Browsing by Subject "Interventions"

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    Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review
    (2025) Mabuza, Lozinyanga; Buchanan, Helen; Ramafikeng, Matumo
    Objectives: To describe occupational therapy interventions for the community re-integration of mental health care users (MHCUs) and the factors that influence this process in low- and middle-income countries (LMICs) Introduction: Mental health issues affect a large portion of the global population, with severe mental illness (SMI) contributing significantly to the global disease burden particularly in LMICs where access to care is limited. Community re-integration for MHCUs is a serious challenge, often leading to the revolving door phenomenon. Community-based mental health care models aim to improve patient outcomes and support re-integration. Occupational therapy plays a significant role in this recovery process; however, the evidence is scattered, with no existing summary of literature for LMICs. Inclusion criteria: This scoping review included studies from 2002 to 2023 that reported occupational therapy interventions for community re-integration of previously institutionalised MHCUs with severe mental illness. The studies were selected from LMICs and included various research designs, theoretical articles, and grey literature. Methods: A search strategy was developed with a subject librarian and PubMed, Scopus, EBSCOHost (CINAHL, Africa-Wide Information, APA PsycArticles, and APA PsycInfo), OATD.org, and WorldCat were searched. The search was conducted from January to February 2023. Two reviewers independently screened eligible studies using the Rayyan web application. The data were extracted using a modified JBI data-charting tool and organised in a table using two organising categories. Data were coded by similar factors, summarised, and reported descriptively. Results: Of the 287 articles identified in the searches, 10 met the inclusion criteria. Sources were from South Africa (5 sources), India (2 sources), China (1 source) and Brazil (1 source), and were mostly qualitative and based in community practice sites. Nine distinct occupational therapy interventions were identified – actuality, community living skills and support, counselling, home visits, life skills, leisure, psychoeducation, self-care, and vocational rehabilitation. The six contributing factors included community-based rehabilitation principles, psychosocial strategies, assessment and outcome measures, the concept of recovery, occupational therapy-led programmes and elements of the interventions. Conclusion: Interventions that aligned with occupational therapy principles that were culturally adapted were particularly effective in facilitating MHCUs' re-integration in LMICs Adapting outcome measures and re-integration indicators to the local context is crucial.
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    Open Access
    Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study
    (2016) Draper, Catherine E; Davidowitz, Kesiah J; Goedecke, Julia H
    Abstract Objective A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Design Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Setting Khayelitsha, Cape Town, SA. Subjects Twenty-one black SA women. Results The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. Conclusions These findings highlight the complexities surrounding participants’ perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.