Developing an Anxiety Screening Tool for Children in South Africa: Protocol for a Mixed Methods Study.

BACKGROUND: Early childhood experiences such as trauma, exposure to violence, and poverty can significantly contribute to childhood anxiety, which is viewed as the most common mental health issue among children. In South Africa, there is no uniform tool to screen for anxiety during early childhood. This study aims to develop a tool to screen for anxiety in children aged 4 to 8 years, which could be utilized by preschool and foundation phase teachers to aid in the early identification of childhood anxiety. OBJECTIVE: The overall objective of this study is to explore understanding and perceptions of childhood anxiety among teachers, parents, and experts and to develop a tool to screen for anxiety in children aged 4 to 8 years. METHODS: This project will use a mixed method design that will consist of 4 stages. Stage 1 will consist of a scoping review. In Stage 2, data will be collected via semistructured interviews with 60 participants, including parents, teachers, and experts, and will be thematically analyzed. Stage 3 will consist of 20 experts and the researcher collaboratively formulating the proposed screening tool in the form of an e-Delphi component. Once the tool is refined, it will be piloted in Stage 4 with 20 teachers, and data will be analyzed with the Shapiro-Wilk test to test for normality. Additionally, factor analysis will be done to refine and restructure the tool as necessary. RESULTS: This project was funded from April 2020 to December 2021. Data collection began in September 2022 and is projected to conclude in December 2022 for the qualitative component. The e-Delphi component is expected to be carried out from March to November 2023. Ethical approval was obtained from the Biomedical Research Ethics Committee in November 2021. CONCLUSIONS: Anxiety in early childhood has been linked to various repercussions in adolescence and adulthood, such as school dropout, substance abuse, anxiety disorders, depression, and suicide ideation. Therefore, identifying the presence of anxiety earlier on and providing the necessary referral services could aid in reducing the negative consequences of unidentified and untreated anxiety in early childhood. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/37364.

Enablers and barriers to effective parenting within the first 1000 days: an exploratory study of South African parents and primary caregivers in low socio-economic communities.

BACKGROUND: The first 1000 days is the period between conception and a child's second birthday. Globally, research on parenting is in an advanced stage, but parenting research focusing specifically on parenting in this developmental phase is limited in South Africa. Therefore, this study explores the enablers and barriers to effective parenting within the first 1000 days through the lens of parents and caregivers in low socio-economic communities. METHODS: This study was conducted in communities in South Africa considered low socio-economic communities in the Western Cape Province of South Africa. An exploratory qualitative research design explored the enablers and barriers to effective parenting within the first 1000 days of life. Thirty participants were purposively selected and interviewed in this study. A semi-structured interview schedule was used for all interviews. The data were analysed using inductive thematic analysis. RESULTS: Two main categories emerged (effective parenting enablers and effective parenting barriers) during the data analysis. The main enablers of effective parenting within the first 1000 days of life include a support system, healthy behaviours/environment, unemployment/job opportunities, religion, information/knowledge, and professional assistance. On the other hand, the main barriers to effective parenting were low socio-economic circumstances, environmental circumstances, lack of partner's support, the negative impact of technology, and lack of access to services. CONCLUSION: Enablers that need to be promoted for effective parenting range from support systems to professional assistance for parents. Also, barriers that need to be removed for effective parenting range from low socio-economic circumstances to a lack of partner's support for parents. This is because effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. Therefore, there is a need to develop policies and interventions to promote effective parenting within the first 1000 days in the communities.

Prevalence estimates of trafficking in persons using statistical definitions: a cross-sectional high-risk community survey in Cape Town, South Africa.

OBJECTIVES: Current research on trafficking in persons (TIP) relies heavily on legal and prosecutorial definitions. A public health approach has called for population-level assessment; however, identification of TIP victims lacks a standardised operational definition. This study applied the Prevalence Reduction Innovation Forum (PRIF) statistical definitions, developed by the US Department of State, to a community survey in Cape Town, South Africa. DESIGNS: A high-risk sampling strategy was used. TIP screening questions from two instruments were matched with PRIF domain indicators to generate prevalence estimates. Sensitivity, specificity and receiver operating characteristics analyses were conducted to assess the performance of the two screeners. SETTING: Cross-sectional survey conducted in Cape Town, South Africa, from January to October 2021. PARTICIPANTS: South Africans and immigrants from other nations residing in Cape Town and its surrounding areas, aged 18 or older, who met the study inclusion criteria for a set of experiences that were identified as TIP risk factors. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measures were PRIF lifetime and past 12-month TIP positivity. Secondary outcome measures included individual and summary measures from the two screeners. RESULTS: Our PRIF algorithm yielded a TIP lifetime prevalence rate of 17.0% and past 12-month rate of 2.9%. Summary measures from each TIP screener showed an excellent range of predictive utility. The summary screener measures yielded statistically significant differences among some demographic and background categories. Several screener items were shown less predictive of the PRIF statistical definition criteria than others. CONCLUSIONS: Prevalence estimates of probable TIP were higher than those reported elsewhere. Our TIP screeners yielded an excellent range of predictive utility for the statistical definitions, promising the potential for wider applications in global and regional TIP research and policymaking. A more systematic sampling strategy is needed even if statistical definitions become widely used.

A comparison of the relationship between parental efficacy and social support systems of single teen mothers across different family forms in South African low socioeconomic communities.

BACKGROUND: Teenage parenting is recognised as one of the greatest health and social problems in South Africa. Research in South Africa has shown that by the age of 18 years, more than 30% of teens have given birth at least once. Teen mothers may feel disempowered because they are 'othered' and consequently, may develop forms of resistance which in most cases may inhibit their ability to parent. Social support is therefore, an imperative intervention for successful teen parenting but this is not clearly understood in South Africa. This study aimed to compare the relationship between parental efficacy and social support systems of single teen mothers across different family forms. METHODS: A quantitative methodology with a cross-sectional comparative correlation design was conducted with 160 single teen mothers who resided with a family in a low socio-economic community. The participants completed a self-report questionnaire that comprised of the Social Provisions Scale, and the Parenting Sense of Competence scale. Descriptive statistics and Pearson correlation were used to investigate the data. RESULTS: A significant positive relationship between social support and parental efficacy was found. When comparing different family forms, single teen mothers' residing with one parent reported greater levels of parental efficacy and single teen mothers' residing with two parents, re-counted high levels of social support under the subscales; guide, reliable and nurture. However, when computing for guardian-skip generation, results show that there is no significant relationship between parental efficacy and social support. As well as no correlation across subscales of social support. CONCLUSION: The positive relationships between social support and parental efficacy are important for planning and applying parenting programmes amongst single teen mothers and facilitating awareness regarding the importance of social support and family forms when considering parenting practices.

COVID-19 Daily Realities for Families: A South African Sample.

The COVID-19 pandemic affected families globally. Empirical research has been explored to understand the impact of COVID-19 on families across countries, however, there are limited findings of how COVID-19 has affected the daily realities of families in South Africa. This study used an exploratory qualitative research approach to explore the experiences of COVID-19 for South African families. Findings suggest that the negative outcomes of COVID-19 experienced by South African families included a shift in the daily routines, restrictions on family events, lack of socialization and loss of connections, family conflicts, financial constraints as well as psychological impacts. On the contrary, the positive outcomes included increased family time and communication, cleanliness, and good health status, and improved financial management. Implications for future research should include research focused on the health impacts of COVID-19 on diverse family structures, family compositions, and family dynamics. In-depth research and findings can assist in developing policies and interventions for families.

Family functioning and satisfaction: A comparative study between hookah users and non-users.

BACKGROUND: Although there has been an exponential growth in hookah use on a global scale, research within the context of South Africa is very limited. While hookah use is known internationally to be a health and addiction risk, the focus is on university students and not on families. AIM: This study aims to compare the family functioning and family satisfaction among hookah users and non-users. SETTING: This study was conducted in low or middle-high class socio-economic status areas of Cape Town, South Africa. METHODS: A quantitative method was employed to test for significant differences with a sample of 1193 participants, in which each participant represented a family. An independent t-test was used to test for significant differences between hookah users and non-users. RESULTS: One-third (34%) of the participants indicated that they smoked hookah pipe, with the general age of onset being 16.5 years. In trying to understand the family context, it was found that 28% of hookah users indicated that the hookah pipe was used as a means of socialising with others in the family, and 24% of parents indicated that they were more accepting of family members smoking the hookah pipe. Findings also suggest that families of hookah users have less cohesion, expressiveness and family satisfaction, and more conflict and permissiveness than families of non-users. CONCLUSION: This study provides and extends knowledge regarding the family in hookah pipe use. This information could assist in reducing hookah pipe use, and building healthier and more resilient communities by formulating prevention and intervention strategies to reduce hookah use.