TOPOWA Study: Social Drivers of Mental Illness among AGYW in Slums.

TOPOWA 研究：贫民窟 AGYW 精神疾病的社会驱动因素。

• 批准号: 10552045
• 负责人: Monica H Swahn
• 金额: $ 65.44万
• 依托单位: KENNESAW STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-18 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10552045
• 关键词: Acute; Address; Adverse effects; Africa South of the Sahara; Age; Alcohols; Anxiety; Arousal and Regulatory Systems; Award; Budgets; Buffers; Clinical Trials; Cohort Studies; Collaborations; Communities; Complex; Development; Disease; Employment; Enrollment; Evaluation; Female Adolescents; Focus Groups; Future; Hormones; Housing; Hydrocortisone; Infrastructure; Intervention; Link; Location; Longterm Follow-up; Maps; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Modeling; National Institute of Mental Health; Negative Valence; Neighborhoods; Outcome; Participant; Pathway interactions; Patient Self-Report; Perception; Physiological; Population; Poverty; Prospective cohort; Psychosocial Assessment and Care; Public Health; Radial; Research; Research Domain Criteria; Resource-limited setting; Role; Saliva; Salivary; Sampling; Sleep; Slum; Stress; Surveys; Symptoms; Tablets; Testing; Time; Training; Training Programs; Uganda; Universities; Vocation; Wakefulness; Work; Youth; alpha-amylase; cohort; community organizations; conditioned fear; dehydroepiandrosterone; design; diaries; empowerment; environmental stressor; experience; fitbit; follow-up; improved; intervention delivery; intervention program; operation; post intervention; prevent; programs; prospective; recruit; resilience; response; sensor; skills training; sleep pattern; sleep quality; social; social determinants; social stressor; socioeconomics; stressor; substance use; suicidal; urban setting; wearable sensor technology; young woman

Project Summary Abstract Despite extensive research linking poverty to mental illness, there is a dearth of studies examining mechanisms of resilience against complex proximal stressors in low-resource settings. Our previous work, conducted during Dr. Swahn’s Fulbright Award and via long-standing collaborations with Makerere University, demonstrates that urban youth in Kampala, Uganda, particularly Adolescent Girls and Young Women (AGYW) experience many adverse social drivers which contribute to their poor mental health. Our proposed TOPOWA project (meaning empowerment) will used a mixed-methods approach to examine the mechanisms for which Socioeconomic Strengthening Targeted Training (SeSTT) moderates the pathway between the adverse effects of poverty (proximal social and environmental stressors) and mental illness among AGYW in Kampala. Previous, but limited, research demonstrates the positive impact of SeSTT on employment and improved mental health among AGYW. Building on the Social Determinants of Mental Health (SDoMH) and the Research Domain Criteria (RDoC) frameworks, we will target AGYW ages 18-24 years, the age period when most mental health symptoms are manifested and expressed. Embedded within the SDoMH conceptual model we will focus on stress, operationalized through the RDoC framework as Negative Valence -Acute, Sustained Threat and Arousal and Regulatory Systems. Using a multicomponent 27-month, parallel prospective cohort design of AGYW, we will recruit 300 participants to determine the pathways and mechanisms of mental health outcomes using 10 quarterly, tablet administered survey assessments (Time 1-10). Participants will be those enrolled in a community-based intervention program (n=150and an age- and location- matched non-intervention community sample (n=150). The objective is to determine the mechanistic changes of SeSTT on the proximal social stressors and mental health outcomes (i.e., anxiety, depression, suicidality and substance use symptoms and disorders) among AGYW.

项目摘要摘要 尽管大量研究将贫困与精神疾病联系起来，但研究死亡 低资源环境中针对复杂代理应力源的弹性机制。我们的 先前的工作，在Swahn博士的富布赖特奖中进行，并通过长期存在 与Makerere大学的合作表明，乌干达坎帕拉的城市青年 特别是青春期的女孩和年轻女性（AGYW）经历了许多不利的社交 导致他们心理健康不良的驾驶员。 我们拟议的托波瓦项目（意味着授权）将使用混合方法 检验社会经济加强目标的机制的方法 训练（SESTT）调节贫困的不利影响（近端社会）之间的途径 坎帕拉AGYW中的环境压力源和精神疾病。以前，但是 有限的研究证明了Sestt对就业的积极影响并改善了 AGYW的心理健康。以心理健康的社会决定因素为基础（SDOMH） 以及研究领域标准（RDOC）框架，我们将针对18-24岁的AGYW， 大多数心理健康症状都表现出来的年龄。嵌入 在SDOMH概念模型中，我们将重点关注通过RDOC操作的压力 框架为负价 - 急性，持续威胁以及唤醒和监管系统。 使用多组分27个月，平行的前瞻性队列AGYW设计，我们将 招募300名参与者来确定心理健康成果的途径和机制 使用10季度，平板电脑管理调查评估（时间1-10）。参与者会 那些参加社区干预计划的人（n = 150和年龄和地点 - 匹配的非干预社区样本（n = 150）。目的是确定 SESTT在近端社会压力源和心理健康成果上的机械变化 （即焦虑，抑郁，自杀性和物质使用符号和疾病） Agyw。