The purpose of this study was to address the aggressive marketing of commercial formula and breastfeeding cessation in Indonesia using an evaluation of a counter-marketing continuing education module. Using a convenience sample (N = 99) of breastfeeding educators and/or counselors, paired t-tests showed a significant increase in participants’ knowledge about counter-marketing after they participated in the training. Findings also showed significant increases post-training for stage of changes, self-efficacy, knowledge, and motivation to perform four key talking behaviors: i.e., involving talking to new and pregnant mothers about corporations’ inappropriate and aggressive marketing of formula, and the risks of becoming dependent on expensive formula and losing the ability to produce their own breast milk. These findings suggested that exposure to the counter-marketing continuing education training served as a brief intervention associated with significant improvements in level of knowledge about counter-marketing among participants and in stage of change self-efficacy, knowledge, and motivation for performing key behaviors of interest. Backward-stepwise regression revealed that higher level of motivation for taking an active role in the proposed campaign (i.e., A Campaign to Expose the Truth about Becoming Dependent on Commercial Formula and Breastfeeding Cessation) was significantly predicted by: (1) higher pre-training self-efficacy for talking to expectant and new mothers about the reasons to breastfeed their infant (β = .327, SEB = .118, p = .007); (2) lower pre-training knowledge for talking to expectant and new mothers about corporations’ inappropriate and aggressive marketing of commercial infant formula (β = -.270, SEB = .092, p = .004); and, (3) higher level of knowledge for taking an active role in the proposed campaign (β = .392, SEB = .083, p = .000). Participants rated the training as very good (74.7%, n = 74). Qualitative data showed that the training provided new knowledge and a new approach in addressing aggressive formula marketing by corporations. Further, participants found that the training has made them more confident and motivated to work with mothers and the community to advocate and educate about negative impacts from commercial formula.

The study was to investigate the effectiveness of Sociocultural Competency Training (SCCT) as an intervention in enhancing self-efficacy among trainees in the health care profession. The purposes of the study were threefold: (a) to evaluate the effectiveness of the training in enhancing the trainees' self-efficacy and behavioural performance; (b) to examine their personal experiences in the learning ofthe sociocultural competencies, and (c) to identify the factors that contribute to effective outcomes. A sample of 84 participants in the Health Sciences program at the Vancouver Community College was recruited. There were 26 local born Canadians and 32 immigrants in the experimental group, whereas 11 local born Canadians and 15 immigrants were in the control group. Experimental group participants took part in an 18- hour training over a 6-week period as part of their regular Human Relations Skills course curriculum. The control group also took the same training course after post-test data collection. This study used both quantitative and qualitative methods. Self-efficacy and behavioural performance were assessed quantitatively by the results from the General Self-Efficacy Scale (GSE), Situational Social Avoidance Scale (SSA), Social Self-Efficacy Scale (SSE), and Interpersonal Skills Checklist (ISC-33). Qualitative data was collected through written feedback from 28 participants and semi-structured interviewing with 24 volunteer interviewees in the experimental group. The results of this study supported the hypotheses that the Sociocultural Competency Training was effective in improving the interpersonal skills and lowering the social avoidance tendency among participants in the experimental group when compared to individuals in the control group. The hypothesis that there would be more significant change in participants' social self-efficacy was also supported. The Sociocultural Competency Training offered effective ways of helping people develop positive self-efficacy and behavioural competencies. Participants reported the training enabled them to have the sociocultural competencies to conduct their professional career in a multicultural community. In the future, the training can be used with high school students, college and university students, international students, professionals, business people, and expatriates who need to learn the sociocultural competencies for career success.

The study was to investigate the effectiveness of Sociocultural Competency Training (SCCT) as an intervention in enhancing self-efficacy among trainees in the health care profession. The purposes of the study were threefold: (a) to evaluate the effectiveness of the training in enhancing the trainees' self-efficacy and behavioural performance; (b) to examine their personal experiences in the learning ofthe sociocultural competencies, and (c) to identify the factors that contribute to effective outcomes. A sample of 84 participants in the Health Sciences program at the Vancouver Community College was recruited. There were 26 local born Canadians and 32 immigrants in the experimental group, whereas 11 local born Canadians and 15 immigrants were in the control group. Experimental group participants took part in an 18- hour training over a 6-week period as part of their regular Human Relations Skills course curriculum. The control group also took the same training course after post-test data collection. This study used both quantitative and qualitative methods. Self-efficacy and behavioural performance were assessed quantitatively by the results from the General Self-Efficacy Scale (GSE), Situational Social Avoidance Scale (SSA), Social Self-Efficacy Scale (SSE), and Interpersonal Skills Checklist (ISC-33). Qualitative data was collected through written feedback from 28 participants and semi-structured interviewing with 24 volunteer interviewees in the experimental group. The results of this study supported the hypotheses that the Sociocultural Competency Training was effective in improving the interpersonal skills and lowering the social avoidance tendency among participants in the experimental group when compared to individuals in the control group. The hypothesis that there would be more significant change in participants' social self-efficacy was also supported. The Sociocultural Competency Training offered effective ways of helping people develop positive self-efficacy and behavioural competencies. Participants reported the training enabled them to have the sociocultural competencies to conduct their professional career in a multicultural community. In the future, the training can be used with high school students, college and university students, international students, professionals, business people, and expatriates who need to learn the sociocultural competencies for career success. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Nurses, midwives and clinical officers referred to as Mid-level Practioners (MLPs) play an important role in the health care system especially in rural Africa. With particular reference to rural Uganda, due to the large shortage of doctors, MLPs handle most of the duties usually meant for doctors, at health centre IV(s). From 2009 to 2011, two training interventions of MLPs were performed at 36 sites in Uganda by the Integrated Infectious Disease Capacity Building Evaluation (IDCAP). The two interventions were: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS) which aimed at improving MLPs’ case management for four diseases: HIV, TB, pneumonia and malaria. In this thesis, we have developed three mathematical models to investigate the effect of the two training interventions on these infectious diseases. All the models are formulated using systems of ordinary differential equations which are structured in three age groups: [0, 5), [5, 14) and [14, 50). We explored the effect of the two training interventions in the context of malaria-pneumonia, HIV-TB co-infections and the four diseases together. Our analysis shows that: i) For malaria-pneumonia, both IMID and the combination of IMID and OSS reduce the number of cases, deaths and prevalence of disease but have no effect on the incident episodes of disease. ii) Results from the HIVTB model propose that HIV and TB testing are important steps in quality of health care and are capable of offsetting slightly negative effects of reduction in ART enrollment and provision of treatment. iii) The HIV-TB-malaria-pneumonia (HTMP) model concurs with the results of the first two models and its results demonstrate that high coverage levels of the training interventions increase the positive effects that the interventions have on mortality and morbidity. Overall, our results suggest that training of MLPs is much more effective for the short term duration diseases such as malaria and pneumonia, where the baseline values for most of the performance indicators are ≥ 0.6, but not so much for long term duration diseases such as HIV and TB, whose baseline values for most of the performance indicators are < 0.6. The results further highlight that problems such as case detection and drug stock-outs need to be addressed in order for training to have substantial impact, especially in instances where the performance indicator proportions are low. / AFRIKAANSE OPSOMMING: Verpleegsters, vroedvroue en kliniese beamptes wat gesamentlik na verwys word as midvlak praktisyns (MVPs) , speel n belangrike rol in die gesondheidsorg sisteem, veral in landelike dele van Afrika. Met spesifieke verwysing na gesondheid sentrums in Uganda, waar daar te min dokters is, hanteer MVPs die meeste van die pligte wat eintlik deur dokters verrig moet word. Vanaf 2009 tot 2011 is twee opleidingsprogramme vir MVPs by 36 fasiliteite in Uganda deur die Integrated Infectious Disease Capacity Building Evaluation (IDCAP) organisasie aangebied. Die twee programme staan bekend as: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS). Beide die programme stel ten doel om die MVPs se pasint bestuur vir die siektes MIV, tuberkulose (TB), longontsteking en malaria te verbeter. Drie wiskundige modelle word in hierdie tesis ontwikkel om die effek van die opleidingsprogramme op hierdie oordraagbare siektes te ondersoek. Al die modelle word geformuleer deur gebruik te maak van stelsels van gewone differensiaal vergelykings wat gestruktureer is in drie ouderdomsgroepe: [0, 5), [5, 14) en [14, 50). Die effek van die opleidings programme word in die konteks van longontstekingmalaria mede-infeksie, MIV- TB mede-infeksie en al vier siektes gelyk, ondersoek. Die analise wys dat: i) Vir longontsteking-malaria mede-infeksie het beide IMID en die kombinasie van IMID en OSS die aantal siekte-gevalle, sterftes en die prevalensie van die siektes verminder, maar het geen effek op die insidensie van siekte-gevalle nie. ii) Resultate van die MIV-TB model dui aan dat MIV en TB toetsing n belangrike aspek van die gehalte van sorg is en dat dit die effense negatiewe effek van die afname in ART inskrywing en voorsiening van behandeling, teenstaan. iii) Die MIV-TB-longontsteking-malaria model (HTMP) stem ooreen met die resultate van die bogenoemde twee modelle en demonstreer dat ho dekking van die opleidingsprogramme die positiewe effek van die programme op mortaliteit en morbiditeit verhoog. In geheel stel die resultate van hierdie studie voor dat die opleiding van MVPs baie meer effektief is vir die korttermyn siektes soos malaria en longontsteking waarvoor die meeste van die beginwaardes van die prestasie-aanwysers ≥ 0.6 is, maar nie soveel vir lang-termyn siektes soos MIV en TB waarvoor die meeste van die beginwaarde van die prestasie-aanwysers < 0.6 is. Die resultate dui verder aan dat opleiding nie voldoende is wanneer die prestasie-aanwysers < 0.6 is nie en dat probleme soos die opsporing van siekte-gevalle en n gebrek aan medisyne by die klinieke aangespreek moet word vir opleiding om aansienlike impak te hê.