Award Holder: Rebecca Pradeilles
University: Loughborough University
Title of Research: Community socio-economic status influences on dietary intake and obesity in South African adolescents

The aim of my PhD is to evaluate the associations between community and household socio-economic status, dietary intake and obesity in urban South African adolescents.

The Ruggles-Gates scholarship enabled me to conduct five months ‘fieldwork in Johannesburg and Soweto. The objectives were to:

- Quantify dietary intakes from food frequency questionnaires (FFQs) of adolescents; Every item consumed within a 7 day recall period was manually coded on the paper questionnaire and then the coded data needed to be entered into a software package (FoodFinder) in order to calculate the total energy, and percent energy from fat, protein, carbohydrates and processed sugars. Quality checks were undertaken in order to make sure that the data were correctly coded and entered in the database. 

This work was the most challenging part of my fieldwork as the coding and capturing process were both repetitive and time-consuming. We managed to code and enter 656 FFQs out of the 1700 FFQs planned initially. Needing to reduce the sample size taught me to be flexible in my approach to the research and enabled me to think about sample size calculations to drive the number of questionnaires needed to complete the work for my PhD. The logistics such as the number of staff who could be involved, software used, network and power cuts were some of the factors that slowed down the process. However, being in charge of the dietary data coding and entering process gave me a better understanding of the data I am working with and also of the limitations and benefits of using that tool in this population and context. I was involved in training staff and carrying out quality controls of a team of people coding the questionnaires. Therefore I have developed some team management skills.

- Collate and clean community socio-economic status data (n=2000) so that these data can be matched to the height, weight and percent body fat of adolescents, along with the dietary intake data; The cleaning process involved a 10% random sample check to identify potential problems with the data entered and required the paper questionnaires to be pulled out and re-entered for one section. Cleaning checks of other variables were also undertaken and missing questionnaires entered in the database.

- Collate and clean household socio-economic status data (n=2000); The cleaning of the household Socio-Economic Status involved the paper questionnaires to be pulled out and two questions needed to be re-entered.

Both the cleaning of the household and community SES data was repetitive and time-consuming but this work was essential in order to improve the quality of the data and be able to rely on the data I am working with. I have also realised the importance of training people to enter data as this is a key phase of the research process. The rewarding outcome of this process was to leave South Africa with a clean data set ready to analyse for my PhD and a better understanding of the data being used in my PhD.

- Conduct focus group discussions (FGDs) with religious leaders (pastor, bishop, teachers, elders, etc…). FGDs were conducted in six different Christian religious organisations with up to ten key religious leaders. A survey was also administered at the beginning of each of these sessions and before the focus group started. Prior to starting the qualitative work, an ethics application was submitted and approved followed by piloting of the FGDs and survey. The focus groups and survey were conducted by me with help from a local research assistant, who facilitated communication and translation where necessary. The focus group discussions were recorded and then transcribed by a local transcriber. 

This work has been challenging but fascinating at the same time. Working with participants was essential to my understanding of the context and thus for interpreting the findings of my analyses. I had to face some logistic issues (difficulty in gathering a high number of religious leaders at the same time, finding a suitable room for the FGDs, obtaining good quality recordings, car breakdowns, research assistant unavailable, etc…) but I developed my skills in organisation, resilience and adaptability. I have also gained some qualitative experience in conducting FGDs.

This research represents an asset and might be useful for developing a grant proposal for obesity prevention interventions for my postdoctoral work as well as having the potential for academic publication. The results of this research will help to identify and develop appropriate preventive intervention strategies for obesity at the community level for urban South African adolescents.