Browsing by Author "Hendricks, Gaironeesa"

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    Adolescents’ Perspectives on the Drivers of Obesity Using a Group Model Building Approach: A South African Perspective
    (2022-02-14) Hendricks, Gaironeesa; Savona, Natalie; Aguiar, Anaely; Alaba, Olufunke; Booley, Sharmilah; Malczyk, Sonia; Nwosu, Emmanuel; Knai, Cecile; Rutter, Harry; Klepp, Knut-Inge; Harbron, Janetta
    Overweight and obesity increase the risk of a range of poor physiological and psychosocial health outcomes. Previous work with well-defined cohorts has explored the determinants of obesity and employed various methods and measures; however, less is known on the broader societal drivers, beyond individual-level influences, using a systems framework with adolescents. The aim of this study was to explore the drivers of obesity from adolescents’ perspectives using a systems approach through group model building in four South African schools. Group model building was used to generate 4 causal loop diagrams with 62 adolescents aged 16–18 years. These maps were merged into one final map, and the main themes were identified: (i) physical activity and social media use; (ii) physical activity, health-related morbidity, and socio-economic status; (iii) accessibility of unhealthy food and energy intake/body weight; (iv) psychological distress, body weight, and weight-related bullying; and (v) parental involvement and unhealthy food intake. Our study identified meaningful policy-relevant insights into the drivers of adolescent obesity, as described by the young people themselves in a South African context. This approach, both the process of construction and the final visualization, provides a basis for taking a novel approach to prevention and intervention recommendations for adolescent obesity.
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    Exploring the development of the effective communication graduate attribute in the clinical technology programme at the Durban University of Technology: student, graduate, and educator perceptions and experiences
    (2025) Prakaschandra, Dorcas Rosaley; Hendricks, Gaironeesa; McNamee, Lakshini
    Effective communication (EC) between health professionals and patients is a core clinical skill and can be developed through the EC graduate attribute (GA). However, in South Africa, despite its adoption by higher education institutions and regulatory bodies, the development of this GA is not emphasised in most medical education programmes, including Clinical Technology (CT). This is partly due to a lack of consensus on how to integrate EC development into both practical and theoretical training. The limited research on students' perceptions, particularly in the global South and within CT, calls for an exploration of the phenomenon. This study, therefore, aimed to understand how the EC GA is developed through the perceptions and experiences of final-year students, new graduates, and academic and clinical educators in the CT programme at the Durban University of Technology. This study drew on Engeström's Activity Theory (AT). Since clinical training is situated and contextualised, it is susceptible to various influences. Encompassed within the AT is an understanding that context, in the form of the theory's components, influences how individuals experience EC development, making this theory suitable as an analytical lens. A qualitative methodology within an interpretivist paradigm was employed. This study adopted a phenomenological research design. Purposive sampling was used to select participants using three focus group discussions (ten final- year students and five new graduates) and ten semi-structured interviews (four academic and six clinical educators). The data analysis for the study was guided by Braun and Clarke's thematic analysis framework The findings revealed four key themes: (T1) Effective Communication as a Continuous Journey, (T2) Organisational Influences on EC Development, (T3) Navigating Cultural, Linguistic, and Interpersonal Dynamics, and (T4) Adapting Communication to Professional Practice. The findings suggest that the development of EC GA, as perceived by participants, often differed from prescribed institutional standards. Key influencing factors included clinical preparation, support structures, and language barriers. Additionally, a misalignment in how EC was conceptualised between students, academics, and clinical educators created further challenges. The study also highlighted the need for a multilingual language policy to enhance students' language proficiency and provide better support in diverse clinical settings in South Africa. This study therefore contributes to the broader discussion in health professions education about the collaborative development of GAs through authentic workplace learning, rather than sole reliance on formal instruction. This study also highlights the need for a re-evaluation of institutional policies on language, curriculum integration, and the importance of academic and clinical partnerships in conceptualising and developing the effective communication GA. Based on these findings, this study recommends introducing a formal communications module, the creation of a supportive learning environment through feedback and mentoring, revising curricula, and incorporating reflection for both educators and students to improve EC GA development.
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    Prenatal alcohol exposure and the early neurodevelopmental outcomes of children in a South African birth cohort study
    (2020) Hendricks, Gaironeesa; Donald, Kirsten A; Malcolm-Smith, Susan; Stein, Dan J
    Introduction: Over the last few decades, prenatal alcohol exposure (PAE) has been a major public health problem both globally and in low- to-middle-income countries (LMICs) such as South Africa. Pregnant women and new mothers are particularly vulnerable; and PAE may be associated with adverse child neurodevelopmental outcomes. However, few studies have explored the association of PAE, including risk factors, and subsequent neurodevelopmental trajectories over multiple timepoints in the early years. Given the high burden of PAE and associated risk factors, and the relative paucity of empirical data, further work in South African populations is warranted. This thesis aimed to investigate the association between PAE and early neurodevelopmental outcomes in the Drakenstein Child Health Study (DCHS), a South African birth cohort. The specific objectives included: 1. a systematic review on the available longitudinal studies exploring the impact of PAE on language, speech and communication development (Chapter 3 Manuscript 1); 2. an exploration of the association between PAE and motor, language and cognitive outcomes in infancy (Chapter 4- Manuscript 2); 3. an investigation of the association between PAE, including interactions of tobacco smoking exposure, and the neurodevelopmental trajectories (motor, language and cognitive outcomes) of children across the first 4 years of life (Chapter 5 Manuscript 3); 4. a comparison of the conversational turn-taking between mothers and their alcohol exposed children compared to those between mothers and their unexposed children (Chapter 6 Manuscript 4). Methods: This thesis included four publications, three of which present data from the DCHS. Pregnant women were enrolled from two public primary healthcare clinics, Mbekweni (a predominantly black African population) and TC Newman (a mixed-ancestry population), and more than 1000 mother-child dyads were followed longitudinally from birth through the first 5 years of life. For this study, both antenatal and postnatal maternal measures were used to assess moderate-to-severe levels of PAE. These measures included the (i) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) antenatally, (ii) a retrospective alcohol questionnaire in the postnatal period at 3-6 weeks and/or 24 months testing age. At 6, 24 and 42 months, early neurodevelopmental outcomes were assessed using the Bayley-III Scales of Infant Development (BSID-III), the Kaufman Assessment Battery for Children (KABC-II) or the Peabody Picture Vocabulary Test (PPVT-IV). Conversational turn-taking in mother-child dyads was also assessed at 42 months testing age. Both univariate and multivariate analyses were used to analyse the data. Results: The findings of this thesisshowed that PAE was significantly associated with both fine motor (B=-3.30, 95%CI 0.06-0.46, p=0.001) and gross motor scores (B=-0.30, 95%CI 0.06-0.44 p=0.001) at 6 months (Chapter 4 Manuscript 2). Chapter 5 (Manuscript 3) showed that when accounting for the interaction between prenatal alcohol and tobacco smoking exposure, impaired fine motor functioning occurred up till 24 months (B=-12.59, 95%CI -21.98- -3.19, p=0.01), but these effects attenuated by 42 months. Significant interactions occurred between prenatal alcohol, including tobacco smoking exposure, and impaired receptive vocabulary (B=-2.49, 95%CI -5.24 -0.27, p=0.02) and cognitive functioning at 24 months (B=- 3.25, 95%CI -5.98- -0.52, p=0.02) (Chapter 5 Manuscript 3). Finally, when exploring conversational turn-taking in alcohol exposed mother-child dyads and unexposed dyads, PAE was significantly associated with conversational turn-taking i.e. child overlapping utterances (OR=3.25, CI 0.98-10.76, p=0.050) (Chapter 6 Manuscript 4). Conclusion: The associations of PAE with early neurodevelopmental outcomes shown here expand on the previous literature. Our findings reported that PAE may influence early neurodevelopmental outcomes, however, future studies should include additional longitudinal studies to replicate the findings, and ongoing follow-up of our own cohort may continue clarify the potential association of PAE and additional risk factors on later neurodevelopmental outcomes at school age and beyond. Effective alcohol programmes targeting pregnant women and interventions to address child developmental impairments in this vulnerable cohort are required.