TOPOWA Project Update
- mswahn
- 7 days ago
- 4 min read
The TOPOWA Project continues to break new ground in our efforts to understand how SocioEconomic Strengthening Targeted Training (SeSTT) implemented by our community partner, the Uganda youth Development Link, may impact the mental health and well-being of adolescent girls and young women living in Kampala’s urban informal settlements.
With one year of the cohort data collection complete, and another year underway, early trends from our prospective cohort study are encouraging. While we await publication of results, we’re optimistic that this research will contribute meaningfully to how we design and implement community-based mental health interventions in low-resource settings.
When the study is completed next year, we will have data from 10 time points across the two years. The time points will enable us to examine patterns of behaviors and outcomes and also examine closely both the shorter and longer term impact of the intervention (SeSTT). We will also be able to examine the structural drivers (at the more macro level) but also how biomarkers like cortisol (stress hormone) and neuroscience (like fear and threat) may impact the mental health outcomes.
At this point we have 10 articles published (see list below) that highlight key findings of the project components already completed (e.g., focus groups, photovoice and pilot studies) as well as some of the early findings from the cohort study. But, the core team and our many collaborators are busy analyzing and preparing more manuscripts for dissemination. Meanwhile, here are some other project highlights.
🔍 What Makes the TOPOWA Study Unique?
Integrated Design: TOPOWA combines psychosocial survey data, wearable technology, daily diaries, biomarkers, and a neuroscience-based fear-conditioning task to explore stress response systems and mental health trajectories in real-world conditions.
Engaged, Longitudinal Approach: Our study follows 300 young women across 10 timepoints over 27 months, making it one of the most comprehensive studies of its kind in Africa.
Community Partnership: Guided by youth and professional advisory boards, we prioritize cultural relevance, participant insight, and ethical rigor at every step.
📌 What’s Next?
In-Depth Analysis: Our team is now exploring how social factors/determinants like poverty, education, quality of life, caregiving, and baseline experiences shape outcomes across the cohort.
Mechanistic Insights: We will soon begin evaluating biomarker and neuroscience data to better understand the stress-mental health connection.
Dissemination and Dialogue: We’re committed to sharing findings with community stakeholders, practitioners, and policymakers—locally and globally—and we are always glad to share papers and presentations with anyone interested.
Writing Group: We are also exploring developing interdisciplinary writing groups with mentoring and support to other researchers who would like to contribute to the project and disseminate findings. Reach out to us if this is of interest.
🤝 Stay Engaged
TOPOWA is more than a study—it’s a platform for collaborative, action-oriented research that centers the experiences of young women navigating complex adversity. We are grateful to our partners, funders, and participants for their ongoing support. And, we're always grateful to UYDEL for leading the implementation of the study and for the fantastic data and project team we have in Kampala.
Follow along as we continue this journey to drive impactful research in global mental health. And if you’re interested in collaboration or learning more, we’d love to hear from you.
Published TOPOWA Papers to Date
Natuhamya, C., Nabukalu, E., Lyons, M., Gittner, K. B., Palmier, J., Culbreth, R., & Swahn, M. H. (2025). Effect of social perspectives in the relationship between suicidal ideation and depression among young women in slums of Kampala, Uganda. BMC psychiatry, 25(1), 568. https://doi.org/10.1186/s12888-025-06930-0
Lyons, M., Palitsky, R., Gittner, K. B., Nabulya, A., Hall, W., Palmier, J., & Swahn, M. H. (2025). Social Drivers of Infectious Disease Transmission and Treatment Among Young Women in Kampala, Uganda's Informal Settlements: A Qualitative Analysis of Focus Group Data From a Community-Based Cohort Study. Health promotion practice, 15248399251328332. Advance online publication. https://doi.org/10.1177/15248399251328332
Nielsen, K. E., Mobley, K., Culbreth, R., Palmier, J. B., Matovu, G., Nabulya, A., & Swahn, M. H. (2025). Wearable technology and daily diaries for studying mental health: lessons learned from pilot studies in Kampala, Uganda. Global mental health (Cambridge, England), 12, e17. https://doi.org/10.1017/gmh.2025.9
Swahn, M. H., Natuhamya, C., Culbreth, R., Palmier, J., Kasirye, R., & Dumbili, E. W. (2025). Alcohol marketing as a commercial determinant of health: daily diary insights from young women in Kampala. Health promotion international, 40(1), daaf002. https://doi.org/10.1093/heapro/daaf002
Swahn, M. H., Nabulya, A., Nassaka, J., & Palmier, J. (2025). Feasibility, Challenges and Lessons Learned: Photovoice Implementation Among Young Women in the Urban Slums in Kampala, Uganda. International Journal of Qualitative Methods, 24. https://www.mdpi.com/1660-4601/21/2/184
Nielsen, K., Mobley, K., Culbreth, R., Palmier, J., Nabulya, A., & Swahn, M. H. (2024). Feasibility and acceptability of wearable devices and daily diaries to assess sleep and other health indicators among young women in the slums of Kampala, Uganda. Digital health, 10, 20552076241288754. https://doi.org/10.1177/20552076241288754
Swahn, M. H., Palmier, J., Culbreth, R., Bbosa, G. S., Natuhamya, C., Matovu, G., & Kasirye, R. (2024). Alcohol Use among Young Women in Kampala City: Comparing Self-Reported Survey Data with Presence of Urinary Ethyl Glucuronide Metabolite. International journal of environmental research and public health, 21(9), 1256. https://doi.org/10.3390/ijerph21091256
Swahn, M. H., Gittner, K. B., Lyons, M. J., Nielsen, K., Mobley, K., Culbreth, R., Palmier, J., Johnson, N. E., Matte, M., & Nabulya, A. (2024). Advancing mHealth Research in Low-Resource Settings: Young Women's Insights and Implementation Challenges with Wearable Smartwatch Devices in Uganda. Sensors (Basel, Switzerland), 24(17), 5591. https://doi.org/10.3390/s24175591
Culbreth, R. E., Nielsen, K. E., Mobley, K., Palmier, J., Bukuluki, P., & Swahn, M. H. (2024). Life Satisfaction Factors, Stress, and Depressive Symptoms among Young Women Living in Urban Kampala: Findings from the TOPOWA Project Pilot Studies. International journal of environmental research and public health, 21(2), 184. https://doi.org/10.3390/ijerph21020184
Swahn, M. H., Nassaka, J., Nabulya, A., Palmier, J., & Vaught, S. (2022). A Qualitative Assessment of Place and Mental Health: Perspectives of Young Women Ages 18-24 Living in the Urban Slums of Kampala, Uganda. International journal of environmental research and public health, 19(19), 12935. https://doi.org/10.3390/ijerph191912935
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