to make certain safer choices regarding their sexual health. CONCLUSION: It is evident that the HIV/AIDS education programmes is making an impact to improve the knowledge of the learners. Further research is however needed to find even more effectives means to provide learners and the rest of the population with more in-depth knowledge regarding HIV/AIDSItem Life skills as predictors of engagement in health risk behaviours: a survey of secondary school learners(LAM Publications Limited, 2011) Pharaoh, Hamilton; Frantz, Jose M.; Smith, MarioThere is consensus that education on the prevention of health risk behaviour and an increased repertoire of life skills could facilitate a reduction in health risk behaviours. This article reports on the results of a survey among 1027 grades 8-10 learners aged 13-18 years and profiles their engagement in smoking, drug use, drinking and sexual activity. It reports on the hypothesis testing for the relationship between life skills, as measured by the Life Effectiveness Questionnaire (LEQ), and engagement in the above mentioned health risk behaviours, as measured by the Youth Risk Behaviour Surveillance Survey (YRBSS). The results concur with South African national surveys of youth risk behaviour regarding the nature and extent of engagement in health risk behaviours. Regression analyses indicated that the combination of the LEQ`s life skill domains (Time management, Achievement, Emotional control, Social competence, Active initiative, Self confidence, Intellectual flexibility and Task leadership) significantly explained between 25% and 56% of the variance in the health risk behaviours (smoking, drinking, drug use, sexual activity). Similarly, this combination of LEQ`s life skill domains significantly explained 4.1% of the variance in physical activity. Time management significantly predicted sexual activity and drug use. Achievement and emotional control significantly predicted drinking, emotional control, time management, social competence, and initiative significantly predicted smoking. Thus, it is recommended that the abovementioned life skill domains be incorporated into intervention programmes or life orientation curricula in order to reduce the incidence of health risk behaviours among South African youth.Item Mentoring and coaching in promoting publications in the Department of Physiotherapy at a local university in South Africa(AOSIS, 2010) Frantz, Jose M.; Rhoda, Anthea; Rowe, Michael; Phillips, Julie; Karachi, Farhana; Mlenzana, Nondwe; Pharaoh, Hamilton; Steyl, Tania; Struthers, PatriciaA growing shift towards research and evidence based practice in academia is associated with requirements to disseminate research results in the form of publication in peer reviewed journals. Mentoring has been identified as an important component of developing young authors, as it increases confidence and competence, and facilitates professional development. This led to the formation of a support group to stimulate peer-review publication in the physiotherapy department at the University of the Western Cape. The Kirkpatrick Framework of Evaluation was used to evaluate the success of the mentoring process which made use of a participatory action research methodology. The writing group consisted of nine academic members of staff and took place over ten weeks. The programme included writing, giving feedback, discussion and peer review on a weekly basis. Focus group discussions were taped and transcribed in order to evaluate the mentoring process by identifying relationships within the data and categorising key concepts, which were shaped into a thematic framework. The findings indicated that participants experienced a variety of emotions throughout the programme, with an overall feeling of personal growth by the end. In addition, participants also reported improved writing, reviewing and communication skills. Six months following the programme, six participants had submitted at least one article to a peer reviewed journal. It is clear from this study that some academics still find the task of writing and reviewing articles daunting, and that guidance and support in the form of a writing programme can be useful.Item The relationship between health risk behaviour and physical activity among high school learners in the Mtwarra region, Tanzania(University of the Western Cape, 2009) Pharaoh, Hamilton; Nannyambe, EdgarINTRODUCTION: Physical inactivity is one of the leading risk factors for major non-communicable diseases, which contribute substantially to the global burden of chronic diseases, disability and death. AIM: The purpose of the study was to investigate the relationship between participation in physical activity and health risk behaviour among high school students in the Mtwarra region, in the United Republic of Tanzania. METHOD: A descriptive quantitative study design was used whereby a stratifi ed sample of the high school students, which included male and female students between the ages of 17 to 26 years. A self administered questionnaire was used following written participant and parental consent. The study measured health risk behaviour such as alcohol use, smoking cigarettes, drug abuse, sedentary lifestyle and sexual behaviour. Quantitative data was captured and analyzed using SAS 9.1 and Statistical Package for Social Sciences (SPSS) version 13.0 programmes. The Kruskal- Wallis` test was used to test the means between variables and the Spearman correlation coefficient test was utilized to test associations between variables related to health risk behaviour and demograp hic variables. RESULTS AND DISCUSSION: Two hundred high school students with a mean age of 20.47 (SD=1.493) participated in this study. Of the total number of participants, 67% was not participating in physical activity. Furthermore, 26% smoked cigarettes, 93% consumed alcohol, 9.5% used drugs and 93% was involved in risky sexual behaviours. The study identified relationships between participation in physical activity and health risk behaviours. The youth involved in risky behaviours like consuming alcoholic drinks and smoking cigarettes were less physically active. CONCLUSION: The results of this study provide valuable information to relevant policymakers and stakeholders for the implementation of physical activity programmes in schools of the Mtwarra region, in the United Republic of Tanzania.Item Research capacity development in a South African higher education institution through a north-south collaboration(Unisa Press, 2014) Frantz, Jose M.; Leach, Lloyd; Pharaoh, Hamilton; Bassett, Susan; Roman, Nicolette V.; Smith, M.R.; Travill, Andre L.One of the constraints that prevent higher education institutions (HEIs) in developing countries from engaging in effective and essential research is a lack of research capacity. This study reports on a north-south collaboration between a group of Flemish universities and an HEI in South Africa with the specific goal of improving productivity, quality and capacity amongst researchers. A collaborative project with multiple subprojects was established in 2003, and extended over two consecutive five-year phases. Document analysis was conducted of annual reports, monitoring and evaluation reports, curriculum vitae of participating members, and progress reports of students and supervisors during this time. The findings of the study illustrate the extent to which research capacity objectives can be achieved through a north-south partnership. Members of the collaboration were able to develop intra- and inter-disciplinary partnerships that resulted in maximising the capacity- building efforts, enhancing both individual and institutional research --capacity--.Item What elements are needed to design a comprehensive youth development programme(HRPUB, 2018) Pharaoh, Hamilton; Smith, Mario; Frantz, Jose M.Interventions to combat engagement in health risk behaviours (HRB) amongst youth produces mixed results. Engagement in HRBs continues to increase with adverse effects on health and well-being. This manuscript reports on a study that attempted to demonstrate the usefulness of Intervention Mapping (IM) in developing contextually relevant programmes with increased buy-in from stakeholders, and the potential to effect behavioural change. The present study used a modified Intervention Mapping (IM) framework that included the first five IM operational steps: 1) Needs assessment (Survey), 2) Identifying performance objectives (Concept Mapping), 3) Methods and strategies (Systematic review), 4) Programme development (Triangulation of all the components in the preceding steps) and 5) Feasibility of the designed programme (Delphi Study). The manuscript demonstrated how the framework enabled the use of multiple methodologies to develop a programme that was methodologically rigorous and empirically grounded. The focus is not on the results of the various steps, but on demonstrating how the steps were applied to facilitate programme development. Ethics clearance was obtained from the UWC Senate Research Committee and all ethics principles observed. The results demonstrate that IM is an appropriate conceptual framework for collaboration that enhances the resultant programme at various levels: theoretical/ conceptual; methodological and practical application/ intervention.