Collaborative health literacy development: a World Health Organization workplace health promotion approach to address tobacco use
- Authors: Duxbury, Theodore Orlando
- Date: 2019
- Subjects: Tobacco use -- Health aspects , Smoking -- Health aspects , Employee health promotion , Employee health promotion -- Computer programs , Rhodes University -- Employees -- Tobacco use
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/104116 , vital:29930
- Description: Background: Non-Communicable Diseases (NCDs) are a major global public health threat and tobacco use in particular is the leading cause of preventable illness and mortality globally. Furthermore, vulnerable and socially disadvantaged people get sicker and die sooner, especially because they are at higher risk of being exposed to harmful products such as tobacco and have limited access to health services. Tobacco use also has a major impact on the workplace, adversely affecting work productivity and increasing absenteeism. Both the living and work environments, therefore, play an important role in contributing towards the NCD epidemic. Demographics, culture, behaviour change reluctance and health literacy are all factors which exacerbate tobacco prevalence in South Africa. Workplace health promotion, however, is not well established in many workplaces. This study aimed to develop, implement and evaluate the effectiveness of a culturallysensitive and contextually-appropriate collaborative workplace health promotion literacy programme on tobacco use, utilizing tailored health information leaflets and the Rhodes University peer educators support staff, guided by the World Health Organization Workplace Health Promotion Framework. Method: The research was conducted using a participatory action research approach, which involved four phases: Firstly, the Exploratory phase assessed tobacco-related health promotion policies and practices at Rhodes University; and established facilitating and constraining factors related to tobacco use. Secondly, the Educational health promotion phase involved designing and testing a health promotion educational intervention to address tobacco use related challenges, which took the form of culturally sensitive and appropriate health information leaflets to be used as an educational intervention Thirdly, in the Implementation phase health promotion training workshops were conducted with volunteering Rhodes University Peer Educators. Finally, an Evaluation phase involved evaluating the tobacco health promotion programme presented to the Rhodes University Peer Educators through a focus group discussion; and evaluating Peer Educator recall on the tobacco related health information discussed during the training workshops through a post-post intervention questionnaire. Eight semi-structured interviews (SSIs) and seven focus group discussions (FGDs) were conducted with support staff, peer educators and key stakeholders to establish the need for a comprehensive workplace health promotion initiative, and to identify the facilitating and constraining factors to conducting such an initiative on tobacco use at the University. Three health information leaflets (HILs) were developed collaboratively with the Peer Educators following a series of scientific, end-user testing approaches. The HILs were tested for readability, comprehension, actionability and suitability. A four-day health promotion training programme was conducted to improve user friendliness, memory retention and recall of the HILs by the peer educators and to improve tobacco related health literacy aspects. The participants’ memory recall was evaluated using a pre- and post-, and post-post-intervention questionnaire to evaluate knowledge transfer. The study participants were also equipped with the completed HILs to distribute to their peers and to use as reference sources of information when needed in future. Results: The peer educators and institutional management supported the need for a tobacco workplace health promotion intervention. The intervention and evaluation phase of this study proved that health information material developed was readable, actionable, suitable, userfriendly, culturally sensitive and contextually appropriate. The workshops resulted in a significant increase in the participants’ tobacco related health knowledge. Through the adoption of a collaborative approach to the research, the participants felt empowered and ready to be agents of change amongst their peers in the workplace. Recommendations: The collective use of external expert reviewers, end-user testing techniques and validated computer programmes are recommended to improve the validity of health promotion research outcomes. A longitudinal study that focus on behaviour change, specifically, with health evaluation and monitoring aspects could be conducted as the next step to this study.
- Full Text:
- Date Issued: 2019
- Authors: Duxbury, Theodore Orlando
- Date: 2019
- Subjects: Tobacco use -- Health aspects , Smoking -- Health aspects , Employee health promotion , Employee health promotion -- Computer programs , Rhodes University -- Employees -- Tobacco use
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/104116 , vital:29930
- Description: Background: Non-Communicable Diseases (NCDs) are a major global public health threat and tobacco use in particular is the leading cause of preventable illness and mortality globally. Furthermore, vulnerable and socially disadvantaged people get sicker and die sooner, especially because they are at higher risk of being exposed to harmful products such as tobacco and have limited access to health services. Tobacco use also has a major impact on the workplace, adversely affecting work productivity and increasing absenteeism. Both the living and work environments, therefore, play an important role in contributing towards the NCD epidemic. Demographics, culture, behaviour change reluctance and health literacy are all factors which exacerbate tobacco prevalence in South Africa. Workplace health promotion, however, is not well established in many workplaces. This study aimed to develop, implement and evaluate the effectiveness of a culturallysensitive and contextually-appropriate collaborative workplace health promotion literacy programme on tobacco use, utilizing tailored health information leaflets and the Rhodes University peer educators support staff, guided by the World Health Organization Workplace Health Promotion Framework. Method: The research was conducted using a participatory action research approach, which involved four phases: Firstly, the Exploratory phase assessed tobacco-related health promotion policies and practices at Rhodes University; and established facilitating and constraining factors related to tobacco use. Secondly, the Educational health promotion phase involved designing and testing a health promotion educational intervention to address tobacco use related challenges, which took the form of culturally sensitive and appropriate health information leaflets to be used as an educational intervention Thirdly, in the Implementation phase health promotion training workshops were conducted with volunteering Rhodes University Peer Educators. Finally, an Evaluation phase involved evaluating the tobacco health promotion programme presented to the Rhodes University Peer Educators through a focus group discussion; and evaluating Peer Educator recall on the tobacco related health information discussed during the training workshops through a post-post intervention questionnaire. Eight semi-structured interviews (SSIs) and seven focus group discussions (FGDs) were conducted with support staff, peer educators and key stakeholders to establish the need for a comprehensive workplace health promotion initiative, and to identify the facilitating and constraining factors to conducting such an initiative on tobacco use at the University. Three health information leaflets (HILs) were developed collaboratively with the Peer Educators following a series of scientific, end-user testing approaches. The HILs were tested for readability, comprehension, actionability and suitability. A four-day health promotion training programme was conducted to improve user friendliness, memory retention and recall of the HILs by the peer educators and to improve tobacco related health literacy aspects. The participants’ memory recall was evaluated using a pre- and post-, and post-post-intervention questionnaire to evaluate knowledge transfer. The study participants were also equipped with the completed HILs to distribute to their peers and to use as reference sources of information when needed in future. Results: The peer educators and institutional management supported the need for a tobacco workplace health promotion intervention. The intervention and evaluation phase of this study proved that health information material developed was readable, actionable, suitable, userfriendly, culturally sensitive and contextually appropriate. The workshops resulted in a significant increase in the participants’ tobacco related health knowledge. Through the adoption of a collaborative approach to the research, the participants felt empowered and ready to be agents of change amongst their peers in the workplace. Recommendations: The collective use of external expert reviewers, end-user testing techniques and validated computer programmes are recommended to improve the validity of health promotion research outcomes. A longitudinal study that focus on behaviour change, specifically, with health evaluation and monitoring aspects could be conducted as the next step to this study.
- Full Text:
- Date Issued: 2019
Health promotion: approaches to dietary salt reduction
- Authors: Mushoriwa, Fadzai
- Date: 2017
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/44761 , vital:25439
- Description: Background Globally, non-communicable diseases are the leading causes of mortality and morbidity, with the majority of these occurring in low-middle income countries. The devastating consequences of non-communicable diseases could be curtailed through better management of four modifiable factors: physical inactivity; tobacco use; harmful use of alcohol; and unhealthy diets. The World Health Organisation has recommended dietary salt reduction as a cost-effective strategy in combatting the burden of NCDs. Consumer awareness and education is one of three primary strategies that have been identified by the World Health Organisation to achieve population-wide salt reduction. It involves the provision of salt reduction knowledge and the promotion of healthy salt related practices. These campaigns are a necessity in populations with high discretionary salt use such as South Africa. For these health promotion activities to succeed, they need to be developed with consideration of factors such as the environment, culture, and socio-economic standing of the intended target population. This two-phase health promotion study was conducted at St Mary’s Development and Care Centre and the Assumption Sisters Nutrition Centre. These are two community based organisations located in Grahamstown, South Africa. A needs assessment was conducted to identify the knowledge and practices of cooks and guardians from these centres on dietary salt reduction. The aim of the second phase of the study was to conduct an educational intervention and to develop a culturally appropriate and contextually specific health information intervention through a participatory process. Method: This was a qualitative study that was supported by elements of quantitative research.. The first phase of the current study was a needs assessment. The first step involved an observational phase with cooks from the centres. The aim was to observe their discretionary salt use during food preparation and to document the salt content in the processed foods available at each centre. Semi-structured interviews were then conducted, with 3 cooks and 16 guardians1 from the centres, to assess their knowledge and practices regarding salt reduction.Parents or the people responsible for the care of the children attending both centres. Guided by findings from the needs assessment phase, an educational intervention was developed. This phase involved the participatory development of three health information leaflets and a series of educational interactive sessions were conducted. Quantitative tests to assess the readability, suitability, and actionability were conducted on the leaflets. Qualitative assessment of the leaflets involved formative evaluations conducted by health care professionals, phase 1 participants, Rhodes University peer educators, an African languages and cultural expert, and a Rhodes University student wellness manager. This step was included to assess the content validity, context specificity, acceptability, and cultural appropriateness of the materials. Educational interactive sessions were guided by constructs of the Social Cognitive Theory and were conducted on three main topics: ‘Salt and my health’, ‘Reducing salt in my diet’, and ‘Reading food labels’. Results: The majority of the processed foods available at both centres contained low to medium levels of salt. Children at the centres were not provided with salt shakers on the tables during meal times. Cooks did not use measuring utensils when adding salt during meal preparation. Semistructured interviews revealed that participants lacked both declarative and procedural knowledge. In terms of declarative knowledge, they were unaware of the daily salt intake recommendations and the relationship between salt and sodium. Participants were able to identify hypertension as one of the health related consequences of high salt consumption. Most participants were responsible for purchasing groceries in their households. Their selfreported food label reading behaviours and inability to read food labels highlighted their lack of procedural knowledge. Most participants reported that they added salt during meal preparation and at mealtimes, highlighting high discretionary salt use. Some participants were also aware of cultural or religious uses of salt. The developed health information leaflets were considered to be written at a readability level appropriate for the target audience. The leaflets were also deemed to be actionable, culturally appropriate, and contextually specific and suitable materials. The educational interactive sessions were found to be interesting and informative. Conclusions: Findings from the needs assessment revealed the need for an educational intervention to address the identified gaps in the participants’ knowledge and practices regarding dietary salt reduction. The developed health information leaflets were found to be informative, culturally appropriate, and contextually specific, as planned. Interactive sessions provided an excellent platform to supply participants with concise and accurate information, increasing the possibility of improving their salt reduction related knowledge.
- Full Text:
- Date Issued: 2017
- Authors: Mushoriwa, Fadzai
- Date: 2017
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/44761 , vital:25439
- Description: Background Globally, non-communicable diseases are the leading causes of mortality and morbidity, with the majority of these occurring in low-middle income countries. The devastating consequences of non-communicable diseases could be curtailed through better management of four modifiable factors: physical inactivity; tobacco use; harmful use of alcohol; and unhealthy diets. The World Health Organisation has recommended dietary salt reduction as a cost-effective strategy in combatting the burden of NCDs. Consumer awareness and education is one of three primary strategies that have been identified by the World Health Organisation to achieve population-wide salt reduction. It involves the provision of salt reduction knowledge and the promotion of healthy salt related practices. These campaigns are a necessity in populations with high discretionary salt use such as South Africa. For these health promotion activities to succeed, they need to be developed with consideration of factors such as the environment, culture, and socio-economic standing of the intended target population. This two-phase health promotion study was conducted at St Mary’s Development and Care Centre and the Assumption Sisters Nutrition Centre. These are two community based organisations located in Grahamstown, South Africa. A needs assessment was conducted to identify the knowledge and practices of cooks and guardians from these centres on dietary salt reduction. The aim of the second phase of the study was to conduct an educational intervention and to develop a culturally appropriate and contextually specific health information intervention through a participatory process. Method: This was a qualitative study that was supported by elements of quantitative research.. The first phase of the current study was a needs assessment. The first step involved an observational phase with cooks from the centres. The aim was to observe their discretionary salt use during food preparation and to document the salt content in the processed foods available at each centre. Semi-structured interviews were then conducted, with 3 cooks and 16 guardians1 from the centres, to assess their knowledge and practices regarding salt reduction.Parents or the people responsible for the care of the children attending both centres. Guided by findings from the needs assessment phase, an educational intervention was developed. This phase involved the participatory development of three health information leaflets and a series of educational interactive sessions were conducted. Quantitative tests to assess the readability, suitability, and actionability were conducted on the leaflets. Qualitative assessment of the leaflets involved formative evaluations conducted by health care professionals, phase 1 participants, Rhodes University peer educators, an African languages and cultural expert, and a Rhodes University student wellness manager. This step was included to assess the content validity, context specificity, acceptability, and cultural appropriateness of the materials. Educational interactive sessions were guided by constructs of the Social Cognitive Theory and were conducted on three main topics: ‘Salt and my health’, ‘Reducing salt in my diet’, and ‘Reading food labels’. Results: The majority of the processed foods available at both centres contained low to medium levels of salt. Children at the centres were not provided with salt shakers on the tables during meal times. Cooks did not use measuring utensils when adding salt during meal preparation. Semistructured interviews revealed that participants lacked both declarative and procedural knowledge. In terms of declarative knowledge, they were unaware of the daily salt intake recommendations and the relationship between salt and sodium. Participants were able to identify hypertension as one of the health related consequences of high salt consumption. Most participants were responsible for purchasing groceries in their households. Their selfreported food label reading behaviours and inability to read food labels highlighted their lack of procedural knowledge. Most participants reported that they added salt during meal preparation and at mealtimes, highlighting high discretionary salt use. Some participants were also aware of cultural or religious uses of salt. The developed health information leaflets were considered to be written at a readability level appropriate for the target audience. The leaflets were also deemed to be actionable, culturally appropriate, and contextually specific and suitable materials. The educational interactive sessions were found to be interesting and informative. Conclusions: Findings from the needs assessment revealed the need for an educational intervention to address the identified gaps in the participants’ knowledge and practices regarding dietary salt reduction. The developed health information leaflets were found to be informative, culturally appropriate, and contextually specific, as planned. Interactive sessions provided an excellent platform to supply participants with concise and accurate information, increasing the possibility of improving their salt reduction related knowledge.
- Full Text:
- Date Issued: 2017
Workplace health promotion: a case of Rhodes University support staff
- Chigumete, Tinatsei Gabriella
- Authors: Chigumete, Tinatsei Gabriella
- Date: 2017
- Subjects: Rhodes University -- Employees -- Health and hygiene , Employee health promotion -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/44509 , vital:25414
- Description: Background: Non-communicable diseases are rapidly advancing as leading causes of morbidity and mortality across social classes, exerting pressure on existing financial, organizational, and human resources. Health promotion is a common practice in the prevention of noncommunicable diseases, but workplace health promotion has not yet been well established in many workplaces. Identification of past workplace initiatives and exploring their facilitating and limiting factors is thus important to take into consideration when planning future initiatives. Well-informed and guided workplace health promotion initiatives are essential to improve the general health of staff, and these also need to take the broader cultural, socioeconomic, and environmental factors influencing non-communicable diseases in the target population into account. This two-phase study was conducted at Rhodes University. A needs assessment was conducted to identify current policies and practices of workplace health promotion and to identify any shortcomings of the initiatives that have previously been attempted to raise awareness of non-communicable diseases at Rhodes University. The second phase of this project aimed to address concerns raised in the first phase through a health promotion initiative for support staff that focuses on the prevention of noncommunicable diseases through heart healthy diets and physical activity. Method: The first phase of the current study involved working with the support staff and key stakeholders. Using the participatory action research approach and the PRECEDE-PROCEED model to guide the research, 11 semi-structured interviews with key stakeholders and 10 focus group discussions were conducted with support staff members to identify factors affecting workplace health promotion. Participant opinions on how to improve these initiatives were sought. The participants were asked to identify areas on which the intended intervention should focus, as well as to identify their preferred means of communicating health messages. During this phase, a group of support staff members who volunteered their involvement in the design and delivery of the educational intervention was also identified. They chose to go by the name, the Health Awareness Group.In an interim phase of the study, three health information leaflets informed by the results from the above activities were designed. These leaflets underwent a series of qualitative evaluations by other health professionals, a culture and African languages expert, and the Health Awareness Group, to assess content validity, context specificity, and cultural appropriateness for the target group. A series of quantitative tests for readability, suitability, and actionability was also conducted. The health information leaflets were then used as written materials in the educational intervention of the project. Members of the Health Awareness Group were also trained as peer educators through a series of workshops. This enabled them to promote and raise awareness of heart healthy diets and physical activity to others in the workplace. Workshops were participatory in nature and were guided by the Social Cognitive Theory. They were also equipped with the completed health information leaflets to distribute to their peers and to use as reference sources of information when needed. Results: Participants in the semi-structured interviews reported that some health promotion initiatives have previously been attempted and advertised to support staff, but the turnout was poor and most staff did not seem to understand the health benefits of these initiatives. The support staff, in turn, stated that most health talks were conducted in English, contained medical jargon, and that they would have preferred these initiatives either to be simplified or presented in their home language, and to display cultural sensitivity. Support staff have also reported that advertisements were too cliche to elicit their interest. They also suggested incentivising initiatives for better participation. Another key suggestion was to facilitate these initiatives in the university departments they work or other convenient venues, rather than at central venues. It was also suggested that these initiatives be part of the work calendar, as they are often 'impromptu' and, as a result, staff members did not have enough notice to take time off work. Several staff members requested 're-runs of these initiatives because one-time show cases are often inadequate'. Colourful visual representations on posters or leaflets, short plays or films were also proposed as modes of delivering health information. During the design of the material to be used for this project's intended intervention, the health information leaflets were deemed readable, suitable, actionable, context-specific, and culturally appropriate. Workshops conducted during Phase 2 of the study proved to be valuable in training peer educators. Members of the Health Awareness Group also deemed the workshops useful, and reported their readiness to be agents of change in the workplace. Conclusions: Based on the input of key stakeholders and support staff, health promotion policies and protocols for non-communicable diseases have not yet been developed. Health promotion initiatives, especially for support staff, that address non-communicable diseases have previously been attempted at the university but were not well-received. Factors affecting workplace health promotion were identified. Knowledge of these factors was useful in designing and tailoring the written educational materials and the educational intervention to the needs of the support staff and to redress the deficiencies of previous initiatives. The health leaflets were deemed appropriate for use by the target population. They addressed pertinent information needs. The health information leaflets and workshops were useful in equipping the Health Awareness Group with knowledge on heart healthy diets and promotion of physical activity. Continued the involvement of representatives from the Human Resources and Wellness offices will assist in ensuring the sustainability of this workplace health initiative.
- Full Text:
- Date Issued: 2017
- Authors: Chigumete, Tinatsei Gabriella
- Date: 2017
- Subjects: Rhodes University -- Employees -- Health and hygiene , Employee health promotion -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/44509 , vital:25414
- Description: Background: Non-communicable diseases are rapidly advancing as leading causes of morbidity and mortality across social classes, exerting pressure on existing financial, organizational, and human resources. Health promotion is a common practice in the prevention of noncommunicable diseases, but workplace health promotion has not yet been well established in many workplaces. Identification of past workplace initiatives and exploring their facilitating and limiting factors is thus important to take into consideration when planning future initiatives. Well-informed and guided workplace health promotion initiatives are essential to improve the general health of staff, and these also need to take the broader cultural, socioeconomic, and environmental factors influencing non-communicable diseases in the target population into account. This two-phase study was conducted at Rhodes University. A needs assessment was conducted to identify current policies and practices of workplace health promotion and to identify any shortcomings of the initiatives that have previously been attempted to raise awareness of non-communicable diseases at Rhodes University. The second phase of this project aimed to address concerns raised in the first phase through a health promotion initiative for support staff that focuses on the prevention of noncommunicable diseases through heart healthy diets and physical activity. Method: The first phase of the current study involved working with the support staff and key stakeholders. Using the participatory action research approach and the PRECEDE-PROCEED model to guide the research, 11 semi-structured interviews with key stakeholders and 10 focus group discussions were conducted with support staff members to identify factors affecting workplace health promotion. Participant opinions on how to improve these initiatives were sought. The participants were asked to identify areas on which the intended intervention should focus, as well as to identify their preferred means of communicating health messages. During this phase, a group of support staff members who volunteered their involvement in the design and delivery of the educational intervention was also identified. They chose to go by the name, the Health Awareness Group.In an interim phase of the study, three health information leaflets informed by the results from the above activities were designed. These leaflets underwent a series of qualitative evaluations by other health professionals, a culture and African languages expert, and the Health Awareness Group, to assess content validity, context specificity, and cultural appropriateness for the target group. A series of quantitative tests for readability, suitability, and actionability was also conducted. The health information leaflets were then used as written materials in the educational intervention of the project. Members of the Health Awareness Group were also trained as peer educators through a series of workshops. This enabled them to promote and raise awareness of heart healthy diets and physical activity to others in the workplace. Workshops were participatory in nature and were guided by the Social Cognitive Theory. They were also equipped with the completed health information leaflets to distribute to their peers and to use as reference sources of information when needed. Results: Participants in the semi-structured interviews reported that some health promotion initiatives have previously been attempted and advertised to support staff, but the turnout was poor and most staff did not seem to understand the health benefits of these initiatives. The support staff, in turn, stated that most health talks were conducted in English, contained medical jargon, and that they would have preferred these initiatives either to be simplified or presented in their home language, and to display cultural sensitivity. Support staff have also reported that advertisements were too cliche to elicit their interest. They also suggested incentivising initiatives for better participation. Another key suggestion was to facilitate these initiatives in the university departments they work or other convenient venues, rather than at central venues. It was also suggested that these initiatives be part of the work calendar, as they are often 'impromptu' and, as a result, staff members did not have enough notice to take time off work. Several staff members requested 're-runs of these initiatives because one-time show cases are often inadequate'. Colourful visual representations on posters or leaflets, short plays or films were also proposed as modes of delivering health information. During the design of the material to be used for this project's intended intervention, the health information leaflets were deemed readable, suitable, actionable, context-specific, and culturally appropriate. Workshops conducted during Phase 2 of the study proved to be valuable in training peer educators. Members of the Health Awareness Group also deemed the workshops useful, and reported their readiness to be agents of change in the workplace. Conclusions: Based on the input of key stakeholders and support staff, health promotion policies and protocols for non-communicable diseases have not yet been developed. Health promotion initiatives, especially for support staff, that address non-communicable diseases have previously been attempted at the university but were not well-received. Factors affecting workplace health promotion were identified. Knowledge of these factors was useful in designing and tailoring the written educational materials and the educational intervention to the needs of the support staff and to redress the deficiencies of previous initiatives. The health leaflets were deemed appropriate for use by the target population. They addressed pertinent information needs. The health information leaflets and workshops were useful in equipping the Health Awareness Group with knowledge on heart healthy diets and promotion of physical activity. Continued the involvement of representatives from the Human Resources and Wellness offices will assist in ensuring the sustainability of this workplace health initiative.
- Full Text:
- Date Issued: 2017
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