South African emerging adults' capacity for resilience in the face of COVID-19 stressors.

Little is known about resilience responses to COVID-19 stressors from emerging adults in minority world contexts. In this cross-sectional study, we explored the association between self-reported COVID-19 stressors and capacity for resilience in 351 emerging adults (Meanage = 24.45, SD = 2.57; 68% female) who self-identified as Black African. We were interested in whether age, gender and neighbourhood quality influenced this association. The main findings were that higher pandemic stress was associated with a greater capacity for resilience. Older participants showed higher levels of resilience, while there was no gender difference in this regard. Those who perceived their neighbourhoods as being of a good quality also showed greater capacity for resilience, despite all participants residing in disadvantaged communities. The theoretical and practical implications of these results are considered.

The Healthiest Company Index: a campaign to promote worksite wellness in South Africa.

OBJECTIVE: To describe a 2010 initiative to encourage companies in South Africa to adopt workplace health promotion programs. METHODS: Data documenting organizational efforts to improve workers' health were collected from 71 participating employers and 11,472 workers completing health assessments. Organizational and employee health were scored on the basis of responses to the surveys that asked about facilities and programs offered, leadership support for health promotion, and employees' health status. RESULTS: In its first year, the initiative recruited 101 organizations and 71 qualified for the award. Results aggregated across these companies focus on elements constituting organizational and individual health, with specific measures that companies can review to determine whether they and their employees are "healthy." CONCLUSIONS: The Healthiest Company Index provided useful baseline data to support employers' efforts to develop and implement effective and impactful health promotion programs.

The impact of aircraft noise exposure on South African children's reading comprehension: the moderating effect of home language.

Given the limited studies conducted within the African continent, the purpose of this study was to investigate the impact of chronic aircraft noise exposure and the moderating effect of home language on the learners' reading comprehension. The sample comprised 437 (52%) senior primary learners exposed to high levels of aircraft noise (Experimental group) and 337 (48%) learners residing in a quieter area (Control group). Of these, 151 learners in the Experimental group spoke English as a first language (EFL) and 162 spoke English as a second language (ESL). In the Control group, the numbers were similarly divided (EFL n = 191; ESL n = 156). A univariate General Linear Model was used to investigate the effects of aircraft noise exposure and language on reading comprehension, while observing for the possible impact of intellectual ability, gender, and socioeconomic status on the results. A significant difference was observed between ESL and EFL learners in favor of the latter (F 1,419 = 21.95, P =.000). In addition a substantial and significant interaction effect was found between the experimental and control groups for the two language groups. For the EFL speakers there was a strong reduction in reading comprehension in the aircraft noise group. By contrast this difference was not significant for the ESL speakers. Implications of the findings and suggestions for further research are made in the article.

Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study.

PURPOSE: A retrospective, longitudinal study examined changes in participation in fitness-related activities and hospital claims over 5 years amongst members of an incentivized health promotion program offered by a private health insurer. DESIGN: A 3-year retrospective observational analysis measuring gym visits and participation in documented fitness-related activities, probability of hospital admission, and associated costs of admission. SETTING: A South African private health plan, Discovery Health and the Vitality health promotion program. PARTICIPANTS: 304,054 adult members of the Discovery medical plan, 192,467 of whom registered for the health promotion program and 111,587 members who were not on the program. INTERVENTION: Members were incentivised for fitness-related activities on the basis of the frequency of gym visits. MEASURES: Changes in electronically documented gym visits and registered participation in fitness-related activities over 3 years and measures of association between changes in participation (years 1-3) and subsequent probability and costs of hospital admission (years 4-5). Hospital admissions and associated costs are based on claims extracted from the health insurer database. ANALYSIS: The probability of a claim modeled by using linear logistic regression and costs of claims examined by using general linear models. Propensity scores were estimated and included age, gender, registration for chronic disease benefits, plan type, and the presence of a claim during the transition period, and these were used as covariates in the final model. RESULTS: There was a significant decrease in the prevalence of inactive members (76% to 68%) over 5 years. Members who remained highly active (years 1-3) had a lower probability (p < .05) of hospital admission in years 4 to 5 (20.7%) compared with those who remained inactive (22.2%). The odds of admission were 13% lower for two additional gym visits per week (odds ratio, .87; 95% confidence interval [CI], .801-.949). CONCLUSION: We observed an increase in fitness-related activities over time amongst members of this incentive-based health promotion program, which was associated with a lower probability of hospital admission and lower hospital costs in the subsequent 2 years.

The association between medical costs and participation in the vitality health promotion program among 948,974 members of a South African health insurance company.

PURPOSE: Examine the association between the levels of participation in an incentive-based health promotion program (Vitality) and inpatient medical claims among members of a major health insurer. DESIGN: A 1-year, cross-sectional, correlational analyses of engagement with a health promotion program and hospital claims experience (admissions costs, days in hospital, and admission rate) of members of a national private health insurer. SETTING: Adult members of South Africa's largest national private health insurer, Discovery Health. Insured members were also eligible for voluntary membership in an insurance-linked incentivized health promotion program, Vitality. SUBJECTS: The study sample included 948,974 adult members of the Discovery Health plan for the year 2006. Of these, 591,134 (62.3%) were also members of the Vitality health promotion program. MEASURES: The study sample was grouped based on registration and the level of engagement with the Vitality health promotion program into the following: not registered (37.5%), registered but not engaged with any health promotion activity (21.9%), low engagement (30.9%), and high engagement (9.5%). High engagement was defined a priori by the accumulation of an arbitrary number of points on the Vitality program, allocated against specific activities (knowledge, fitness-related activities, assessment and screening, and healthy choices). Hospital admission costs, the number of days in hospital, and hospital admission rates were compared among highly engaged members and those members who were not enrolled in the program, nonengaged, and lowly engaged. Data were normalized for age, gender, plan type, and chronic disease status. RESULTS: Highly engaged members had lower costs per patient, shorter stays in hospital, and fewer admissions compared with other groups (p < .001). Low or no engagement was not associated with lower hospital costs. Admission rates were also 7.4% lower for cardiovascular disease, 13.2% lower for cancers, and 20.7% lower for endocrine and metabolic diseases in the highly engaged group compared with any of the other groups (p < .01). CONCLUSIONS: Engagement in an incentive-based wellness program, offered by a health insurer, was associated with lower health care costs.