Search Results (15)

Adolescents living with HIV (ALHIVs) are considered a priority population in the fight against HIV, requiring dedicated services. The COVID-19 pandemic and subsequent disruptions deprived ALHIVs on antiretroviral therapy (ART) of the care and social support essential for treatment adherence and positive treatment outcomes. This study describes health managers’ and healthcare workers’ responses to the impact of COVID-19 on service delivery to ALHIVs in HIV treatment in the Cape Town Metropole. A descriptive qualitative design was employed, where semi-structured individual interviews (n = 13) were conducted with senior and programme managers as well as healthcare workers between April and October 2023. Inductive thematic analysis was performed using Atlas.ti version 23. Two main themes emerged from these interviews: “HIV service delivery to adolescents during the COVID-19 pandemic” and “Lessons learnt—the way forward”. The de-escalation of health services at primary health facilities and the disruption of HIV services resulted in disengagement from care by ALHIVs, increasing mental health and treatment challenges. This warrants the restoration of psychosocial support services and the re-engagement of ALHIVs. The findings from this study can function as a guide for health systems and healthcare providers to navigate future pandemics to ensure that vulnerable populations such as ALHIVs continue to receive care and treatment. Full article

The increase in domestic violence—particularly against women—is one of the most alarming indirect effects of the COVID-19 pandemic affecting countries worldwide. Following a mixed-methods approach, this paper examines religious leaders’ perspectives on and their engagement with this topic. It scrutinises the findings of the online survey Religious Leaders’ Perspectives on Corona, conducted from 2020 to 2021 by the Research Programme on Religious Communities and Sustainable Development at Humboldt-Universität zu Berlin. Most answers came from the African continent and showed that more female than male leaders perceived an increase in domestic violence during the pandemic or see the need to respond to this topic. However, both male and female participants warned that domestic violence is underreported, inter alia, because of religio-cultural norms. To illustrate how the relationship between women and men in marriage is understood and (re)interpreted and how domestic violence is addressed in individual communities, this paper additionally draws on semi-structured interviews with church leaders conducted in Burkina Faso, Ghana, Kenya, Nigeria, South Africa, Tanzania, and Uganda from 2017 to 2019 and in 2022. In addition to forms of support and advocacy against domestic violence, the examples also show that church leaders might call for women’s empowerment while upholding the idea of male headship. Full article

The increasing burden of non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD) in low- and middle-income countries (LMICs) poses a considerable threat to public health. Community-driven CVD risk screening, referral and follow-up of those at high CVDs risk is essential to supporting early identification, treatment and secondary prevention of cardiovascular events such as stroke and myocardial infarction. This protocol describes a multi-country study that aims to implement and evaluate a community health worker (CHW)-led CVD risk screening programme to enhance referral linkages within the local primary care systems in sub-Saharan Africa (SSA), using a participatory implementation science approach. The study builds upon a prior community-driven multicentre study conducted by the Collaboration for Evidence-based Health Care and Public Health in Africa (CEBHA+). This is a participatory implementation research. The study will leverage on the CVD risk citizen science pilot studies conducted in the four selected CEBHA+ project countries (viz. Ethiopia, Rwanda, Malawi, and South Africa). Through planned engagements with communities and health system stakeholders, CHWs and lay health worker volunteers will be recruited and trained to screen and identify persons that are at high risk of CVD, provide referral services, and follow-up at designated community health clinics. In each country, we will use a multi-stage random sampling to select and then screen 1000 study participants aged 35–70 years from two communities (one rural and one urban). Screening will be done using a simple validated non-laboratory-based CVD risk assessment mobile application. The RE-AIM model will be used in evaluating the project implementation outcomes, including reach, fidelity, adoption and perceived effectiveness. Developing the capacities of CHWs and lay health worker volunteers in SSA to support population-based, non-invasive population-based CVD risk prevention has the potential to impact on early identification, treatment and secondary prevention of CVDs in often under-resourced communities. Using a participatory research approach to implementing mobile phone-based CHW-led CVD risk screening, referral and follow-up in SSA will provide the evidence needed to determine the effectiveness of CVD risk screening and the potential for scaling up in the wider region. Full article

We present an overview of how teacher training can work as a key element in good professional performance with students at risk of exclusion. The work derives from a doctoral thesis that analyzes a school reengagement program in the region of Murcia (Spain): Occupational Classrooms. The research was theoretically based on an ecological approach of risk of educational exclusion and a multidimensional approach of school engagement. Focusing on a mixed-methods approach with a multilevel convergent nested design, it was possible to investigate multiple levels: macro (policies), meso (school), and micro (classroom), as well as interrelated elements that influence in the possibilities of re-engagement of these students. The results showed notable deficiencies in the professional performance of teachers working with students at risk, revealing difficulties in the professional development of teachers linked to administrative, institutional, cultural, and personal determinants. Similarly, negative repercussions were detected stemming from the involvement of the teaching staff and on the results of the students and their options for continuity in their educational trajectory. To conclude, the importance of cultivating both the necessary conditions for adequate training, as well as those aimed at making teachers feel supported, included, and recognized, were highlighted in this study. Full article

Evidence-based practice is a salient solution that has been presented to address the persistent educational attainment gap linked to economic disadvantage. However, most schools do not engage with research, and we know little about facilitating school-led research use at scale. Linking different approaches to studying educational effectiveness, equity and change, and drawing on cultural-historical activity theory, this study develops intermediate theory about the mechanisms influencing institutions’ success in using research. In the context of the Opportunity Area Programme, supporting place-based interventions in the UK’s most socio-economically disadvantaged regions, we conducted a theory-led evaluation of the Evidence-Based Practice Fund (EBPF), aimed at supporting school-led research engagement to improve learning outcomes. We analysed the documentation of 83 EBPF projects, 8 focus groups, and a school survey. We demonstrate that enabling schools to address locally identified needs motivates research engagement but formulating these as stimulus for change requires scaffolding. Schools were keen but needed re-translation to use research to address those challenges. Low-key school-to-school support was found adequate. Leadership support and collaboration were significant but require relational expertise and professional learning to be effective. This study demonstrates that the use of research by schools at scale is possible and can transform a school’s agency in developing their own practice to improve equity. Full article

Universities are coming under increasing pressure to re-invent the way that engineering is taught in order to produce graduates that are capable of meeting the skills needs of the country’s industries. This paper described an active project where Design Thinking (DT) methodology is being applied in a novel way to Engineering Curriculum Development. Enterprise partners from a range of different manufacturing sectors participated in a series of Curriculum Development workshops and the results were cross referenced with subjects taught on existing engineering programmes internationally. This process highlighted the need for increased training in Lean, 6-Sigma, transversal and soft skills competencies, and the need to review how and when content is delivered. A survey was developed from the results of the workshops and sent out to a larger cohort of industry contacts for feedback on the proposed Engineering curriculum. Design Thinking methodology has helped ensure our customers’ needs are met by building the curriculum framework around competencies identified by both industry and academia while ensuring the students engage in a significant learning experience through experiential and applied learning using the latest immersive technologies. Full article

Background: ‘We Can Quit2’ pilot randomised controlled trial determined the feasibility [of conducting a community-based trial of We Can Quit, a peer-delivered stop-smoking programme (group support, combination nicotine replacement therapy (NRT), and tailored individual support) for women living in socioeconomically disadvantaged areas in Ireland. Lessons from a knowledge exchange (KE) workshop that reengaged trial stakeholders are presented. Methods: The trial dissemination plan included invitation of community, regional and national stakeholders (n = 176) to a KE interactive workshop, who received an accessible brief beforehand. Trial findings were presented. Enhancements to community engagement, participants’ recruitment and retention, and policy priorities arising from the research were discussed. Field notes and responses to a post-event anonymous questionnaire were analysed using thematic content analysis. Results: Workshop attendees (41/176, 23%) recommended: dedicated additional time to engage community stakeholders; social prescribing pathways to enhance recruitment; more adaptation of trial-related information and assistance in completion of data forms for low literacy individuals; encouraging women to join healthy community programmes to facilitate retention and sustainability; removal of barriers to access NRT; and ongoing provision of cessation services tailored to disadvantaged groups. Conclusions: The findings are relevant to the implementation of other community-based health interventions for disadvantaged groups, to policy makers and to service providers. Full article

Attempts to understand the patterns behind student disengagement and early school leaving have traditionally focussed on early school leavers’ individual characteristics. More recently, however, studies have begun to focus on the extent to which early school leaving is shaped by school-level factors, and in particular the central role of teachers and pedagogy, in (dis)engaging students. Studies have consistently shown how negative teacher–student relations can dominate the lives of young people, leading to poor attendance and behavioural issues which often culminate in them disengaging, leaving or being expelled from school. Furthermore, there is a growing interest in the role of pedagogical strategies in enhancing teacher–student relations, increasing student engagement and bringing about more socially just systems of education. Using in-depth qualitative interviews with staff working in a school engagement programme aimed at preventing early school leaving (the School Completion Programme) and young people who have left school early and who are now participating in an alternative education setting in Ireland as well as staff in those settings (the National Youthreach Programme), this paper provides a unique comparison of two approaches to learner engagement. Findings highlight the centrality of caring and respectful relationships between teachers and students across the two programmes. This paper suggests that aspects of the ‘productive pedagogies’ framework are being used to overcome barriers by placing equal emphasis on student wellbeing and formal learning. However, both programmes operate outside ‘mainstream’ education, with little scope for integration with the mainstream system. This paper concludes that at the micro level, the programmes are effective in re-engaging young people with education but argues that this has little impact at a broader level, where mainstream school practices impacting on student disengagement and early school leaving remain unchanged. Full article

The aim of this study was to explore how a youth sport development programme in connection with a major event may facilitate sustainable outcomes for the organization of youth sports in Norway. The context of the study involved the Norwegian Olympic and Paralympic Committee and Confederation of Sports’ initiative to increase young people’s engagement within Norwegian organized sports. The result of the initiative was the Young Leaders Programme (YLP) in connection with the 2016 Lillehammer Youth Olympic Games. Young people’s perceptions of the YLP, as well as how these perceptions relate to its implementation, are evaluated to determine the extent to which the programme may make a difference to sustainable youth engagement in organized sports. Qualitative data were generated through interviews with 16 YLP participants, aged 16–20, and five implementing agents. Applying the framework of processes affecting sustainability, the study shows how certain forms of sustainability can be enhanced while constraining other forms at the same time. The findings highlight that project design and implementation play a more crucial role in creating organizational sustainability than in creating individual sustainability. Furthermore, we were able to reveal that the engagement of young people in sport events as volunteers fosters individual sustainability, of which sport organizations and sporting communities should take advantage by providing arenas where young people can re-engage in sport organizations and thus contribute as change agents to a sustainable organization for youth sports. Full article

Whole-school physical activity (PA) promotion programmes are recommended to increase youth PA. Evaluation of programmes is essential to ensure practice is guided by evidence. This paper evaluates the Active School Flag (ASF), a whole-school PA promotion programme in Ireland, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ASF was evaluated across three levels—(1) administration, (2) application, (3) outcomes—using a mixed-methods case study design. Existing data sources were reviewed, the programme coordinator was interviewed, and a pilot study was conducted to investigate impact on 3rd and 5th class students (3 schools, n = 126 students, age range 8–12 years). In-school Moderate to Vigorous Physical Activity (MVPA; by accelerometery), motivation for PA (BREQ), PA self-efficacy (PASES), school affect and peer social support (Kidscreen27) were measured pre-programme (0 months), post-programme (8 months), and at retention (12 months). Teacher perceptions of classroom behaviour (CBAST) were also measured pre- and post-programme. ASF has been successful in engaging 46% of primary schools nationally. Students’ in-school moderate–vigorous PA increased in all pilot-study schools from pre-programme to retention (η² = 0.68–0.84). ASF programme design facilitates implementation fidelity, adoption and maintenance through buy in from schools and government stakeholders. ASF presents as an effective PA promotion programme in the short-to-medium term for primary schools. This RE-AIM evaluation provides evidence of ASF effectiveness, alongside valuable findings that could support programme improvement, and inform future similar programmes. Full article

Children and youth at risk, particularly those placed in child and youth care centres (CYCC) in South Africa, have suffered from school disengagement due to multiple barriers to learning such as the exposure to crime and violence at a young age. As children and youth at risk at these centres find it difficult to engage in learning, new approaches need to be found to re-engage their interest to learn. This article discusses how the ‘Curriculum of Care’, an adaptation of the Curriculum and Assessment Policy Statement (CAPS), responds to the educational needs of children and youth at risk at a CYCC in the Western Cape. It draws primarily from interviews and a focus group discussion with the centre manager and teachers at the institution. The findings reveal that positive learning outcomes, and the effective integration of children and youth at risk, are shaped by positive teacher–learner relationships; however, the findings raise questions about the extent to which such a curriculum prepares children and youth at risk for life after they leave the institution. The article suggests that the institutions providing education and care for children and youth at risk need to provide a curriculum balancing academic rigour with care to promote a holistic, inclusive education programme that enables youth and children at risk to effectively navigate their entry into society. Full article

Background: Normative feedback is an intervention strategy commonly used in drug prevention programmes. This study collected process evaluation data about how programme recipients engage with social norms (SN) feedback in The GOOD Life intervention and how they experience it. Methods: Eight focus group interviews were conducted with a total of 44 adolescents (pupils aged 14–16 years) who have participated in the social-norms-based intervention The GOOD Life. The interviews focused on three topics: (1) interest in and impact of the intervention; (2) perception of the intervention elements; and (3) suggestions for improvement of The GOOD Life. They were transcribed and analysed with content analysis. Results: The analysis revealed that The GOOD Life motivated pupils to re-evaluate their own drug use behaviour and overall met their interest regarding receiving engaging and non-moral forms of drug prevention programmes. While pupils perceived the normative feedback session in the classroom and the posters with SN messages as positive, stimulating and surprising, the web-based application with SN feedback was rarely used and less positively evaluated. Anonymity and confidentiality were regarded as essential to provide honest answers in the poll. The pupils suggested even more variety in ways to engage them and to use more gaming elements. Conclusions: SN feedback was well perceived by adolescents. The intervention met their interest and needs and was able to achieve the intended impact of challenging norm perceptions. Anonymity and confidentiality are key in order to build trust and engage adolescents in the intervention. Full article

While academic literature has paid careful attention to the technological efforts―drugs, tests, and tools for vector control―deployed to eliminate Gambiense Human African Trypanosomiasis (HAT), the human resources and health systems dimensions of elimination are less documented. This paper analyses the perspectives and experiences of frontline nurses, technicians, and coordinators who work for the HAT programme in the former province of Bandundu in the Democratic Republic of the Congo, at the epidemic’s very heart. The research is based on 21 semi-structured interviews conducted with frontline workers in February 2018. The results highlight distinctive HAT careers as well as social elevation through specialised work. Frontline workers are concerned about changes in active screening strategies and the continued existence of the vector, which lead them to question the possibility of imminent elimination. Managers seem to anticipate a post-HAT situation and prepare for the employment of their staff; most workers see their future relatively confidently, as re-allocated to non-vertical units. The findings suggest concrete pathways for improving the effectiveness of elimination efforts: improving active screening through renewed engagements with local leaders, conceptualising horizontal integration in terms of human resources mobility, and investing more in detection and treatment activities (besides innovation). Full article

The ambition of this two-part article is to argue for immanent critique as a research strategy in sustainability studies. We do this by picking up and developing two central, cross-cutting themes in sustainability research, namely interdisciplinarity and normativity. It is widely suggested that the problem-driven and solution-focused orientation in sustainability studies necessitates interdisciplinarity and an engagement with questions of normativity, each creating problems regarding how science is conducted. For interdisciplinarity, questions remain regarding by what scientific procedure rational (i.e., non-arbitrary) interdisciplinarity can be accomplished. For normativity, it is unclear whether normativity can be addressed scientifically, or only politically; in other words, can normativity be objectively incorporated in sustainability research, and if so, how? Ultimately, the paper asks and answers the following questions: when should a researcher move from one discipline to another in sustainability research and, how do we judge the validity of the normative values that are deemed necessary for sustainability? In Part I, we show the silences, gaps, vagueness and inadequacies of how these themes are currently addressed in sustainability science literature, and from this move to propose immanent critique as a potential strategy for dealing with them in a scientific manner. In Part II, we exemplify our strategy by applying it to re-construct the debate over sustainable development, by far the most prominent topical focus in sustainability science research, producing a novel systematized typology of sustainable development approaches in the process. We conclude with reflections on how this paper amounts to an initial contribution to the construction of a Lakatosian research programme in sustainability studies. Full article

Health literacy is a critical determinant of health, which can empower individuals and lead to engagement in collective health promotion action and is also a crucial component in the self-management of illness. The current study moves beyond a focus on functional health literacy and presents findings from a longitudinal qualitative (LQ) study consisting of three phases. This paper presents findings from the second phase of the study, which assessed the development of health literacy capacities of individuals attending a structured cardiovascular risk reduction programme in Ireland. The study objectives were to: explore perceptions of changes in interactions and information exchange within health consultations; identify the facilitators associated with changes in health literacy capacities; assess developments in engagement with broader contexts for health literacy capacities. A LQ study design was undertaken, which employed repeat interview methodology with 19 participants (aged 36–76 years) 12 weeks after beginning a structured cardiovascular risk reduction programme. Health literacy levels were assessed using the HLS-EU 47 item instrument in phase 1 (68% limited health literacy (HL), 32% adequate health literacy). A semi-structured interview guide, (informed by Sørensen’s conceptual model of health literacy), was used to explore the development of health literacy and to identify changes in knowledge, attitudes and experiences over time. Thematic analysis was used, informed by aspects of Saldaña’s framework for longitudinal qualitative data analysis. All participants reported having acquired increased understanding of issues relevant to their health and self-care. Participants described health literacy capacities that incorporate aspects of all levels of health literacy (functional, interactive and critical). Core themes were identified corresponding to changes in these levels: re-engagement with health information and increased understanding of risk and protective factors (changes in functional health literacy); changes in interactions with healthcare providers (HCP) (changes in interactive health literacy); enhanced psychological insights and understanding the broader determinants of health (changes in critical health literacy). Findings support the development of health literacy capacities across the functional, interactive and critical health literacy domains. Participants are capable of locating responsibility for health beyond the individual level and are making sense of knowledge within their own social contexts. Individuals, regardless of their initial health literacy levels, are capable of engaging with broader issues that can impact on their health and can be supported to develop these critical health literacy capacities. Full article