379 research outputs found
Integrating online-offline interactions to explain societal challenges
Despite the wide literature on the consequences of Information and Communication Technologies (ICTs) use, the literature still lacks understanding about the societal consequences, positive or negative, intended or unintended. ICTs can yield the good and the bad. Consequences of technology usages on society are paradoxical. The paradoxical outcomes can be ta threat to the sustainability of society. Because interactions spread beyond the online space and its outcomes are paradoxical, societal challenges are complex problems. But not only complex problem, rather social complex problem. To harvest society, we need a better understanding of social complex problems. To do so, we adopted a multi-study dissertation model. To achieve that goal, the three studies of this doctoral work adopt a qualitative approach and a critical realist philosophy.
This dissertation focuses on the societal implications of online phenomena that spillover offline. We look at a first case: The Arab Spring and aim at understanding how an online community that started on Facebook materialized in urban space, changing the political landscape (Study 2). Addressing these kind of contemporaneous events does not come without analytical challenges. Therefore, we use and extend a semiotic analytical tool to face the representational complexity of the data collected (Study 1) with a discussion of the underlying philosophical assumptions. Finally, online communities can also have social costs by providing an echo chamber to socially undesirable behaviors. We aim at offering a conceptual explanation of how these online interactions turn into offline behaviors with negative spillovers (Study 3)
Fit for life: an exploration of the approaches used by sport-for-development NGOs to monitor and evaluate programmes offered in schools
Includes summary.Includes bibliographical references.The study aimed at exploring the approaches used by sport-for-development organisations to monitor and evaluate their programmes offered to schools in the Cape Metropole. The study contributes to the growing fields of programme monitoring and evaluation (M&E) as well as sport-for-development in South Africa. The studyās sample comprised NGOs that used sport as an entry point to engage young people and engender behavioural change, thereby reducing youth vulnerability to sexual and reproductive health issues
Academic Health Science Centers and Health Disparities: A Qualitative Review of the Intervening Role of the Electronic Health Record and Social Determinants of Health
Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an abundance of resources and networks to advance health equity as a high-impact goal and strategic imperative. Relatively little progress, however, has been made to better understand the potentially transformative nature of how digital health technologies (DHT)āsuch as mobile health apps, electronic health record (EHR) and electronic medical record (EMR) systems, smart āwearableā devices, artificial intelligence, and machine learningāmay be optimized to better capture and analyze social determinants of health (SDH) data elements in order to inform strategies to address health disparities. Even less has been explored about the challenging implementation of electronic SDH screening and data capture processes within AHCs and how they are used to better inform decisions for patient and community care. This research examines how AHC institutions, as complex education-healthcare bureaucracies, have prioritized this specific challenge amongst many other competing incentives and agendas in order to ultimately develop better evidence-based strategies to advance health equity. While there are clear moral, ethical, and clinical motives for improving health outcomes for vulnerable populations, when an AHC demonstrates that electronically screening and capturing SDH can improve the ability to understand the āupstreamā factors impacting their patients\u27 health outcomes, this can inform and influence policy-level choices in government legislation directed at community-level factors. A qualitative thematic analysis of interview data from AHC administrators and leadership illustrates how AHCs have mobilized their EHR as a featured component of their healthcare delivery system to address health disparities, exposing other related, multifactorial dimensions of the Institution and region. Key findings indicated that: electronic SDH screening and updating workflow processes within an AHCās clinical enterprise is a significant venture with multiple risks and the potential of failure. Universal adoption and awareness of SDH screening is hampered by notions of hesitancy, skepticism, and doubt as to an AHCās ability to meaningfully extract and use the data for decision-support systems. Additional investment in resources and incentive structures for capturing SDH are needed for continued monitoring of patient health inequalities and community social factors. Data from this and future replicated studies can be used to inform AHC and government decisions around health and social protection, planning, and policy
Development of an educational package for the universal human papillomavirus (HPV) vaccination programme: a co-production study with young people and key informants.
BACKGROUND: The English schools-based human papillomavirus (HPV) vaccination programme is routinely offered to all young people aged 12-13Ā years, to prevent cancers affecting the cervix, vulva, vagina, penis, anus and mouth. Lower uptake among some population groups has been identified, in part, because of unmet information needs among young people. To address these unmet needs we report intervention planning and development processes to co-produce an educational package about the HPV vaccine. METHODS: We used co-production research methodologies and the 'person-based approach' involving the following iterative stages: (i) collating and analysing primary and secondary evidence, including HPV vaccine communication materials, interviews and workshops; (ii) developing guiding principles; (iii) undertaking a behavioural analysis informed by the Behaviour Change Wheel and the Behaviour Change Technique taxonomy; (iv) development of a preliminary logic model; (v) co-production of resources, and; (vi) refinement of resources informed by feedback from young people and key informants. RESULTS: We co-produced EDUCATE, a theory-based educational package, that is designed to be delivered to young people prior to being offered the HPV vaccine to support uptake. Young people and key informants identified the following key issues to include as content: (i) HPV-related information; (ii) how vaccines work; (iii) safety and side-effects of the HPV vaccine; (iii) eligibility for the HPV vaccination programme, and; (iv) preparation of young people to receive the HPV vaccine. A manual for professionals (e.g. immunisation nurses, school staff) delivering the intervention and a PowerPoint presentation, interspersed with five short films, were co-produced with young people and key informants. Following feedback, the content of the EDUCATE package was refined to increase acceptability, engagement, and persuasiveness to the target users. CONCLUSION: Engagement with young people and key informants was integral to the development of our rigorously developed, theory-based intervention to address young people's information needs about the HPV vaccination programme. The acceptability and persuasiveness of the package has been maximised by working closely with young people and key informants to develop the content. An implementation study to examine how the EDUCATE package is implemented in practice and the impact on uptake of the HPV vaccination programme is underway
Co-development of online violence against women and girls prevention interventions with school-going adolescents
Background: Violence against women and girls (VAWG)amongst adolescents remains a global public health problem. Globally, an estimated 24 per cent of girls aged 15-19 are reported to have experienced VAWG before the age of 20. Experience of VAWG has far reaching health and educational consequences. Thus, the prevention of VAWG needs to be a priority. In recent years, there has been an increase in web-based or online violence prevention interventions. However, these interventions are either secondary prevention interventions, or primary prevention interventions, focused on emergency or protective solutions. Current evidence indicates that group-based participatory violence prevention interventions are an important approach to the primary prevention of VAWG but there remains a gap in understanding if these interventions can be delivered online. Further, it remains unclear if co-development of group-based participatory violence prevention interventions with young people ā which has been proposed to enhance contextualisation of interventions ā can occur online. Goal and specific objectives: This study aimed to explore and understand the feasibility of co-developing an online group-based participatory VAWG prevention intervention for adolescents. The specific objectives of this study were (i) from the perspective of experts understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, (ii) from the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online and (iii) Undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescents. ix Methods: This qualitative study was conducted in Gqeberha (formerly known as Port Elizabeth), in the Nelson Mandela Bay municipality, Eastern Cape Province of South Africa. The study was guided by the intervention development framework: 6 Essential Steps for Quality Intervention Development (6SQuID). Data were collected online using in-depth semi-structured interviews, with 20 experts sampled through convenience and snowball strategies and 18 purposively sampled adolescents, to achieve objectives one and two. This was then followed by a co-development process with high school-going adolescents (ages 18- 19 years) to achieve objective three. In the co-development process, the candidate worked with a small group of adolescents (four adolescents) for five sessions online, over a period of two weeks. In these sessions, the co-development team engaged in discussions on sexual violence, which resulted in creation of a problem tree and populated a theory of change table. Data were transcribed in English, verbatim and analysed using thematic network analyses. Findings: Findings for the first objective about understanding from the perspective of experts the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, showed experts identified several opportunities for these. Specifically, experts identified the potential of bringing these interventions to scale, which has been a challenge for in-person interventions, as well as accessing hard to reach groups, such as people in conflict settings, those on the move and people with limited mobility. However, experts felt there were many complex questions in the development of an online VAWG prevention intervention that needed resolving. Some of the challenges raised by experts included concerns of achieving privacy, trust, and safety online, which are central to achieving transformative communication. Experts also struggled to grapple with how a sense of community could be achieved online. There were also concerns amongst experts about material challenges such as access to devices, access to data and poor connectivity. x Interestingly, younger experts were more open to online participatory interventions than the more experienced experts. Findings for objective two āfrom the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered onlineā, young people reported they were keen and open to the idea of online group-based participatory VAWG prevention interventions. They discussed how they enjoyed engaging in online groups and often experienced a sense of belonging in these groups. Yet, like the experts, school-going adolescents were concerned about safety, privacy, and trust in online groups. These concerns shaped adolescentsā willingness to disclose sensitive information online and ability to engage in open dialogue. Concern over privacy, trust and safety online also influenced adolescentsā choices over which apps to engage with, and with whom. Young people were active in thinking through and addressing how they dealt with safety, privacy and trust issues online. The third objective was āto undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescentsā, which was done over two weeks. A range of positive outcomes were identified. Firstly, young people enjoyed the level of autonomy and their depth of involvement in the process. They had come into the process anticipating being lectured to and were pleasantly surprised to find that their role was central, and they would drive the process. Secondly, adolescents were eager to be involved and appreciated being āheardā. This allowed for a more extensive exploration of their understanding on the topic, and development of the intervention activities that emerged. Thirdly, young people found it easy to build rapport online, both amongst each other, and with the facilitator, which made communication in the group easier. Importantly, this group of adolescents had their own laptops, or cell phones to use, and the project provided data for the young people to participate. However, there were also challenges to the process of coxi development. The central challenge was that young people and facilitator often slipped into a form of teacher-learner communication, driven by their prior histories of didactic education, which led the adolescents to āfearingā to give āwrongā responses. The facilitator also struggled on how to maintain adolescentsā autonomy of thought, while also incorporating āscientific evidenceā in the emerging intervention activities. Furthermore, the more talkative school-going adolescents took the centre stage in the discussions, with the quieter ones remaining quiet. Conclusions: The findings of this study showed that the feasibility of taking group-based participatory interventions online are possible, but this is shaped by a complex set of factors, that impact on the possibilities for transformative communication, and on the creation of safe social spaces ā such as trust, privacy, safety. The central question is whether the theoretical constructs of transformative communication and safe social spaces are achievable online. A significant step in moving towards enabling transformative communication online will be addressing the issues of privacy, safety and trust. Careful training of facilitators around skills to facilitate group-based participatory VAWG prevention interventions online is also recommended. The complexities of delivering online participatory interventions require careful consideration, and this needs to be developed and thought about in conjunction with school-going adolescents (the target group), to ensure that interventions resonate with their needs and requirements. Future directions in this research field are provided.Thesis (PhD) -- Faculty of Health Sciences, 202
Co-development of online violence against women and girls prevention interventions with school-going adolescents
Background: Violence against women and girls (VAWG)amongst adolescents remains a global public health problem. Globally, an estimated 24 per cent of girls aged 15-19 are reported to have experienced VAWG before the age of 20. Experience of VAWG has far reaching health and educational consequences. Thus, the prevention of VAWG needs to be a priority. In recent years, there has been an increase in web-based or online violence prevention interventions. However, these interventions are either secondary prevention interventions, or primary prevention interventions, focused on emergency or protective solutions. Current evidence indicates that group-based participatory violence prevention interventions are an important approach to the primary prevention of VAWG but there remains a gap in understanding if these interventions can be delivered online. Further, it remains unclear if co-development of group-based participatory violence prevention interventions with young people ā which has been proposed to enhance contextualisation of interventions ā can occur online. Goal and specific objectives: This study aimed to explore and understand the feasibility of co-developing an online group-based participatory VAWG prevention intervention for adolescents. The specific objectives of this study were (i) from the perspective of experts understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, (ii) from the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online and (iii) Undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescents. ix Methods: This qualitative study was conducted in Gqeberha (formerly known as Port Elizabeth), in the Nelson Mandela Bay municipality, Eastern Cape Province of South Africa. The study was guided by the intervention development framework: 6 Essential Steps for Quality Intervention Development (6SQuID). Data were collected online using in-depth semi-structured interviews, with 20 experts sampled through convenience and snowball strategies and 18 purposively sampled adolescents, to achieve objectives one and two. This was then followed by a co-development process with high school-going adolescents (ages 18- 19 years) to achieve objective three. In the co-development process, the candidate worked with a small group of adolescents (four adolescents) for five sessions online, over a period of two weeks. In these sessions, the co-development team engaged in discussions on sexual violence, which resulted in creation of a problem tree and populated a theory of change table. Data were transcribed in English, verbatim and analysed using thematic network analyses. Findings: Findings for the first objective about understanding from the perspective of experts the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, showed experts identified several opportunities for these. Specifically, experts identified the potential of bringing these interventions to scale, which has been a challenge for in-person interventions, as well as accessing hard to reach groups, such as people in conflict settings, those on the move and people with limited mobility. However, experts felt there were many complex questions in the development of an online VAWG prevention intervention that needed resolving. Some of the challenges raised by experts included concerns of achieving privacy, trust, and safety online, which are central to achieving transformative communication. Experts also struggled to grapple with how a sense of community could be achieved online. There were also concerns amongst experts about material challenges such as access to devices, access to data and poor connectivity. x Interestingly, younger experts were more open to online participatory interventions than the more experienced experts. Findings for objective two āfrom the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered onlineā, young people reported they were keen and open to the idea of online group-based participatory VAWG prevention interventions. They discussed how they enjoyed engaging in online groups and often experienced a sense of belonging in these groups. Yet, like the experts, school-going adolescents were concerned about safety, privacy, and trust in online groups. These concerns shaped adolescentsā willingness to disclose sensitive information online and ability to engage in open dialogue. Concern over privacy, trust and safety online also influenced adolescentsā choices over which apps to engage with, and with whom. Young people were active in thinking through and addressing how they dealt with safety, privacy and trust issues online. The third objective was āto undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescentsā, which was done over two weeks. A range of positive outcomes were identified. Firstly, young people enjoyed the level of autonomy and their depth of involvement in the process. They had come into the process anticipating being lectured to and were pleasantly surprised to find that their role was central, and they would drive the process. Secondly, adolescents were eager to be involved and appreciated being āheardā. This allowed for a more extensive exploration of their understanding on the topic, and development of the intervention activities that emerged. Thirdly, young people found it easy to build rapport online, both amongst each other, and with the facilitator, which made communication in the group easier. Importantly, this group of adolescents had their own laptops, or cell phones to use, and the project provided data for the young people to participate. However, there were also challenges to the process of coxi development. The central challenge was that young people and facilitator often slipped into a form of teacher-learner communication, driven by their prior histories of didactic education, which led the adolescents to āfearingā to give āwrongā responses. The facilitator also struggled on how to maintain adolescentsā autonomy of thought, while also incorporating āscientific evidenceā in the emerging intervention activities. Furthermore, the more talkative school-going adolescents took the centre stage in the discussions, with the quieter ones remaining quiet. Conclusions: The findings of this study showed that the feasibility of taking group-based participatory interventions online are possible, but this is shaped by a complex set of factors, that impact on the possibilities for transformative communication, and on the creation of safe social spaces ā such as trust, privacy, safety. The central question is whether the theoretical constructs of transformative communication and safe social spaces are achievable online. A significant step in moving towards enabling transformative communication online will be addressing the issues of privacy, safety and trust. Careful training of facilitators around skills to facilitate group-based participatory VAWG prevention interventions online is also recommended. The complexities of delivering online participatory interventions require careful consideration, and this needs to be developed and thought about in conjunction with school-going adolescents (the target group), to ensure that interventions resonate with their needs and requirements. Future directions in this research field are provided.Thesis (PhD) -- Faculty of Health Sciences, 202
"It's all country boys:" rural young male perceptions of risk and protective factors for dating violence and technology-based interventions as an acceptable response
In 2019, one in eight US teens reported experiencing Teen Dating Violence (TDV) as physical, psychological, sexual, and online abuse. Studies show rural youth report up to twice the physical violence rates of urban youth but remain grossly undersampled and understudied, particularly rural young males. The Health-e BROs! Study (Better & Healthy Relationship Outcomes) was designed to begin to address this gap. An understudied aspect of dating violence prevention is young people's perception and communication of risks associated with TDV victimization and perpetration. Overall, 14 rural young males participated in three online focus groups, and another 13 completed phone interviews stratified by age - 15-17 (middle adolescents) and 18-24 (emerging adults). In this dissertation, two specific aims were addressed using distinct analytical approaches. First, using an interpretive and dialectical approach grounded in relational dialectics theory (RDT), this study explored TDV risk communication and risk perceptions among rural young males (ages 15-24). Our interpretive analysis identified two main themes of risk and protection dialectics: (1) Dialectics of Social Tensions and (2) Dialectics of Help-Seeking & Help-Giving. Within each main theme, constitutive sub-themes are described as dialectics accompanied by participant quotes. Dialectical tensions and contradictions were used as a heuristic framework. Our second aim investigated: (a) what rural male youth consider useful content, resources, and features in app-based dating violence prevention intervention and (b) unmet needs related to barriers and facilitators for using this type of intervention in rural contexts. The Unified Theory of Acceptance and Use of Technology (UTAUT) guided the second aim, and a qualitative descriptive approach was used to analyze this aim. Findings bear implications for advocates and practitioners working with rural youth in planning developmentally and culturally appropriate anti-TDV programs and will yield intervention, policy, and for researchers by providing a broader framework for the development of theory and effective violence prevention practice in low-income, rural contexts.Includes bibliographical reference
Health Crises and Media Discourses in Sub-Saharan Africa
This is an open access book which brings together leading scholars and critical discourses on political, economic, legal, technological, socio-cultural and systemic changes and continuities intersecting media and health crises in Sub-Saharan Africa. The volume extensively discusses COVID-19 but it also covers other epidemics, such as malaria, HIV/AIDS as well as āsilentā health crises such as mental health---simmering across the subcontinent. The chapters fill knowledge gaps, highlight innovations, unpack the complexities surrounding the media ecosystem in times of health crises. They explore, among other issues, the politics of public health communication; infodemics; existential threats to media viability; draconian legislations; threats to journalists/journalism; COVID-related entrepreneurship, marginalization, and more. This is a timely resource for academics, advocacy groups, media practitioners and policy makers working on crises and media reporting, not just in Africa but anywhere in the global South
Perspectives and Theories of Social Innovation for Ageing Population
In recent years we may observe increasing interest in the development of social innovation both regarding theory as well as the practice of responding to social problems and challenges. One of the crucial challenges at the beginning of the 21st century is population ageing. Various new and innovative initiatives, programs, schemes, and projects to respond to negative consequences of this demographic process are emerging around the world. However, social theories related to ageing are still insufficiently combined with these new practices, social movements, organisational models, and institutions. Many scholars are still using notions and tools from classical theories of social gerontology or the sociology of ageing such as disengagement theory, activity theory, and successful and productive ageing. Such theories do not sufficiently explain ageing in the context of, for example, a broad use of the information and communications technologies (ICTs) including robotics and automation, new healthcare and long-term care models, advancements in the development and governance of age-friendly environments, and public engagement of older adults into co-production of services delivered by public, private, non-governmental as well as non-formal entities
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