A contextualisation approach to health promotion guideline development in South Africa

Journal article


N Siegfried, B Draper, G Draper, M Porter, C Bonaconsa, J Hunter, L Moeng-Mahlangu and S Asmall. (2018). A contextualisation approach to health promotion guideline development in South Africa. SAMJ South African Medical Journal. 108(12), pp. 1036-1041. https://doi.org/10.7196/SAMJ.2018.v108i12.13129
AuthorsN Siegfried, B Draper, G Draper, M Porter, C Bonaconsa, J Hunter, L Moeng-Mahlangu and S Asmall
Abstract

Background. Risk factors for chronic illness contribute significantly to the disease burden in South Africa. The National Department of Health (NDoH) commissioned the development of a toolkit of health promotion guidelines for use by healthcare professionals working in the primary care setting to address this burden.

Objectives. To (i) demonstrate the contextualisation approach to evidence-based health promotion recommendations; and (ii) present the development process of a contextually sensitive and illustrated fit-for-purpose product.

Methods. A contextualised approach was used whereby evidence from rigorous guidelines produced elsewhere was tailored to local conditions. The scope of the toolkit included five risk factors and 22 conditions identified by the NDoH and was underpinned by the Theory of Planned Behaviour. Potential health promotion messages relevant to risks, conditions or both were formulated as population, intervention, comparison and outcome (PICO) questions. The team searched for and selected evidence for each PICO question in a stepwise hierarchical manner and categorised sources as: (i) World Health Organization (WHO) guidelines; (ii) Cochrane systematic reviews; and (iii) non-Cochrane systematic reviews. Those messages supported by source-based evidence were included in the toolkit with culturally appropriate illustrations. Regular engagement with stakeholders included an initial health department stakeholder consultation, a focus group with national programme managers on the appearance and content of a draft toolkit, and a presentation of the final draft at a forum of provincial managers. Final approval of the toolkit rested with programme representatives.

Results. A total of 152 PICO questions were formulated. Supporting evidence was identified from 42 current WHO guidelines and 45 Cochrane systematic reviews to answer 147 PICO questions with several guidelines relevant to more than one risk or condition. Evidence for a further five PICO questions was obtained from non-Cochrane systematic reviews. Six additional service delivery messages and four ‘no harm’ messages were included to align the toolkit with current national guidelines. The illustrated toolkit was well received by stakeholders nationally and provincially, with programme managers expressing a high degree of willingness to adopt a preventive approach in the primary care clinic setting.

Conclusions. Use of a tailored contextualised approach to health promotion guidelines resulted in a culturally appropriate tool based on evidence gathered from rigorous sources and probably reduced development time and costs. Adherence to a robust framework to identify evidence ensured that the toolkit conforms to international guideline development standards.

Keywordshealth promotion; guidelines; primary care; South Africa
Year2018
JournalSAMJ South African Medical Journal
Journal citation108 (12), pp. 1036-1041
PublisherSouth African Medical Association
ISSN0256-9574
Digital Object Identifier (DOI)https://doi.org/10.7196/SAMJ.2018.v108i12.13129
Scopus EID2-s2.0-85057575068
Open accessPublished as ‘gold’ (paid) open access
Publisher's version
License
File Access Level
Open
Publication process dates
Deposited07 May 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8vzv5/a-contextualisation-approach-to-health-promotion-guideline-development-in-south-africa

Download files


Publisher's version
  • 62
    total views
  • 24
    total downloads
  • 0
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Youth sport as a context for supporting mental health: Adolescent male perspectives
Swann, Christian, Telenta, Joanne, Draper, Georgia, Liddle, Sarah, Fogarty, Andrea, Hurley, Diarmuid and Vella, Stewart. (2018). Youth sport as a context for supporting mental health: Adolescent male perspectives. Psychology of Sport and Exercise. 35(March, 2018), pp. 55 - 64. https://doi.org/10.1016/j.psychsport.2017.11.008