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Hennein R, Nanziri LM, Musinguzi J, Ggita JM, Turimumahoro P, Ochom E, Gupta AJ, Halder A, Katamba A, White MA, Pietrzak RH, Armstrong-Hough M, Davis JL. Cultural Adaptation and Validation of the General Self-Efficacy Scale in Ugandan Community Health Workers. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:371-383. [PMID: 37736283 PMCID: PMC10512428 DOI: 10.1007/s43477-022-00064-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/18/2022] [Indexed: 09/23/2023]
Abstract
Self-efficacy is central to community health workers' capacity and motivation to deliver evidence-based care; thus, validated measures of self-efficacy are needed to assess the effectiveness of community health worker programs. In this study, we culturally adapted and evaluated the General Self-Efficacy Scale among community health workers in Uganda using multiple methods. We adapted the ten-item General Self-Efficacy Scale through cross-cultural discussions within our multidisciplinary research team, translation from English into Luganda and back-translation into English, and six cognitive interviews with community health workers. We administered the adapted scale in a staged, two-part cross-sectional study, including a total of 147 community health workers. Exploratory factor analysis yielded three factors, which we labeled problem-solving, persistence, and resourcefulness. This three-factor solution had good model fit (standardized root mean square residual = 0.07) and explained 53.4% of the variance. We found evidence of convergent validity, as scores for the total scale were positively correlated with years of experience (r = 0.48; p < .001) and perceived social support (r = 0.39, p < .001). Scores were also higher among those with higher educational attainment in one-way analysis of variance and Bonferroni-corrected post hoc tests [F (2,72) = 9.16, p < .001]. We also found evidence of discriminant validity, as scores for the total scale were not correlated with age (r = - 0.07, p = .55), in agreement with literature showing that general self-efficacy is an age-independent construct. The internal consistency of the adapted scale was within the acceptable range for a pilot study (Cronbach's α = 0.61). This evaluation of a Uganda-adapted General Self-Efficacy Scale demonstrated promising psychometric properties; however, larger studies with repeated measures are warranted to further assess the adapted scale's factor structure, validity, reliability, and stability over time.
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Affiliation(s)
- Rachel Hennein
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Leah M. Nanziri
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - Johnson Musinguzi
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - Joseph M. Ggita
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | | | - Emmanuel Ochom
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - Amanda J. Gupta
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anushka Halder
- Department of Social and Behavioral Sciences, New York University, New York, NY, USA
| | - Achilles Katamba
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Clinical Epidemiology and Biostatistics Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Marney A. White
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Robert H. Pietrzak
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Mari Armstrong-Hough
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Social and Behavioral Sciences, New York University, New York, NY, USA
- Department of Epidemiology, New York University, New York, NY, USA
| | - J. Lucian Davis
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, CT, USA
- Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
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Folayan MO, Ibigbami O, ElTantawi M, Abeldaño GF, Ara E, Ayanore MA, Ellakany P, Gaffar B, Al-Khanati NM, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Osamika BE, Popoola BO, Quadri MFA, Roque M, Shamala A, Al-Tammemi AB, Yousaf MA, Virtanen JI, Zuñiga RAA, Okeibunor JC, Nguyen AL. Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study. BMC Psychiatry 2022; 22:48. [PMID: 35062920 PMCID: PMC8777174 DOI: 10.1186/s12888-021-03617-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/24/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies. METHODS The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. RESULTS Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). CONCLUSION The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria. .,Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, 22005, Nigeria.
| | - Olanrewaju Ibigbami
- grid.10824.3f0000 0001 2183 9444Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Maha ElTantawi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Giuliana Florencia Abeldaño
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,School of Medicine, University of Sierra Sur, Oaxaca, Mexico
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.412997.00000 0001 2294 5433Government College for Women, Maulana Azad Road, Srinagar, J&K India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449729.50000 0004 7707 5975Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411975.f0000 0004 0607 035XDepartment of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411975.f0000 0004 0607 035XDepartment of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Nuraldeen Maher Al-Khanati
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.416197.c0000 0001 0247 1197Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411831.e0000 0004 0398 1027Department of Preventive Dental Sciences, Jazan University, Jazan, Saudi Arabia ,grid.5012.60000 0001 0481 6099Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Abeedah Tu-Allah Khan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9582.60000 0004 1794 5983Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449469.20000 0004 0516 1006Regent’s University London, London, United Kingdom
| | - Ntombifuthi P. Nzimande
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9008.10000 0001 1016 9625Department of Economic and Social Geography, University of Szeged, Szeged, Hungary
| | - Bamidele Emmanuel Osamika
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.259956.40000 0001 2195 6763Department of Psychology, Miami University Oxford, Ohio, USA
| | - Bamidele Olubukola Popoola
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9582.60000 0004 1794 5983Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411831.e0000 0004 0398 1027Department of Preventive Dental Sciences, Division of Dental Public Health, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mark Roque
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.412892.40000 0004 1754 9358Department of Maternity & Childhood Nursing, College of Nursing, Taibah University, Madinah, Kingdom of Saudi Arabia
| | - Anas Shamala
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.444917.b0000 0001 2182 316XDepartment of Preventive and Biomedical Science, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Ala’a B. Al-Tammemi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.7122.60000 0001 1088 8582Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary ,grid.7122.60000 0001 1088 8582Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XInstitute of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590 Pakistan
| | - Jorma I. Virtanen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.1374.10000 0001 2097 1371Faculty of Medicine, University of Turku, Turku, Finland
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
| | - Joseph Chukwudi Okeibunor
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.463718.f0000 0004 0639 2906Research Development and Innovations, Assistant Regional Director Cluster, WHO Regional Office for Africa, Brazzaville, Congo
| | - Annie Lu Nguyen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.42505.360000 0001 2156 6853Department of Family Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA USA
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Jiang M, Yang J, Song Y, Zheng J, Li X, Yang G, Ma Y, Xu P, Zhang Z, Pan X, Wang Y. Social support, stigma, and the mediating roles of depression on self-reported medication adherence of HAART recipients in China. AIDS Care 2019; 31:942-950. [PMID: 30829055 DOI: 10.1080/09540121.2019.1587360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Discrimination of people living with HIV/AIDS (PLWHA) is a persistent issue in China, which affects their psychological health. However, the association between psychological factors and adherence to highly active antiretroviral therapy (HAART) has not been systematically investigated before. Therefore, this study examined the impact of social support, depression, and medication-taking self-efficacy on ART adherence among PLWHA based on Cha et al.'s model, and included "stigma" to the original model to explain the psychological mechanism. Of the 504 participants receiving HAART, 37.8% had mild-to-severe depression. According to structural equation modeling, social support was directly associated with depression, stigma, and adherence; depression partially mediated the positive relationship between social support and adherence self-efficacy and the negative association between stigma and self-efficacy. The modified and extended Cha et al.'s model had a satisfactory fit. Interventions to improve mental health through mental health services, social support, and enhancement of adherence self-efficacy beliefs are required.
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Affiliation(s)
- Man Jiang
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Jiezhe Yang
- b Department of AIDS/STDs Control and Prevention , Zhejiang CDC , Hangzhou , People's Republic of China
| | - Yang Song
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Jinlei Zheng
- b Department of AIDS/STDs Control and Prevention , Zhejiang CDC , Hangzhou , People's Republic of China
| | - Xinghui Li
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Guang Yang
- c Department of Medical Affairs , Eye & Ent Hospital of Fudan University , Shanghai , People's Republic of China
| | - Ye Ma
- d National Center for AIDS/STD Control and Prevention , China CDC , Beijing , People's Republic of China
| | - Peng Xu
- d National Center for AIDS/STD Control and Prevention , China CDC , Beijing , People's Republic of China
| | - Ziqi Zhang
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
| | - Xiaohong Pan
- b Department of AIDS/STDs Control and Prevention , Zhejiang CDC , Hangzhou , People's Republic of China
| | - Ying Wang
- a School of Public Health/ Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China , Fudan University , Shanghai , People's Republic of China
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Li L, Ji G, Liang LJ, Lin C, Hsieh J, Lan CW, Xiao Y. Efficacy of a multilevel intervention on the mental health of people living with HIV and their family members in rural China. Health Psychol 2017; 36:863-871. [PMID: 28530433 DOI: 10.1037/hea0000503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE HIV has a profound impact on infected individuals and their families. This study evaluated the efficacy of an intervention aimed at improving the mental health of people living with HIV (PLH) and their family members. METHOD A randomized controlled trial of 475 PLH and 522 family members was conducted in Anhui, China. The intervention comprised activities at individual, family, and community levels. The study outcomes, which included depressive symptoms and coping with illness for the PLH and depressive symptoms and caregiver burden for the family members, were assessed at baseline and at 6-, 12-, 18-, and 24-month follow-up. We used a mixed-effects regression model with village- and participant-level random effects to assess the intervention effect on the improvement of outcome measures. RESULTS Relative to the control condition, the PLH and family members of the intervention group reported a significant reduction in depressive symptoms. The largest difference in depressive symptoms was observed at 6 months for the PLH and at 12 months for family members. Decreases in perceived caregiver burden over time were observed for family members in both conditions; however, the group difference did not reach statistical significance. Significant intervention effect on the coping with illness was reported by the PLH. CONCLUSIONS The study highlights the importance of empowering families affected by HIV to confront the challenges together rather than individually. It may be optimal for future programs to include both PLH and their family members to maximize intervention effects through strengthening interactions and support within a family. (PsycINFO Database Record
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Affiliation(s)
- Li Li
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles
| | - Guoping Ji
- Anhui Provincial Center for Women and Child Health
| | - Li-Jung Liang
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles
| | - Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles
| | - Julie Hsieh
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles
| | - Chiao-Wen Lan
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles
| | - Yongkang Xiao
- Anhui Provincial Center for Disease Control and Prevention
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