Examining the direct and indirect effect that individual and contextual risk factors have in predicting substance abuse
- Authors: Fouten, Elron Steve
- Date: 2024-10-11
- Subjects: Structural equation modeling , Substance abuse South Africa , Ecological Systems Theory , Path analysis (Statistics) , Personality , Confirmatory factor analysis
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/467006 , vital:76806 , DOI https://doi.org/10.21504/10962/467006
- Description: Substance abuse levels in South Africa have continued to rise, with the age of first experimentation with drugs reported as being 10 years. Several studies have shown that substance abuse has an adverse impact on users, their families and their communities, resulting in a number of social, psychological and economic struggles. Moreover, substance abuse places an increased psychological, social and financial burden on the individual and the family, as it has been related to the destabilisation of the nuclear and extended family units, permeating every area of life and affecting the very social fabric of society. This study therefore endeavoured to determine which of the individual and contextual risk factors measured by the South African Substance Use Contextual Risk Instrument (SASUCRI) best predicts substance abuse in a sample of self-identified substance abusers. Additionally, the study sought to determine the magnitude, strength and direction of the interaction of the individual and contextual risk factors in predicting substance abuse. The specific aims of the study were: 1) to build a theoretical model that best approximates the identified and measured individual and contextual factors associated with substance abuse, 2) to use structural equation modelling (SEM) to test the adequacy of the model’s fit to the data that have been collected, 3) to use SEM to statistically determine which of the perceived individual or contextual factors best predict substance abuse, and 4) to use SEM to statistically determine which combination of perceived individual and contextual factors best predict substance abuse. To achieve these aims, the study applied SEM to data collected from individuals seeking either inpatient or outpatient treatment for substance abuse in the Eastern Cape and Western Cape Provinces of South Africa, respectively. The purpose of SEM is to a priori specify a theoretical causal model consisting of a set of predicted covariances between variables, and then test whether it is plausible when compared to the observed data. The appropriateness of performing SEM exists in its ability and suitability to examine the nature and magnitude of postulated dependence relationships, while simultaneously assessing the direct and indirect relations of the variables. The theoretical causal model that was tested contained latent and manifest variables that were identified as risk factors for substance abuse. The causal model was informed by Bronfenbrenner’s (1977a, 1986) ecological systems theory (EST) and was specified to approximate the different systems of the theory. Data for the study were collected using the relatively newly developed and validated SASUCRI. The results of the confirmatory factor analysis (CFA) showed that the SASUCRI was a reliable and valid instrument to use with this population, and that the results of the structural model can be interpreted with confidence. The fit statistics, for the normal theory and related bootstrap latent path SEM, all indicate that the model is an excellent fit to the data CMIN/DF = 2.82, NFI = .946, CFI = .97, RMSEA = .04., thus achieving the study’s objective. The normal theory analysis of the paths in the diagram identified the microsystem, “Access/proximity to drugs” (APTD) and “Concerns for future” (CFF) as significant predictors of substance abuse, whereas the bootstrap analysis of the paths identified the macrosystem, APTD and CFF as significant predictors of substance abuse. This study identified 10 risk profiles that interact in the prediction of substance abuse; these are: individuals with low self-efficacy (SE) who perceive their family as lacking or having low intra-family communication, who lack positive peer support, who perceive criminal behaviours as normal, who feel a strong need to fit in, who are less religious, who have easy access to drugs, who lack a sense of community traditions and belonging, who see public displays of substance use (SU) as normal, and who lack concern for the future, are at 59% greater risk of substance abuse. Though micro level factors (low SE, lack of or low intra-family communication, and a lack of positive peer support) and meso-level factors (normalisation of criminal activity, a strong need to fit in, and being less religious) does not significantly predict abuse, they significantly interact with external factors in predicting substance abuse. Thus, it is only when they interact with factors located in the other systems (exosystem, macrosystem and chronosystem) that they become significant predictors of substance abuse. Conversely, exosystem (easy access to drugs), macrosystem (lack of a sense of community traditions and belonging, commonplace public displays of SU), and chronosystem factors (lack of concern for the future), independently are significant predictors of substance abuse. These findings carry significant public health implications by challenging the prevailing focus on individual-based interventions. Recognising that the drivers of substance abuse extend beyond individual factors, this study therefore advocates for interventions that address the broader systems contributing to the issue. This has the potential to inform more effective and holistic public health strategies. Finally, this study emphasises the need for comprehensive strategies that span different systems, acknowledging the role of family, community and societal factors. This call for complex interventions aligns with the ecological systems perspective, advocating for a paradigm shift in how we address SU by considering the broader environmental influences that contribute to the problem. In summary, this study not only contributes to the academic understanding of SU, but also has practical implications for public health policies and interventions. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2024
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- Date Issued: 2024-10-11
Pharmacists’ attitudes and perception of using pictograms as a communication tool in practice
- Authors: Okeyo, Sam Juma
- Date: 2022-04-06
- Subjects: Picture-writing South Africa , Communication in public health South Africa , Pharmacists South Africa Attitudes , Health literacy South Africa , Patient education South Africa , Structural equation modeling , Theory of planned behavior
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/290693 , vital:56775
- Description: Pictograms, when used in conjunction with verbal and written information, are known to be effective in improving comprehension and recall of medicines information and in supporting communication between healthcare professionals and patients. However, pictograms are seldom used in routine pharmacy practice, and little is known about pharmacists’ opinions of pictograms and their intention to possibly incorporate pictograms into routine practice. This study aimed to investigate pharmacists’ opinions relating to pictograms as a communication tool, and, by applying the Theory of Planned Behaviour (TPB), to explore their intention to use pictograms in pharmacy practice as well as the barriers to their use. The quantitative study design involved a two-phase approach. Phase 1 was a descriptive, cross-sectional online national survey of pharmacists. The 70-item, four-section survey was primarily based on the constructs of TPB, which included attitude, intention, subjective norm, and perceived behavioural control. The last survey section recruited pharmacists for a follow-up Phase 2 survey. Following a pilot study, the survey was emailed to all pharmacists registered with the South African Pharmacy Council. Descriptive statistics for survey items were generated. Pearson correlation investigated the correlation between participant characteristics, familiarity with pictograms and use of pictograms in practice. Structural Equation Modelling (SEM) determined if there was a significant relationship between attitude, subjective norm and perceived behavioural control with intention to use pictograms. A total of 426 pharmacists responded to the Phase 1 survey. Most pharmacists were familiar with the term ‘pictogram’; however, over three-quarters of pharmacists had never observed pictograms being routinely used in a pharmacy setting. When presented with pictograms designed for a low health literate population, most pharmacists thought the design and overall look of the pictograms would be easy for most patients in South Africa to understand (71.6 ± 24.0). Two-thirds of pharmacists (65.0 ± 30.6), felt that pictograms should be used for all patient populations. More than 85% of pharmacists agreed that pictograms should be used for dosage instructions, auxiliary or additional information, warnings, and storage instructions. However, fewer (58-68%) felt that indication, side effects and risk communication information should be accompanied by pictograms. Pharmacists demonstrated positive attitudes towards using pictograms in practice (mean = 4.2 ± 0.9; range: 1 - 5), while perceived behavioural control (mean = 3.0 ± 1.2; range: 1 - 5), subjective norm (mean = 3.8 ± 1.0; range 1 - 5) and intention (mean = 3.3 ± 1.0; range 1 - 5) were all neutral. Attitude (β = -0.25, p < 0.117), however, was not a significant predictor of intention while perceived behavioural control (β = -0.83, p < 0.000) presented with a significant negative correlation with intention. Subjective norm (β = 0.57, p <0.000) was the strongest predictor of intention. Scale reliability ranged from 0.770 to 0.865 for the TPB constructs. Phase 2 aimed to expand on, and further investigate Phase 1 findings relating to current and intended pharmacist behaviour and opinions concerning pictogram usage. As Phase 2 looked to investigate issues in greater depth, questions included open-ended response options. The survey link was emailed to all pharmacists who had voluntarily offered to participate in Phase 2. Frequency data for all questions were generated, and content analysis was undertaken for the free-response comments offered by pharmacists. A total of 35 pharmacists responded to the Phase 2 survey. Most pharmacists who routinely used pictograms initiated their use with support from pharmacists’ colleagues (8/12) and their supervisor/manager (6/7). Pharmacists who stated their intention to use pictograms anticipated receiving support from their pharmacists' colleagues (18/23) and manager/supervisor (15/23). All 12 pharmacists who were routinely using pictograms reported a positive effect on patient communication, with almost all having encountered no negative aspects of using pictograms (11/12). Almost all pharmacists intending to use pictograms could foresee benefits from their use (22/23). Misinterpretation of pictograms was a prevalent barrier common to both pharmacists routinely using pictograms and to those intending to use pictograms. Increased workload was regarded as a prevalent barrier only by pharmacists intending to use pictograms. This study was the first national study of pharmacists to investigate their opinion of pictograms and their use and to adopt a theoretical approach to consider pharmacist intention to use pictograms in routine pharmacy practice. Pharmacists generally expressed positive attitudes to pictograms but showed inadequate understanding of pictogram use. Pharmacists using pictograms reported the positive effect of pictograms on their patient communication, whereas those planning to use pictograms could foresee the benefits of using pictograms despite regarding increased workload as a barrier. As the strongest predictor of intention was subjective norm, this construct should therefore be targeted to motivate pharmacists to adopt the use of pictograms. , Thesis (MPharm) -- Faculty of Pharmacy, Pharmacy, 2022
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- Date Issued: 2022-04-06
An investigation into the use of social media channels within the South African retail banking environment in support of creating and maintaining brand loyalty
- Authors: Purohit, Ashish
- Date: 2015
- Subjects: Social media -- Economic aspects , Banks and banking -- Internet marketing -- South Africa , Bank marketing -- South Africa , Brand loyalty -- South Africa , Branding (Marketing) -- South Africa , Structural equation modeling
- Language: English
- Type: Thesis , Masters , MCom
- Identifier: vital:1157 , http://hdl.handle.net/10962/d1018920
- Description: The use of social media in the retail banking environment has changed the way the banking industry communicates with customers, creates sales and performs marketing and operational tasks. Social media strategies need to be aligned to business goals and effectively used to integrate social media as part of the overall marketing strategy. Only by understanding brand loyalty, multi-channel systems and social media channels can marketers effectively implement social media. In measuring brand loyalty, factors that influence customer buying behaviour and components that influence online interaction are essential in engaging different groups of customers in social media. This research study aimed to examine the use of social media within the South African retail banking environment with a focus on creating and maintaining brand loyalty. An exploratory, mixed method research design was employed. Data collection instruments used in the study includes online surveys, structured interviews, and focus groups. Participants consisted of marketing personnel and customers. Three lead/head social media marketing personnel participated in the interview process, 14 marketing personnel took the online survey and 4 participated in a focus group. Participants for the online survey also consisted of 40 customers who were connected through the internet and performed various online banking activities. Data was analysed both quantitatively and qualitatively. Data from the online surveys completed by customers was analysed quantitatively using descriptive analysis, structural equation modelling (SEM) and factor analysis which was performed on the brand loyalty variables and the brand loyalty measures. Content analysis was used to qualitatively analyse data from the structured interviews. Data from the online surveys completed by marketing personnel was analysed quantitatively and qualitatively. Findings indicated that social media forms an integral part of the marketing strategy that needs be aligned with the core business goals. Banks therefore need to focus on creating campaigns that are fun, exciting and appealing to the target market. A culture of innovation and new ideas is essential to grow the product/service. Building brand trust and creating customer satisfaction forms the core of creating brand loyalty on social media. Banks need to be aware of factors that influence customer brand loyalty and components that influence loyalty on social media in order to measure things that matter through analytical tools so that an actionable strategy can be put in place and implemented.
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- Date Issued: 2015
The relationship between leadership and organisational effectiveness among indigenous banks in Kenya
- Authors: Muriithi, Samuel Muiruri
- Date: 2015
- Subjects: Leadership -- Kenya , Organizational effectiveness -- Kenya , Transformational leadership -- Kenya , Strategic planning -- Kenya , Community banks -- Kenya , Structural equation modeling , Emotional intelligence
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:1208 , http://hdl.handle.net/10962/d1020015
- Description: Defining leadership effectiveness (LE) remains a controversial subject with scholars and researchers disagreeing on a common definition. Most studies term leadership effectiveness as the leaders’ ability to successfully exercise personal influence and abilities in order to accomplish set standards. Such leadership effectiveness was measured using three elements, namely influence, follow commitment and versatility. To be effective, leaders must possess certain competencies and perform specific tasks (independent variables). In this study, three leadership competencies, namely strategic thinking, emotional effectiveness and transformational leadership were examined. Similarly, seven leadership tasks (set organisational direction, develop human capital, build core competencies, create organisational alignment, sustain appropriate organisational culture, manage change and establish balanced organisational control) were identified as essential for the attainment of leadership effectiveness (intervening variable) which, in turn, leads to organisational effectiveness (dependent variable). Given the importance of leadership effectiveness to organisational effectiveness, the purpose of this study was to identify, investigate and empirically test the possible relationship between leadership effectiveness and organisational effectiveness within the Kenyan indigenous banks. To achieve the aim of the study, a survey was undertaken using a structured self-administered questionnaire. The respondents were identified using both probability and non-probability techniques with the survey yielding 257 usable questionnaires that were statistically analysed. The proposed hypothetical relationship between leadership effectiveness and organisational effectiveness was assessed using Structural Equation Modelling (SEM), a multivariate statistical technique. The SEM included Cronbach’s alpha and confirmatory factor analyses to assess the dicriminant reliability and validity of the measuring instrument, and Goodness-of-fit indices. The study findings demonstrated the existence of a strong relationship between leadership competencies, tasks performed and leadership effectiveness which in turn impacts on organisational effectiveness, in this case the overall effectiveness of the Kenyan indigenous banks.
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- Date Issued: 2015