Neo Morojele - Academia.edu (original) (raw)

Papers by Neo Morojele

International Journal of Mental Health and Addiction, 2018

Many drinkers globally are at risk of developing an alcohol use disorder (AUD). The study aimed t... more Many drinkers globally are at risk of developing an alcohol use disorder (AUD). The study aimed to identify the extent of AUDs and associated individual and societal-level risk factors or vulnerabilities among adult drinkers in a country with high levels of heavy episodic drinking. A household survey was conducted in the Tshwane Metro, South Africa, using multistage stratified cluster random sampling. Complete data were available on 949 adult drinkers. Half (49%) reported symptoms of alcohol problems, as a proxy for AUDs, as measured using the RAPS4. Gender and age were not associated with symptoms of alcohol problems. White persons had 74% lower odds of symptoms of alcohol problems compared to Black Africans, and persons who reported stressful life events in the past 6 months were four times more likely to report symptoms of alcohol problems. Persons whose primary drinking location was a pub/bar/tavern and Bother club^were more than twice as likely to have

Journal of Community & Applied Social Psychology, 1992

Changes in beliefs and attitudes that accompany Minnesota Model (MM) treatment are examined in te... more Changes in beliefs and attitudes that accompany Minnesota Model (MM) treatment are examined in terms of Brickman et al.'s Compensatory Model of coping, and Ajzen's theory of planned behaviour. Questionnaires were completed both on intake and at discharge, by 61 patients who successfully completed treatment at a residential MM facility. The questionnaires measured the patients' attributions of responsibility for the cause of, and for recovery from, their addictions, and their beliefs about outcomes, normative pressures and personal control with respect to their abstinence. It is shown that between intake and discharge there is a marked reduction in the patients' feelings of personal responsibility for their addiction, whilst their sense of personal control over their recovery increases significantly. In general, the patients' evaluations of recovery were more favourable on discharge than on intake, although little change was observed in the overall level of percei...

Addiction Research, 1995

ABSTRACT We report a factor analytic study of the Promis questionnaires, designed to evaluate add... more ABSTRACT We report a factor analytic study of the Promis questionnaires, designed to evaluate addiction in 16 behavioural areas. Data were taken from the clinical records of 191 men and 281 women admitted to the Promis Recovery Centre for treatment of addictions. Primary scale factor scores were obtained for each patient and subjected to factor analysis. A two-factor solution (oblique rotation) was indicated. Factor 1 (“Nurturanee”) included Caffeine, Work, Exploitative relationships (submissive). Shopping, Exercise, Food bingeing, Food starving and Compulsive helping (dominant and submissive). Factor 2 (“Hedonism”) comprised Alcohol, Nicotine, Recreational Drugs, Gambling, Exploitative relationships (dominant). Sex and Prescription drugs. Factor 1 was strongly associated with primary diagnoses of Overeating, Bulimia and Anorexia, and Factor 2 with Drug problems, and to a lesser extent Alcohol. When controlling for the effects of diagnosis women generally scored high on Nurturanee, but were no less Hedonistic than men. Men and women share broadly the same factor structures.

AIDS Care, 2014

Strong research evidence has shown that medical male circumcision significantly reduces heterosex... more Strong research evidence has shown that medical male circumcision significantly reduces heterosexual HIV acquisition among men. However, its effectiveness is enhanced by behavioural factors such as condom use. Currently, little is known of unprotected sex associated with male circumcision (MC) among alcohol-drinking tavern-going men, or whether engagement in unprotected sex may differ between men who have been traditionally circumcised and those who have been medically circumcised. The study sought to determine the relative importance of alcohol consumption and MC as correlates of unprotected sex and to compare the risk of engaging in unprotected sex between traditionally circumcised and medically circumcised tavern-going men from two rural villages in NorthWest province, South Africa. Data from 314 adult men (≥18 years) were analysed. The men were recruited from four bars/taverns using systematic sampling. They responded to questions regarding their demographic characteristics, alcohol consumption, circumcision status and method (where applicable), and engagement in unprotected sex. Descriptive analyses and bivariate and multivariate logistic regression analyses were conducted. Age, education, relationship status, alcohol consumption and traditional male circumcision (TMC) were independently and significantly associated with unprotected sex. Specifically, probable alcohol dependence and traditional circumcision were independent risk factors for engaging in unprotected sex among tavern-going men. Traditionally circumcised men had a higher risk of engaging in unprotected sex than medically circumcised men. Interventions aimed at reducing alcohol consumption, encouraging protective behaviour among men who have undergone TMC, and increasing condom use are needed in bar/tavern settings. HIV prevention education must be urgently incorporated into TMC programmes.

AIDS and Behavior

Although alcohol use is associated with depression, it is unclear if brief alcohol reduction inte... more Although alcohol use is associated with depression, it is unclear if brief alcohol reduction interventions can ameliorate depression and psychological distress among people with HIV (PWH). We use data from a two-arm randomised controlled trial to examine this question. PWH on antiretroviral treatment (ART) were randomly assigned to receive a brief intervention or treatment as usual (n = 622). Screening was done with the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, Centre for Epidemiological Studies Depression inventory and Kessler Psychological Distress Scale, at baseline and at 3- and 6-months post-baseline. Changes in depression and psychological distress was assessed using analysis of covariance models with baseline measures of alcohol consumption, sex and age included as covariates and adjusting for baseline symptom severity. Changes in alcohol consumption between baseline and follow-up were included in the analysis to establish if this affected outcomes. For both...

International Journal of Alcohol and Drug Research

From comparisons of World Health Organization statistics, it is clear that people in lower-income... more From comparisons of World Health Organization statistics, it is clear that people in lower-income countries experience more harms per litre of alcohol and different types of harms compared to those from higher-income countries. Yet studies in higher-income countries dominate research on policies to prevent alcohol problems. The paper reports on results of collaborative work to map priority areas for research relevant to low- and middle-income countries. Research focus areas were identified and discussed among potential coauthors from diverse fields with relevant knowledge, with agreement reached on an initial list of seven research priority areas. Areas identified include: (1) the effects of choices (e.g., national vs. local, monopoly vs. licensing system) in organising the alcohol market; (2) involvement/separation of alcohol industry interests in decisions on public health regulation; (3) options and effectiveness of global agreements on alcohol governance; (4) choices and exper...

SPIRIT Checklist. (DOC 120 kb)

Case report form. (DOCX 58 kb)

International Journal of Alcohol and Drug Research, 2021

In 2021, COVID-19 continued to confound, and sometimes devastate, our family, social and working ... more In 2021, COVID-19 continued to confound, and sometimes devastate, our family, social and working lives. We hope for and work towards a less disrupted, peaceful and more environmentally sustainable and equitable 2022. Despite the difficulties faced by researchers around the world, we have remained committed to making important contributions, we have adapted and found better ways to connect virtually, and we have continued to collaborate on projects and co-author papers that increase our understanding of the use of, and harm linked to, alcohol, other drugs and gambling.

The International Journal of Alcohol and Drug Research, 2021

Welcome to the first issue of Volume 9 of IJADR for 2021. This issue has papers that are likely t... more Welcome to the first issue of Volume 9 of IJADR for 2021. This issue has papers that are likely to be of interest to a very broad audience. Again, we have a spread of international papers addressing issues related to (a) the measurement of cost of alcohol-attributable illness in studies across the globe (Carr et al., 2021); (b) drinking at home in Australia (Aplin et al., 2021); (c) the operationalisation of the Alcohol Use Disorders Identification Test (AUDIT) in the Russian Federation and other countries where Russian-language versions of the instrument have been used (Bunova et al., 2021); (d) alcohol consumption and problems among sexual minority women (SMW) in the United States of America (Hughes et al., 2021); and (e) emotions of shame and guilt feelings among people with alcohol use disorders (AUDs) in Turkey (Vatansever & Ozgur-Ilhan., 2021). There are many interesting, useful and important lessons about measuring alcohol consumption, alcohol-related problems and costs from ...

Publishing Addiction Science: A Guide for the Perplexed, 2017

The International Journal of Alcohol and Drug Research, 2020

In alignment with the Society's aims, the journal's objectives are to publish and promote social ... more In alignment with the Society's aims, the journal's objectives are to publish and promote social and epidemiological research on alcohol and foster a comparative understanding of alcohol use and alcohol problems internationally. The Journal also publishes papers focused on other drugs and addictive substances and has a history of soliciting and publishing papers on special issues that are likely to be of interest to its readership. Since its inception, IJADR has also sought to highlight culturally diverse views on alcohol and other drug problems, and provide a specific outlet for research from low and middle income countries. It seeks to support and publish qualitative and mixed methods papers, in addition to quantitative studies, and our strong senior editorial team reflects that capacity. IJADR has also been able to address the gender imbalances in addiction journals, as have been indicated in a paper by Mathilda Hellman (2020), as women are well represented on our editorial team.

Background: In South Africa, like other low-and middle-income countries, interventions are needed... more Background: In South Africa, like other low-and middle-income countries, interventions are needed to address the impact of hazardous drinking on adherence to antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability and potential impact. As part of a randomized controlled trial of a brief motivational interviewing and problem-solving therapy (MI-PST) intervention among PLWH who report hazardous drinking, we interviewed participants about their perceptions of this alcohol-reduction intervention. Methods: The trial was conducted in HIV treatment clinics operating from 6 hospitals in the Tshwane region of South Africa. In the trial, 305 participants were randomly assigned to the intervention comprising four modules of MI-PST delivered over two sessions. We conducted qualitative in-depth interviews of participants' views about the acceptability and usefulness of the intervention for facilitating behaviour change on completion of the last intervention session and at the six-month study end-point. Twenty-four participants were interviewed after the final intervention session and 25 at the six-month follow up. Data were analysed using the framework approach. Results: Three themes emerged from the interviews that reflect participants' perceptions of the acceptability and usefulness of this intervention. The first theme describes participants' perceptions of the acceptability of screening and brief alcohol-focused interventions for PLWH. The second theme describes participants' views of the usefulness of the intervention for reducing alcohol use and addressing life stressors. The third theme reflects participants' views on how the intervention could be modified for greater reach and impact. Conclusion: Findings suggest that participants considered this intervention to be acceptable and useful for facilitating reductions in alcohol consumption. This study is the first to describe how PLWH applied the skills taught in the MI-PST intervention to manage and cope with daily problems instead of drinking heavily.

South African Journal of Clinical Nutrition, 2010

Trials, 2019

Background: South Africa is among the seven highest tuberculosis (TB) burden countries. Harmful l... more Background: South Africa is among the seven highest tuberculosis (TB) burden countries. Harmful lifestyle behaviours, such as smoking and alcohol, and poor adherence to medication can affect clinical outcomes. Modification of these behaviours is likely to improve TB treatment outcomes and has proven possible using motivational interviewing (MI) techniques or use of short message service (SMS) text messaging. There have been no studies assessing the effect of combined MI and SMS interventions on multiple lifestyle factors and TB treatment outcomes. Methods: This is a prospective, multicentre, two-arm individual randomised controlled trial looking at the effectiveness and cost-effectiveness of a complex behavioural intervention (the ProLife programme) on improving TB and lifestylerelated outcomes in three provinces of South Africa. The ProLife programme consists of an MI counselling strategy, delivered by lay health workers, augmented with subsequent SMS. We aim to recruit 696 adult participants (aged 18 years and over) with drug-sensitive pulmonary TB who are current smokers and/or report harmful or hazardous alcohol use. Patients will be consecutively enrolled at 27 clinics in three different health districts in South Africa. Participants randomised individually to the intervention arm will receive three MI counselling sessions one month apart. Each MI session will be followed by twice-weekly SMS messages targeting treatment adherence, alcohol use and tobacco smoking, as appropriate. We will assess the effect on TB treatment success, using standard World Health Organization (WHO) treatment outcome definitions (primary outcome), as well as on a range of secondary outcomes including smoking cessation, reduction in alcohol use, and TB medication and anti-retroviral therapy adherence. Secondary outcomes will be measured at the three-month and six-month follow-ups. Discussion: This trial aligns with the WHO agenda of integrating TB care with the care for chronic diseases of lifestyle, such as provision of smoking cessation treatments, and with the use of digital technologies. If the ProLife programme is found to be effective and cost-effective, the programme could have significant implications for TB treatment globally and could be successfully implemented in a wide range of TB treatment settings.

BMC health services research, Jan 4, 2017

Poor, Black African males are underrepresented as patients in facilities that treat problem drink... more Poor, Black African males are underrepresented as patients in facilities that treat problem drinking in Cape Town, South Africa. Reasons for this remain unclear, but factors such as the kinds of treatment provided, perceptions of treatment efficacy, social stigma and traditional treatment beliefs have been suggested as possible barriers to treatment seeking. This descriptive study examined the availability and nature of problem drinking treatment facilities in Khayelitsha, a largely poor township of Black, Xhosa-speaking Africans, on the outskirts of Cape Town. Seven treatment facilities for problem drinking in adult males were identified using data from the Department of Social Development in the City of Cape Town. Staff members were identified as key informants at each of the treatment facilities, and were interviewed using a structured questionnaire. Twelve interviews were conducted. Findings indicated that the available alcohol treatment facilities were relatively new, that trea...

Drug and alcohol review, Jan 2, 2018

The International Alcohol Control (IAC) Study is a multi-country collaborative project to assess ... more The International Alcohol Control (IAC) Study is a multi-country collaborative project to assess patterns of alcohol consumption and the impact of alcohol control policy. The aim of this paper is to report the methods and implementation of the IAC. The IAC has been implemented among drinkers 16-65 years in high- and middle-income countries: Australia, England, Scotland, New Zealand, St Kitts and Nevis, Thailand, South Africa, Peru, Mongolia and Vietnam (the latter four samples were sub-national). Two research instruments were used: the IAC survey of drinkers and the Alcohol Environmental Protocol (a protocol for policy analysis). The survey was administered via computer-assisted interview and the Alcohol Environmental Protocol data were collected via document review, administrative or commercial data and key informant interviews. The IAC instruments were readily adapted for cross-country use. The IAC methodology has provided cross-country survey data on key measures of alcohol consu...

Drug and alcohol review, Jan 4, 2018

To report data on the implementation of alcohol policies regarding availability and marketing, an... more To report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high-income to three high-middle income countries, and one low-middle income country. This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross-country comparison and change over time. All countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High-income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available i...

South African Medical Journal, 2012