Exploring the mental health and wellbeing of adolescent parent families affected by HIV in South Africa

探讨南非受艾滋病毒影响的青少年父母家庭的心理健康和福祉

• 批准号: ES/Y00860X/1
• 负责人: Kathryn Steventon Roberts
• 金额: $ 14.99万
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FY00860X%2F1
• 关键词: Exploring; mental; health; wellbeing; adolescent

Africa's adolescent population (10-19 years; WHO,2017) are the fastest growing the in world - projected to reach 435 million by 2050 (United Nations,2019). Consequently, the health of adolescents, of which mental health is a fundamental component, is becoming increasingly important to promote individual potential, and ensure the prosperity of the region, and future generations. Poor mental health within adolescence has broad negative implications for individuals and wider society (United Nations Population Fund,2014). Yet, the mental health of children and adolescents remains an overlooked global health priority. Both experiencing adolescent pregnancy and living with HIV have been found to be associated with poor mental health (Vreeman,2017; Dahmen,2019). However, there is a dearth of literature (beyond the candidate's thesis) exploring mental health when both phenomena co-occur. Adolescents and their children living with and affected by HIV are a core population in both the future prosperity of the sub-Saharan Africa region and the HIV response. However, adolescent parent families living with and affected by HIV remain understudied, and thus underserved with regard to intervention and prevention.The HEY BABY study is a cohort study of over 1000 adolescent mothers (both living with and not living with HIV) and their children residing in the Eastern Cape province, South Africa. Four components of data are collected within the study: (i) a health and wellbeing questionnaire (including validated mental health measures), (ii) a parenting questionnaire (giving detail on parenting experience), (iii) a direct assessment of child cognitive development, and (iv) child health records. Cross-sectional analyses of these data (undertaken by the candidate) have highlighted elevated poor mental health among adolescent mothers living with HIV compared to mothers not living with HIV, lower child development scores among children born to adolescent mothers compared to adult mothers within the sub-Saharan African region, and lower developmental scores among children living with HIV and HIV exposed uninfected children compared to children unexposed to HIV. These analyses have also identified an association between maternal posttraumatic stress and lower child cognitive development scores, and low paternal engagement within the care of their children (<20%). Violence exposure and lack of social support were found to be correlates of poor mental health among adolescent mothers in the sample, however longitudinal analyses is required to further understand such findings. The proposed fellowships aims to allow the candidate to: 1. Consolidate the works within the candidate's PhD and extending these works to include longitudinal follow-up data. These works will focus on identifying amenable factors that could be integrating into policy and programming to improve the mental health of adolescent parents (both mothers and fathers) affected by HIV, and the development of their children. These works will also on developing a greater understanding the experience of fathers of children born to adolescent mothers (an often-overlooked group)2. Develop analyses and manuscripts for publication and dissemination 3. Attend conferences, and stakeholder meetings to allow for knowledge transition and networking 4. Develop the foundations for future possible collaborations focusing on the mental health of adolescent parent families from both sub-Saharan Africa and high-income countries with the aim of extend the application of findings from both the thesis and postdoctoral activities5. Undertake further training to build skills relating to methodology, and to establish a career in academia 6. Develop funding applications to advance the works undertaken as part of this postdoctoral fellowship, and to further address the need for data to allow for the effective development of meaningful policy and programming to serve current and future generations

非洲青少年人口（10-19 岁；世界卫生组织，2017 年）是世界上增长最快的 - 预计到 2050 年将达到 4.35 亿（联合国，2019 年）。因此，青少年的健康（其中心理健康是一个基本组成部分）对于促进个人潜力、确保该地区和子孙后代的繁荣变得越来越重要。青春期心理健康状况不佳会对个人和更广泛的社会产生广泛的负面影响（联合国人口基金，2014）。然而，儿童和青少年的心理健康仍然是一个被忽视的全球卫生优先事项。研究发现，经历青少年怀孕和感染艾滋病毒都与心理健康状况不佳有关（Vreeman，2017；Dahmen，2019）。然而，当这两种现象同时发生时，探索心理健康的文献（除了候选人的论文之外）却很缺乏。感染艾滋病毒和受艾滋病毒影响的青少年及其子女是撒哈拉以南非洲地区未来繁荣和艾滋病毒应对工作的核心人群。然而，对感染艾滋病毒和受艾滋病毒影响的青少年父母家庭的研究仍然不足，因此在干预和预防方面服务不足。HEY BABY 研究是一项针对 1000 多名青少年母亲（包括感染艾滋病毒和未感染艾滋病毒）及其孩子的队列研究居住在南非东开普省。研究收集了四个数据组成部分：(i) 健康和福祉调查问卷（包括经过验证的心理健康测量），(ii) 育儿调查问卷（提供育儿经历的详细信息），(iii) 对儿童认知发展的直接评估，以及 (iv) 儿童健康记录。对这些数据的横断面分析（由候选人进行）强调，与未感染艾滋病毒的母亲相比，感染艾滋病毒的青少年母亲的心理健康状况较差，与亚裔成年母亲相比，青少年母亲所生的孩子的儿童发育得分较低。 -撒哈拉非洲地区，与未接触艾滋病毒的儿童相比，感染艾滋病毒的儿童和接触艾滋病毒的未感染儿童的发育得分较低。这些分析还发现，母亲创伤后压力与儿童认知发展得分较低以及父亲在照顾孩子方面的参与度较低（<20%）之间存在关联。研究发现，样本中的青少年母亲遭受暴力和缺乏社会支持与心理健康状况不佳有关，但需要进行纵向分析来进一步了解这些发现。拟议的奖学金旨在让候选人能够： 1. 巩固候选人博士期间的工作，并将这些工作扩展到包括纵向后续数据。这些工作将侧重于确定可纳入政策和规划的适宜因素，以改善受艾滋病毒影响的青少年父母（包括母亲和父亲）的心理健康及其子女的发展。这些作品还将加深对青春期母亲（经常被忽视的群体）所生孩子的父亲们的经历的理解2。制定分析和手稿以供出版和传播 3. 参加会议和利益相关者会议，以促进知识转移和建立联系 4. 为未来可能的合作奠定基础，重点关注撒哈拉以南非洲和高海拔地区青少年父母家庭的心理健康收入国家，旨在扩大论文和博士后活动的研究结果的应用5。进行进一步培训，以培养与方法论相关的技能，并在学术界建立职业生涯 6. 制定资助申请，以推进作为博士后奖学金一部分所开展的工作，并进一步满足数据需求，以便有效发展有意义的研究服务当代人和子孙后代的政策和规划