Browsing by Author "Hendricks, Lynn"

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    A mega-aggregation framework synthesis of the barriers and facilitators to linkage, adherence to ART and retention in care among people living with HIV
    (BMC, 2021) Hendricks, Lynn; Eshun-Wilson, Ingrid; Rohwer, Anke
    Background: People living with human immunodeficiency virus (PLHIV) struggle with the challenges of living with a chronic disease and integrating antiretroviral treatment (ART) and care into their daily lives. The aims of this study were as follows: (1) to undertake the first mega-aggregation of qualitative evidence syntheses using the methods of framework synthesis and (2) make sense of existing qualitative evidence syntheses that explore the barriers and facilitators of adherence to antiretroviral treatment, linkage to care and retention in care for PLHIV to identify research gaps. Methods: We conducted a comprehensive search and did all screening, data extraction and critical appraisal independently and in duplicate. We used the Kaufman HIV Behaviour Change model (Kaufman et al., 2014) as a framework to synthesise the findings using the mega-aggregative framework synthesis approach, which consists of 8 steps: (1) identify a clearly defined review question and objectives, (2) identify a theoretical framework or model, (3) decide on criteria for considering reviews for inclusion, (4) conduct searching and screening, (5) conduct quality appraisal of the included studies, (6) data extraction and categorisation, (7) present and synthesise the findings, and (8) transparent reporting. We evaluated systematic reviews up to July 2018 and assessed methodological quality, across reviews, using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. Results: We included 33 systematic reviews from low, middle- and high-income countries, which reported on 1, 111,964 PLHIV. The methodological quality of included reviews varied considerably. We identified 544 unique thirdorder concepts from the included systematic reviews, which were reclassified into 45 fourth-order themes within the individual, interpersonal, community, institutional and structural levels of the Kaufman HIV Behaviour Change model. We found that the main influencers of linkage, adherence and retention behaviours were psychosocial and personal characteristics—perceptions of ART, desires, fears, experiences of HIV and ART, coping strategies and mental health issues—interwoven with other factors on the interpersonal, community, institutional and structural level. Using this approach, we found interdependence between factors influencing ART linkage, retention and adherence and identified the need for qualitative evidence that explores, in greater depth, the complex relationships between structural factors and adherence, sociodemographic factors such as community violence and retention, and the experiences of growing up with HIV in low- and middle-income countries—specifically in children, youth, women and key populations. Conclusions: This is the first mega-aggregation framework synthesis, or synthesis of qualitative evidence syntheses using the methods of framework synthesis at the overview level. We found the novel method to be a transparent and efficient method for assessing the quality and making sense of existing qualitative systematic reviews.
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    Prehospital providers’ perspectives for clinical practice guideline implementation and dissemination : strengthening guideline uptake in South Africa
    (Public Library of Science, 2019) McCaul, Michael; Hendricks, Lynn; Naidoo, Raveen
    Background: In 2016 the first African emergency care clinical practice guideline (CPG) was developed for national uptake in the prehospital sector in South Africa, with implementation starting in 2018. Comprehensive uptake of CPGs post development is not a given, as this requires effective and efficient dissemination and implementation strategies that take into account the perceptions, barriers and facilitators of the local end-users. This study aimed to identify prehospital end-users’ perceptions of the emergency care guidelines, including barriers and facilitators for national decision makers, to strengthen CPG uptake in South Africa. Methods: Our study employed a descriptive qualitative research design, including nine focus groups with 56 operational emergency care providers across four major provinces in South Africa. Data was analysed using thematic analysis in ATLAS.ti. Ethics approval was provided by Stellenbosch University. Results: Themes related to provider perceptions, expectations and guideline uptake emerging from the data was unofficial and unclear communication, broadening versus limiting guideline expectations, conflicted personal reactions and spreading the word. Challenges to dissemination and implementation included poor communication, changes to scope of practice, and limited capacity to upskill existing providers. Facilitators included using technology for enduser documents, local champions to support change, establishing online and modular training, and implementation by independent decision makers. Conclusion: This study provides an overview of the perceptions of operational emergency care providers and how their experiences of hearing about and engaging with the guidelines, in their industry, can contribute to the dissemination, implementation and uptake of emergency care guidelines. In order to disseminate and implement an emergency care CPG, decision makers must take into account the perceptions, barriers, and facilitators of local end-users.
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    Race and health : dilemmas of the South African health researcher
    (African Sun Media, 2020) Volmink, Jimmy; Hendricks, Lynn; Mazibuko, Lindokuhle; Swartz, Leslie
    We begin this chapter by discussing responses by members of our team to comments on articles submitted to major international journals focusing on health research. Recently, when one of our manuscripts was close to being accepted, the editors asked the author team to change its use of the term “coloured” to “mixed race”. Shortly after this, another journal asked us to change the term “coloured” to “people of diverse origin”. Some years ago, we were asked by a journal published in the USA to change our use of “coloured” by describing our (South African) research participants as “African American”! Lastly, when a reviewer read a manuscript we wrote about the Mamre Community Health Project, a project in a South African community where most inhabitants identify as “coloured”, we were asked to expand on the rituals and practices of what the reviewer called “the Mamre”. In this particular case, the implication was that there was an African tribe called “the Mamre” similar in nature, we assume, to “the Nuer”, a “tribe” described by Evans-Pritchard1 in the middle of the twentieth century.