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Everett-Murphy K.,University of Cape Town | De Villiers A.,Non communicable Diseases Research Unit NCDRU | Ketterer E.,Research and Programme Development | Steyn K.,University of Cape Town
Health Education Research

As part of a comprehensive programme to prevent non-communicable disease in South Africa, there is a need to develop public education campaigns on healthy eating. Urban populations of lower socioeconomic status are a priority target population. This study involved formative research to guide the development of a nutrition resource appropriate to the budgetary constraints and information needs of poor households in the major urban centres of South Africa. Twenty-two focus groups were convened to explore the target audience's knowledge, beliefs, attitudes and practices as they related to healthy eating and their views about the proposed nutrition resource (N=167). A brief questionnaire assessed eating and cooking practices among focus group participants. Key informant interviews with eight dieticians/nutritionists working with this population added to the focus group findings. The research identified important issues to take into account in the development of the resource. These included the need to: directly address prevalent misconceptions about healthy eating and unhealthy eating practices; increase self-efficacy regarding the purchasing and preparation of healthy food; represent diverse cultural traditions and consider the issues of affordability and availability of food ingredients. This study demonstrates the value of using formative research in the design of nutritionrelated communication in a multicultural, poor, urban South African setting. ©The Author 2015. Source

Uys M.,University of Cape Town | Draper C.E.,University of Cape Town | Hendricks S.,University of Cape Town | De Villiers A.,Non communicable Diseases Research Unit NCDRU | And 3 more authors.
American Journal of Health Behavior

Objectives: To assess the impact of a whole-of-school health promotion program targeting healthy eating and physical activity on physical fitness levels, and physical activity-related knowledge, attitudes and behavior of primary school children. Methods: Sixteen primary schools were randomly assigned as intervention (N = 8) and control (N = 8) schools. A selection of tests from the Eurofit testing battery was used to assess changes in fitness levels over the 3 years of the intervention. Anthropometric measurements included height and weight. A physical activity knowledge, attitude and behavior (KAB) questionnaire was administered to participants. Multi-level mixed effect linear models were used to assess differences between intervention and control schools. Results: No overall improvement in physical fitness was found. The sit-ups score improved significantly in the intervention group (p < .05). No overall intervention effects were found on the determinants of physical activity behavior. Knowledge improved in both the intervention (p = .005) and control (p < .001) groups. Conclusion: The lack of a specific intervention effect on fitness levels and physical activity-related KAB indicates that a "low intensity" intervention is not effective in South African primary school settings. Copyright © PNG Publications. All rights reserved. Source

De Villiers A.,Non communicable Diseases Research Unit NCDRU | Steyn N.P.,University of Cape Town | Draper C.E.,University of Cape Town | Hill J.,Non communicable Diseases Research Unit NCDRU | And 4 more authors.
BMC Public Health

Background: The HealthKick intervention, introduced at eight primary schools in low-income settings in the Western Cape Province, South Africa, aimed to promote healthy lifestyles among learners, their families and school staff. Eight schools from similar settings without any active intervention served as controls. Methods: The Action Planning Process (APP) guided school staff through a process that enabled them to assess areas for action; identify specific priorities; and set their own goals regarding nutrition and physical activity at their schools. Educators were introduced to the APP and trained to undertake this at their schools by holding workshops. Four action areas were covered, which included the school nutrition environment; physical activity and sport environment; staff health; and chronic disease and diabetes awareness. Intervention schools also received a toolkit comprising an educator's manual containing planning guides, printed resource materials and a container with physical activity equipment. To facilitate the APP, a champion was identified at each school to drive the APP and liaise with the project team. Over the three-years a record was kept of activities planned and those accomplished. At the end of the intervention, focus group discussions were held with school staff at each school to capture perceptions about the APP and intervention activities. Results: Overall uptake of events offered by the research team was 65.6 % in 2009, 75 % in 2010 and 62.5 % in 2011. Over the three-year intervention, the school food and nutrition environment action area scored the highest, with 55.5 % of planned actions being undertaken. In the chronic disease and diabetes awareness area 54.2 % actions were completed, while in the school physical activity and sport environment and staff health activity areas 25.9 and 20 % were completed respectively. According to educators, the low level of implementation of APP activities was because of a lack of parental involvement, time and available resources, poor physical environment at schools and socio-economic considerations. Conclusions: The implementation of the HealthKick intervention was not as successful as anticipated. Actions required for future interventions include increased parental involvement, greater support from the Department of Basic Education and assurance of sufficient motivation and 'buy-in' from schools. © 2015 de Villiers et al. Source

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