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This paper illustrates the practical implementation of intervention research when adapting a family assessment tool between countries. Developing countries such as South Africa are emphasising the indigenisation of practices to ensure applicable theories and practices when addressing unique societal contexts or challenges. New social work technology can be developed using the process of intervention research. This paper analyses the application of intervention research using the social constructionism paradigm in addressing the research problem of how a family assessment tool can be transferred from one country to another, with the main focus being on feedback and the application of this method by the researchers. Forty‐six social workers were trained in the use of the assessment tool, and feedback on the adaptation of the tool was gathered during focus group discussions on various occasions. Results indicate the importance of contextualising the tool within the context of specific countries to ensure relevancy and applicability, especially among different racial and cultural groups, as well as to ensure that the relevant stakeholders are consulted in the development of new technology. Intervention research ensures a rigorous research process to adapt existing technology to a local context. 'This paper illustrates the practical implementation of intervention research when adapting a family assessment tool between countries' Key Practitioner Messages: Intervention research is an appropriate approach in adapting tools from one context to another.Focus group discussion enhances the ability of practitioners to jointly construct practice realities.The applicability of assessment tools is enhanced by widely consulting with practitioners. [ABSTRACT FROM AUTHOR]

In South Africa Education White Paper 6 introduced the establishment of Institutional‐Level Support Teams (ILST) at school level to support the learning and teaching process by identifying and addressing learner, teacher and institutional needs. The core priority of these teams is to implement properly co‐ordinated learner and teacher support services. This paper therefore explores the effectiveness of the ILSTs in providing support services at Full‐Service Schools (FSS). In this article the Rubin, Plovnick and Fry's GRPI model of team effectiveness (1977) was used to explore the effectiveness of the ILSTs in selected schools. By means of focus group interviews, data was generated from two strata, namely ILST members and district officials working directly with FSS. The study was a case study within a qualitative research design. Data was analysed using an inductive analytical framework and a group interpretive data analysis method. The results indicate some efficacy of support provision, but with numerous challenges regarding attention to the desired results, agreement on the standards and expectations, misunderstanding of the boundaries in which ILSTs operate, individual and shared responsibilities, conflict resolution, and effective methods for dealing with conflict. [ABSTRACT FROM AUTHOR]

Industrialization and urbanization processes have challenged deeply held traditional gender norms and facilitated the emergence of modern ideologies in South Africa. This paper seeks to explore the gendered roles of family members on maternal and child nutrition and investigate indications of perceived change in related practices. A qualitative secondary analysis was conducted of data from nine focus group discussions (FGDs) held with men (n = 3) and women (n = 6) aged ≥18. Data from the FGD were coded and thematic analysis conducted. We found that elderly women seem to have a central advisory role with respect to maternal and child nutrition and that men and elderly women upheld patriarchal gender divisions of labour, which entrust mothers with the primarily responsibility for young children's nutrition. Young mothers relied on elderly women for provision of childcare and nutritious foods for children; however, they demonstrated some resistance to traditionally feminized forms of food preparation. We found that men's involvement in children's nutrition was limited, though they expressed a preference to be more involved in maternal and child nutrition and care practices. A gender transformative approach to policy development, which includes elderly women and men, has the potential to promote more gender‐equitable nutrition practices, increase young women's self‐efficacy and support them to overcome barriers that could be limiting their decision making power in achieving optimal nutrition for themselves and their children. [ABSTRACT FROM AUTHOR]

Abstract: This paper adopts a qualitative case study on the generalist service delivery model of I‐Care, a Durban‐based non‐governmental organization that works with male street children. Fifteen face‐to‐face interviews were conducted with 10 I‐Care employees and 5 former street children. A focus group was set up with I‐Care employees. Although existing literature is forthright about a generalist approach for children at risk, it remains unclear how to implement this approach in practice. This paper reviews a continuity of 5 fundamental social work practices for working with street children: (a) outreach work, (b) child–family and child–community mediation, (c) transitory care centres and programmes, (d) brokerage, and (e) mentorship and follow‐ups. The study analyses how these practices contribute to the capability and agency expansion of the street children and outlines challenges that service providers and former street children experience. The main challenges acknowledged are balancing between the agency and protection of street children and the adaptation of children to street life. The study proposes intervention strategies to overcome these challenges. [ABSTRACT FROM AUTHOR]

Background This paper reports part of the findings of a study which exposed sexual violence in schools for learners with mild intellectual disability in South Africa. Special attention was paid on factors contributing to such a problem. Methods Data were collected using focus groups and individual interviews with 16 learners with mild intellectual disability at two special schools in South Africa. This was followed by individual interviews with the school nurse and social worker, and an analysis of schools' books of incidents. Results Factors contributing to sexual violence at schools for learners with mild intellectual disability included: (i) peer pressure, (ii) concealment of reported incidents of sexual violence, (iii) unsupervised areas linked to schools and (iv) arranged relationships. Conclusion The following suggestions are put forth: (i) awareness programmes, (ii) sensitization of teachers about the consequences and prevention of sexual violence, (iii) boundaries within which the arranged relationship occurs, (iv) intensification of sexuality education and (v) supervision around the school premises. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Physiotherapists form an important part of the inter-professional team that cares for critically ill patients in intensive care units ( ICU). No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for physiotherapy within critical care, which poses a threat to physiotherapy practice and professional credibility. Methods The aim of this paper was to describe the nominal group technique ( NGT) used to identify the minimum standards of clinical practice needed by physiotherapists to ensure safe and independent practice in South African ICUs. Results Twenty-five subjects participated in one of three forums. Sixty-six concepts were considered in the three domains ( knowledge, skills and attitudes). Not all concepts were discussed by all three focus groups. Just over half (54% n = 14) the concepts generated in the knowledge domain; a third of the concepts (35% n = 7) generated in the skills domain and only 10% ( n = 2) of attitudes were consistently raised by all three groups. Almost two-thirds of the concepts generated (62% n = 41) were considered in more than one domain. Only six concepts reached the threshold consensus level across all three focus groups, four knowledge parameters and two skills. Conclusion The NGT allowed for the cross-stimulation of ideas in an engaging yet anonymous and structured manner. The importance of discussion in reaching consensus is highlighted. Going forward, it is intended to use the concepts generated through this process as the foundation for further consensus-building activities among the wider physiotherapy and intensive care communities. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop and refine strategies for preserving nurses' professional dignity. Background: Professional dignity is a non‐negotiable nursing professional value. It should at all times be respected because of the worthiness of nurses as professional human beings. They are at the centre of healthcare societies. Their worth and contributions to the health of others should be acknowledged and preserved. Methods: Descriptive qualitative research was conducted during the development of the strategies while applying the principles of strategic navigation. The process was guided by the findings of the initial phase of the study and contextualised literature. Focus group discussions were held with healthcare professionals for the refinement of the strategies in two private hospitals in South Africa. Findings: The strategies unfolded multiple possibilities to value nurses' professional dignity. These were pathways for respecting, appreciating and supporting nurses; honouring nurses' desire to hold the well‐being of patients in the highest regard; supporting nurses in fulfilling their professional roles; enabling nurses to take pride in themselves and the nursing profession; supporting nurses in demanding and complex circumstances and supporting nurses in coping with humiliating workplace experiences. Conclusion: Strategies to ensure successful outcomes in preserving nurses' professional dignity were developed and refined. The professional dignity experiences that mattered most were presented. Implications for nursing/health policy: Valuing nurses' professional dignity promotes respect and support for nurses and their desire to prioritise patient‐centred care, contributing to improved nursing practice and nurses' confidence to assert their professional dignity. Preserving nurses' professional dignity is a necessity in healthcare. It should be affirmed in equal standing in nursing codes of conduct, nursing curriculums and healthcare policies. [ABSTRACT FROM AUTHOR]

Female‐initiated HIV prevention methods, such as oral pre‐exposure prophylaxis (PrEP) and the vaginal ring, may be important risk reduction strategies for breastfeeding women. Given their novelty, information about the sociocultural context and how it influences perceptions of and support for their use during breastfeeding is lacking. To address this gap, we conducted 23 focus group discussions separately with pregnant and breastfeeding women, male partners and grandmothers (N = 196) and 36 in‐depth interviews with key informants in Malawi, South Africa, Uganda and Zimbabwe. We analysed the data using a framework analysis method. Overall, breastfeeding was the norm, and participants described the transference of health (e.g., nutrition) and disease (e.g., HIV) to children through breast milk. Participants considered the early breastfeeding period as one of high HIV transmission risk for women. They explained that male partners tend to seek outside sexual partners during this period because women need time to recover from delivery, women focus their attention on the child, and some men are disgusted by breast milk. Participants highlighted concerns about the drugs in oral PrEP transferring to the child through breast milk, but fewer worried about the effects of the vaginal ring because the drug is localized. Women, grandmothers and key informants were supportive of women using these HIV prevention methods during breastfeeding, while male partners had mixed opinions. These findings can be used to tailor messages for promoting the use of PrEP or the vaginal ring during breastfeeding in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

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Family and teacher partnerships have an important role to play in the education of learners with disabilities. The South African Schools Act of 1996 has made provision for families to play a pivotal role in the school governing body, whether their child has a disability or not. National and international research shows that strong family–teacher partnerships improve children's academic performance as well as the family's quality of life. This study explores families' and teachers' co‐operative experiences of supporting learners with disabilities in special and full‐service schools in South Africa. Data were drawn from 39 individual interviews with teachers and five focus group discussions with 27 family members of learners with disabilities. The findings show both positive and negative interactive experiences regarding communication, extending learning from school to home, power dynamics and advocacy, and commitment. Consideration of these aspects will contribute to improving education for learners with disabilities. [ABSTRACT FROM AUTHOR]

Oral history presents an especially effective way of exploring the multitudinous, contradictory, and contextual meanings that are attached to the notion of community. In this study, we argue for narrative‐discourse analysis as a critical means of studying contested community memories. We rely on focus group discussions and individual interviews to explore oral histories of state‐sanctioned relocation of residents of Thembelihle, a low‐income community in Johannesburg, South Africa. Our analysis revealed the sharply splintered politics that characterizes oral histories of this community. We argue that oral histories, in their contradictory and visceral fullness, are able to point toward a politics of resistance that is sensitive to inequalities, and that are willed toward emancipatory future‐building. We conclude by underlining the need for community psychologists to engage with a politics of memory that is sensitive to power differentials, historiography, and broader currents of oppression. [ABSTRACT FROM AUTHOR]

Introduction: In 2014, the South African government adopted a differentiated service delivery (DSD) model in its "National Adherence Guidelines for Chronic Diseases (HIV, TB and NCDs)" (AGL) to strengthen the HIV care cascade. We describe the barriers and facilitators of the AGL implementation as experienced by various stakeholders in eight intervention and control sites across four districts. Methods: Embedded within a cluster‐randomized evaluation of the AGL, we conducted 48 in‐depth interviews (IDIs) with healthcare providers, 16 IDIs with Department of Health and implementing partners and 24 focus group discussions (FGDs) with three HIV patient groups: new, stable and those not stable on treatment or not adhering to care. IDIs were conducted from August 2016 to August 2017; FGDs were conducted in January to February 2017. Content analysis was guided by the Consolidated Framework for Implementation Research. Findings were triangulated among respondent types to elicit barriers and facilitators to implementation. Results: New HIV patients found counselling helpful but intervention respondents reported sub‐optimal counselling and privacy concerns as barriers to initiation. Providers felt insufficiently trained for this intervention and were confused by the simultaneous rollout of the Universal Test and Treat strategy. For stable patients, repeat prescription collection strategies (RPCS) were generally well received. Patients and providers concurred that RPCS reduced congestion and waiting times at clinics. There was confusion though, among providers and implementers, around implementation of RPCS interventions. For patients not stable on treatment, enhanced counselling and tracing patients lost‐to‐follow‐up were perceived as beneficial to adherence behaviours but faced logistical challenges. All providers faced difficulties accessing data and identifying patients in need of tracing. Congestion at clinics and staff attitude were perceived as barriers preventing patients returning to care. Conclusions: Implementation of DSD models at scale is complex but this evaluation identified several positive aspects of AGL implementation. The positive perception of RPCS interventions and challenges managing patients not stable on treatment aligned with results from the larger evaluation. While some implementation challenges may resolve with experience, ensuring providers and implementers have the necessary training, tools and resources to operationalize AGL effectively is critical to the overall success of South Africa's HIV control strategy. [ABSTRACT FROM AUTHOR]

Enrollers play a critical yet often overlooked role in clinical research, particularly in informed consent processes. Study retention may depend in part on how complex information is conveyed to potential participants. This qualitative study aimed to assess communicative barriers during consent and enrolment in two South African TB/HIV clinical studies. In particular, we compared our own perceptions of potential challenges to consent with that of thirteen enrollers, gained via reflective journaling and focus group discussions. Some overlap of identified challenges was evident, including terminology, jargon and consent document format. However there were mismatches to identified challenges. Enrollers provided further insights into potential challenges to consent, in particular, blood withdrawal, discussion of sexual issues and misunderstanding of study participation. Enrollers also reported feeling ill-equipped to provide counselling when participants became distressed. We offer several recommendations for strengthening the inclusion of enrollers in the development of clinical research protocols and consent documents. [ABSTRACT FROM AUTHOR]

Abstract: Background: Burns are a global public health problem. In South Africa, the rate of paediatric burn deaths is 5 times higher than other upper middle‐income countries, with concentrations in impoverished settings. Globally, the majority of research focuses on expert and caregiver descriptions of burn occurrence, causation, and prevention, with limited consideration of children's perspectives. This study investigated children's understanding of the causation and prevention of childhood burns. Methods: Data were collected from eighteen 10‐ to 11‐year‐old children living in selected impoverished, fire‐affected neighbourhoods in Cape Town, through 3 isiXhosa focus groups. All focus groups were transcribed, coded, and analysed for emerging themes through thematic analysis. Results: Themes regarding burn causation and risks centred around 4 themes: (a) developmental limits in context; (b) domestic chores, child capacity, and inability to say “no”; (c) inadequate supervision and compromised caregiving; and (d) unsafe structures. Child accounts of prevention pertained to (e) burn injury prevention activities in comprised environments and emphasized child agency, and upgrading the physical environment. Conclusion: The children in this study ascribed burn injuries as the consequence of their developmental limits in the context of poverty, constraints on parental supervision, and unsafe environments. The children recommended safety education and upgrading their physical environments as part of burns injury prevention. The child accounts offer useful insights to inform safety interventions in impoverished settings. [ABSTRACT FROM AUTHOR]

Background Internationally adults with intellectual disability are largely cared for by their families, especially in low- to middle-income countries ( LAMIC). Compared to high-income countries, little is known about their experiences in LAMIC such as South Africa. Methods Focus group discussions were carried out with 37 family caregivers ( FCGs) in the Cape Town metropole. These were transcribed and analysed thematically. Core categories were identified and validated through member checking. Results Family caregivers showed strong commitment to care despite the heavy responsibility and burden of care that women especially experience. They recognize the limited personal growth opportunities for people with intellectual disability that increases the caregiving burden. FCGs identify supports and resources in the community that assist them with their care responsibilities but often feel let down by services. Conclusions Improved family supports appropriate to the resources in LAMIC are needed especially when existing carers are no longer able to provide care. [ABSTRACT FROM AUTHOR]

In South Africa, rates of adoption remain low while the number of fostered children continually rises. Little is known about the public perceptions, beliefs and experiences that inform decisions to either foster or adopt in South Africa. This qualitative research explored these issues among a national sample of childless adults, biological parents, kin and non‐kin fostering parents and prospective and successful adopters. Fostering is driven predominantly by access to subsidies but is also informed by socio‐cultural beliefs. Low adoption rates are influenced by an absence of subsidies, poor access to quality adoptive services and a lack of information about adoption. [ABSTRACT FROM AUTHOR]

Background: Although much health information‐seeking behaviour (HISB) research has been reported in patients with good literacy skills, little is known about HISB in patients with limited literacy skills served by under‐resourced health‐care systems. Objective: To investigate medicine information‐seeking behaviour and information needs in patients with limited literacy. Methods: Using a question guide, four focus group discussions (FGDs) were conducted to explore themes related to information needs, information‐seeking practices and awareness of and ability to utilize information sources. Twenty‐two isiXhosa‐speaking long‐term patients with limited formal education were recruited from a primary health‐care clinic in South Africa. Discussions were audio‐recorded and transcribed verbatim. NVivo® was used for initial coding of transcripts. Codes were analysed, and potential themes and subthemes in the entire data set were identified and refined. Findings: The results of this study reflect a passive, disempowered patient. Poor awareness of information sources, lack of health‐related knowledge and stigma contributed to a lack of information‐seeking practice, thus potentially adversely influencing patient–provider interactions. Patients neither asked questions nor were encouraged to ask questions. All expressed an unmet need for information and a desire for receiving the illustrated written medicines‐related information displayed in the FGDs. The main sources of information were health‐care professionals, followed by family and friends. Conclusion: The significant level of patient disempowerment and passivity reported amongst patients underpinned their inability to actively seek information. Neither sources of information nor types of appropriate medicines information could be identified. Unmet information needs and a desire for information were reported. [ABSTRACT FROM AUTHOR]