Health numeracy is a necessary skill for accessing health services. Immigrants have lower levels of health numeracy compared to host populations which constrains their access to health information necessary to make quality health decisions. Factors contributing to immigrants??? low health numeracy skills include language and mathematics self-efficacy. Language is associated with how people acquire and process numeric information. Some languages have more numeric concepts than others. Speakers of languages that lack one or more numeric concepts may be constrained in the comprehension of health information that contains such concepts. Moreover, they may lack the self-efficacy to engage in numeric tasks containing such concepts. Therefore, the overall objectives of this study were: 1) to investigate the effect of primary language and 2) mathematics self-efficacy on its speakers??? comprehension of numeric health information presented in a different language; and also 3) to investigate how speakers of low and high numeric concept languages process numeric health information when the information is presented in a language which is not their primary or first language. The study involved sixty Kikuyu (a low numeric concept language) and sixty Mandarin (a high numeric concept language) speaking immigrants to Canada. Demographic data was collected from the 120 participants using a general information questionnaire. Numeracy was assessed using a context-free numeracy tool (French Kit). Short test of functional literacy in adults (S-TOFHLA) and the newest vital signs (NVS) were used to assess health numeracy and literacy, and self-efficacy was measured with the Mathematics Self-Efficacy Scale (MSES) and the Subjective Numeracy Scale (SNS). Processing of numeric health information was assessed qualitatively using the think-aloud method. Descriptive statistics were generated for performance in numeracy, health numeracy and literacy, and in mathematics self-efficacy. Multiple regression analysis was conducted to determine the predictors of numeracy and health numeracy. Protocol analysis was conducted for the verbal information obtained from the think-aloud process. Results, interpretations and implications for public health practice and research are discussed.

The United Nations has projected that Africa’s urban population will expand from fourth largest to becoming the second largest of the world’s regions by the year 2050. Patterns of migration and urbanisation have therefore been highlighted as significant focus areas for research and policy. Movement has the potential to result in improved living conditions and well-being, but may also reinforce inequalities and conditions of vulnerability. These consequences may pose particular risks in the case of children, and understanding the patterns, drivers and outcomes associated with child mobility is therefore critical. South Africa provides an important setting in which to explore child movements. The shift within the country from politically controlled migration to movement based on choice has resulted in high levels of mobility both to and within urban areas. Children have been shown to participate in such movements either independently or in conjunction with connected adults. However, there is currently little knowledge of the patterns and consequences of child residential mobility in South Africa, particularly within the urban environment. This PhD thesis attempts to address this research gap. Data from Birth to Twenty, a cohort of South African urban children living in Greater Johannesburg, was used to investigate three central research questions concerning residential mobility of cohort children over a 14 year period. Specifically, the thesis aimed to determine the frequencies and patterns of residential mobility observed over the first 14 years of the children’s lives, to examine the associations with mobility of children over a set of domains relating to the child, the child’s primary caregiver, and the child’s household and to assess the relationships between residential and school mobility and a set of educational outcomes. Routine data collected over the course of the Birth to Twenty study was supplemented with data from a Residential Move Questionnaire, administered to children’s primary caregivers in order to validate and provide additional information concerning the children’s residential movements over the time frame. The research objectives were achieved through the use of cross-sectional and longitudinal analysis techniques applied to these data. In particular, multilevel event-history analysis was used to model the children’s residential movements over time. Of the 3273 children enrolled into the cohort in 1990, two thirds of the children (64%) had moved home at least once by the time they reached 15 years of age. Nonetheless, a third of the children had never moved, indicating stability or a lack of opportunity for movement amongst this urban child population. Mobility was found to be more likely amongst children whose primary caregivers had no formal education and who lived in households with fewer assets and less access to services, suggesting that residential movement within this group of children was more common in the context of disadvantage. Extending these findings to an exploration of children’s educational outcomes revealed some unexpected results. The analyses provided evidence of a positive association between changes in residence and numeracy and literacy scores, and school mobility was found to be associated with grade repetition, however, a negligible relationship was found between residential mobility and school progression. In conclusion, mobility is associated with opportunities for some children in the cohort and challenges or hardships for others. However, even in the instance of movement connected to disadvantage, changes of residence did not prejudice children in terms of the educational outcomes investigated. This is suggestive of children’s possible resilience and adaptability in the face of change and highlights the potential for mobility to influence children’s lives positively. The findings concerning the relationship between mobility and child well-being run counter to trends observed in high-income countries and on that basis, the need for further research into dynamics associated with child mobility in other low- and middle-income country settings is highlighted. There is justification for monitoring child mobility in South Africa; mobility trends provide a valuable indicator of children’s living situations as well as the spatial and social changes occurring in the country more broadly. Keywords: residential mobility; internal migration; urban children; South Africa; eventhistory models; school progression; numeracy and literacy; school mobility

No description available.

Title from second page of PDF document. Includes bibliographical references (p. 91-98).