Implementation and effectiveness outcomes of Community Health Advocacy Teams to improve long-lasting insecticide net distribution and use in six districts in Ghana: A one-group pre-post-test study.

Malaria remains a leading cause of illness and death especially among children and pregnant women in Ghana. Despite the efforts made by the National Malaria Elimination Programme (NMEP), including distribution of Long-Lasting Insecticide Nets (LLINs) to households through periodic Point Mass Distribution (PMD) campaigns and continuous channels (antenatal, schools and postnatal), there is a gap between access and use of LLINs in Ghana. An effective and functional community-based group that would seek to improve the effectiveness of LLIN distribution before, during, after PMD Campaigns and continuous distribution at the community level could help address this gap. This paper assesses the implementation outcomes and short-term effectiveness of the pilot implementation of co-created community health advocacy teams (CHAT) intervention in Ghanaian communities to plan and implement campaigns to increase LLIN use. The study employed a one-group pre-post study design and measured implementation outcomes (acceptability, appropriateness, and feasibility) and effectiveness outcomes (LLIN awareness, LLIN access, willingness to purchase LLIN, and LLIN use) among 800 community households. The CHAT intervention was implemented for four months across six districts in the Eastern and Volta regions of Ghana. The data were downloaded directly from REDCap and analyzed statistically (descriptive and McNemar test of association) using SPSS 22 software. After the implementation period, the majority of respondents in all six districts indicated that the CHAT intervention was acceptable (89.8%), appropriate (89.5%), and feasible (90%). Also, there was a significant association between baseline and end-line assessment on all four effectiveness outcome measures. Household members' awareness of, access to, willingness to purchase, and use of LLINs increased significantly over the four-month period that the CHAT intervention was implemented. The study concludes that CHAT is an acceptable, appropriate, and feasible intervention for supporting the National Malaria Programme in LLIN PMD and for engaging in Social and Behaviour Change Communication activities through the continuous channels of distribution. Additionally, the CHAT demonstrates short-term effectiveness outcomes in terms of creating LLIN awareness, providing access to LLIN, and encouraging Ghanaian community members to be willing to purchase and use LLINs. Although the activities of CHAT members were largely voluntary, integration into the existing primary health care system will make it sustainable.

Assessing health-related quality of life and clinical outcomes of patients with diabetes accessing healthcare in two public hospitals in south-eastern Ghana: a cross-sectional descriptive study.

BACKGROUND: Diabetes is a significant contributor to kidney failure, heart attack, strokes, lower limb amputation, blindness, and other complications that negatively impact health-related quality of life (HRQOL). This study assessed the HRQOL and clinical outcomes of patients with diabetes accessing healthcare in south-eastern Ghana. METHODS: This was a hospital-based cross-sectional descriptive study conducted in the Ho Municipal and Ho Teaching Hospitals in Ghana among patients with type 2 diabetes who were seeking healthcare at both hospitals for at least 12 months. Systematic random sampling technique was used to select 310 respondents out of the total sample size of 326 patients with type 2 diabetes and data were collected using diabetes-39 questionnaire. The data were analysed using STATA 16.0. Socio-demographic and clinical variables were expressed as frequencies and percentages. Differences between proportions were tested using Chi-square to identify predictors of poor HRQOL and Pearson correlation for association. The p < 0.05 was considered significant. RESULTS: Out of 310 respondents, 171 (55.0%) had poor HRQOL. The predictors of poor HRQOL were age (p < 0.008), education (p < 0.028), employment (p < 0.001), residence (p < 0.01), duration of diabetes (p < 0.002), diabetes education (p < 0.001), BMI (p < 0.005), and glycaemic control (p < 0.001). Energy and mobility (63.2%), anxiety and worry (53.9%), and diabetes control (49.6%) dimensions were the most prevalent of poor HRQOL. Diabetes education, complications, being diabetic for 16 years and above, earning income, resident in rural area, being married, being pensioner and national Service Personnel, and diabetes comorbidities were significantly associated with HRQOL. CONCLUSIONS: More than half of the respondents had poor HRQOL. Clinical and public health efforts should focus on effective control and screening measures for the individual patients and general population.

Factors associated with glycaemic control among patients with type 2 diabetes mellitus in Ho, Ghana: A cross-sectional study.

Background: The purpose of this study was to assess the status of glycaemic control and associated factors among patients with type 2 diabetes mellitus patients. Methods: This was a hospital-based cross-sectional descriptive study of 326 patients with type 2 diabetes at the Ho Municipal and Teaching Hospitals. The adequate sample size was calculated using Yamane formula N/1 + Ne2, with 95 % confidence interval, 5 % margin of error and 10 % non-response rate and a sample size of 326 was determined. Using the sampling frame of patients chart, systematic random sampling technique was used to select the study participants. Glycaemic level was assessed using fasting blood glucose (FBG) readings. A poor glycaemic control was when an average of three months blood glucose level was above 130 mg/dl (7 mm/L). Data was analysed using STATA version 15.0. Results: Out of 310 patients who participated in the study, more than two-thirds (76.1 %) had poor glycaemic control. Patients who use combination of oral medication and insulin (AOR = 3.67, 95 % CI: 1.34-8.74), patients with diabetes for 16 years or more (AOR = 4.67, 95 % CI: 2.44-9.29), patients who did not practised diabetes self-care activities (AOR = 4.32, 95 % CI: 2.82-9.31) and patients with complications were (AOR = 2.47, 95%CI: 1.45-8.66) more likely to have poor glycaemic control. Age, employment, diabetes education, comorbidities, diabetes self-care activities, treatment type, complications, resident and duration of diabetes were significantly associated with poor glycaemic control. Conclusion: Based on this findings, teaching and counselling provided by nurses, physicians, dietitians and pharmacists should focus on improving adherence to diabetes self-care activities to attain good glycaemic control.

Pilot implementation of community health advocacy teams to improve the effectiveness of long-lasting insecticide net distribution through both campaigns and continuous channels in Ghana: a qualitative study of opportunities and barriers to implementation.

Introduction: In Ghana, the National Malaria Elimination Programme (NMEP) distributes long-lasting insecticide net (LLIN) to households for free through the periodic point mass distribution (PMD) campaign and continuous distribution to populations most vulnerable to malaria. It is known that the existence of effective and functional community-based groups could influence positive behaviours regarding health interventions promoted through health campaigns. However, there is no evidence of functional community-based groups that aim to improve the effectiveness of LLIN distribution campaigns by transitioning into primary healthcare delivery. This study aimed to explore the opportunities and barriers to the pilot implementation of co-created community health advocacy teams (CHATs) to improve the effectiveness of LLIN distribution through both campaigns and continuous channels in Ghana. Methods: A qualitative research approach was used among 43 CHAT members across six communities in the Eastern and Volta regions of Ghana. The CHAT constitutes significant community actors whose roles are centred on key elements of community/social mobilisation and capacity building, all nested in social and behaviour change communication (SBCC) strategies. The CHATs were pilot implemented in all study communities for 4 months after which we identified opportunities and barriers during implementation. CHAT members participated in six focus group discussions which were audio recorded, transcribed verbatim, and analysed thematically using the NVivo 13. Results: CHATs were instrumental in sensitising community members through SBCC strategies. Moreover, there were changes in the behaviour of community members who were receptive towards and participated in CHAT activities. Community members were accurately informed about malaria (e.g., causes and preventive measures). However, the CHAT experienced barriers during implementation, including a lack of financial support to aid in transportation, organisation of meetings, and outreach activities. Additionally, the level of participation by CHAT members in activities and the medium of communication among members were key areas of concern. Conclusion: The CHATs would be instrumental in promoting LLINs' use during and after PMD campaigns through community outreaches. It is therefore necessary to provide resources to support their operations and a good network to address communication barriers. Finally, continuous capacity strengthening of CHAT members by the NMCP is important.

Women's sexual empowerment and utilization of long-acting reversible contraceptives in Ghana: evidence from the 2014 demographic and health survey.

BACKGROUND: Long-Acting Reversible Contraceptives (LARC) contribute significantly to a decline in unintended pregnancies globally. However, not much is known about women's sexual empowerment and their utilization of Long-Acting Reversible Contraceptives in Ghana. The main objective of this study was to examine the association between women's sexual empowerment and LARC utilization in Ghana. METHODS: We used data from 5116 sexually active women who participated in the 2014 Ghana Demographic and Health Survey. Women's sexual empowerment was defined as women's perception of their right to self-determination and equity in sexual relations, and their ability to express themselves in sexual decision-making. A sum of scores was created with four dichotomous items as sexual empowerment score (0 = low sexual empowerment; 1, 2, and 3 = medium sexual empowerment; and 4 = high sexual empowerment). Multivariable binary logistic regression analyses were performed to establish the association between women's sexual empowerment and the use of LARC. Pearson Chi-square test was used in data analysis. The results are presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs) at a statistical significance of p < 0.05. RESULTS: The prevalence of LARC utilization among sexually active women in Ghana was 6%. Majority of the women had medium sexual empowerment (91%). Although not statistically significant, the likelihood of utilizing LARC was lowest among women with high level of sexual empowerment (aOR = 0.62; CI = 0.27-1.43). On the other hand, Utilization of LARC increased with an increase in age. Women with parity four or more had higher odds of utilizing LARC as compared to women with zero birth (aOR = 9.31; CI = 3.55-24.39). Across religion, women who belong to the Traditional religion (aOR = 0.17; CI = 0.04-0.71) and Islam religion (aOR = 0.52; CI = 0.36-0.76) had lower odds of LARC utilisation as compared to Christian women. Women who make health decisions with someone else (aOR = 1.52; CI = 1.12-2.09) had higher odds of LARC utilisation as compared to women who make health decision alone. CONCLUSION: Age, health decision maker, parity and religion were found to have a significant relationship with LARC utilization. Specifically, uneducated women, unemployed women and women who practice traditional religion were less likely to utilise LARC. However, women's sexual empowerment did not have a significant relationship with LARC. There is therefore the need for planning interventions for LARC utilization in line with educating women on the benefits and potential side effects of LARC. Also, there is a need for interventions targeted at increasing access to LARC among sexually active women.

Burnout and allostatic load among health workers engaged in human resourced-constrained hospitals in Accra, Ghana.

BACKGROUND: Burnout syndrome is a psycho-social disorder which develops in an individual exposed to chronic stress on the job. Health workers in sub-Saharan Africa (SSA) are at increased risk of burnout due to job-related challenges. Burnout does not only affect the job performance of employees, but could result in dysregulation of multiple physiological systems (allostatic load) in victims and predispose them to non-communicable diseases (NCDs). This study examined the association between burnout and allostatic load among health workers engaged in human resourced-constrained hospitals in Accra, Ghana. METHOD: This study was a hospital-based cross-sectional study involving 1264 health workers (clinicians and non-clinicians) from three public hospitals in Accra, Ghana who were recruited using a proportionate stratified random sampling technique. The participants completed a questionnaire which collected general and burnout information. In addition, each participant's anthropometric; biochemical and hemodynamic indices were measured. The allostatic load in the participants was determined using eleven (11) biomarkers from the neuro-endocrine, cardiovascular, metabolic and anthropometric measures. The relationship between burnout and allostatic overload (high allostatic load) was determined at the bivariate and multivariable levels. The data analysis was done with the aid of Stata 15.0 at a 95% confidence level. RESULTS: The prevalence of burnout was 20.57%, higher in non-clinicians than clinicians (26.74% vs 15.64, p <  0.001). Also, non-clinical participants had higher levels of emotional exhaustion and depersonalization than the clinical participants. Over a quarter (26.27%) of the participants had allostatic overload manifesting as high allostatic load. Furthermore, for a one unit increase in overall burnout, the odds of experiencing allostatic overload was increased by 17.59 times (AOR = 17.59, 95% CI: 11.7-26.4) as compared to those without burnout and similar findings were found for the individual components of burnout syndrome with high allostatic load. CONCLUSION: Burnout among health workers is associated with multi-system physiological dysregulation manifesting as high allostatic load; a major risk factor for NCDs. It is recommended that measures aimed at reducing burnout and allostatic overload such as structured psychological counseling and healthy lifestyle patterns are recommended for health workers engaged in stressful work settings to reduce their risk of NCDs.

Burnout syndrome among healthcare workers during COVID-19 Pandemic in Accra, Ghana.

BACKGROUND: The emergence of the corona virus disease 2019 (COVID-19) has increased the workload of health workers particularly those in sub-Saharan Africa predisposing them to extra job-related stress and its associated job-related burnout. Burnout reduces the number, distribution and productivity of health workers. This study sought to determine personal and job-related characteristics of health workers in Accra, Ghana that influenced their experience of burnout during the COVID-19 pandemic. METHOD: A cross-sectional study was conducted among 1,264 health workers recruited from three public hospitals in Accra, Ghana between March to November, 2020. The participants were recruited using a proportionate stratified sampling technique and completed a pre-tested questionnaire that collected information on socio-demographic and job-related factors. Also, the questionnaire assessed participants' level of resilience and job-related burnout. Pearson's chi-square test was used to determine the association between burnout and the socio-demographic as well as job-related factors. However, for variables with observations less than six, a Fisher's exact test, was used to determine the associations. After the binary analysis, multivariate logistic regressions were used to determine the strength of association between the socio-demographic as well as job-related factors and burnout. Data analyses were conducted at a significant level (alpha 0.05) and power of 95% confidence with the aid of Stata 15.0. RESULTS: The prevalence of burnout among the participants was 20.57% with non-clinicians displaying higher burnout compared to clinicians (26.74&% v 15.64%, p< 0.001). Health workers with 1-5 years working experience were 26.81 more likely to experience burnout (AOR = 26.81, CI = 6.37-112.9). Night shifts defined as shifts between 8:00pm to 8:00am was associated with the 1.86 odds of experiencing burnout (OR = 1.86; 95% CI: 1.33-2.61; p<0.001). Also, participants of the primary level facility were 3.91 times more likely (AOR = 3.91, 95% CI = 2.39-6.41) to experience burnout on the job. Similarly, participants with additional jobs were 1.14 times more likely (AOR = 1.14, 95% CI = 0.75-1.74) to experience burnout. In addition, participants harboring intentions of leaving their current jobs were 4.61 times more likely (AOR = 4.61, 95% CI = 2.73-7.78) to experience burnout. Furthermore, participants with perceived high workload were 2.38 times more likely (AOR = 2.38, 95% CI = 1.40-4.05) to experience burnt-out on the job. CONCLUSION: There is high prevalence of burnout among health workers in Accra particularly during the onslaught of the COVID-19 pandemic. Working on night shifts and at the primary level of healthcare is significantly associated with increased odds of experiencing burnout.We recommend shift rotation for staff and adequate resource provision for primary level hospitals. The high burnout in this study could be influenced by other factors such as the grief caused by multiple losses and also the limited supportive resources for health workers.

Pregnant adolescents' lived experiences and coping strategies in peri-urban district in Southern Ghana.

BACKGROUND: Adolescence, a transition period from childhood to adulthood forms the foundation of health in later life. The adolescence period which should have been characterised by good health is often marred with life-threatening and irreparable consequences of public health concern. Teen pregnancy is problematic because it could jeopardise adolescents' safe transition to adulthood which does not only affect adolescents, but also their families, babies and society. There is ample evidence about the determinants and effects of teen pregnancy, but it is fragmented and incomplete, especially in Sub-Sahara Africa. This study presents pregnant adolescents' voices to explain significant gaps in understanding their lived experiences and coping strategies. METHODS: This narrative inquiry, involved in-depth interviews with 16 pregnant adolescents, who were recruited from a peri-urban district in Southern Ghana using purposive and snowball techniques in health facilities and communities respectively. The audio recorded interviews were transcribed verbatim and analysed manually using content analysis. RESULTS: Many pregnant adolescents are silent victims of a hash socio-economic environment, in which they experience significant financial deprivation, parental neglect and sexual abuse. Also, negative experiences of some adolescent girls such as scolding, flogging by parents, stigmatisation and rejection by peers and neighbors result in grieve, stress and contemplation of abortion and or suicide. However, adolescents did not consider abortion as the best option with regard to their pregnancy. Rather, family members provided adolescents with critical support as they devise strategies such as avoiding people, depending on God and praying to cope with their pregnancy. CONCLUSION: Adolescent pregnancy occurred through consensual sex, transactional sex and sexual abuse. While parents provide support, pregnant adolescents self-isolate, depend on God and pray to cope with pregnancy and drop out of school. We recommend that the Ministries of Education and Health, and law enforcement agencies should engage community leaders and members, religious groups, non-governmental organisations and other key stakeholders to develop interventions aimed at supporting girls to complete at least Senior High School. While doing this, it is also important to provide support to victims of sexual abuse and punish perpetrators accordingly.

University students' alcohol use behaviour and self-efficacy to abstain from alcohol use: data from Ghana.

OBJECTIVES: The university students' alcohol use behaviour and alcohol use self-efficacy data were collected among Ghanaian university students. This survey had two main objectives: (a) to examine the factorial validity, structure, and reliability of the 20-item alcohol abstinence self-efficacy scale among undergraduate students and (b) to examine the role of alcohol abstinence self-efficacy in the pros and cons of alcohol use. These two objectives have been published as separate research articles without the data (including data management) that were used for analyses. As the data are not already available as part of these published papers, this data note provides a composite and integrated data grounded on these published research articles with detailed information on the instruments used to collect data, raw data in statistical software, managed/coded data in statistical software, and generated correlation matrix used to perform complex analysis. DATA DESCRIPTION: The data includes information on two major dimensions: (a) alcohol abstinence self-efficacy-negative affect, social interactions and positive states, physical pain/illness, and alcohol craving (thoughts about using) and (b) decisional balance-measuring the benefits (pros) of alcohol use and the costs (cons) of alcohol use. In addition, data were collected on socio-demographic characteristics of students including their age, sex, level/year in school, stream of study, place of residence and religious affiliation. The data collected is more representative of students in private universities.

Participation and attitudes towards gambling in Ghanaian youth: an exploratory analysis of risk and protective factors.

PURPOSE: There is little information on youth gambling in Ghana even though there is an unprecedented emergence of various types of gambling and gambling venues throughout the country. The aim of this cross-sectional exploratory study was to examine the role of perceived social difficulties and perceived protective social factors in participation and attitudes of Ghanaian youth towards gambling using data from a school-based survey (n = 770). METHODS: Participants completed measures on perceived social difficulties, perceived protective social factors, attitudes towards gambling and participation in four types of gambling. RESULTS: Sports betting was the most common form of gambling. There were significant differences in gambling participation with males gambling more than females. Youth who reported more perceived social difficulties from family and friends had a more positive attitude and a negative attitude towards gambling, respectively. Youth who reported higher protective social factors from family and teachers were less likely to have a negative attitude towards gambling. In all situations, high frequency gambling resulted in a more positive attitude towards gambling. CONCLUSION: Perceived social difficulties influences Ghanaian youths to have a positive attitude towards gambling, however, protective social factors from family and teachers may help youth to have a negative attitude towards gambling, gamble less and consequently achieve academic success.

Parental involvement could mitigate the effects of physical activity and dietary habits on mental distress in Ghanaian youth.

INTRODUCTION: Parental involvement in physical activity and dietary habits have been found to play a substantial role in the mental health of young people. However, there is little evidence about the associations between parental involvement, health behaviours and mental health among Ghanaian youth. This study sought to examine the role of parental involvement in the association between physical activity, dietary habits and mental health among Ghanaian youth. METHODS: Data were obtained from the 2012 Ghana Global School-based Student Health Survey (GSHS). The study population consisted of 1,984 school going youth in high schools with a median age of 15 years old, (53.7%) males. Bivariate and multivariate logistic regression statistical models using complex samples method were performed. RESULTS: The prevalence of mental distress was 18.1%, 16.6% and 23% for loneliness, feeling worried and suicidal ideation respectively. Younger students were more likely to feel lonely, worried and have suicidal ideation than older students. Students from low socio-economic backgrounds were significantly more likely to report loneliness, worry and suicidal ideation. After adjusting for socio-demographic characteristics, some physical activity and eating habits were associated with experiencing loneliness, worry and suicidal ideation but after introducing parental involvement, there was a decrease in the likelihood of some health behaviour factors in both physical activity and dietary habits to be associated with loneliness, worry and suicidal ideation. CONCLUSION: Physical inactivity and poor dietary habits could have a negative effect on mental distress, however, parental involvement could mitigate the impact of these lifestyle habits on mental distress and should therefore be taken into consideration in efforts aimed at encouraging positive lifestyle habits for good mental health among Ghanaian youth.

Socio-demographic characteristics and psychosocial consequences of sickle cell disease: the case of patients in a public hospital in Ghana.

BACKGROUND: Sickle cell disease (SCD) is of major public health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Ghana. The objective of this study was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. METHODS: A cross-sectional research design was used that involved the completion of questionnaires on socio-demographic characteristics, quality of life, coping mechanisms, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. RESULTS: Results showed that majority of the patients were single, female, less than 39 years old and had attained secondary school level of education or less. Also, patients were more satisfied by the presence of love, friends and relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having faith in God was the most frequently reported mechanisms for coping with an unbearable SCD attacks. Results of multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. CONCLUSIONS: It is recommended that a holistic intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators.

Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.

Assessing alcohol abstinence self-efficacy in undergraduate students: psychometric evaluation of the alcohol abstinence self-efficacy scale.

BACKGROUND: Alcohol use is a major public health concern with respect to its impact on youth morbidity and mortality. Self-efficacy to abstain from alcohol use in young people is an important prevention and intervention strategy in future alcohol dependence. However, research on the assessment of self-efficacy to abstain from alcohol use among undergraduate students is almost non-existent in Ghana, apparently due to the unavailability of a standardised testing instrument. The purpose of this study was to examine the factor validity, structure, and reliability of the 20-item Alcohol Abstinence Self-efficacy Scale (AASES) in undergraduate students in Ghana. FINDINGS: Two hundred and fifteen undergraduate students studying in a private university with a mean age of 23.5 years participated in the study by completing the AASES. Results of a confirmatory factor analysis showed that the data did not fit the initial four-factor AASES model. Subsequent exploratory factor analysis showed that the AASES is a unidimensional construct (in the total sample and a subsample of drinkers), contrary to findings found in western cultures. The AASES also had a high Cronbach's alpha. Although the AASES was unidimensional in this study, each of the original four-factor model also had high and acceptable Cronbach's alpha. CONCLUSION: The original AASES structure was not confirmed in this study but a unidimensional factor was found suggesting that the AASES could be used as an instrument for assessing alcohol abstinence self-efficacy in undergraduate students in Ghana, although further validation research is needed in larger as well as in different samples.

Factor structure and psychometric properties of the General Health Questionnaire (GHQ-12) among Ghanaian adolescents.

PURPOSE: There is little information about the reliability and validity of the 12-item General Health Questionnaire (GHQ-12) in Ghana. This study sought to examine the reliability and factor structure of the GHQ-12 in Ghanaian adolescents. METHODS: High school students (N = 770) completed the GHQ-12 and the Adolescent Stress Questionnaire (ASQ). Internal consistency, convergent validity and exploratory factor analysis were used. RESULTS: A two factor structure, each with six items, was extracted. The total GHQ-12 had acceptable internal consistency and a generally high correlation with the ASQ subscales. CONCLUSION: The GHQ-12 can be used in Ghanaian samples, but more research is needed to confirm its factor structure.

Exploring Ghanaian adolescents' meaning of health and wellbeing: a psychosocial perspective.

There is presently no internationally agreed upon set of indicators for assessing adolescent health and what "health and wellbeing" means to adolescents. The psychosocial context of family, friends, and school plays a crucial role in the construction of health and wellbeing by adolescents. In spite of this, not much is known about the meaning Ghanaian adolescents attach to their health and wellbeing and the role of stress and social support in the construction of this meaning. This study explores how perceived social support and stress influence the construction of the meaning of health and wellbeing to Ghanaian adolescents. Eleven respondents purposively selected from 770 males and females participated in semi-structured interviews, which were transcribed verbatim and analysed with thematic analysis. Findings pointed to the fact that health and wellbeing was largely construed as "ability to perform daily functions," such as ability to take critical decisions and a general sense of vitality and mental strength. These were influenced by perceived social support ("encouragement and advice" and "religiosity or spirituality") and stress ("teasing, strictness, quarrels, and arguments"). These findings suggest that effective communication, mutual respect, and support from significant others, in the midst of stressful life events, contribute substantially to a holistic construction and meaning of health and wellbeing by Ghanaian adolescents.

Perceived social support and parental education as determinants of adolescents' physical activity and eating behaviour: a cross-sectional survey.

PURPOSE: To examine the role of perceived social support and parental education on physical activity and eating behaviour of Ghanaian adolescents. METHODS: Seven hundred and seventy Senior High School students (504 boys and 266 girls) between the ages of 14-21 years participated by completing questionnaires on perceived social support, physical activity and eating behaviour. The highest education attained by either parent or guardian was also obtained. Multivariate analysis of covariance was the main statistical test used to analyse the data. RESULTS: The results showed significant gender differences in physical activity and eating behaviour combined, with boys more likely to engage in physical activity than girls, and girls also more likely to engage in healthy eating behaviour than boys, albeit the effect was not statistically significant. While perceived social support had a significant positive effect on eating behaviour and physical activity, parental education had a significant effect only on eating behaviour but not physical activity. CONCLUSION: Perceived social support from family coupled with parental education provides more opportunities for adolescents to engage in healthy eating behaviour. Also, parents' educational attainment alone does not necessarily guarantee that adolescents will engage in physical activity; providing the needed social support and conducive home environment is more likely to induce physical activity behaviours. Finally, physical activity and eating behaviour should not be construed as alternative health behaviours as suggested by gender differentials in these health behaviours.

Social support, stress, health, and academic success in Ghanaian adolescents: a path analysis.

The aim of this study is to gain a better understanding of the role psychosocial factors play in promoting the health and academic success of adolescents. A total of 770 adolescent boys and girls in Senior High Schools were randomly selected to complete a self-report questionnaire. School reported latest terminal examination grades were used as the measure of academic success. Structural equation modelling indicated a relatively good fit to the posteriori model with four of the hypothesised paths fully supported and two partially supported. Perceived social support was negatively related to stress and predictive of health and wellbeing but not academic success. Stress was predictive of health but not academic success. Finally, health and wellbeing was able to predict academic success. These findings have policy implications regarding efforts aimed at promoting the health and wellbeing as well as the academic success of adolescents in Ghana.

Exploring the Role of Self-Esteem and Parenting Patterns on Alcohol Use and Abuse Among Adolescents.

The type of parental child-rearing practices used by parents and guardians substantially influence children's self-esteem and consequently their decision to engage in alcohol use, its abuse. The aim of this study was to explore the role of self-esteem and parenting patterns on alcohol use and abuse among adolescents. Three hundred and sixteen boys and girls in Senior High Schools completed self-report questionnaires assessing self-esteem, parenting patterns and alcohol use and abuse. The results showed that while girls reported lesser self-esteem than boys, boys reported higher levels of alcohol use and abuse than girls. Also, authoritative parenting pattern had a positive effect on self-esteem and a negative effect on alcohol use. On the other hand, authoritarian and permissive parenting patterns had negative effects on self-esteem and positive effects on alcohol use, with slight variations. These results provide valuable information regarding strategies aimed at fostering parent-child relationship and rapport with the ultimate aim of bolstering the self-esteem of adolescents to subsequently eschew insalubrious behaviour, particularly alcohol use and abuse.