Health Psychology and Behavioral Medicine最新文献

{"title":"Evaluation of a WASH/MNCH targeted primary health care program in Uganda; a mixed methods study.","authors":"Comfort Hajra Mukasa,&nbsp;Maureen Nankanja,&nbsp;Margaret Mugisa,&nbsp;Ojoro Valentine,&nbsp;Patrick Kagurusi","doi":"10.1080/21642850.2023.2185245","DOIUrl":"https://doi.org/10.1080/21642850.2023.2185245","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the impact of Maternal Newborn and child health (MNCH) and Water, Sanitation and Hygiene (WASH) interventions on skilled birth attendance (SBA) and neonatal sepsis remains unclear. We conducted this study in Amuru district to generate evidence.</p><p><strong>Methods: </strong>A before-and-after study design was conducted. Interventions implemented included; training of HCWs, construction of WASH facilities, and health education of communities. A digitized structured questionnaire was used to obtain data on ANC and SBA, WASH practices and prevalence of pneumonia and diarrhea among 466 expectant mothers and caretakers of under-fives at baseline, midterm and endline. Data on sepsis incidence, ANC, SBA and WASH status was obtained from six healthcare facilities. A total of 12 KIIs and 12 FGDs were conducted. Data were analyzed using STATA 15. Two sample tests of proportions were used to compare findings at baseline and endline. Qualitative data were analyzed using thematic content analysis.</p><p><strong>Results: </strong>The number of women delivering at HCFs significantly increased from 41.4% to 63.0% (<i>p</i> < .0001). Incidence of neonatal sepsis reduced from 0.6% to 0.2% (<i>p</i> = .0687), although the difference was not significant. Community-level findings also indicated a decline in cases of water-borne illnesses; cases of dysentery decreased from 10.0% to 0.6%, cases of cholera decreased from 8.9% to 1.9% at endline, cases of typhoid decreased from 26.5% to 12.7% at endline.</p><p><strong>Conclusion: </strong>This study revealed that integrated WASH/MNCH interventions can significantly increase ANC and SBA, reduce incidences of neonatal sepsis, diarrhea, pneumonia, and other related diseases and improve WASH practices in communities. Significant improvements in WASH/IPC and the capacity of HCWs to deliver safe MNCH services are realized.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2185245"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9125243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary validation of the Klenico diagnostic software self-report module through comparison with the diagnostic gold standard in an outpatient routine clinical sample.","authors":"Stefan Reutimann,&nbsp;David Milanovic,&nbsp;Marco D Gulewitsch,&nbsp;Mareike Augsburger","doi":"10.1080/21642850.2023.2244576","DOIUrl":"https://doi.org/10.1080/21642850.2023.2244576","url":null,"abstract":"<p><strong>Background: </strong>Inaccuracy in current diagnostic procedures for mental disorders can lead to misdiagnosis and increase the burden on the healthcare system. Therefore, Klenico, a diagnostic software designed to support comprehensive and efficient clinical diagnostic procedures that is easy to apply in everyday clinical practice, was developed. This study aimed to take the first step toward validating the Klenico self-report module.</p><p><strong>Methods: </strong>Data of 115 patients from a German psychotherapeutic outpatient clinic were included in this study. Criterion validity was tested by comparing Klenico with the diagnoses based on the structured clinical interview for DSM-IV (SCID). Construct validity was investigated by comparing Klenico with commonly used self-reporting questionnaires.</p><p><strong>Results: </strong>The results showed that most of the Klenico disorder domains were able to differentiate between corresponding diagnoses and other diagnoses, confirming criterion validity. Construct validity was demonstrated by high correlations with the compared convergent questionnaire scales and non-significant or low correlations with most of the divergent scales.</p><p><strong>Conclusions: </strong>These preliminary results demonstrate the psychometric properties of the Klenico self-report module and imply that the Klenico system has high potential to improve the accuracy of diagnostic procedures in everyday clinical practice.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2244576"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10566938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lean method for selecting determinants when developing behavior change interventions.","authors":"Rik Crutzen,&nbsp;Gjalt-Jorn Ygram Peters","doi":"10.1080/21642850.2023.2167719","DOIUrl":"https://doi.org/10.1080/21642850.2023.2167719","url":null,"abstract":"<p><p>When developing behavior change interventions in a systematic way, it is important to select determinants relevant to the target behavior. Data is needed to gain insight into the determinant structures (the relative strengths of associations between determinants and behavior) and their univariate distributions. This insight is crucial to select the most relevant determinants, but at the same time institutions tasked with behavior change (e.g. prevention organizations, municipal health services) often operate under prohibitive resource constraints, which also extend to how easily they can collect data from a sample. This paper introduces CIBERlite - an approach that furnishes the intervention developer with an idea of the relevance of a limited number of determinants using short measurements informed by theory. The first study (<i>N</i> = 401) in a series of three explores the convergent validity of short and full measurements of determinants derived from the Reasoned Action Approach. The short measurements are used in the main study (<i>N</i> = 415) that serves as a proof-of-concept for the CIBERlite plot, an efficient visualization combining data of determinant structures and their univariate distributions for eight behaviors. The unexpected patterns detected in the main study led to an expert estimation study (<i>N</i> = 45), which shows that individual experts have difficulty in predicting how people score on determinants. This stresses the importance of conducting determinant studies and CIBERlite is a valuable alternative to do so if resources are limited.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2167719"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10623486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative dyadic approach to explore the experiences and perceived impact of COVID-19 restrictions among adolescents and their parents.","authors":"Pooja Saini,&nbsp;Anna Hunt,&nbsp;Joanna Kirkby,&nbsp;Jennifer Chopra,&nbsp;Emma Ashworth","doi":"10.1080/21642850.2023.2173601","DOIUrl":"https://doi.org/10.1080/21642850.2023.2173601","url":null,"abstract":"<p><strong>Background: </strong>While evidence exists for the negative and positive effects of the COVID-19 pandemic and associated lockdown on the mental health and well-being of adolescents and parents separately, the potential impact of lockdown, and the effective coping strategies that have been used have so far, by both children and their parents still needs to be explored.</p><p><strong>Method: </strong>A dyadic approach was used to explore the perceived impact of COVID-19 restrictions among early adolescents and their parents in Northwest England. Nine parents (8 female and 1 male) and their 10 children (6 boys and 4 girls) aged 11-13, were recruited from 4 secondary schools to be interviewed. Remote interviews took place between October and December 2020 for the adolescents and between March and May 2021 for their parents. Inductive thematic analysis was used.</p><p><strong>Results: </strong>Five inter-related themes were identified: (1) overcoming barriers for learning at home; (2) juggling a work-life balance; (3) loss of experiences; (4) caring for other family members; and (5) adopting new self-care and coping strategies during the pandemic.</p><p><strong>Conclusion: </strong>Themes identified will help to inform policy and practice for supporting adolescents and parents in the future, including the promotion of positive coping strategies and the provision of resources for adolescents, schools and families.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2173601"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10742067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torn between two lovers - on being a psychologist in a university medical centre.","authors":"Ad A Kaptein","doi":"10.1080/21642850.2023.2170379","DOIUrl":"https://doi.org/10.1080/21642850.2023.2170379","url":null,"abstract":"<p><strong>Background: </strong>Psychology as applied to health and illness has a relatively short history. Nevertheless, that history shows a rapid development of the theoretical models that guide the field over the past 60 years. Core theoretical approaches are concisely reviewed, in the context of Kaplan's paper 'Behavior as the central outcome in health care' (1990), which is used as a model to examine the extent to which these approaches embrace Kaplan's notions.</p><p><strong>Advances: </strong>Empirical studies from the health psychology domain are used, which demonstrate the gains in terms of quality of life and behavioural outcomes in patients with (chronic) somatic diseases. Over a period of some 60 years, theoretical models and core concepts in psychology as applied to health and illness have evolved from psychosomatic views to neuropsychology, quality of life, patient education, self-management, illness perceptions, patient-reported outcome measures (PROMs), shared decision-making (SDM) and health humanities (HH). The more recent models (SDM, HH) appear to align to a considerable degree with adopting 'behavior as the central outcome an outcome in health care'; shared decision-making and health humanities focus on encouraging patients to make sense of and give meaning to their illness in order to attain optimal psychosocial adjustment.</p><p><strong>Conclusions: </strong>In addition to 'behavior as the central outcome in health care', a new definition of the concept of health (i.e. 'the ability to adapt and to self-manage' - Huber et al., 2011) seems to favour patients, healthcare providers, society, and health psychology. Incorporating this concept into medical care may be viewed as a challenge for health psychologists - and as a source of continual struggle with strong biomedical forces.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2170379"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9888463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10700107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences on change in expected and actual health behaviors among first-year university students.","authors":"Chrys Gesualdo,&nbsp;Martin Pinquart","doi":"10.1080/21642850.2023.2174697","DOIUrl":"https://doi.org/10.1080/21642850.2023.2174697","url":null,"abstract":"<p><strong>Background: </strong>First-year students often adopt health risk behaviors during their first semester such as increased consumption of unhealthy food, decreased physical activity, and increased alcohol use. Expectations, social tie's efforts to motivate behavior, and coresidence with parents can influence said behaviors.</p><p><strong>Aims: </strong>We assessed how students' health behaviors and expectations change over the first semester, and how the aforementioned factors influence the maintenance or change of behavior and expectations.</p><p><strong>Methods: </strong>A longitudinal survey design was implemented. A total of <i>N</i> = 163 German first-year students (81% female; 18% male; 1% non-binary; <i>M</i> _age = 21.20, <i>SD</i> = 2.66) completed online questionnaires, including the NCHRBS and AUDIT, during the Covid-19 pandemic at the beginning (November 2020) and after the end (May 2021) of their first semester.</p><p><strong>Results: </strong>Current and expected food consumption and physical activity became healthier over time. The current and expected number of drinks consumed per month increased. Change in expectations for physical activity, number of drinks and binge drinking were predicted by the initial respective behavior. The number of drinks and expected physical activity became unhealthier in relation to reported initial parental influence to drink and to be physically inactive. Moving out of the parental home predicted an increase in current and expected number of drinks and in current and expected binge drinking. These effects of moving out were not mediated by perceived parental or peer influence.</p><p><strong>Conclusions: </strong>Interventions should target these behaviors and expectations during the first semester and address parental influence on physical activity and alcohol use.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2174697"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10742063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing cigarette-cue attentional bias between people with HIV/AIDS and people with opioid use disorder who smoke.","authors":"Gopalkumar Rakesh,&nbsp;Joseph L Alcorn,&nbsp;Rebika Khanal,&nbsp;Seth S Himelhoch,&nbsp;Craig R Rush","doi":"10.1080/21642850.2023.2255028","DOIUrl":"https://doi.org/10.1080/21642850.2023.2255028","url":null,"abstract":"<p><strong>Background: </strong>Special populations like people living with HIV/AIDS (PLWHA) and people with opioid use disorder (OUD) smoke tobacco cigarettes at rates three to four times greater than the general population. Patients with tobacco use disorder exhibit attentional bias (AB) for cigarette cues. Eye tracking can quantify this bias by measuring fixation time (FT) on cigarette and matched neutral cues, to calculate an AB score. Although previous studies have measured this bias in people who smoke without any other comorbid conditions, no study, to our knowledge, has measured or compared this bias in special populations.</p><p><strong>Methods: </strong>We performed exploratory analyses on eye tracking data collected in two separate randomized clinical trials (RCTs) (NCT05049460, NCT05295953). We compared FT and cigarette-cue AB score (measured by subtracting FT on neutral cues from FT on cigarette cues) between PLWHA and people with OUD who smoke, using a visual probe task and Tobii Pro Fusion eye tracker. We used two cigarette cue types, one encompassing people smoking cigarettes and the other consisting of cigarette paraphernalia. We used two cue presentation times, 1000 and 2000 milliseconds (ms).</p><p><strong>Results: </strong>Cues of people smoking cigarettes elicited greater AB than cues of cigarette paraphernalia across both subject groups when cues were presented for 2000 ms, but not 1000 ms. PLWHA who smoke exhibited greater AB for cues of people smoking cigarettes than cigarette paraphernalia when presented for 2000 ms compared to people with OUD who smoke.</p><p><strong>Conclusion: </strong>We use cigarette-cue AB to quantify craving and cigarette consumption in two populations smoking at elevated rates. The addition of social cues potentiates cigarette cue AB, based on cue type and stimulus presentation time. Understanding the neurobiology of this relationship can help design novel smoking cessation treatments that target AB and prevent relapse in these populations with suboptimal response to smoking cessation treatments.</p><p><strong>Trial registration: </strong>Clinical trials that provided the data for post hoc analyses are NCT05049460 and NCT05295953.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2255028"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/17/RHPB_11_2255028.PMC10486286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of a personalised script-elicitation method for improving evening sleep hygiene habits.","authors":"Anya Mohideen,&nbsp;Clara Bouvin,&nbsp;Gaby Judah,&nbsp;Federica Picariello,&nbsp;Benjamin Gardner","doi":"10.1080/21642850.2022.2162904","DOIUrl":"https://doi.org/10.1080/21642850.2022.2162904","url":null,"abstract":"<p><strong>Background: </strong>Attempts to improve evening sleep hygiene have overlooked that sleep preparation behaviours are often undertaken automatically with little awareness; that is, habitually. This mixed-methods study assessed aspects of the feasibility and acceptability of a novel behavioural intervention procedure ('script elicitation'), which encourages reflection on and reorganisation of the content and sequencing of habitual evening pre-sleep routines.</p><p><strong>Methods: </strong>The study was advertised via social media, and circular lists at a UK university. Twenty-four UK-based adults, reporting <6 h/night sleep, were recruited. At baseline, they completed sleep hygiene and quality measures, then participated in an online, one-to-one script elicitation interview. This involved the interviewer working with the participant to generate a fine-grained description of the content, organisation and variability of their typical pre-sleep routine, and plan a more sleep-conducive alternative routine to follow over the next week. One week later, participants completed sleep quality and hygiene measures, and a semi-structured interview about the intervention. Feasibility was assessed using quantitative data on response rates and attrition, and acceptability via sleep hygiene and quality scores, and qualitative data on intervention experiences.</p><p><strong>Results: </strong>All criteria were met. The target response rate was exceeded, none of the 24 participants dropped out, and sleep hygiene and quality scores either improved or remained stable. In interviews, all participants reported finding script elicitation useful. Script elicitation raised participants' awareness of habitual sleep hygiene routines, which gave many a newfound sense of autonomy over changing their sleep hygiene habits. While the habitual nature of existing routines obstructed change for some participants, most reported successfully changing aspects of their routine, and achieving behaviour, sleep and wellbeing improvements.</p><p><strong>Discussion: </strong>Script elicitation is a promising and acceptable method for tackling poor evening sleep hygiene habits. A more rigorous trial is warranted.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2162904"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10498930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the temporal self-regulation theory to understand sugar-sweetened beverage consumption among Chinese college students.","authors":"Hui-Lan Xiao,&nbsp;Cheng-Yan Jin,&nbsp;Guang-Dong Zhang,&nbsp;Chun-Qing Zhang","doi":"10.1080/21642850.2023.2208213","DOIUrl":"https://doi.org/10.1080/21642850.2023.2208213","url":null,"abstract":"<p><strong>Objective: </strong>Worldwide, there is a growing trend that college students are consuming more and more sugar-sweetened beverages (SSBs). In order to develop effective intervention strategies, it is important to explore what social-cognitive factors impact on college students' SSB consumption. Building on the temporal self-regulation theory (TST), the current study aimed to examine the effects of intention, behavioral prepotency, and self-regulatory capacity on SSB consumption among college students.</p><p><strong>Design: </strong>Data were collected from five hundred Chinese college students online. Participants self-reported their intention, behavioral prepotency (environmental cues and habits), self-regulatory capacity, and behaviors of SSB consumption.</p><p><strong>Results: </strong>Study findings showed that intention, behavioral prepotency, and self-regulatory capacity accounted for 32.9% of variance in SSB consumption. In terms of the direct effects, intention, behavioral prepotency, and self-regulatory capacity were significantly associated with the SSB consumption among college students. In addition, self-regulatory capacity and habits but not the environmental cues showed significant moderation effects on the intention-SSB consumption path, indicating that individual factors rather than environmental cues influenced the intention-behavior path of SSB consumption among college students.</p><p><strong>Conclusion: </strong>Findings of the current study demonstrated that the TST can be used to explain and understand the impacts of social-cognitive factors on college students' SSB consumption. Future research can apply TST to develop effective intervention programs targeting the reduction of SSB consumption among college students.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2208213"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/c9/RHPB_11_2208213.PMC10150612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9779813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and protective factors for mental health and wellbeing among adolescent orphans.","authors":"Megan Cherewick,&nbsp;Ronald E Dahl,&nbsp;Samantha Bertomen,&nbsp;Emily Hipp,&nbsp;Priyanka Shreedar,&nbsp;Prosper F Njau,&nbsp;Jenn A Leiferman","doi":"10.1080/21642850.2023.2219299","DOIUrl":"https://doi.org/10.1080/21642850.2023.2219299","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Results of the fitted structural equation model indicated that structural paths from protective factors to psychopathology (<i>β </i>= -0.53, <i>p </i>= 0.015) and mental wellbeing (<i>β </i>= 0.72, <i>p </i>= 0.014) outcomes were significant. Structural paths from risk factors to psychopathology (<i>β </i>= -0.34, <i>p </i>= 0.108) and mental wellbeing (<i>β </i>= -0.24, <i>p </i>= 0.405) were not significant.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"11 1","pages":"2219299"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/f7/RHPB_11_2219299.PMC10234133.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9579700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}