Browsing by Subject "Context"

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    Exploring the role of context in emerging adults' experiences of occupational possibilities and occupational choice in a community in the Western Cape: a narrative inquiry
    (2025) Wicht, Minkateko; Sonday, Amshuda; Crawford-Browne, Sarah
    Introduction: Occupational therapists recognise that health and wellbeing are inextricably linked to people's occupations. Many emerging adults within the Western Cape, South Africa, are experiencing numerous social, economic, and educational challenges which may constrain their occupational engagement and negatively influence their transition into adulthood. Understanding how contexts shape the occupational possibilities and occupational choice of emerging adults will allow occupational therapists, who work with emerging adults in constraining contexts, to better support their transition into adulthood, promote meaningful and purposeful occupational engagement and ultimately enable health and wellbeing. Research Aim: The aim of this study was to explore how living in a community within Bredasdorp, Western Cape, shapes the experience of occupational possibilities and occupational choice of emerging adults aged between 18 and 25 years. Research Design: This qualitative study was informed by the social constructivist/interpretivist paradigm and used a narrative inquiry design. It utilized a transactional perspective of occupation and Laliberte-Rudman's theory of occupational possibilities and Galvaan's theory of occupational choice as the guiding theoretical frameworks. Five participants were recruited, through purposive sampling methods, with the assistance of a community-based organisation. Photovoice methods were used to generate visual data for interviews. Narrative data was then generated through two in-depth unstructured narrative interviews per participant. Data Analysis: Data was analysed using both analyses of narratives and narrative analyses methods and included three levels of analysis, namely, narrative story writing; coding, editing and member-checking of narrative stories; and individual case analysis and cross-case analysis. Findings: One overarching theme emerged from the analysis which showed that occupational possibilities and occupational choice were not dependent on either individual agency or contexts but rather resulted from an interplay between the two. Conclusion: The participants' contexts played an integral role in shaping their occupational possibilities and occupational choices and influenced their health and wellbeing by supporting or constraining a range of available choices, resources, opportunities and possibilities. This study also found that there was a transactional relationship between occupational possibilities and occupational choice. Lastly, there was some fit between the theory of emerging adulthood and the participants' experiences within their contexts.
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    Open Access
    Testing the contextual Interaction theory in a UHC pilot district in South Africa
    (2022-03-15) Michel, Janet; Mohlakoana, Nthabiseng; Bärnighausen, Till; Tediosi, Fabrizio; Evans, David; McIntyre, Di; Bressers, Hans T A; Tanner, Marcel
    Background World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens. Method Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps. Results All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.