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

项目摘要 尽管广泛的研究将贫困与精神疾病联系起来，但缺乏研究 在低资源环境下，对复杂的近端压力源的弹性机制。我们 以前的工作，在Swahn博士的富布赖特奖期间进行，并通过长期的 与马凯雷雷大学合作，证明了乌干达坎帕拉的城市青年， 特别是少女和年轻妇女（AGYW）经历了许多不利的社会 导致他们心理健康状况不佳的司机。 我们提出的TOPOWA项目（意为授权）将使用混合方法 审查加强社会经济能力所针对的机制的方法 培训（SeSTT）缓和了贫困的不利影响（近端社会）之间的途径， 和环境压力源）和坎帕拉AGYW中的精神疾病。以前，但是 有限的，研究表明，SeSTT对就业的积极影响，并改善 青年女青年协会的心理健康状况。建立心理健康的社会决定因素（SDoMH） 和研究领域标准（RDoC）框架，我们将针对年龄在18-24岁的AGYW， 大多数心理健康症状表现出来的年龄段。嵌入式 在战略防御与人力资源部的概念模型中，我们将把重点放在压力上，通过国防部作战指挥中心来实施 负效价框架-急性，持续的威胁和唤醒和监管系统。 使用AGYW的多因素27个月平行前瞻性队列设计，我们将 招募300名参与者，以确定心理健康结果的途径和机制 使用10个季度，片剂管理的调查评估（时间1-10）。参与者将被 参加社区干预计划的患者（n= 150，年龄和地点- 匹配的非干预社区样本（n=150）。目标是确定 SeSTT对近端社会应激源和心理健康结局的机制变化 (i.e.,焦虑、抑郁、自杀和物质使用症状和障碍）， AGYW。

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.