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Objective: The aim of this study was to explore the structural and external validity of the recently developed Questionnaire for Eudaimonic Well-Being (QEWB), scrutinising the parcelling approach used by Waterman and colleagues to confirm the unidimensional structure of the scale. Method: A multicultural South African student sample (n = 325) was used. Parceland item-level confirmatory factor analysis and item-level exploratory factor analysis were conducted to explore the scale's structural validity. External validity was examined via attenuation corrected correlations with scores on criterion measures. Results:On parcel-level a one-dimensional structure fitted well, but since the assumption of unidimensional parcels was violated, the use of parcelling was contraindicated. Item-level analyses revealed a multidimensional factor structure. The scale showed good convergent and discriminant validity. Conclusions: The QEWB shows potential for future use, given that the multidimensionality of the scale is acknowledged. Some items may need revision.

Age, gender, marital status, education attainment, employment status, and environmental setting explain different amounts of variance in psychological well-being and mental health. Inconsistent findings are reported for the socio-demographic variables in psychological well-being depending amongst others on the definition and measurement of well-being, context and the nature of the population. The present study explored the association of socio-demographic variables in an African context using two models that conceptualise and measure well-being as a holistic integrated and complex construct, namely the General Psychological Well-being model (GPW) and the Mental Health Continuum model (MHC). The study was conducted among an African sample in the North West Province of South Africa. A sample of 459 male and female Setswanaspeaking adults from rural and urban areas completed measures of general psychological well-being and the mental health continuum. Descriptive statistics, correlations, crosstabulations and regression analyses were computed. Findings indicate that socio-demographic variables play a role in determining holistic psychological well-being in a South African Setswana-speaking community. Urban living, employment, education and being married were associated with higher psychological well-being. Rural or urban environmental setting, followed by employment status, accounted for the greatest variance in psychological well-being measures. Age and gender were not significantly associated with well-being. The findings suggest that the current state of African rural living is detrimental to well-being. Through employment being an index of socio-economic status, the unemployed experience poor well-being. Future research efforts to explore the mechanisms of these relationships, and context-relevant intervention programmes are recommended.

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BackgroundGlobally hypertension is stabilising, but in sub-Saharan Africa the incidence of hypertension remains on an increase. Although this might be attributed to poor healthcare and ineffective antihypertensive treatment, there is a limited understanding of population and individual-specific cardiovascular pathophysiology – necessary for effective prevention and treatment strategies in Africa. As there is a lack of longitudinal studies tracking the early pathophysiological development of hypertension in black populations, the African-PREDICT study was initiated. The purpose of this paper is to describe the detailed methodology and baseline cohort profile of the study.Methods and resultsFrom 2013 to 2017, the study included 1202 black (N = 606) and white (N = 596) men and women (aged 20–30 years) from South Africa – screened to be healthy and clinic normotensive. At baseline, and each 5-year follow-up examination, detailed measures of health behaviours, cardiovascular profile and organ damage are taken. Also, comprehensive biological sampling for the ‘omics’ and biomarkers is performed. Overall, the baseline black and white cohort presented with similar ages, clinic and 24-hour blood pressures, but black adults had lower socioeconomic status and higher central systolic blood pressure than white individuals.ConclusionsThe prospective African-PREDICT study in young black and white adults will contribute to a clear understanding of early cardiovascular disease development.

Background/Objectives:Psychosocial stress has been proposed to contribute to obesity, particularly abdominal, or central obesity, through chronic activation of the neuroendocrine systems. However, these putative relationships are complex and dependent on country and cultural context. We investigated the association between psychosocial factors and general and abdominal obesity in the Prospective Urban Rural Epidemiologic study.Subjects/Methods:This observational, cross-sectional study enrolled 151 966 individuals aged 35–70 years from 628 urban and rural communities in 17 high-, middle- and low-income countries. Data were collected for 125 290 individuals regarding education, anthropometrics, hypertension/diabetes, tobacco/alcohol use, diet and psychosocial factors (self-perceived stress and depression).Results:After standardization for age, sex, country income and urban/rural location, the proportion with obesity (body mass index ⩾30 kg m−2) increased from 15.7% in 40 831 individuals with no stress to 20.5% in 7720 individuals with permanent stress, with corresponding proportions for ethnicity- and sex-specific central obesity of 48.6% and 53.5%, respectively (P<0.0001 for both). Associations between stress and hypertension/diabetes tended to be inverse. Estimating the total effect of permanent stress with age, sex, physical activity, education and region as confounders, no relationship between stress and obesity persisted (adjusted prevalence ratio (PR) for obesity 1.04 (95% confidence interval: 0.99–1.10)). There was no relationship between ethnicity- and sex-specific central obesity (adjusted PR 1.00 (0.97–1.02)). Stratification by region yielded inconsistent associations. Depression was weakly but independently linked to obesity (PR 1.08 (1.04–1.12)), and very marginally to abdominal obesity (PR 1.01 (1.00–1.03)).Conclusions:Although individuals with permanent stress tended to be slightly more obese, there was no overall independent effect and no evidence that abdominal obesity or its consequences (hypertension, diabetes) increased with higher levels of stress or depression. This study does not support a causal link between psychosocial factors and abdominal obesity.

This study sought to explore, describe and determine whether an HIV stigma-reduction community "hub" intervention would change the HIV stigma experiences of people living with HIV (PLWH) and the stigmatisation by the community in an urban area in South Africa. A convergent parallel mixed-method design with a single case pre-test post-test design and an interpretive description approach was utilised. The sample for this study included 62 PLWH recruited through accessibility sampling and 570 community members recruited through random voluntary sampling. A sub-sample of both groups, selected using purposive voluntary sampling, was utilised for the in-depth interviews about stigma experiences of PLWH, and for perceptions and attitudes of the community toward PLWH. Both quantitative and qualitative data showed that stigma is present. Although no statistically significant changes were found, small practically significant changes were demonstrated in the experiences of PLWH and in the perceptions and attitudes of the community. The extent of changes was much more obvious in the responses of the PLWH and the community during their post-intervention qualitative interviews than the changes found with the quantitative measures. This study thus concludes that the HIV stigma-reduction community hub intervention was successful in initiating the onset of changes in a community through the PLWH and people living close to PLWH (PLC) as community mobilisers active in the community hub to mobilise their own communities towards HIV stigma reduction through social change.