Browsing by Author "Swart, Elizabeth C."

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    Are intentions to change, policy awareness, or health knowledge related to changes in dietary intake following a sugar-sweetened beverage tax in South Africa? A before-and after study
    (BMC, 2022) Essman, Michael; Zimmer, Catherine; Dillman Carpentier, Francesca; Swart, Elizabeth C.; Smith Taillie, Lindsey
    Background In April 2018, South Africa implemented the Health Promotion Levy (HPL), one of the first sugarsweetened beverage (SSB) taxes to be based on each gram of sugar (beyond 4 g/100mL). The objectives of this study were to examine whether the psychological constructs tax awareness, SSB knowledge, SSB risk perception, and intentions to reduce SSB intake were associated with taxed beverage intake, whether they changed from pre- to posttax, and whether they modified the effect of the HPL. Methods We collected single day 24-hour dietary recalls surveyed from repeat cross-sectional surveys of adults aged 18–39 years in Langa, South Africa. Participants were recruited in February-March 2018 (pre-tax, N = 2,481) and February-March 2019 (post-tax, N = 2,507) using door-to-door sampling. Surveys measured tax awareness, SSB knowledge, SSB risk perception, and intention to reduce SSB intake. SSB intake was estimated using a two-part model. To examine changes over time, logistic regression models were used for binary outcomes (tax awareness and intention to reduce SSB consumption) and linear regression models for continuous outcomes (SSB knowledge SSB risk perceptions). Effect modification was tested using interaction terms for each psychological construct with time. Results No constructs were associated with SSB intake at baseline. At post-tax, the predicted probability to consume taxed beverages was 33.5% (95% CI 28.5–38.5%) for those who expressed an intention to reduce SSB intake compared to 45.9% (95% CI 43.7–48.1%) for those who did not. Among consumers, intending to reduce SSB intake was associated with 55 (95% CI 28 to 82) kcal/capita/day less SSBs consumed. Tax awareness, SSB knowledge, and SSB risk perception increased by a small amount from pre- to post-tax. Intentions to reduce SSB intake was lower in the post-tax period. The tax effect on SSB intake was modified by SSB knowledge and intention to reduce SSB intake, with higher levels of each associated with lower SSB intake.
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    Examining the news media reaction to a national sugary beverage tax in South Africa: A quantitative content analysis
    (Springer Nature, 2021) Swart, Elizabeth C.; Essman, Michael; Stoltze, F.M
    : South Africa was the first sub-Saharan African country to implement a sugar-sweetened beverage (SSB) tax called the Health Promotion Levy (HPL) in April 2018. Given news media can increase public awareness and sway opinions, this study analyzed how the media represented the HPL, including expressions of support or challenge, topics associated with the levy, and stakeholder views of the HPL.
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    Social work and food security: Case study on the nutritional capabilities of the landfill waste pickers in South Africa
    (SAGE Publications, 2017) Schenck, Catherina; Blaauw, Phillip F.; Viljoen, Jacoba M.M.; Swart, Elizabeth C.
    Food security (or the lack of it) has a direct impact on people’s well-being and is of great concern to many disciplines. The study on which the article is based used Drèze and Sen’s ‘nutritional capability’ concept as a theoretical framework to explain the food (in)security of landfill waste pickers. A cross-sectional research approach was followed, coupled with a triangulation mixed method research design. Viewing the waste pickers against the nutritional capability framework highlighted the important role that social work should play in focusing on people’s capabilities within their particular context.
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    Women's experiences of amenorrhea following Depo-Provera use at a district hospital in Malawi
    (University of the Western Cape, 2016) Mwafulirwa, Boss; Kwaleyela, Concepta N.; Swart, Elizabeth C.
    Depo-Provera, an injectable contraceptive, is utilized by about 30% of married women in Malawi. Most women have reported their preference to use Depo-Provera due to its effectiveness in preventing pregnancy, reversibility and easy to use since it is given once at 12-weeks intervals. Despite the method having such advantages, it has menstrual effects, and one of the major concerns for women, particularly in Africa, is amenorrhea. In Malawi, 40% of Depo-Provera users report experiencing amenorrhea after one year of use. Despite the concern for amenorrhea, some women have continued using the method. Literature shows that there is limited information on women's experiences of amenorrhea following use of Depo-Provera. A descriptive phenomenological research design was used to explore and describe women’s experiences of amenorrhea following use of Depo-Provera in order to understand how women experience amenorrhea and give meaning to the experience. Data were collected through in-depth unstructured interviews with six women, who were selected using purposive sampling. The interviews were conducted in Tumbuka language. Data analysis was done using Colaizzi’s method of analyzing descriptive phenomenological data. Five themes and some sub-themes emerged from data analysis. The themes were: "Lack of knowledge on cause of amenorrhea", "Fear of pregnancy", "Misconceptions associated with Depo-Provera Induced Amenorrhea", "Lack of proper counseling on amenorrhea resulting from Depo-Provera use" and "Amenorrhea not perceived as a problem when midwives provide adequate information". The themes showed that women accessing family planning services from Chitipa district hospital were not provided with information on amenorrhea resulting from using Depo- Provera. Hence, they expressed fear when they experienced the side effect. Participants stated that they were afraid of becoming infertile after using the family planning method, getting pregnant as well as amenorrhea itself. Their intention to discontinue using the method was largely associated with negative rumors, beliefs and misconceptions. The conclusion of the study is that there is need for midwives to provide information on amenorrhea resulting from Depo-Provera use. This will assist clients to understand that amenorrhea could occur as a side effect, and hence improve continued utilization of the method.