Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women

Abstract

Background Relationships between mental health and multiple health behaviours have not been explored in young South African women experiencing social constraints. The aim of this study was to identify associations between mental health indicators and risk factors with physical activity, sedentary behaviour, and sleep, amongst young women living in Soweto, a predominantly low-income, urban South African setting. Methods For this cross-sectional study, baseline measurements for participants (n = 1719, 18.0–25.9 years old) recruited for the Healthy Life Trajectories Initiative were used including: physical activity, sedentary behaviour (sitting, screen and television time), sleep (duration and quality), depression and anxiety indicators, emotional health, adverse childhood experiences, alcohol-use risk; social vulnerability, self-efficacy, and social support. Results Multiple regression analyses showed that depression (β = 0.161, p < 0.001), anxiety (β = 0.126, p = 0.001), adverse childhood experiences (β = 0.076, p = 0.014), and alcohol-use risk (β = 0.089, p = 0.002) were associated with poor quality sleep. Alcohol-use risk was associated with more screen time (β = 0.105, p < 0.001) and television time (β = 0.075, p < 0.016). Social vulnerability was associated with lower sitting time (β = − 0.187, p < 0001) and screen time (β = − 0.014, p < 0.001). Higher self-efficacy was associated with more moderate- to vigorous-intensity physical activity (β = 0.07, p = 0.036), better-quality sleep (β = − 0.069, p = 0.020) and less television time (β = − 0.079, p = 0.012). Having no family support was associated with more sitting time (β = 0.075, p = 0.022). Binomial logistic regression analyses supported these findings regarding sleep quality, with anxiety and depression risk doubling the risk of poor-quality sleep (OR = 2.425, p < 0.001, OR = 2.036, p = 0.003 respectively). Conclusions These findings contribute to our understanding of how mental health indicators and risk factors can be barriers to health behaviours of young women in Soweto, and that self-efficacy and social support can be protective for certain of these behaviours for these women. Our results highlight the uniqueness of this setting regarding associations between mental health and behaviours associated with non-communicable diseases risk.

Development, Implementation, and Process Evaluation of Bukhali: An Intervention from Preconception to Early Childhood

“…Less than half of the women reported any leisure time physical activity, although 86% of women met physical activity guidelines (based on self-report), but this was typically accumulated through transport-or work-related activity (Prioreschi et al, 2021). Poor quality sleep was reported by a third of the women in this sample, with 19% and 15% were classified as having depression and anxiety respectively, and 24% were at risk for harmful alcohol use (Draper et al, 2022a(Draper et al, , 2022b.…”

Development of the Brazilian Version of a Pan-Canadian Behavior Change Program and Its Health and Fitness Outcomes

“…Given the health disparities between populations across the globe, there have been multiple calls for culturally appropriate interventions, particularly in LMICs, which are grossly underrepresented in the literature [ 10 , 12 , 67 ]. This includes widespread calls to adapt interventions that have demonstrated efficacy and/or effectiveness in a culturally appropriate manner for LMICs [ 13 , 68 , 69 ].…”

Young women’s health behaviours in context: a qualitative longitudinal study in the Bukhali trial

“…Pilot data from the Bukhali trial highlight that the social vulnerability of these young women is exacerbated by parity (Ware et al, 2021), food insecurity (Kehoe et al, 2021), and mental health risks (Draper, Cook, et al, 2022). Young black women living in urban low-income settings such as Soweto are particularly vulnerable to being classified as 'NEET' (not in education, employment or training).…”

“…The NEET rate in South African youth (15-24 years) has been increasing over the past 10 years, and has been consistently over 30% (Mudiriza & de Lannoy, 2022). In terms of health behaviours, tobacco use was found in 29% of the pilot sample (Soepnel et al, 2022); less than half reported any leisure time physical activity (Prioreschi et al, 2021), and a third of women reported poor sleep quality (Draper, Cook, et al, 2022). Further qualitative work also drew attention to the relatively low priority given to health, and the "preconception knowledge gap" amongst young women in Soweto (Bosire et al, 2021;Draper et al, 2020).…”