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

项目摘要摘要 尽管大量研究将贫困与精神疾病联系在一起，但很少有研究考察 在资源匮乏的环境中对抗复杂近端应激源的弹性机制。我们的 之前的工作，在斯瓦恩博士的富布赖特奖期间进行，并通过长期的 与Makerere大学的合作表明，乌干达坎帕拉的城市青年， 尤其是青春期女孩和青年妇女(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。 我们提议的TOPOWA项目(意味着赋权)将使用混合方法 审查加强社会经济目标的机制的方法 培训(SeSTT)缓和贫困的不利影响之间的途径(近端社会 和环境应激源)和精神疾病。以前的，但是 有限，研究表明SeSTT对就业的积极影响和改善 AGYW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，我们将以18-24岁的AGYW为目标， 心理健康症状最明显和表现出来的年龄阶段。嵌入式 在SDoMH概念模型中，我们将重点关注通过RDoC实现的压力 作为负价的框架--急性、持续威胁、唤醒和监管系统。 使用AGYW的多组分27个月的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、平板电脑执行的调查评估(时间1-10)。参与者将是 那些参加以社区为基础的干预计划的人(n=150，年龄和地点- 匹配的非干预社区样本(n=150)。目标是确定 SESTT对近端社会压力源和心理健康结局影响的机制变化 (即焦虑、抑郁、自杀和药物使用症状和障碍) 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.