Objective understanding of five front-of-pack labels among consumers in Nelson Mandela Bay, South Africa

Objective: This study aimed to assess the objective understanding of five front-of-pack label formats, namely the Reference Intake, Multiple Traffic Light label, Nutri-Score, health endorsement logo and warning label, among consumers in Nelson Mandela Bay, South Africa. Design: This was a cross-sectional, exploratory study. Setting: Interviewer-administered surveys were conducted at 12 randomly selected food retail outlets in an urban setting.Subjects: A total of 359 adult participants were included in this study. Outcome measures: Objective understanding was measured by asking participants to rank food products according to their nutritional quality, using the displayed front-of-pack label. Results: The type of front-of-pack label significantly influenced ranking ability (p < 0.00001). All the evaluative front-of-pack labels significantly improved the participants' ability to identify healthier food products compared with the no-label control. The reductive Reference Intake, however, showed no significant impact on consumer understanding. Conclusion: Evaluative front-of-pack labels significantly improved the participants' ability to identify healthier food products, when compared with the Reference Intake and no-label control. Future research should test the objective understanding of culturally diverse groups in South Africa, particularly among rural populations.

Levels of health literacy and English comprehension in patients presenting to South African primary healthcare facilities

Background: Health literacy is a relatively new concept in the South African primary healthcare (PHC) sector as well as globally, and limited new literature is available on the topic. In this study, we focused on investigating, describing and comparing health literacy scores calculated using three different tools to assess a patient's level of English comprehension. Health literacy is defined as the degree to which patients have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions. South Africa is a linguistically and culturally diverse country, yet English is often used as the main language for imparting health education in PHC facilities. Patients often do not comprehend the health education received. Primary healthcare workers need to determine the health literacy levels of their patients before imparting health education. The REALM-R (SA 1, 2 and 3) tools are adapted from the original REALM-R to test health literacy levels of South African PHC patients. The Learning Ability Battery (LAB) is a tool used to determine English comprehension levels.Aim: The aim of this was to investigate, describe and compare health literacy and English comprehension levels of PHC patients using three locally adapted REALM-R (SA) tools and the LAB. Setting: This study was conducted at five PHC facilities in the City of Tshwane, Gauteng. Methods: A prospective, quantitative and comparative design was chosen for this study. In general, a descriptive design was applied for the presentation of the results. The sample size was 200 patients from five different PHC clinics. Data were collected using REALM-R (SA 1, 2 and 3) to determine the health literacy levels and the LAB to determine the English comprehension levels. Results: Majority of the patients scored high using the REALM-R (SA) tools. For the LAB, 68% scored 11­40 out of 50. Only 8% scored 41­50 out of 50. A significant difference was found between the actual school grade achieved and the school grade according to the LAB. Conclusion: The results of the study indicated that although patients are able to read and pronounce medical words as such used in the REALM-R (SA) tools, it does not necessarily mean that they are able to comprehend the meaning of the words as indicated by the results of the LAB. Currently, the REALM-R (SA) tools only test health literacy levels based on word recognition and pronunciation. It is recommended that a word comprehension section be added to determine patients' understanding of the words

Family perceptions of intellectual disability: understanding and support in Dar es Salaam

When attempting to understand the construct of intellectual disability in different contexts, speaking to family members in addition to the individual with the disability may provide new insight about understandings of and responses to intellectual disability in society and may help to identify the forms of support that are available or needed to ensure the quality of life of people with disabilities. This article outlines and discusses interviews that were conducted in Dar es Salaam, Tanzania, with family members of children and adults with intellectual disabilities. These interviews explore how families came to understand that their child had an intellectual disability, the availability of family support, and family hopes and dreams for the future, and were a part of a wider exploratory study that gathered insight from individuals with disabilities, families, and other providers of support to explore understandings and perceptions of disability in Dar es Salaam. Understanding family experiences will help researchers; policy makers, non-governmental organisations, and others to identify family strengths and family support needs which can ultimately improve family quality of life and the quality of life of the member with a disability

Understanding Participation in a Hospital-Based HIV Support Group in Limpopo Province; South Africa

Background: Support groups are an appropriate way of delivering psychosocial support to people living with HIV/AIDS; especially in low-resource countries. The aim of the study was to understand why people with HIV attended psychosocial support groups. Methods: This was a qualitative study design using focus-group discussions in which support-group members volunteered to participate. Five focus groups were involved in the study. Results: The participants attended because they were referred by a health-care worker; wanted information; wanted emotional support; accompanied an ill relative or knew about the support group. Perceived benefits included receiving psychological support; accepting one's HIV status; reducing stigma and isolation; increasing hope; forging new friendships; helping others; obtaining HIV-related information; developing strategies to change behaviour; gaining access to medical care at the adjoining HIV clinic and receiving food donations. Negative aspects of attending the support group included the large size of the support group; long queues at the HIV clinic; concerns about confidentiality and negative staff attitudes towards the participants. Leaders were concerned about conflict; burn-out and impractical protocols. Access to disability grants was also a concern. Conclusions: Support groups can assist members to cope with the various challenges associated with living with HIV/ AIDS through offering structured emotional; informational; instrumental and material support. Support group sizes should be limited. A structured curriculum containing up-to-date information about ART should also be offered to support groups. Social workers should furthermore be involved to facilitate access to appropriate social grants. Finally; support group leaders should receive appropriate training and regular debriefing

From Bowditch to Beta-Blockers : Evolution of the Understanding of the Importance of Heart Rate and Myocardial Energetics in Cardiomyopathy

During the past three decades; every aspect of cardiomyopathy has undergone dramatic change. When examining the literature on the physiological aspects of the failing heart; one immediately recognises that South Africa has made a contribution : Brink; Bester and Lochner evaluated the possible therapeutic aspects of the Bowditch phenomenon and myocardial energetics in cardiomyopathy almost four decades ago; at a time when the condition even had another name; myocardiopathy

Comprehension and Acceptability of a Patient Information Leaflet (PIL) for Antiretroviral Therapy

The patient information leaflet (PIL) is recognised as playing a key role in informing patients about their medicines. The objectives of this research were to evaluate the read- ability and understanding of a PIL for the first-line ARV (antiretroviral) regimen available in the South African public health sector; and investigate its acceptability in the target Xhosa population. The study took place between August 2003 and July 2004. A PIL was designed for the antiretroviral regimen of stavudine; lamivudine and efavirenz; using established usability guidelines. South African legal requirements concerning PILs were incorporated and the PILs were available in both eng and isiXhosa. Sixty Xhosa participants between the ages of 18 and 61 years old; with varied levels of education; ranging from no schooling to tertiary level education; were interviewed and demographic data were collected. All participants had stated that they could read. They were asked to read the PIL and a series of questions was asked to assess its comprehension and acceptability. The overall average rate of understanding was 80. Six of the 20 questions were located and understood by all participants; and only two questions resulted in less than an 85 correct response.The PIL was rated as difficult to read by only three participants. Physical appearance and quantity of information were highly rated and all partici- pants were enthusiastic about the inclusion of pictograms