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- De Man, Jeroen, et al.
(författare)
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Motivational determinants of physical activity in disadvantaged populations with (pre)diabetes : a cross-cultural comparison
- 2022
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background 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. Methods 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. Results The studied motivational constructs showed scalar invariance. Latent mean levels of perceived social support and barrier self-efficacy were lower in South Africa and Sweden. Structural models (for different PA outcomes) were not consistent across settings except for the association between perceived social support and identified regulation. Identified regulation was only associated with vigorous PA in Uganda and with moderate PA in South Africa. The association between social support and PA outcomes ranged from weak to not significant and the association between self-efficacy and PA was not significant. Self-reported PA was highest in Uganda and lowest in Sweden. Self-reported vigorous PA was significantly related to lower hemoglobin A1c levels, while moderate PA was not. Conclusions Findings suggest that: 1) it is feasible to compare a motivational process model across diverse settings; 2) there is lower perceived social support and self-efficacy in the urban, migrant samples; 3) identified regulation is a more promising determinant of PA than self-efficacy or social support in these populations; 4) associations between motivational determinants and PA depend on the perceived type and/or intensity of PA; 5) perceived relatedness functions as a basic psychological need across diverse settings; and 6) people's perception of the PA they perform depends on their perceived level of intensity of PA which would have major implications for health promotion.
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| 2. |
- Ogbe, Emilomo, et al.
(författare)
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Opportunities for linking research to policy : lessons learned from implementation research in sexual and reproductive health within the ANSER network
- 2018
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Ingår i: Health Research Policy and Systems. - : Springer Science and Business Media LLC. - 1478-4505. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for policy-makers to use research evidence in their work.Methods: A participatory workshop with researchers was organised in November 2017 by the Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) to address this gap. ANSER is a consortium of experienced researchers, some of whom have policy-making experience, working on sexual and reproductive health and rights issues across 16 countries and 5 continents. The experiential learning cycle was used to guide the workshop discussions based on case studies and to encourage participants to focus on key lessons learned. Workshop findings were thematically analysed using specific stages from Hanney et al.'s (Health Res Policy Syst 1:2, 2003) framework on the place of policy-making in the stages of assessment of research utilisation and outcomes.Results; The workshop identified key strategies for translating research into policy, including joint agenda-setting between researchers and policy-makers, as well as building trust and partnerships with different stakeholders. These were linked to stages within Hanney et al.'s framework as opportunities for engaging with policy-makers to ensure uptake of research findings.Conclusion: The engagement of stakeholders during the research development and implementation phases, especially at strategic moments, has a positive impact on uptake of research findings. The strategies and stages described in this paper can be applied to improve utilisation of research findings into policy development and implementation globally.
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| 3. |
- Tabana, Hanani
(författare)
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Uptake of HIV testing : assessing the impact of a home-based intervention in rural South Africa
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Despite the introduction of HIV counselling and testing (HCT) methods about 30 years ago, HIV testing uptake remains low in most high HIV prevalence settings. To date, knowledge of status still remains a critical approach in the fight against HIV and a first step to prevention, access to care, treatment, and support. Home-based HIV counselling and testing (HBHCT) is a novel approach that may complement the long-standing approaches for delivering HIV testing. Main Aim: To assess the impact of an HBHCT intervention on the uptake of HIV testing in a rural community in KwaZulu-Natal province, South Africa, using a pragmatic cluster randomised control trial design. Methods: All 4 research studies (Paper I-IV) were sub-studies of a cluster randomised control trial called Good Start HBHCT. The studies were conducted in rural Umzimkhulu sub-district. The intervention was HBHCT offered by trained lay counsellors to all adults residing in the intervention clusters (8 communities). In the control arm (8 communities) people accessed the standard of care (mainly clinic based HIV testing). The primary outcome measured in the trial was uptake of HIV testing. A baseline survey was conducted prior to the intervention in all 16 community clusters to measure uptake of HIV testing using an interviewer administered questionnaire (Paper I). Post-intervention, the same questionnaire (with additional questions on secondary outcomes) was administered (Paper II). In-depth qualitative interviews were conducted with couples who tested and received results together during the intervention (Paper III). We also conducted a cost-effectiveness analysis to compare the HBHCT approach versus clinic HCT (Paper IV). Results: The reported uptake of previous HIV testing among 5,821 participants in 16 community clusters was 32% at baseline. Women reported higher testing rates than men, 39% versus 17% respectively (Paper I). The HBHCT intervention increased testing rates from 32% to 69% in the intervention arm, while a smaller increase was observed in the control arm, from 31% to 47% (Paper II). People who received HBHCT had a higher likelihood of having tested compared to those in the control arm, (PR 1.54, 95% CI: 1.32-1.81). The prevalence of couple HIV counselling and testing was about twice as high in the intervention arm as it was in the control arm (PR 2.24, 95% CI: 1.49-3.03). The intervention had a significant effect on some secondary outcomes; notably, a protective effect against having more than one sexual partner in the past three months, which was 55% lower in the intervention arm (Paper II). For couples tested together, mutual knowledge of status challenged their relationships in different ways, depending on HIV status and gender. For discordant and concordant positive couples, the HIV status confirmed suspicions of infidelity, while negative couples were happy and regained trust. Concordant positive couples expected their positive status. Men reported that knowledge of status was an incentive to change their behaviour (Paper III). The economic evaluation demonstrated that HBHCT was more cost-effective in increasing uptake of HCT. The average cost per client was $29 for HBHCT compared to $38 for HCT in the clinic (Paper IV). Conclusions: HBHCT increased HIV counselling and testing and encouraged couple HCT. In addition to increasing HCT uptake, HBHCT was more cost-effective. The intervention also had protective effects on HIV risk behaviour. Thus, the findings provided evidence for wider implementation of the HBHCT approach.
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