Self-esteem and self-concept as correlates of life satisfaction and attitudes toward school among Ghanaian girls.

During adolescence, youth experience several physical, psychosocial, and cognitive changes. Self-esteem and self-concept are identified as protective factors for adolescents in high-income countries, but studies are limited in sub-Saharan Africa. We examined the associations of self-esteem and self-concept with life satisfaction and attitudes toward school using baseline data from 97 Ghanaian adolescent girls at risk of school dropout. Ordinary Least Squares regression models were fitted to examine the association between self-esteem and self-concept on school attitudes and life satisfaction. Self-esteem was positively associated with life satisfaction. Self-concept was associated with more positive attitudes toward school. Hence, self-esteem and self-concept may be critical protective factors in promoting adolescent girls' life satisfaction and positive attitudes toward school.

Short-term impact of a combination intervention on family cohesion: Results from a pilot cluster-randomized clinical trial in Northern Ghana.

Child labor remains a concern in sub-Saharan Africa. Yet, evidence-based preventive efforts are limited. We analyzed longitudinal data from Ghanaian adolescent girls in a pilot randomized clinical trial testing the preliminary impact of a combination intervention on family cohesion as a protective factor against child labor and school dropout. While there was no statistical difference between the control and intervention groups at 9 months, the results show that family cohesion scores improved significantly from baseline to 9 months for the ANZANSI intervention group. Qualitative results indicated improved family cohesion in the intervention group. Hence, future studies should further examine this promising social work intervention.

Suubi + Adherence4Youth: a study protocol to optimize the Suubi Intervention for Adherence to HIV treatment for youth living with HIV in Uganda.

BACKGROUND: Suubi is an evidenced based multi-component intervention that targets psychosocial and economic hardships to improve ART adherence, viral suppression, mental health, family financial stability, and family cohesion for adolescents living with HIV (ALHIV) in Uganda. Suubi was originally tested as a combined package of four components: 1) Financial Literacy Training; 2) incentivized matched Youth Savings Accounts with income-generating activities; 3) a manualized and visual-based intervention for ART adherence and stigma reduction; and 4) engagement with HIV treatment-experienced role models. However, it is unknown if each component in Suubi had a positive effect, how the components interacted, or if fewer components could have produced equivalent effects. Hence, the overall goal of this new study is to identify the most impactful and sustainable economic and psychosocial components across 48 health clinics in Uganda. METHODS: A total of 576 ALHIV (aged 11-17 years at enrollment) will be recruited from 48 clinics and each clinic will be randomized to one of 16 study conditions. Each condition represents every possible combination of the 4 components noted above. Assessments will be conducted at baseline, 12, 24, 36 and 48- months post-intervention initiation. Using the multi-phase optimization strategy (MOST), we will identify the optimal combination of components and associated costs for viral suppression, as well as test key mediators and moderators of the component-viral suppression relationship. DISCUSSION: The study is a shift in the paradigm of research to use new thinking to build/un-pack highly efficacious interventions that lead to new scientific knowledge in terms of understanding what drives an intervention's success and how to iterate on them in ways that are more efficient, affordable and scalable. The study advances intervention science for HIV care outcomes globally. TRIAL REGISTRATION: This project was registered at clinicaltrials.gov (NCT05600621) on October, 31, 2022. https://clinicaltrials.gov/ct2/show/NCT05600621.

A Review of the Cultural Gender Norms Contributing to Gender Inequality in Ghana: An Ecological Systems Perspective.

While significant progress has been made in improving the wellbeing of women and girls around the world, a gender gap still exists between men and women which is very evident in Ghana. Gender inequalities continue to persist in Ghana because of cultural gender norms that exalt and favor men and put women in subordinate and subservient roles. These cultural gender norms hinder women's development and widen gender inequality between men and women in different system levels of society. Therefore, there is a need to examine the influence of these cultural gender norms on women's lives using a systems framework to capture a full picture of women's experiences at these systemic levels of society. In this paper, we use Bronfenbrenner's ecological systems multilevel approach to examine the impact of these cultural gender norms on women's lives at the different system levels. We conducted a desk review of studies published in sub-Saharan Africa focused on cultural gender norms and gender inequality. The findings showed that the impact of cultural gender norms on gender inequality at the levels of the four social systems (microsystem, mesosystem, exosystem, and macrosystem) are interconnected, creating and widening the inequality gap between men and women. Cultural gender norms influence gender role socialization in the home, which then transmits to the school and religious institutions as the mesosystem. At the school level, cultural gender norms act as a mesosystem manifest through discriminatory classroom practices, gender role assignment of school responsibilities, and gender role representations in textbooks. In Christianity and Islam, cultural gender norms create doctrines that enforce men's domination over women, and, in the workplace, cultural gender norms have gendered labor by defining a man's occupation and limiting women to domestic and low-paying occupations. The mass media is the exosystem that displays images of women to fit cultural gender norms of what is defined as acceptable for women. Finally, the macrosystem is the overall sociocultural norms that have been accepted by society that perpetuate discriminatory practices against women.

Afrocentric Cultural Norms, Mental Health Functioning, and the Perception of Intimate Partner Violence Among Young Black Men.

Intimate partner violence (IPV) is a serious public health concern that profoundly impacts the lives of women globally. While IPV cuts across race, socioeconomic status, age groups, and geography, Black women are disproportionately affected. Prior studies report that Black women predominantly couple with Black men and thus, understanding factors associated with IPV perpetration among Black men is essential. Subsequently, the present study explored an important gap in the literature, exploring how collectivism, a core belief ascribed to Afrocentric cultural norms, and factors associated with mental health functioning in emerging adult Black men in the USA is associated with their views of IPV. Data for the study was drawn from a sample of self-identifying Black American males between the ages of 18 and 25 (n=300). Regression analysis demonstrated no significant relationship between age, household income, and education level among participants. Anxiety had a significant relationship with intimate partner beliefs with participants with increased anxiety having more problematic intimate partner beliefs. A model including anxiety, collectivism, and aggressiveness was a significant predictor of problematic intimate partner beliefs. In the final model, collectivism and aggressiveness were statistically significant predictors of perceptions endorsing IPV. Participants who reported higher levels of global aggressive confrontation with others were more likely to endorse IPV. Overall, participants with a sense of value for collectivism over individualism were least likely to endorse IPV. This study provides evidence that cultural norms potentially have a role in Black men's beliefs about IPV. Implications for future research are provided.

Correction: Sensoy Bahar et al. "ANZANSI Program Taught Me Many Things in Life": Families' Experiences with a Combination Intervention to Prevent Adolescent Girls' Unaccompanied Migration for Labor. Int. J. Environ. Res. Public Health 2022, 19, 13168.

There was an error in the original publication [...].

Mental Health Treatment-Seeking Appraisal, Afrocentric Cultural Norms, and Mental Health Functioning: Buffering Factors of Young Black Men's Externalizing Behavior.

BACKGROUND: Depression rates are disproportionately high among Black American Men. This disparity--compounded by low mental healthcare seeking rates and high incorrect diagnosis rates in men--could be related to masculine norms, including self-reliance, restrictive emotionality, and stoicism. Furthermore, men are more likely to engage in externalized behavior, such as aggression, to cope with mental health challenges; this pattern is influenced by cultural and environmental factors. Contrary to these detrimental factors, social relationships, belief in social networks, and collectivism have been associated with positive mental health in these populations. Similarly, an Afrocentric worldview (including concepts like Ubuntu and African self-consciousness) has been hypothesized to promote positive mental health outcomes among Black American men. However, little research exists on harnessing these factors as a means of increasing health-seeking behaviors in young Black males. AIM: To elucidate the effect of region, depression, African humanism, collectivism, and help-seeking values and needs concerning aggression in young Black males. METHOD: This study included Black or African American participants (n = 428) identifying as male, aged 18-25 years, who responded to a Qualtrics survey with questions on region, aggression, depression, African humanism, collectivism, and help-seeking value and need. RESULTS: Hierarchical linear regression revealed that collectivism, humanness, value, and the need for seeking treatment were inversely associated with aggression (p < 0.001). DISCUSSION/CONCLUSION: Highlighting the effect of cultural norms and help-seeking behaviors and the aggravating effect of depression on aggression in young Black males can help to develop aggression-mitigating interventions rooted in Afrocentric Norms.

"ANZANSI Program Taught Me Many Things in Life": Families' Experiences with a Combination Intervention to Prevent Adolescent Girls' Unaccompanied Migration for Labor.

Approximately 160 million children work as child laborers globally, 39% of whom are female. Ghana is one of the countries with the highest rates of child labor. Child labor has serious health, mental health, and educational consequences, and those who migrate independently for child labor are even at higher risk. Yet, evidence-based efforts to prevent unaccompanied child migration are limited. In this study, we examined the acceptability of a family-level intervention, called ANZANSI (resilience in local language) combining two evidence-based interventions, a family economic empowerment intervention and a multiple family group family strengthening intervention, to reduce the risk factors associated with the independent migration of adolescent girls from the Northern region to big cities in Ghana. We conducted semi-structured interviews separately with 20 adolescent girls and their caregivers who participated in ANZANSI. Interviews were conducted in the local language and transcribed and translated verbatim. Informed by the theoretical framework of acceptability, the data were analyzed using thematic analysis. The results showed high intervention acceptability among both adolescent girls and their caregivers, including low burden, positive affective attitude, high perceived effectiveness, low opportunity costs, and high self-efficacy. The study findings underline the high need for such interventions in low-resource contexts in Ghana and provide the foundation for testing this intervention in a larger randomized trial.