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Our TOPOWA project

The TOPOWA project is a 5-year long research study, funded by the NIH, to address the social drivers of mental illness in low-income settings. Our study will determine the link between place and mental health among young women who live in the slums of Kampala, Uganda.  The study will also determine if vocational training and women empowerment initiatives such as strengthening entrepreneurship skills will improve mental health trajectories for women in poverty. The collaborative and transdisciplinary study has many different project pieces and brings together researchers from Kennesaw State University, Georgia State University and Makerere University. The Community Based Organization that will lead the study implementation and intervention is our long-term partner the Uganda Youth Development Link.  Read more below. And, meet the project team


Focus Groups

We will conduct focus group discussions with young women to determine how they perceive their environment. We will also ask them if living in urban slums may contribute to depression and anxiety or to resilience and fortitude.  We will try to pinpoint what aspects of the environment may be most impactful. This information will then be used to collect survey data from the women in our cohort study.


We will conduct a PhotoVoice project, a participatory qualitative study component that comprises both art and behavioral science. We will engage with the young women who live in the slums and empower them to capture their environment through photograpy. Through their lens we will get their views of how they feel and what impacts their mental health. This project component will include group discussions and reflections of the photographs to increase our understanding how the social drivers impact mental health among these young women. 


Community Mapping

To understand the specific environmental influences and how they contribute to mental health, we will also map communities where study participants live. We will extend previous research and our previous work on the "slum rating scale" to quantify exposure to commercial determinants of health, as well as the typical indicator of urban slums such as lack of water, lack of sanitation, overcrowding, and non-durable housing structures. 

Cohort Studies

The key component of the TOPOWA study will assess the outcomes of vocational training as an intervention to address the link between poverty and mental illness. We will conduct two parallel cohort studies, one which will receive the intervention, to assess sadness, anxiety and suicidality over two years. We will also measure several biomarkers of stress and stress response including cortisol levels and sleep patterns. This study component begins in 2023.

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