Browsing by Author "Kathleen Kahn"

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    A community mobilization intervention to improve engagement in HIV testing, linkage to care, and retention in care in South Africa: a cluster-randomized controlled trial
    (2022-09) Sheri A. Lippman; Audrey Pettifor; Mi-Suk Kang Dufour; Chodziwadziwa Whiteson Kabudula; Rhian Twine; Dean Peacock; Rhandzekile Mathebula; Aimée Julien; Rebecca West; Torsten B. Neilands; Ryan Wagner; Ann Gottert; F. Xavier Gómez Olivé; Dumisani Rebombo; Nicole Haberland; Julie Pulerwitz; Louis Pappie Majuba; Stephen Tollman; Kathleen Kahn
    Background: Community Mobilization (CM), engaging communities in a process to collectively enact change, could improve HIV testing and care engagement. We assessed whether CM increased HIV testing, linkage to, and retention in care over time in intervention relative to control communities. Methods: Fifteen communities in Mpumalanga, South Africa were randomized to either a CM intervention engaging residents to address social barriers to HIV testing and treatment or to control. Implementation occurred from August 2015-July 2018. Outcomes included quarterly rates of HIV testing, linkage to care, and retention in care documented from health facility records among 18-49 year-old residents of intervention and control communities over the three years of study. Intention-to-treat analyses employed generalized estimating equations stratified by sex. ClinicalTrials.gov number NCT02197793. Findings: Residents in eight intervention communities (N=20,544) and seven control communities (N=17,848) contributed data. Among men, HIV testing increased quarterly by 12·1% (Relative Change (RC):1·121, 95%CI:1·099-1·143) in intervention communities and 9·5% (RC:1·095, 95%CI:1·075-1·114) in control communities; differences by arm were marginally significant (exponentiated interaction coefficient:1·024, 95%CI:0·997-1·052, p-value=0·078). Among women, HIV testing increased quarterly by 10·6% (RC:1·106, 95%CI:1·097-1·114) in intervention and 9·3% (RC:1·093, 95%CI:1·084-1·102) in control communities; increases were greater in intervention communities (exponentiated interaction coefficient:1·012, 95%CI:1·001-1·023, p-value=0·043). Quarterly linkage increased significantly among intervention community women (RC:1·013, 95%CI:1·002-1·023) only. Quarterly retention fell among women in both arms; however, reductions were tempered among intervention women (exponentiated interaction coefficient:1·003, 95%CI:<1·000-1·006, p-value=0·062). No significant differences were detected in linkage or retention among men. Interpretation: CM was associated with modest improvements in select trial outcomes. The sum of these incremental, quarterly improvements achieved by addressing social barriers to HIV care engagement can impact epidemic control. However, achieving optimal impacts will likely require integrated efforts addressing both social barriers through CM and provision of improved service delivery.
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    Assessing risk for HIV infection among adolescent girls in SouthAfrica: an evaluation of the VOICE risk score (HPTN 068)
    (2019-07) Danielle Giovenco; Audrey Pettifor; Catherine MacPhail; Kathleen Kahn; Ryan Wagner; Estelle Piwowar-Manning; Jing Wang; James P Hughes
    AbstractIntroduction:To maximize impact and minimize costs, antiretroviral pre-exposure prophylaxis (PrEP) interventions should beoffered to those at highest risk for HIV infection. The risk score derived from the VOICE trial is one tool currently being uti-lized to determine eligibility in adolescent PrEP trials in sub-Saharan Africa. This study is aimed at evaluating the utility of therisk score in predicting HIV incidence among a cohort of adolescent girls in rural South Africa.Methods:We utilized data from HIV Prevention Trials Network (HPTN) 068, a phase III randomized controlled trial con-ducted in rural Mpumalanga province, South Africa. School-attending young women aged 13 to 20 years were enrolled intothe trial from 2011 to 2012 and followed for up to three years. A risk score based on individual-level risk factors measuredat enrolment was calculated for HPTN 068 participants who completed a one-year follow-up visit and were HIV seronegativeat enrolment. Possible scores ranged from 0 to 10. A proportional hazards model was then used to determine if risk score atenrolment was predictive of incident HIV infection at follow-up and an area under the curve analysis was used to examine thepredictive ability of the score.Results and Discussion:The risk score had limited variability in the HPTN 068 sample. Scores≥5 identified 85% of incidentinfections from 94% of the sample, compared to the VOICE sample in which scores≥5 identified 91% of incident infectionsfrom only 64% of participants. The risk score did not predict HIV incidence after one year of follow-up (hazardratio=1.029; 95% confidence interval (CI): 0.704, 1.503,p=.884) and showed poor predictive ability (area under thecurve=0.55; 95% CI: 0.44, 0.65). Certain individual risk factors that comprise the risk score may be context specific or notrelevant for adolescent populations. Additional factors should be considered when assessing risk for the purposes of deter-mining PrEP eligibility.Conclusions:The VOICE risk score demonstrated low utility to predict HIV incidence in the HPTN 068 sample. Findings high-light the need for an age and developmentally appropriate tool for assessing risk for HIV infection among adolescents. Use ofthe VOICE risk score for determining PrEP eligibility in younger populations should be carefully considered.
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    Associations Between Key Psychosocial Stressors and Viral Suppression and Retention in Care Among Youth with HIV in Rural South Africa
    L Filiatreau; Audrey Pettifor; Nkosinathi Masilela; Rhian Twine; Francesc Gomez-Olive Casas; N Haberland; Chodziwadziwa Kabudula; Sheri Lippman; Kathleen Kahn
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    Associations Between Key Psychosocial Stressors and Viral Suppression and Retention in Care Among Youth with HIV in Rural South Africa
    (2021-02-24) Lindsey M; Filiatreau; Audrey Pettifor; Jessie K; Edwards; Nkosinathi Masilela; Rhian Twine; F. Xavier Gómez-Olivé; Nicole Haberland; Chodziwadziwa Whiteson Kabudula; Sheri A; Lippman; Kathleen Kahn
    Despite improvements in access to antiretroviral treatment over the past decade, sub-optimal HIV care outcomes persist among youth with HIV (YWH) in rural South Africa. Psychosocial stressors could impede improved HIV treatment outcomes within this population. We linked self-reported psychosocial health and demographic data from a cross-sectional survey conducted among YWH aged 12–24 in rural South Africa to individual medical record data, including facility visit history and viral load measurements. Poisson regression with robust standard errors was used to estimate the associations between five psychosocial stressors- heightened depressive symptoms (Center for Epidemiological Studies-Depression scale scores ≥ 16), lower social support (Medical Outcomes Social Support Scale scores ≤ 38), lower resilience (Conner-Davidson Resilience Scale scores ≤ 73), lower self-esteem (Rosenberg Self-Esteem Scale scores ≤ 21), and higher perceived stress (Sheldon Cohen Perceived Stress Scale scores ≥ 10)- and viral non-suppression (viral load ≥ 400 copies/mL) and loss to care (no documented clinic visits within the 90 days prior to survey), separately. A total of 359 YWH were included in this analysis. The median age of study participants was 21 (interquartile range: 16–23), and most were female (70.2%), single (82.4%), and attending school (54.7%). Over a quarter of participants (28.1%) had heightened depressive symptoms. Just 16.2% of all participants (n = 58) were lost to care at the time of survey, while 32.4% (n = 73) of the 225 participants with viral load data were non-suppressed. The prevalence of non-suppression in individuals with lower self-esteem was 1.71 (95% confidence interval: 1.12, 2.61) times the prevalence of non-suppression in those with higher self-esteem after adjustment. No meaningful association was observed between heightened depressive symptoms, lower social support, lower resilience, and higher perceived stress and viral non-suppression or loss to care in adjusted analyses. Retention in care and viral suppression among YWH in rural South Africa are below global targets. Interventions aimed at improving viral suppression among YWH should incorporate modules to improve participant’s self-esteem as low self-esteem is associated with viral non-suppression in this setting. Future studies should longitudinally explore the joint effects of co-occurring psychosocial stressors on HIV care outcomes in YWH and assess meaningful differences in these effects by age, gender, and route of transmission.
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    Associations between WASH-related violence and depressive symptoms in adolescent girls and young women in South Africa (HPTN 068): a cross-sectional analysis
    (2022-07-05) Ruvani T Jayaweera; Dana Goin; Rhian Twine; Torsten B Neilands; Ryan G Wagner; Sheri A Lippman; Kathleen Kahn; Audrey Pettifor; Jennifer Ahern
    Objective: There is a lack of research on experiences of WASH-related violence. This study aims to quantify the association between experience or worry of violence when using the toilet or collecting water and depressive symptoms among a cohort of young women in South Africa. Methods: Data are from visit 3 of the HPTN 068 cohort of adolescent girls in rural Mpumalanga Province, South Africa. Participants (n=1798) included in this analysis were aged 13-21 at baseline. Lifetime experience of violence or fear of violence when using the toilet and collecting water was collected by self-report; depressive symptoms in the past week were measured using the Center for Epidemiological Studies Depression Scale (CES-D). We used G-computation to calculate the prevalence difference (PD) and prevalence ratio of depression (CES-D score >15) associated with each domain of violence, controlling for baseline covariates. Findings: A total of 15.1% of respondents reported experiencing violence when using the toilet; 17.1% reported experiencing violence when collecting water and 26.7% reported depression. In adjusted models, those who reported experiencing violence when using the toilet had an 18.1% higher prevalence of depression (95% CI: 11.6% to 24.4%) than those who did not experience violence when using the toilet. Adjusted prevalence of depression was also higher among those who reported violence when collecting water (PD 11.9%, 95% CI: 6.7% to 17.2%), and who worried about violence when using the toilet (PD 12.8%, 95% CI: 7.9% to 19.8%), as compared with those who did not report these experiences. Worrying about violence when collecting water was not associated with depression after adjusting for covariates. Conclusion: Experience of WASH-related violence is common among young women in rural South Africa, and experience or worry of experiencing violence is associated with higher prevalence of depressive symptoms.
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    Associations between WASH-related violence and depressive symptoms in adolescent girls and young women in South Africa (HPTN 068): a crosssectional analysis
    (2022-06-13) Ruvani T Jayaweera; Dana Goin; Rhian Twine; Torsten B Neilands; Ryan G Wagner; Sheri A Lippman; Kathleen Kahn; Audrey Pettifor; Jennifer Ahern
    Objective There is a lack of research on experiences of WASH-related violence. This study aims to quantify the association between experience or worry of violence when using the toilet or collecting water and depressive symptoms among a cohort of young women in South Africa. Methods Data are from visit 3 of the HPTN 068 cohort of adolescent girls in rural Mpumalanga Province, South Africa. Participants (n=1798) included in this analysis were aged 13–21 at baseline. Lifetime experience of violence or fear of violence when using the toilet and collecting water was collected by self-report; depressive symptoms in the past week were measured using the Center for Epidemiological Studies Depression Scale (CES-D). We used G-computation to calculate the prevalence difference (PD) and prevalence ratio of depression (CES-D score >15) associated with each domain of violence, controlling for baseline covariates. Findings A total of 15.1% of respondents reported experiencing violence when using the toilet; 17.1% reported experiencing violence when collecting water and 26.7% reported depression. In adjusted models, those who reported experiencing violence when using the toilet had an 18.1% higher prevalence of depression (95% CI: 11.6% to 24.4%) than those who did not experience violence when using the toilet. Adjusted prevalence of depression was also higher among those who reported violence when collecting water (PD 11.9%, 95% CI: 6.7% to 17.2%), and who worried about violence when using the toilet (PD 12.8%, 95% CI: 7.9% to 19.8%), as compared with those who did not report these experiences. Worrying about violence when collecting water was not associated with depression after adjusting for covariates. Conclusion Experience of WASH-related violence is common among young women in rural South Africa, and experience or worry of experiencing violence is associated with higher prevalence of depressive symptoms.
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    Associations between WASHrelated violence and depressive symptoms in adolescent girls and young women in South Africa HPTN 068 a crosssectional analysis
    Ruvani T Jayaweera; Dana Goin; Rhian Twine; Torsten B Neilands; Ryan Wagner; Sheri Lippman; Kathleen Kahn; Audrey Pettifor; Jennifer Ahern
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    Associations of father and adult male presence with first pregnancy and HIV infection: Longitudinal evidence from adolescent girls and young women in rural South Africa (HPTN068)
    (2021-01-08) Lisa Marie Albert; Jess Edwards; Brian Pence; Ilene S; Speizer; Susan Hillis; Kathleen Kahn; F Xavier Gómez-Olivé; Ryan G. Wagner; Rhian Twine; Audrey Pettifor
    This study, a secondary analysis of the HPTN 068 randomized control trial, aimed to quantify the association of father and male presence with HIV incidence and first pregnancy among 2533 school-going adolescent girls and young women (AGYW) in rural South Africa participating in the trial between March 2011 and April 2017. Participants' ages ranged from 13-20 years at study enrollment and 17-25 at the post-intervention visit. HIV and pregnancy incidence rates were calculated for each level of the exposure variables using Poisson regression, adjusted for age using restricted quadratic spline variables, and, in the case of pregnancy, also adjusted for whether the household received a social grant. Our study found that AGYW whose fathers were deceased and adult males were absent from the household were most at risk for incidence of first pregnancy and HIV (pregnancy: aIRR = 1.30, Wald 95% CI 1.05, 1.61, Wald chi-square p = 0.016; HIV: aIRR = 1.27, Wald 95% CI 0.84, 1.91, Wald chi-square p = 0.263) as compared to AGYW whose biological fathers resided with them. For AGYW whose fathers were deceased, having other adult males present as household members seemed to attenuate the incidence (pregnancy: aIRR = 0.92, Wald 95% CI 0.74, 1.15, Wald chi-square p = 0.462; HIV: aIRR = 0.90, Wald 95% CI 0.58, 1.39, Wald chi-square p = 0.623) such that it was similar, and therefore not statistically significantly different, to AGYW whose fathers were present in the household.
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    Body composition and physical activity as mediators in the relationship between socioeconomic status and blood pressure in young South African women: a structural equation model analysis
    (2018-11-11) Richard J Munthali; Mercy Manyema; Rihlat Said-Mohamed; Juliana Kagura; Stephen Tollman; Kathleen Kahn; F Xavier Gómez-Olivé; Lisa K Micklesfield; David Dunger; Shane A Norris
    Objectives Varying hypertension prevalence across different socioeconomic strata within a population has been well reported. However, the causal factors and pathways across different settings are less clear, especially in sub-Saharan Africa. Therefore, this study aimed to compare blood pressure (BP) levels and investigate the extent to which socioeconomic status (SES) is associated with BP, in rural and urban South Africa women. Setting Rural and urban South Africa. Design Cross-sectional. Participants Cross-sectional data on SES, total moderate and vigorous physical activity (MVPA), anthropometric and BP were collected on rural (n=509) and urban (n=510) young black women (18–23 years age). Pregnant and mentally or physically disabled women were excluded from the study. Results The prevalence of combined overweight and obesity (46.5% vs 38.8%) and elevated BP (27.0% vs 9.3%) was higher in urban than rural women, respectively. Results from the structural equation modelling showed significant direct positive effects of body mass index (BMI) on systolic BP (SBP) in rural, urban and pooled datasets. Negative direct effects of SES on SBP and positive total effects of SES on SBP were observed in the rural and pooled datasets, respectively. In rural young women, SES had direct positive effects on BMI and was negatively associated with MVPA in urban and pooled analyses. BMI mediated the positive total effects association between SES and SBP in pooled analyses (ß 0.46; 95% CI 0.15 to 0.76). Conclusions Though South Africa is undergoing nutritional and epidemiological transitions, the prevalence of elevated BP still varies between rural and urban young women. The association between SES and SBP varies considerably in economically diverse populations with BMI being the most significant mediator. There is a need to tailor prevention strategies to take into account optimizing BMI when designing strategies to reduce future risk of hypertension in young women. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the license is given, and indication of whether changes were made.
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    Building knowledge, optimising physical and mental health and setting up healthier life trajectories in South African women (Bukhali): a preconception randomised control trial part of the Healthy Life Trajectories Initiative (HeLTI)
    (2022-03-25) Shane A Norris; Catherine E Draper; Alessandra Prioreschi; CM Smuts; Lisa Jayne Ware; CindyLee Dennis; Philip Awadalla; D Bassani; Zulfiqar Bhutta; Laurent Briollais; D William Cameron; Tobias Chirwa; B Fallon; CM Gray; Jill Hamilton; J Jamison; Heather Jaspan; Jennifer Jenkins; Kathleen Kahn; AP Kengne; Estelle V Lambert; Naomi Levitt; Marie-Claude Martin; Michele Ramsay; Daniel Roth; Stephen Scherer; Daniel Sellen; Wiedaad Slemming; Deborah Sloboda; M Szyf; Stephen Tollman; Mark Tomlinson; Suzanne Tough; Stephen G Matthews; Linda Richter; Stephen Lye
    is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs. Methods and analysis Bukhali is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18–28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height2 ) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development. Ethics and dissemination Ethical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent.
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    Built Environment and HIV Linkage to Care in Rural South Africa
    (2023-01) Nosipho Shangase; Brian Pence; Sheri A. Lippman; Mi-Suk Kang Dufour; Chodziwadziwa Whiteson Kabudula; F. Xavier Gomez-Olive; Kathleen Kahn; Audrey Pettifor
    Background: We assessed built environment (residential density, landuse mix and aesthetics) and HIV linkage to care (LTC) among 1,681 (18–49 years-old) residents of 15 Mpumalanga villages, South Africa. Methods: Multilevel models (linear-binomial) were used for the association between built environment, measured using NEWS for Africa, and LTC from a clinical database of 9 facilities (2015–2018). Additionally, we assessed effect-measure modification by universal test-and-treat policy (UTT). Results: We observed, a significant association in the adjusted 3-month probability of LTC for residential density (risk difference (RD)%: 5.6, 95%CI: 1.2–10.1), however, no association for land-use mix (RD%: 2.4, 95%CI: 0.4, 5.2) and aesthetics (RD%: 1.2, 95% CI: 4.5–2.2). Among those diagnosed after UTT, residents of high land-use villages were more likely to link-to-care than those of low land-use villages at 12 months (RD%: 4.6, 95%CI: 1.1–8.1, p < 0.04), however, not at 3 months (RD%: 3.0, 95%CI: 2.1–8.0, p > 0.10). Conclusion: Findings suggest, better built environment conditions (adequate infrastructure, proximity to services etc.) help facilitate LTC. Moreover, UTT appears to have a protective effect on LTC.
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    Can verbal autopsies be used on a national scale Key findings and lessons from South Africas national causeofdeath validation study
    (CO-ACTION PUBLISHING) M Maqungo; N Nannan; B Nojilana; E Nichols; E et al; Jessica Price; Kathleen Kahn; Chodziwadziwa Kabudula
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    CHAT SA: Modification of a Public Engagement Tool for Priority Setting for a South African Rural Context
    (2022-02-01) Aviva Tugendhaft; Marion Danis; Nicola Christofides; Kathleen Kahn; Agnes Erzse; Marthe Gold; Rhian Twine; Audrey Khosa; Karen Hofman1
    Background: Globally, as countries move towards universal health coverage (UHC), public participation in decision making is particularly valuable to inform difficult decisions about priority setting and resource allocation. In South Africa (SA), which is moving towards UHC, public participation in decision-making is entrenched in policy documents yet practical applications are lacking. Engagement methods that are deliberative could be useful in ensuring the public participates in the priority setting process that is evidence-based, ethical, legitimate, sustainable and inclusive. Methods modified for the country context may be more relevant and effective. To prepare for such a deliberative process in SA, we aimed to modify a specific deliberative engagement tool - the CHAT (Choosing All Together) tool for use in a rural setting. Methods: Desktop review of published literature and policy documents, as well as 3 focus groups and modified Delphi method were conducted to identify health topics/issues and related interventions appropriate for a rural setting in SA. Our approach involved a high degree of community and policy-maker/expert participation. Qualitative data were analysed thematically. Cost information was drawn from various national sources and an existing actuarial model used in previous CHAT exercises was employed to create the board. Results: Based on the outcomes, 7 health topics/issues and related interventions specific for a rural context were identified and costed for inclusion. These include maternal, new-born and reproductive health; child health; woman and child abuse; HIV/AIDS and tuberculosis (TB); lifestyle diseases; access; and malaria. There were variations in priorities between the 3 stakeholder groups, with community-based groups emphasizing issues of access. Violence against women and children and malaria were considered important in the rural context. Conclusion: The CHAT SA board reflects health topics/issues specific for a rural setting in SA and demonstrates some of the context-specific coverage decisions that will need to be made. Methodologies that include participatory principles are useful for the modification of engagement tools like CHAT and can be applied in different country contexts in order to ensure these tools are relevant and acceptable. This could in turn impact the success of the implementation, ultimately ensuring more effective priority setting approaches.
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    Child support grant expansion and cognitive function among women in rural South Africa Findings from a natural experiment in the HAALSI cohort
    (PUBLIC LIBRARY SCIENCE) R Chakraborty; Lindsay Kobayashi; J Jock; Cody Wing; E etal; Lisa Berkman; Kathleen Kahn; Chodziwadziwa Kabudula; Molly Rosenberg
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    Cohort Profile South African Population Research Infrastructure Network SAPRIN
    Mark Collinson; T Mudzana; T Mutevedzi; Kathleen Kahn; E Maimela; Francesc Gomez-Olive Casas; T Mngomezulu; Chodziwadziwa Kabudula; Stephen Tollman; E et al
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    Cohort Profile: Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI).
    (2018) F Xavier Go´ mez-Olive´; Livia Montana; Ryan G Wagner; Chodziwadziwa W Kabudula; Julia K Rohr; Kathleen Kahn; Till Ba¨rnighausen; Mark Collinson; David Canning; Thomas Gaziano; Joshua A Salomon; Collin F Payne; Alisha Wad; Stephen M Tollman; Lisa Berkman
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    Cohort Profile: South African Population Research Infrastructure Network (SAPRIN)
    (2021-12-30) Mark A Collinson; Taurayi Mudzana; Tinofa Mutevedzi; Kathleen Kahn; Eric Maimela; F Xavier Go´ mez-Olive´; Thobeka Mngomezulu; Dickman Gareta; Chodziwadziwa W Kabudula; Rathani Nemuramba; Joseph Tlouyamma; Stephen Tollman; Kobus Herbst
    South Africa is striving to emerge from a legacy of gross social injustice and consequent health and socioeconomic inequality, to becoming a country where all residents have opportunities to build productive lives. However, recent declines in economic performance and unemployment, exacerbated by weaknesses in national and provincial level governance, coupled with colliding epidemics of HIV/ AIDS and non-communicable diseases, have left the country’s leadership with serious, seemingly intractable challenges. Moreover as with most countries, the effects of stringent sociobehavioural responses to the coronavirus disease 2019 (COVID-19), with serious economic consequences, serve to amplify such challenges.
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    Consensus study on factors influencing the academic entrepreneur in a middle-income country’s university enterprise
    (2023-05-20) Alfred Austin Farrell; James Ashton; WitnessMapanga; Maureen Joffe; Nombulelo Chitha; Mags Beksinska; Wezile Chitha; Ashraf Coovadia; Clare L. Cutland; RobinL. Drennan; Kathleen Kahn; Lizette L. Koekemoer; Lisa K.Micklesfield; JacquiMiot; Julian Naidoo; Maria Papathanasopoulos; Warrick Sive; Jenni Smit; StephenM. Tollman; Martin G. Veller; Lisa J.Ware; Jeffrey Wing; Shane A. Norris
    Purpose – This study aims to ascertain the personal characteristics of a group of successful academic entrepreneurs in a South African university enterprise and the prevalent barriers and enablers to their entrepreneurial endeavour. Design/methodology/approach – The authors used a Delphi process to identify and rank the characteristics, enablers, barriers and behaviours of entrepreneurial academics, with a Nominal Group Technique applied to establish challenges they encounter managing their enterprise and to propose solutions. Findings – Perseverance, resilience and innovation are critical personal characteristics, while collaborative networks, efficient research infrastructure and established research competence are essential for success. The university’s support for entrepreneurship is a significant enabler, with unnecessary bureaucracy and poor access to project and general enterprise funding an impediment. Successful academic entrepreneurs have strong leadership, and effective management and communication skills. Research limitations/implications – The main limitation is the small study participant group drawn from a single university enterprise, which complicates generalisability. The study supported the use of Krueger’s (2009) entrepreneurial intentions model for low- and middle-income country (LMIC) academic entrepreneur investigation but proposed the inclusion of mitigators to entrepreneurial activation to recognize contextual deficiencies and challenges.