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: 10375045
• 负责人: Monica H Swahn
• 金额: $ 68.21万
• 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/10375045
• 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; Depression and Suicide; Development; Disease; Employment; Enrollment; Evaluation; Female Adolescents; Focus Groups; Future; Hormones; Housing; Hydrocortisone; Infrastructure; Intervention; Link; Location; Longterm Follow-up; Maps; Measures; 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; Wakefulness; Work; Youth; alpha-amylase; base; cohort; 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; 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.

项目概要 摘要 尽管有大量研究将贫困与精神疾病联系起来，但仍有一些研究死亡 资源匮乏环境中针对复杂近端压力源的恢复机制。 之前的工作，在 Swahn 博士获得富布赖特奖期间进行，并通过长期 与马凯雷雷大学合作，表明乌干达坎帕拉的城市青年， 特别是少女和年轻女性 (AGYW) 经历了许多不利的社会影响 导致他们心理健康状况不佳的司机。 我们提出的TOPOWA项目（意思是赋权）将采用混合方法 方法来审查社会经济强化目标的机制 培训（SeSTT）调节贫困的不利影响之间的途径（近端社会 和环境压力）和坎帕拉 AGYW 的精神疾病 以前，但是。 有限，研究表明 SeSTT 对就业和改善的积极影响 AGYW 的心理健康。以心理健康的社会决定因素 (SDoMH) 为基础。 和研究领域标准 (RDoC) 框架，我们将针对年龄 18-24 岁的 AGYW， 大多数心理健康症状表现出来的年龄阶段。 在 SDoMH 概念模型中，我们将重点关注压力，并通过 RDoC 进行操作 框架为负价-急性、持续的威胁、唤醒和监管系统。 使用 AGYW 的多组分 27 个月平行前瞻性队列设计，我们将 招募 300 名参与者来确定心理健康结果的途径和机制 参与者将使用 10 次季度平板电脑评估（时间 1-10）。 参加基于社区的干预计划的人（n=150，年龄和地点 匹配的非干预社区样本（n=150）。 SeSTT 对近端社会压力源和心理健康结果的机制变化 （即焦虑、抑郁、自杀和药物滥用症状和障碍） AGYW。