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Franchino-Olsen H, Orkin M, Meinck F. Toward a Contextually Sensitive Understanding of Polyvictimization: A Latent Class Analysis of Violence, Risks, and Protections Among South African Adolescents From Highly Deprived Settings. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241233273. [PMID: 38407004 DOI: 10.1177/08862605241233273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
South African adolescents experience a high prevalence of violence victimization alongside the health and economic burdens of HIV/AIDS and poverty. Polyvictimization is a useful theory and framework that allows for a nuanced understanding of lived adolescent experience patterns. Polyvictimization examinations are further enriched by person-centered analytical approaches. This study used latent class analysis to differentiate a sample of South African adolescents from highly deprived communities by their polyvictimization profiles and contextual violence risk and protective factors. Adolescents were sampled twice (2010/2011; 2011/2012), and data reflected their lifetime (sexual abuse) or recent (all other forms of assessed abuse/violence) violence victimizations, as well as individual, household, and community characteristics. Model fit indices supported a seven-class model with adolescents in high, moderate, and low polyvictimization classes. Adolescents in the high polyvictimization classes experienced a heavy burden of poverty and multiple forms of violence across contexts and were distinguished by HIV/AIDS and disability. Adolescents in the low polyvictimization class experienced relatively little violence, despite living in violent communities, and low household and individual burdens of HIV/AIDS and disability. Findings emphasize the importance of considering adolescent violence through a contextually sensitive polyvictimization lens to understand the complex web of violence that adolescents experience. This work supports previous research in low-resource South African settings highlighting the interconnected nature of violence, poverty, disability, and HIV/AIDS. Future research should explore these complex violence patterns and their effects, while program and policy actions must target and prevent adolescent violence especially for those impacted by poverty, disability, and HIV/AIDS.
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Affiliation(s)
| | - Mark Orkin
- University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Franziska Meinck
- University of Edinburgh, UK
- University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- North-West University, Vanderbijlpark, South Africa
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2
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Zani B, Luckett B, Thurman TR. COVID-19 pandemic stressors, familial discord, and anxiety among adolescents living with HIV in South Africa: pathways to non-adherence. AIDS Care 2024:1-8. [PMID: 38301123 DOI: 10.1080/09540121.2024.2308025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Adolescents living with HIV (ALHIV) have poorer adherence to antiretroviral treatment (ART). This study investigates the interconnectivity of stressors induced by the COVID-19 pandemic, anxiety and family dynamics on adolescents' adherence to ART. A telephone survey was conducted among 196 South African ALHIV previously enrolled in support groups. Generalized structural equations modeling was used to understand how pandemic-related stressors affected ART adherence. Respondents reported experiencing life stressors since the implementation of COVID-19 restrictions, including doing worse at school (32%), loss of household income (44%) and less food available (38%). Forty-two percent reported greater verbal aggression from adults at home and 60% experienced anxiety. The structural equations model demonstrated a direct path from experiencing life stressors to increased verbal aggression from caregivers, which led to anxiety and ultimately, poorer ART adherence. Each stressor experienced increased the odds of experiencing verbal aggression by 51% (OR=1.51, 95%CI=1.14-2.00) which, in turn, increased the odds of having anxiety four-fold (OR=4.1, 95%C =2.16-7.76). Anxiety was associated with a 74% reduction in the odds of being fully ART adherent (OR=0.26, 95%CI=0.08-0.81). COVID-19-induced stressors exacerbated the mental and physical vulnerability of ALHIV. Findings elucidate how both discord at home and anxiety can result in poorer ART adherence.
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Affiliation(s)
- Babalwa Zani
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
| | - Brian Luckett
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
| | - Tonya R Thurman
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
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3
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Kaburi RM, Kaburi BB. Formal support services and (dis)empowerment of domestic violence victims: perspectives from women survivors in Ghana. BMC Womens Health 2023; 23:539. [PMID: 37848884 PMCID: PMC10583341 DOI: 10.1186/s12905-023-02678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND As part of efforts to prevent violence against women, several countries have institutionalized formal support services including legislations to prevent, protect victims, and deter perpetrators of domestic violence (DV). Prior research on formal support service utilization shows that DV survivors do not get the necessary services they deserve. However, much remains to be known about the experiences of women survivors of DV who accessed a range of formal support services and how their experiences (dis)empowered them. Here, we assessed the experiences of Ghanaian women survivors of DV with formal support services vis-à-vis the provisions of the Ghana DV Act and insights of subject experts. METHODS From May to August 2018, we recruited a total of 28 participants: 21 women survivors of DV in Weija-Gbawe Municipality of Ghana, and 7 experts from the police, human rights, and health professions. We used two sets of in-depth interview guides: one to collect data on survivors' experiences, and the second for the insights of experts. We performed summary descriptive statistics on survivors' sociodemographic characteristics and used thematic analysis to assess their experiences of DV; and access to, patronage, and response of formal support services. RESULTS Of 21 DV survivors, 19 (90.1%) were aware of the existence of the DV law, however none was well informed of their entitlements. DV survivors have low formal education and are not economically empowered. Some DV survivors are revictimized in the process of accessing formal services. DV survivors expect the government to provide them with shelter, upkeep, medical, and legal aid. All the 21 survivors had at least one contact with a women's rights organization and were knowledgeable of their supporting services namely legal services, temporary shelter, and psychosocial support. CONCLUSIONS The experiences of DV survivors do not reflect the legal provisions of Ghana's DV Act. Government under funding of formal services and negative gender norms are disempowering to survivors. NGOs are popular among women survivors of DV in Ghana for the education, legal, and material support they provide. A close collaboration between the government and NGOs could better mitigate DV in Ghana.
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Affiliation(s)
| | - Basil Benduri Kaburi
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, University of Ghana, Accra, Ghana
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Bokolo NP, Van Niekerk RL, Mathews V, Leach L. A Systematic Review Protocol for the Effectiveness of Psycho-Educational Intervention Programmes in Addressing the Psychological Risk Factors Associated with Non-Communicable Diseases among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6467. [PMID: 37569009 PMCID: PMC10418932 DOI: 10.3390/ijerph20156467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
The psychological health concerns and risk factors associated with non-communicable disease among adolescents have been prioritized on the agenda of international health institutions globally. The aims of this systematic review are to determine the various types of psycho-educational intervention programmes developed to address the psychological risk factors associated with non-communicable diseases among adolescents, and to assess the effectiveness of the psycho-educational intervention programmes. The systematic review will include case-control and randomized controlled studies. The review will be conducted using the following electronic databases, PubMed, CINAHL, Science Direct, Cochrane Library, SCOPUS, and ERIC, as well as the grey literature for the thesis repository from 2012 to 2022. The key search terms will include intervention programme, adolescents (aged 10-19 years), psychological risk factors and non-communicable diseases. The studies identified by the search strategy will be downloaded into Mendeley and exported to Covidence software for screening, quality assessment and data extraction. The quality assessment tool that will be utilized is the Joanna Briggs Institute critical appraisal checklists to ensure relevance and quality of the articles. This systematic review will use two types of data analysis: narrative synthesis of qualitative studies and meta-analysis of quantitative studies. The findings from this systematic review will provide evidence-based tools for the management of psychological risk factors associated with non-communicable diseases, as well as present key insights for future intervention programmes on the management of psychological risk factors associated with NCDs among adolescents.
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Affiliation(s)
- Nokwanda P. Bokolo
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Rudolph Leon Van Niekerk
- Department of Psychology, Faculty of Social Sciences and Humanities, University of Fort Hare, Private Bag X9083, 50 Church Street, East London 5201, South Africa
| | - Verona Mathews
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Bellville 7535, South Africa
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5
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Jocson RM, Alampay LP, Lachman JM, Maramba DHA, Melgar ME, Ward CL, Madrid BJ, Gardner F. Pre-post Mixed Methods Study of a Parent and Teen Support Intervention to Prevent Violence Against Adolescents in the Philippines. J Adolesc Health 2023; 73:102-109. [PMID: 37086250 DOI: 10.1016/j.jadohealth.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE This study examines the feasibility of a culturally adapted parenting intervention (MaPa Teens) within the national cash transfer system to reduce violence against adolescents, the first such program in the Philippines. METHODS Thirty caregiver-adolescent dyads who were beneficiaries of a government conditional cash transfer program participated in a pilot of a locally adapted version of the Parenting for Lifelong Health for Parents and Teens program. Primary outcomes of reducing child maltreatment and associated risk factors were evaluated using a single-group, pre-post design. Focus group discussions explored the perceptions of participants and facilitators regarding program acceptability and feasibility. RESULTS Significant and moderate reductions were reported in overall child maltreatment and physical abuse (caregiver and adolescent reports) and in emotional abuse (adolescent report). There were significant reductions in neglect, attitudes supporting punishment, parenting stress, parental and adolescent depressive symptoms, parent-child relationship problems, and significant improvement in parental efficacy in managing child behavior. Adolescents reported reduced behavior problems, risk behavior, and witnessing of family violence. Participants valued learning skills using a collaborative approach, sustained their engagement between sessions through text messages and phone calls, and appreciated the close interaction with caring and skilled facilitators. Program areas of improvement included addressing barriers to attendance, increasing adolescent engagement, and revising the sexual health module. DISCUSSION The study provides preliminary support for the effectiveness and feasibility of the program in reducing violence against Filipino adolescents. Findings suggest potential adaptations of the program, and that investment in more rigorous testing using a randomized controlled trial would be worthwhile.
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Affiliation(s)
- Rosanne M Jocson
- National Institute of Education, Nanyang Technological University, Singapore, Singapore.
| | - Liane Peña Alampay
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Jamie M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom; Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | | | - Marika E Melgar
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Catherine L Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Rondebosch, South Africa
| | - Bernadette J Madrid
- Child Protection Unit, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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Cherewick M, Dahl RE, Bertomen S, Hipp E, Shreedar P, Njau PF, Leiferman JA. Risk and protective factors for mental health and wellbeing among adolescent orphans. Health Psychol Behav Med 2023; 11:2219299. [PMID: 37274749 PMCID: PMC10234133 DOI: 10.1080/21642850.2023.2219299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
Background Research has demonstrated the importance of understanding risk factors for mental health and wellbeing. Less research has focused on protective factors that protect mental health and promote wellbeing in diverse contexts. Estimating structural paths from risk protective factors to psychopathology and wellbeing can inform prioritization of targeted investment in adolescent health programs that seek to modify factors that are most closely associated with mental wellbeing. Study objective The purpose of this study was to examine risk factors (e.g. emotional neglect, emotional abuse, physical neglect, stigma) and protective factors (e.g. community relationships, self-esteem, and autonomy) among adolescent orphans, protective associations with depression, anxiety and externalizing behaviors and promotive associations with hope, happiness, and health. Methods The analytic sample was collected between January and March of 2019 and included 350 adolescent orphans ages 10-15 from three districts in Tanzania. Participants completed survey interviews, 75-90 min in length, that measured risk and protective factors, psychological symptoms, and mental wellbeing measures. Results Results of the fitted structural equation model indicated that structural paths from protective factors to psychopathology (β = -0.53, p = 0.015) and mental wellbeing (β = 0.72, p = 0.014) outcomes were significant. Structural paths from risk factors to psychopathology (β = -0.34, p = 0.108) and mental wellbeing (β = -0.24, p = 0.405) were not significant. Conclusion In a sample of vulnerable youth, protective factors (e.g. community relationships, self-esteem, and autonomy) were significantly associated with reduced depression, anxiety and externalizing behaviors and increased hope, happiness, and health in a structural equation model that included risk factors (emotional neglect, emotional abuse, physical neglect). Results suggest that strong community relationships, self-esteem and autonomy may be important modifiable factors to target in intervention programs aimed at supporting adolescent mental wellbeing.
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Affiliation(s)
- Megan Cherewick
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, USA
| | - Ronald E. Dahl
- Institute of Human Development, University of California Berkeley, Berkeley, CA, USA
| | - Samantha Bertomen
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, USA
| | - Emily Hipp
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, USA
| | - Priyanka Shreedar
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, USA
| | | | - Jenn A. Leiferman
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, USA
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7
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Johnson SL, Kim ET, Rieder AD, Green EP, Finnegan A, Chase RM, Zayzay J, Puffer ES. Pathways from parent mental health to child outcomes in Liberia: Testing cross-sectional and longitudinal serial mediation models. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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8
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Factors influencing healthcare-seeking behaviour of South African adolescents. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01572-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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9
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Psychometric properties of the ASEBA Child Behaviour Checklist and Youth Self-Report in sub-Saharan Africa - A systematic review. Acta Neuropsychiatr 2022; 34:167-190. [PMID: 35466902 DOI: 10.1017/neu.2022.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Behavioural screening tools may be used to identify at-risk children in resource-limited settings in sub-Saharan Africa. The ASEBA forms (Child Behaviour Checklist and Youth Self-Report) are frequently translated and adapted for use in sub-Saharan African populations, but little is known about their measurement properties in these contexts. METHODS We conducted a systematic review of all published journal articles that used the ASEBA forms with sub-Saharan African samples. We evaluated the reported psychometric properties, as well as the methodological quality of the psychometric evaluations, using COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidelines. RESULTS Fifty-eight studies reported measurement properties of the ASEBA forms. Most studies came from Southern (n = 29, 50%) or East African (n = 25, 43%) countries. Forty-nine studies (84%) used translated versions of the tool, but details regarding the translation process, if available, were often sparse. Most studies (n = 47, 81%) only reported internal consistency (using coefficient alpha) for one or more subscale. The methodological quality of the psychometric evaluations ranged from 'very good' to 'inadequate' across all measurement properties, except for internal consistency. CONCLUSIONS There is limited good quality psychometric evidence available for the ASEBA forms in sub-Saharan Africa. We recommend (i) implementing a standardised procedure for conducting and reporting translation processes and (ii) conducting more comprehensive psychometric evaluations of the translated versions of the tools.
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Ndetei DM, Mutiso VN, Musyimi CW, Alietsi RK, Shanley JR, Bhui KS. The feasibility of using life skills training in primary schools to improve mental health and academic performance: a pilot study in Kenya. BMC Psychiatry 2022; 22:131. [PMID: 35177007 PMCID: PMC8855590 DOI: 10.1186/s12888-022-03781-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/14/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There is no Kenyan evidence on the relationship between mental illness and academic performance. We aimed to determine the effect of life skills training on mental health and academic performance. METHODS We administered to 1848 primary school children a researcher designed socio-demographic questionnaire, and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) to their parents, followed by eight sessions of life skills training. We extracted data from the individual records of each child on overall performance pre and post training separated by one year. We conducted descriptive statistics, paired sample t-tests, multivariate linear regression analysis and linear mixed model analysis to assess changing patterns of academic performance and any predictive characteristics. RESULTS There was significant (p < 0.05) improvement in overall academic performance (aggregate marks and all individual subjects) for both lower primary and upper primary classes after the life-skills training intervention. For lower classes (2-4 grades) increase in academic performance was significantly associated with fathers and mothers education levels, region and class. For upper classes, (5-7 grades) increase in academic performance was associated with region, class and age. CONCLUSIONS Life skills training is recommended as it could improve academic performance, but predicted by socio-demographic factors.
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Affiliation(s)
- David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya. .,Department of Psychiatry, University of Nairobi, Nairobi, Kenya. .,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Christine W Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Rita K Alietsi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Jenelle R Shanley
- School of Graduate Psychology, Pacific University, Forest Grove, USA
| | - Kamaldeep S Bhui
- Department of Psychiatry, University of Oxford, Oxford, England.,World Psychiatric Association Collaborating Centre for Research and Training, London, UK
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Tăut D, Băban A, Frantz I, Dănilă I, Lachman JM, Heinrichs N, Ward CL, Gardner F, Fang X, Hutchings J, Raleva M, Lesco G, Murphy H, Foran H. Prevention of child mental health problems through parenting interventions in Southeastern Europe (RISE): study protocol for a multi-site randomised controlled trial. Trials 2021; 22:960. [PMID: 34961518 PMCID: PMC8710933 DOI: 10.1186/s13063-021-05817-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood adversities, such as poor parental practices, exposure to violence, and risk behaviours strongly impact children's future mental and behavioural problems. Adversities affect families living in disadvantaged environments and low- and middle-income countries (LMICs) to a greater extent than in high-income countries. Parenting programmes are an effective way to alleviate them, although their outreach and scalability is still limited in LMICs. METHODS/DESIGN A multi-site randomised controlled trial will be conducted in North Macedonia, Republic of Moldova and Romania to test the efficacy and cost-effectiveness of an optimised version of the promising Parenting for Lifelong Health Programme for Young Children (PLH-YC, 5 sessions), against a standard lecture on parenting issues (control group, 1 session). At least 864 participants who report having children between 2 and 9 years old who display elevated levels of behavioural difficulties will be randomised on a 1:1 basis to the intervention and control groups. The primary outcome will consist of parent report of child oppositional aggressive behaviour. Post-test (four months) and follow-up (12 months) assessments will provide information on short- and longer-term effects of PLH-YC compared to the parenting lecture in the control group. DISCUSSION This randomised trial will test the efficacy of PLH-YC in alleviating child behavioural problems and assess the cost-effectiveness, transportability across three different cultural contexts, and potential for scalability of the programme. TRIAL REGISTRATION ClinicalTrials.gov ., Registration number: NCT04721730 ( https://clinicaltrials.gov/ct2/show/NCT04721730 ). Registered 13.01.2021.
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Affiliation(s)
- Diana Tăut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania.
| | - Adriana Băban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Inga Frantz
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Ingrid Dănilă
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice - ALTERNATIVA, Skopje, North Macedonia
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Hugh Murphy
- Institute for Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Heather Foran
- Institute for Psychology, University of Klagenfurt, Klagenfurt, Austria
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12
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Natukunda HPM, Mubiri P, Cluver LD, Ddumba-Nyanzi I, Bukenya B, Walakira EJ. Which Factors Are Associated With Adolescent Reports of Experiencing Various Forms of Abuse at the Family Level in Post-Conflict Northern Uganda? JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP12067-NP12096. [PMID: 31789094 DOI: 10.1177/0886260519888526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Research assessing familial violence against adolescents, using caregiver-adolescent dyads, is limited in post-conflict settings. This study aimed to determine the prevalence and factors associated with adolescent-reported familial abuse in post-conflict northern Uganda. It also assessed the relationship between abuse subtypes and (a) beliefs supporting aggression and (b) adolescent well-being and life satisfaction. A randomly selected community-based sample of 10- to 17-year-old adolescents (54% girls) and their caregivers (N = 427 dyads) in two northern Uganda districts was used. Abuse outcomes were adolescent reported. All measures used standardized tools that have been adapted for research in resource-limited settings. Analyses used multivariable linear regressions in Stata 14/IC. Overall, physical, emotional, and sexual abuse rates were 70% (confidence interval [CI] = [65.7, 74.4]), 72% (CI = [67.4, 76.0]), and 18.0% (CI = [14.0, 21.2]), respectively. Polyvictimization was 61% (CI = [55.4, 64.7]). There were no gender differences regarding adolescent reports of physical and emotional abuse, but adolescent girls were more likely to report sexual abuse and polyvictimization than adolescent boys. All forms of adolescent-reported abuse (except sexual abuse) were associated with caregiver reports of harsh disciplinary practices. In addition, emotional abuse was associated with physical and sexual abuse. Physical abuse was associated with being an orphan and emotional abuse. Sexual abuse was associated with being a girl, older adolescent age, living in a larger household, and emotional abuse. Polyvictimization was positively associated with being an orphan, younger caregiver age, caregiver-reported poor monitoring and supervision, and higher household socioeconomic status, but negatively associated with lower parental role satisfaction. Physical and emotional (but not sexual) abuse and polyvictimization were associated with beliefs supporting aggression among adolescents. All abuse subtypes were associated with lower levels of perceived well-being and life satisfaction among adolescents in this study. Child abuse prevention programs have the potential to improve adolescent-caregiver interaction and interrupt the violence transmission cycle in this setting.
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Affiliation(s)
- Helen P M Natukunda
- Makerere University, Kampala, Uganda
- MRC Harwell Institute, UK Research and Innovation, Oxfordshire, UK
- University of Oxford, UK
| | | | - Lucie D Cluver
- University of Oxford, UK
- University of Cape Town, South Africa
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13
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Tan M. New Directions for the Consideration of HIV: Heterogeneity and the Cognition of Time. New Dir Child Adolesc Dev 2021; 2020:11-23. [PMID: 32324328 DOI: 10.1002/cad.20327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It has been almost 40 years since HIV emerged in the human population with an alarming impact in 1981, quickly reaching pandemic proportions. Reaching the goal of eradication, or at least ending the pandemic, however, has not been as easy as hoped. To better understand and therefore better address the persistence and often devastating effects of this now chronic disease, the heterogeneity of HIV-in the virus-human and human-human relationships it engages-is parsed in discussions of the groups affected and the multiple factors that drive the diverse effects of the disease, both of which make treatment and prevention of the disease highly challenging. The construct of time cognition is then considered as a heretofore unexplored factor that may inform our understanding of HIV-relevant behaviors.
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15
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Herrero Romero R, Hall J, Cluver L, Meinck F, Hinde E. How Does Exposure to Violence Affect School Delay and Academic Motivation for Adolescents Living in Socioeconomically Disadvantaged Communities in South Africa? JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3661-NP3694. [PMID: 29909713 DOI: 10.1177/0886260518779597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
To date, little is known about the effects of violence on the educational outcomes of adolescents in disadvantaged communities in South Africa. In response, self-report data were collected from a socioeconomically disadvantaged sample of 503 adolescents aged 10 to 18 participating in a child abuse prevention trial in the Eastern Cape. Adolescents were purposively selected in the trial. This study applies Latent Profile Analysis (LPA) to examine relationships between past-month exposure to violence, school delay, and academic motivation. About 93.8% of adolescents in the sample experienced poly-violence-exposure to at least two forms of violence in the past month. Results identified two distinct profiles in the socioeconomically disadvantaged sample: Profile 1, adolescents exposed to more frequent poly-violence, and Profile 2, adolescents exposed to less frequent poly-violence. Being exposed to more frequent poly-violence was associated with greater risk of school delay-based on age-appropriate grade in South Africa. However, being exposed to more frequent poly-violence was not associated with lower academic motivation-adolescents showed high rates of wanting to achieve. Our findings suggest that exposure to more frequent poly-violence increases risk of school delay among adolescents from disadvantaged communities, while not affecting their academic motivation. Thus, although adolescents maintained aspirations and goals to do well at school, exposure to high frequency of violence affected their capacity to fulfill these aims.
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Affiliation(s)
| | | | - Lucie Cluver
- University of Oxford, UK
- University of Cape Town, South Africa
| | - Franziska Meinck
- University of Oxford, UK
- North-West University, Vanderbijlpark, South Africa
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Mthiyane N, Harling G, Chimbindi N, Baisley K, Seeley J, Dreyer J, Zuma T, Birdthistle I, Floyd S, McGrath N, Tanser F, Shahmanesh M, Sherr L. Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa. BMC Public Health 2021; 21:478. [PMID: 33691665 PMCID: PMC7945212 DOI: 10.1186/s12889-021-10527-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 02/28/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND HIV affects many adolescent girls and young women (AGYW) in South Africa. Given the bi-directional HIV and mental health relationship, mental health services may help prevent and treat HIV in this population. We therefore examined the association between common mental disorders (CMD) and HIV-related behaviours and service utilisation, in the context of implementation of the combination DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) HIV prevention programme in rural uMkhanyakude district, KwaZulu-Natal. DREAMS involved delivering a package of multiple interventions in a single area to address multiple sources of HIV risk for AGYW. METHODS We analysed baseline data from an age-stratified, representative cohort of 13-22 year-old AGYW. We measured DREAMS uptake as a count of the number of individual-level or community-based interventions each participant received in the last 12 months. CMD was measured using the validated Shona Symptom Questionnaire, with a cut off score ≥ 9 indicating probable CMD. HIV status was ascertained through home-based serotesting. We used logistic regression to estimate the association between CMD and HIV status adjusting for socio-demographics and behaviours. RESULTS Probable CMD prevalence among the 2184 respondents was 22.2%, increasing steadily from 10.1% among 13 year-old girls to 33.1% among 22 year-old women. AGYW were more likely to report probable CMD if they tested positive for HIV (odds ratio vs. test negative: 1.88, 95% confidence interval: 1.40-2.53). After adjusting for socio-demographics and behaviours, there was evidence that probable CMD was more prevalent among respondents who reported using multiple healthcare-related DREAMS interventions. CONCLUSION We found high prevalence of probable CMD among AGYW in rural South Africa, but it was only associated with HIV serostatus when not controlling for HIV acquisition risk factors. Our findings highlight that improving mental health service access for AGYW at high risk for HIV acquisition might protect them. Interventions already reaching AGYW with CMD, such as DREAMS, can be used to deliver mental health services to reduce both CMD and HIV risks. There is a need to integrate mental health education into existing HIV prevention programmes in school and communities.
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Affiliation(s)
| | - Guy Harling
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, UK
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology & Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- University of KwaZulu-Natal, Durban, South Africa
| | - Natsayi Chimbindi
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Kathy Baisley
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
| | - Janet Seeley
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
| | - Jaco Dreyer
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Thembelihle Zuma
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | | | - Sian Floyd
- London School of Hygiene and Tropical Medicine, London, UK
| | - Nuala McGrath
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
| | - Frank Tanser
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, UK
- University of Southampton, Southampton, UK
- University of Lincoln, Lincoln, UK
| | - Maryam Shahmanesh
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, UK
- University of KwaZulu-Natal, Durban, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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Shenderovich Y, Cluver L, Eisner M, Murray AL. Moderators of treatment effects in a child maltreatment prevention programme in South Africa. CHILD ABUSE & NEGLECT 2020; 106:104519. [PMID: 32485323 DOI: 10.1016/j.chiabu.2020.104519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/29/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous research has found mixed results on whether the most disadvantaged families benefit as much as less disadvantaged families from parenting interventions designed to reduce child maltreatment, and little in known in low-income settings. OBJECTIVE In this study, we test the effects of child, caregiver, household, and community characteristics as treatment moderators of intervention outcomes - child maltreatment and parenting practices. We test characteristics previously examined elsewhere as well as factors relevant to the South African context. PARTICIPANTS AND SETTING This analysis includes adolescents (ages 10-18) and their caregivers (N = 552 pairs) who participated in a randomised trial of a parenting programme in the Eastern Cape Province of South Africa. METHODS Data from the caregiver and adolescent standardised questionnaires collected at baseline, post-test (1-month post-intervention), and follow-up (5-9 months) were analysed using longitudinal multilevel analyses. We tested seven hypothesised moderators for each of the primary outcomes through interactions of treatment effect with baseline moderators. RESULTS No moderator effects were statistically significant after correcting for multiple comparisons testing. Hence, in line with several recent studies examining moderation effects in parenting programmes, our study suggests that parenting interventions aiming to reduce child maltreatment and promote parenting skills in low- and middle-income countries may be similarly effective for families facing various levels of economic, social, and health risk factors. CONCLUSIONS It may be useful to explicitly power trials for testing moderator effects, study different types of moderators and use person-centred analyses to further understand variations in treatment effects.
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Affiliation(s)
- Yulia Shenderovich
- Department of Social Policy and Intervention, Centre for Evidence-Based Intervention, University of Oxford, Barnett House, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom; Institute of Criminology, University of Cambridge, Sidgwick Avenue, CB3 9DA, Cambridge, United Kingdom.
| | - Lucie Cluver
- Department of Social Policy and Intervention, Centre for Evidence-Based Intervention, University of Oxford, Barnett House, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, 7925, Cape Town, South Africa.
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, CB3 9DA, Cambridge, United Kingdom; Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zürich, Switzerland.
| | - Aja Louise Murray
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, CB3 9DA, Cambridge, United Kingdom; Department of Psychology, University of Edinburgh, Room F16, Psychology Building, 7 George Square, Edinburgh, EH8 9JZ, United Kingdom.
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18
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Goin DE, Pearson RM, Craske MG, Stein A, Pettifor A, Lippman SA, Kahn K, Neilands TB, Hamilton EL, Selin A, MacPhail C, Wagner RG, Gomez-Olive FX, Twine R, Hughes JP, Agyei Y, Laeyendecker O, Tollman S, Ahern J. Depression and Incident HIV in Adolescent Girls and Young Women in HIV Prevention Trials Network 068: Targets for Prevention and Mediating Factors. Am J Epidemiol 2020; 189:422-432. [PMID: 31667490 PMCID: PMC7306677 DOI: 10.1093/aje/kwz238] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 12/31/2022] Open
Abstract
The human immunodeficiency virus (HIV) epidemic among adolescent girls and young women (AGYW) in sub-Saharan Africa is a critical public health problem. We assessed whether depressive symptoms in AGYW were longitudinally associated with incident HIV, and identified potential social and behavioral mediators. Data came from a randomized trial of a cash transfer conditional on school attendance among AGYW (ages 13-21 years) in rural Mpumalanga Province, South Africa, during 2011-2017. We estimated the relationship between depressive symptoms and cumulative HIV incidence using a linear probability model, and we assessed mediation using inverse odds ratio weighting. Inference was calculated using the nonparametric bootstrap. AGYW with depressive symptoms had higher cumulative incidence of HIV compared with those without (risk difference = 3.5, 95% confidence interval (CI): 0.1, 7.0). The strongest individual mediators of this association were parental monitoring and involvement (indirect effect = 1.6, 95% CI: 0.0, 3.3) and reporting a partner would hit her if she asked him to wear a condom (indirect effect = 1.5, 95% CI: -0.3, 3.3). All mediators jointly explained two-thirds (indirect effect = 2.4, 95% CI: 0.2, 4.5) of the association between depressive symptoms and HIV incidence. Interventions addressing mental health might reduce risk of acquiring HIV among AGYW.
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Affiliation(s)
- Dana E Goin
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol University, Bristol, United Kingdom
- Bristol Biomedical Research Centre, National Institute for Health Research, Bristol, United Kingdom
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Alan Stein
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Audrey Pettifor
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri A Lippman
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Kathleen Kahn
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Torsten B Neilands
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Erica L Hamilton
- HIV Prevention Trials Network Leadership and Operations Center, Science Facilitation Department, FHI 360, Durham, North Carolina
| | - Amanda Selin
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Carolina Population Center, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Catherine MacPhail
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Ryan G Wagner
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gomez-Olive
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Rhian Twine
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - James P Hughes
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Yaw Agyei
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Oliver Laeyendecker
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
- Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Stephen Tollman
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer Ahern
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California
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Shenderovich Y, Eisner M, Cluver L, Doubt J, Berezin M, Majokweni S, Murray AL. What Affects Attendance and Engagement in a Parenting Program in South Africa? PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:977-986. [PMID: 30121876 PMCID: PMC6182387 DOI: 10.1007/s11121-018-0941-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Parenting programs are a promising approach to improving family well-being. For families to benefit, programs need to be able to engage families actively in the interventions. Studies in high-income countries show varying results regarding whether more disadvantaged families are equally engaged in parenting interventions. In low- and middle-income countries (LMICs), almost nothing is known about the patterns of participation in parent training. This paper examines group session attendance and engagement data from 270 high-risk families enrolled in the intervention arm of a cluster-randomized controlled trial in South Africa. The trial evaluated a 14-week parenting intervention aiming to improve parenting and reduce maltreatment by caregivers. The intervention was delivered in 20 groups, one per study cluster, with 8 to 16 families each. Overall, caregivers attended 50% of group sessions and children, 64%. Using linear multilevel models with Kenward-Roger correction, we examined child and caregiver baseline characteristics as predictors of their attendance and engagement in the group sessions. Variables examined as predictors included measures of economic, educational, and social and health barriers and resources, as well as family problems and sociodemographic characteristics. Overall, the study yielded no evidence that the level of stressors, such as poverty, was related to attendance and engagement. Notably, children from overcrowded households attended on average 1.2 more sessions than their peers. Our findings suggest it is possible to engage highly disadvantaged families that face multiple challenges in parenting interventions in LMICs. However, some barriers such as scheduling, and alcohol and substance use, remain relevant.
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Affiliation(s)
- Yulia Shenderovich
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, England.
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, England
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, England.,HIV Mental Health Research Unit, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jenny Doubt
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, England
| | - McKenzie Berezin
- Department of Applied Psychology, New York University, 246 Greene Street, New York, NY, 10003, USA
| | - Sybil Majokweni
- HIV Mental Health Research Unit, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Aja Louise Murray
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA, England
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20
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Werfalli M, Murphy K, Kalula S, Levitt N. Current policies and practices for the provision of diabetes care and self-management support programmes for older South Africans. Afr J Prim Health Care Fam Med 2019; 11:e1-e12. [PMID: 31478747 PMCID: PMC6739530 DOI: 10.4102/phcfm.v11i1.2053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND One of the most important primary health challenges currently affecting older people in South Africa (SA) is the increasing prevalence of non-communicable disease (NCD). Research is needed to investigate the current state of care and self-management support available to older diabetic patients in SA and the potential for interventions promoting self-management and community involvement. AIM This study aimed to review current policies, programmes and any other interventions as they relate to older people with diabetes with a view to assess the potential for the development of a self-management programme for older persons attending public sector primary health care services in Cape Town, South Africa. SETTING Eighteen community health centres (CHCs) formed the sampling frame for the study. METHODS This study aimed to review current policies and programmes as they relate to older people with diabetes. It involved a documentary review and qualitative individual interviews with key informants in the health services and Department of Health. RESULTS Several national initiatives have sought to advance the health of older people, but they have only been partially successful. There are however multiple efforts to re-orientate the health-care system to focus more effectively on NCDs, which benefit older patients with diabetes. The establishment of community-based services to provide self-management support, promote health and ease access to medicine helps overcome many of the commonly cited barriers to care experienced by older patients. What may be equally important is that practitioners gain the communication skills and educational resources to effectively educate and counsel patients on lifestyle behaviour change and self-care management. CONCLUSION This article alerts policy-makers and clinicians to some of the specific issues considered to be pertinent and important in the care and management of older diabetic patients. Many of these would also be applicable to older patients with other chronic conditions.
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Affiliation(s)
- Mahmoud Werfalli
- Chronic Disease Initiative for Africa, Cape Town; and Department of Medicine, Division of Endocrinology and Diabetic Medicine, University of Cape Town, Observatory, Cape Town.
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21
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Harrison C, Loxton H, Somhlaba NZ. Stress and Coping: Considering the Influence of Psychological Strengths on the Mental Health of At-Risk South African Adolescents. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/13575279.2019.1604492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Carmen Harrison
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Helene Loxton
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Nceba Z. Somhlaba
- Department of Psychology, University of the Western Cape, Bellville South Africa
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22
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Shamu S, Shamu P, Zarowsky C, Temmerman M, Shefer T, Abrahams N. Does a history of sexual and physical childhood abuse contribute to HIV infection risk in adulthood? A study among post-natal women in Harare, Zimbabwe. PLoS One 2019; 14:e0198866. [PMID: 30608938 PMCID: PMC6319705 DOI: 10.1371/journal.pone.0198866] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 11/14/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women. METHODS A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother's antenatal HIV status. Participants were interviewed about childhood abuse including physical or sexual abuse before 15 years of age, forced first sex before 16, HIV risk factors such as age difference at first sex before age 16. Multivariate analyses assessed the associations between mother's HIV status and child physical and sexual abuse while controlling for confounding variables. RESULTS More than one in four (26.6%) reported abuse before the age of 15: 14.6% physical abuse and 9.1% sexual abuse,14.3% reported forced first sex and 9.0% first sex before 16 with someone 5+ years older. Fifteen percent of women tested HIV positive during the recent antenatal care visit. In multivariate analysis, childhood physical abuse (aOR 3.30 95%CI 1.58-6.90), sexual abuse (3.18 95%CI: 1.64-6.19), forced first sex (aOR 1.42, 95%CI: 1.00-2.02), and 5+ years age difference with first sex partner (aOR 1.66 95%CI 1.09-2.53) were independently associated with HIV infection. CONCLUSION This study highlights that child physical and/or sexual abuse may increase risk for HIV acquisition. Further research is needed to assess the pathways to HIV acquisition from childhood to adulthood. Prevention of child abuse must form part of the HIV prevention agenda in Sub-Saharan Africa.
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Affiliation(s)
- Simukai Shamu
- Health Systems Strengthening Division, Foundation for Professional Development, Pretoria, South Africa
- School of Public Health, University of the Western Cape, Belville, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Patience Shamu
- Wits Reproductive Health Research Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Christina Zarowsky
- School of Public Health, University of the Western Cape, Belville, South Africa
- University of Montreal Hospital Research Centre, Montreal, Canada
| | - Marleen Temmerman
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
- Obstetrics and Gynaecology, Agha Khan University, Nairobi, Kenya
| | - Tamara Shefer
- Department of Women and Gender Studies, University of the Western Cape, Belville, South Africa
| | - Naeemah Abrahams
- School of Public Health, University of the Western Cape, Belville, South Africa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
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23
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Hatcher AM, Gibbs A, Jewkes R, McBride RS, Peacock D, Christofides N. Effect of Childhood Poverty and Trauma on Adult Depressive Symptoms Among Young Men in Peri-Urban South African Settlements. J Adolesc Health 2019; 64:79-85. [PMID: 30327276 DOI: 10.1016/j.jadohealth.2018.07.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/19/2018] [Accepted: 07/25/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Depressive disorders contribute to health declines among young men, but little is known about how childhood trauma alongside poverty alters depressive symptoms in young adulthood. These life-course dynamics are particularly under-researched in African settings. METHODS We assessed how childhood trauma and poverty were associated with depressive symptomology among young men (aged 18-30 years). Data were collected through community-based surveys in two peri-urban, South African settlements. Validated measures assessed childhood abuse, depressive symptomology, and food insecurity. Markers of childhood poverty and young adult socioeconomic predictors were also assessed. RESULTS A total of 2,427 young men reported low levels of income, food security, and education. One-third of the sample (39.2%) reported symptoms consistent with probable depression. The majority (76.9%) reported one or more forms of childhood abuse, which was predicted by childhood hunger. Compared with counterparts without childhood trauma, those with physical, sexual, or psychological childhood abuse had a higher risk of later depressive symptoms (adjusted odds ratio [AOR]=2.37,2.42,2.39, respectively). A fully saturated linear mixed model showed each form of childhood trauma predicted increased depressive symptomology in adulthood, with the combination of physical, sexual, and psychological abuse strongly predicting increased depressive symptoms (coef=6.78, 95%CI=5.78-8.17). In all models, childhood poverty and adult poverty independently predicted young adult depressive symptoms. CONCLUSION Household poverty may be a key reason that children experience abuse and, in turn, common mental disorders in young adulthood. Structural interventions for food security, employment, and parenting are essential to break the intergenerational nexus of poverty, trauma, and health in peri-urban settings.
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Affiliation(s)
- Abigail M Hatcher
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Medicine, University of California, San Francisco, San Francisco, California.
| | - Andrew Gibbs
- Gender and Health Division, South African Medical Research Council, Pretoria, South Africa
| | - Rachel Jewkes
- Gender and Health Division, South African Medical Research Council, Pretoria, South Africa
| | - Ruari-Santiago McBride
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dean Peacock
- Sonke Gender Justice, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Meinck F, Boyes ME, Cluver L, Ward CL, Schmidt P, DeStone S, Dunne MP. Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers. CHILD ABUSE & NEGLECT 2018; 82:45-58. [PMID: 29860107 DOI: 10.1016/j.chiabu.2018.05.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/24/2018] [Accepted: 05/26/2018] [Indexed: 05/14/2023]
Abstract
Child abuse prevention research has been hampered by a lack of validated multi-dimensional non-proprietary instruments, sensitive enough to measure change in abuse victimization or behavior. This study aimed to adapt the ICAST child abuse self-report measure (parent and child) for use in intervention studies and to investigate the psychometric properties of this substantially modified tool in a South African sample. First, cross-cultural and sensitivity adaptation of the original ICAST tools resulted in two preliminary measures (ICAST-Trial adolescents: 27 items, ICAST-Trial caregivers: 19 items). Second, ICAST-Trial data from a cluster randomized trial of a parenting intervention for families with adolescents (N = 1104, 552 caregiver-adolescent dyads) was analyzed. Confirmatory factor analysis established the hypothesized 6-factor (adolescents) and 4-factor (caregivers) structure. Removal of two items for adolescents and five for caregivers resulted in adequate model fit. Concurrent criterion validity analysis confirmed hypothesized relationships between child abuse and adolescent and caregiver mental health, adolescent behavior, discipline techniques and caregiver childhood abuse history. The resulting ICAST-Trial measures have 25 (adolescent) and 14 (caregiver) items respectively and measure physical, emotional and contact sexual abuse, neglect (both versions), and witnessing intimate partner violence and sexual harassment (adolescent version). The study established that both tools are sensitive to measuring change over time in response to a parenting intervention. The ICAST-Trial should have utility for evaluating the effectiveness of child abuse prevention efforts in similar socioeconomic contexts. Further research is needed to replicate these findings and examine cultural appropriateness, barriers for disclosure, and willingness to engage in child abuse research.
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Affiliation(s)
- Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, United Kingdom; OPTENTIA, Faculty of Health Sciences, North-West University, 1174 Hendrick Van Eck Boulevard, 1900 Vanderbijlpark, South Africa.
| | - Mark E Boyes
- Faculty of Health Sciences, School of Psychology, Curtin University, Perth, Australia.
| | - Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Catherine L Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa.
| | - Peter Schmidt
- Institut für Politikwissenschaft, Justus-Liebig-Universität Gießen, Gießen, Germany.
| | - Sachin DeStone
- Warwick Medical School, University of Warwick, Coventry, United Kingdom.
| | - Michael P Dunne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Visser M, Thurman TR, Spyrelis A, Taylor TM, Nice JK, Finestone M. Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa. EVALUATION AND PROGRAM PLANNING 2018; 68:124-134. [PMID: 29549782 DOI: 10.1016/j.evalprogplan.2018.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/19/2018] [Accepted: 03/03/2018] [Indexed: 06/08/2023]
Abstract
Preventing HIV among young people is critical to achieving and sustaining global epidemic control. Evidence from Western settings suggests that family-centred prevention interventions may be associated with greater reductions in risk behaviour than standard adolescent-only models. Despite this, family-centred models for adolescent HIV prevention are nearly non-existent in South Africa - home to more people living with HIV than any other country. This paper describes the development and formative evaluation of one such intervention: an evidence-informed, locally relevant, adolescent prevention intervention engaging caregivers as co-participants. The programme, originally consisting of 19 sessions for caregivers and 14 for adolescents, was piloted with 12 groups of caregiver-adolescent dyads by community-based organizations (CBOs) in KwaZulu-Natal and Gauteng provinces. Literature and expert reviews were employed in the development process, and evaluation methods included analysis of attendance records, session-level fidelity checklists and facilitator feedback forms collected during the programme pilot. Facilitator focus group discussions and an implementer programme workshop were also held. Results highlighted the need to enhance training content related to cognitive behavioural theory and group management techniques, as well as increase the cultural relevance of activities in the curriculum. Participant attendance challenges were also identified, leading to a shortened and simplified session set. Findings overall were used to finalize materials and guidance for a revised 14-week group programme consisting of individual and joint sessions for adolescents and their caregivers, which may be implemented by community-based facilitators in other settings.
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Affiliation(s)
- Maretha Visser
- Department of Psychology, University of Pretoria, Pretoria, South Africa.
| | - Tonya R Thurman
- Tulane University School of Social Work, New Orleans, LA, USA; Highly Vulnerable Children Research Center (HVC-RC), Cape Town, South Africa; Tulane International, LLC, Cape Town, South Africa
| | - Alexandra Spyrelis
- Highly Vulnerable Children Research Center (HVC-RC), Cape Town, South Africa; Tulane International, LLC, Cape Town, South Africa
| | - Tory M Taylor
- Highly Vulnerable Children Research Center (HVC-RC), Cape Town, South Africa; Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Johanna K Nice
- Tulane University School of Social Work, New Orleans, LA, USA; Highly Vulnerable Children Research Center (HVC-RC), Cape Town, South Africa
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Herrero Romero R, Hall J, Cluver L, Meinck F. Can supportive parenting protect against school delay amongst violence-exposed adolescents in South Africa? CHILD ABUSE & NEGLECT 2018; 78:31-45. [PMID: 28964563 DOI: 10.1016/j.chiabu.2017.09.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/30/2017] [Accepted: 09/18/2017] [Indexed: 06/07/2023]
Abstract
Exposure to multiple forms of violence is common amongst adolescents from socioeconomically disadvantaged communities in South Africa. Adolescents' exposure to violence at home, in school and in their communities can lead to detrimental outcomes in education. In particular, adolescents who are more frequently exposed to multiple forms of violence are at risk of school delay. This paper investigates the potential for supportive parenting to protect against adolescents' school delay in this context. With this aim, this paper applies structural equation modelling to a sample of 503 adolescents exposed to multiple forms of violence from 40 socioeconomically disadvantaged communities. Adolescents' self-report data on child abuse in the family, school and community, and adolescents' perceptions of positive parenting, consistent discipline, good monitoring, parental involvement and social support were analyzed. Results showed that perceptions of more positive parenting and consistent discipline moderated the relationship between more frequent exposure to multiple forms of violence and school delay. Our findings suggest that supportive parenting has the potential to protect against school delay for poly-victimized adolescents in South Africa.
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Affiliation(s)
- Rocio Herrero Romero
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom.
| | - James Hall
- Southampton Education School University of Southampton, University Road, Southampton SO17 1BJ, United Kingdom.
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town J-Block, Groote Schuur Hospital Observatory, Cape Town, South Africa.
| | - Franziska Meinck
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom; OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbijlpark, 1900 Gauteng, South Africa.
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Shulman S, Scharf M. Adolescent psychopathology in Times of Change: The need for integrating a developmental psychopathology perspective. J Adolesc 2018; 65:95-100. [PMID: 29567491 DOI: 10.1016/j.adolescence.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In addition to the major physical, sexual and cognitive changes, as well as changes in relationships with parents and peers, in recent years adolescents also have to cope with many technological changes and increasing societal instabilities. Most of the existing research has examined the extent to which increasing uncertainties might impact expression of psychopathology and its magnitude. Emerging from a developmental psychopathology perspective, we are looking first for a better understanding of the meaning that adolescents give to these changes, which in turn is likely to affect their behavior. We are also looking for better understanding the importance of the role parents, and other societal systems/institutions (such as peers) play in ameliorating or enhancing the likelihood of maladaptive adolescent behavior under these circumstances.
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Meinck F, Fry D, Ginindza C, Wazny K, Elizalde A, Spreckelsen TF, Maternowska MC, Dunne MP. Emotional abuse of girls in Swaziland: prevalence, perpetrators, risk and protective factors and health outcomes. J Glob Health 2018; 7:010410. [PMID: 28607670 PMCID: PMC5460395 DOI: 10.7189/jogh.07.010410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Research on emotional child abuse in sub–Saharan Africa is scarce. Few studies thus far have examined prevalence, risk and protective factors for emotional child abuse or the associations between emotional abuse and girls’ health. Methods A nationally representative two–stage, cluster–sampled, household survey of females aged 13–24 years (n = 1244) on childhood abuse victimisation was conducted. Participants completed interviewer–assisted questionnaires. Associations between emotional abuse and putative risk, and protective factors and health outcomes were analyzed using separate logistic regression models accounting for sampling design. Marginal effects of cumulative risk factors for emotional abuse victimisation were examined. Results Lifetime prevalence of emotional abuse was 28.5% with 58.3% of these girls reporting many abusive incidents. The most common perpetrators were female (27.8%) and male (16.7%) relatives and, more rarely, biological parents. Risk factors associated with emotional abuse were frequent caregiver changes (odds ratio (OR) 1.42, 95% confidence interval (CI) 1.03–1.970, poverty (OR 1.51, 95% CI 1.12–2.03), and physical abuse (OR 1.98, 95% CI 1.45–2.71) and sexual abuse (OR 2.22, 95% CI 1.57–3.10) victimisation. Being close to one’s mother was a protective factor (OR 0.88, 95% CI 0.80–0.97). Risk for emotional abuse increased from 13% with no risk factors present to 58.4% –with all four risk factors present. Health outcomes associated with emotional child abuse were suicidal ideation (OR 1.85, 95% CI 1.30–2.63) and feeling depressed (OR 1.89, 95% CI 1.31–2.71). Conclusions Girls in Swaziland experience high levels of emotional abuse victimisation. Emotional abuse is associated with economic disadvantage, family factors, other types of abuse victimisation and poor mental health. Therefore, a holistic approach to prevention is needed, incorporating poverty reduction and programmes to improve parent–child relationships, reduce the use of harsh criticism, and change parenting social norms.
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Affiliation(s)
- Franziska Meinck
- University of Oxford, Oxford, England, UK.,OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbijlpark, South Africa
| | - Deborah Fry
- Moray House School of Education, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Kerri Wazny
- Moray House School of Education, University of Edinburgh, Edinburgh, Scotland, UK
| | - Aldo Elizalde
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | | | | | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Herrero Romero R, Hall J, Cluver L. Exposure to violence, teacher support, and school delay amongst adolescents in South Africa. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2018; 89:1-21. [PMID: 29336474 DOI: 10.1111/bjep.12212] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/10/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many adolescents in South Africa are exposed to multiple types of violence, socio-economic disadvantage, and low-quality education: all risk factors for educational outcomes including school delay (grade enrolment below that which is age-appropriate). Supportive teacher-student relationships are known to be associated with improved academic outcomes in high-income contexts. AIMS To investigate whether the academic and emotional support provided by teachers can protect against school delay for adolescents exposed to multiple types of violence and socio-economic disadvantage in South Africa. SAMPLE High-risk sample of 503 adolescents aged 10-18 exposed to multiple types of violence and socio-economic disadvantage at home, in school, and in their communities. METHODS Multilevel aggregated structural equation modelling was applied to pre/post-RCT data. This investigated whether associations between adolescent exposure to violence and school delay could be lessened by having teachers who were academically and/or emotionally supportive. RESULTS More frequent exposure to 'poly-violence' and receiving more emotional support from teachers were independently associated with greater school delay. On the contrary, higher academic support from teachers was associated with lower school delay. Neither academic nor emotional teacher support was found to moderate the relationship between more frequent exposure to 'poly-violence' and an increased risk of adolescent school delay. CONCLUSION Adolescents' academic support from teachers is low in poorly resourced school contexts in South Africa. School-based secondary prevention programmes assisting teachers with more training and academic support in deprived contexts have potential to reduce the impact of violence and socio-economic disadvantage on adolescents' school delay.
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Affiliation(s)
| | - James Hall
- Southampton Education School, University of Southampton, UK
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, UK.,Department of Psychiatry and Mental Health, University of Cape Town, South Africa
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30
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Boydell N, Nalukenge W, Siu G, Seeley J, Wight D. How mothers in poverty explain their use of corporal punishment: A qualitative study in Kampala, Uganda. THE EUROPEAN JOURNAL OF DEVELOPMENT RESEARCH 2017; 29:999-1016. [PMID: 29213191 PMCID: PMC5714261 DOI: 10.1057/s41287-017-0104-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Corporal punishment in the early years is associated with anti-social behaviour and violence, but little is known about its social and cultural context in low income countries. This paper analyses how 12 deprived women in Kampala, Uganda, perceived corporal punishment, drawing on repeated semi-structured interviews. All thought it was sometimes necessary, for three main reasons. First, it was an important strategy to ensure good behaviour and maintain their and their child's, respectability, crucial to self-respect given severe poverty. Second, it was a means of establishing household routines and managing scarce resources. Third, it was a way to protect children from health risks. However, all mothers thought corporal punishment could be excessive, and most said it can be counter-productive, making children 'stubborn'. There appeared to be considerable variation in their degree of harsh parenting and emotional support. These findings could inform culturally appropriate interventions to reduce violence against children.
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Affiliation(s)
- Nicola Boydell
- Centre for Research on Families and Relationships, University of Edinburgh, Edinburgh, UK
| | | | - Godfrey Siu
- MRC/UVRI Uganda Research Unit On AIDS, Entebbe, Wakiso, Uganda
| | - Janet Seeley
- MRC/UVRI Uganda Research Unit On AIDS, Entebbe, Wakiso, Uganda
| | - Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Ameli V, Meinck F, Munthali A, Ushie B, Langhaug L. Associations between adolescent experiences of violence in Malawi and gender-based attitudes, internalizing, and externalizing behaviors. CHILD ABUSE & NEGLECT 2017; 67:305-314. [PMID: 28327416 DOI: 10.1016/j.chiabu.2017.02.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
Little is known about adolescent exposure to and factors associated with violence in Malawi. The aim of this research was to describe the prevalence of exposure to violence among adolescents in Malawi, and test the hypotheses that such exposures are associated with gender-based violent attitudes, and with internalizing and externalizing problems. In 2014, 561 primary school pupils were interviewed (50% girls), and logistic regression analysis was performed on gender-stratified data, adjusting for sociodemographic differences. Both girls and boys had witnessed domestic violence (28.5% & 29.6%), experienced emotional abuse at home (23.1% & 22.9%), physical abuse at home (28.1% & 30.4%), physical abuse at school (42.4% & 36.4%), and been bullied (33.8% & 39.6%). Among girls, internalized violent attitudes towards women were associated with emotional abuse at home (OR 2.1) and physical abuse at school (OR 1.7). Condoning rape was associated with physical abuse at school (OR 1.9). Bullying perpetration was associated with emotional abuse at home (OR 4.5). Depression was associated with emotional abuse at home (OR 3.8) and physical abuse at school (OR 2.4). Among boys, violent attitudes towards women and condoning rape were not associated with violence exposure. Bullying perpetration was associated with having been a victim of bullying (OR 2.9) and physical abuse at school (OR 2.7). Depression was associated with emotional abuse at home (OR 2.9), domestic violence (OR 2.4) and physical abuse at school (OR 2.5). These findings can inform programs designed to reduce violence victimization among Malawian girls, both in homes and schools.
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Affiliation(s)
- Vira Ameli
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK; OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbeijlpark, South Africa
| | | | - Boniface Ushie
- Regional Psychosocial Support Initiative (REPSSI), Johannesburg, South Africa
| | - Lisa Langhaug
- Regional Psychosocial Support Initiative (REPSSI), Johannesburg, South Africa
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Abstract
Violence in childhood is a serious health, social and human rights concern globally, there is, however, little understanding about the factors that explain the various forms of violence in childhood. This paper uses data on childhood violence for 10,042 individuals from four countries. We report Odds Ratios from pooled logit regression analysis with country fixed effects model. There is no gender difference in the overall incidence of childhood violence. The data shows that 78% of girls and 79% of boys have suffered some form of violence before the age of 18 years. Odds of violence are higher among richer households, among individuals who have attended school and among individuals who have been married or in marriage-like arrangements. Individuals who justify wife beating have significantly higher likelihood of having faced violence themselves. Most perpetrators of violence against children - physical, emotional and sexual - are people known to them in their homes and community, and not strangers. There is limited understanding of the factors that explain violence in childhood. This study highlights some key factors that can explain this phenomenon.
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Affiliation(s)
- Shamika Ravi
- a Development Economics , Brookings India , New Delhi.,b Governance Studies Program , Brookings Institution , Washington , DC , USA
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