Hope Matters: Developing and Validating a Measure of Future Expectations Among Young Women in a High HIV Prevalence Setting in Rural South Africa (HPTN 068)

Abstract

Hope is a future expectancy characterized by an individual’s perception that a desirable future outcome can be achieved. Though scales exist to measure hope, they may have limited relevance in low resource, high HIV prevalence settings. We developed and validated a hope scale among young women living in rural South Africa. We conducted formative interviews to identify the key elements of hope. Using items developed from these interviews, we administered the hope scale to 2533 young women enrolled in an HIV-prevention trial. Women endorsed scale items highly and the scale proved to be unidimensional in the sample. Hope scores were significantly correlated with hypothesized psycholosocial correlates with the exception of life stressors. Overall, our hope measure was found to have excellent reliability and to show encouraging preliminary indications of validity in this population. This study presents a promising measure to assess hope among young women in South Africa.

The value of hope: development and validation of a contextual measure of hope among people living with HIV in urban Tanzania a mixed methods exploratory sequential study

“…This dimension is similar to the third dimension of our hope scale; positive future expectations and meeting goals. Moreover, our question items under this dimension were similar; Example our item HS23 "I can reach/meet my goals" was similar to the question item PM7 "It is easy for me to reach my goals" [45] in the South African local hope scale. Setting goals and working toward them effectively is an important aspect of hope.…”

“…The three dimensions of hope in our scale are not completely different from previously developed hope scales. A more recently developed local hope scale among PLH in similar settings of South Africa, which focused on HIV infected young women aged 13-20 years [45], showed one dimension reflecting future expectations and meeting goals. This dimension is similar to the third dimension of our hope scale; positive future expectations and meeting goals.…”

“…The study was conducted in Dar es Salaam, the largest city in Tanzania, with a population of 4.5 million, and just over half (51%) residing in informal settlements [50]. The city has the third highest prevalence of HIV in the country of 6.2% against a national prevalence of 5.2% [45]. Annual mortality among PLH accessing antiretroviral (ART) medication is 13.1% [51], and depressive disorders are among mortality contributing factors [51][52][53][54].…”

“…However, there is limited use and integration of hope concepts and related non-pharmacological therapies in Tanzania and other African countries. This is in part due to the lack of relevant measures of hope developed for use in African populations living in SSA [28,45,46]. Almost all the tools for measuring hope were adopted from western cultural settings and most of them have not been validated in African settings.…”

Cash Transfers, Young Women’s Economic Well-Being, and HIV Risk: Evidence from HPTN 068

“…Power in sexual relationships was measured using the 12-item sexual relationship power scale (SRPS), adapted for South Africa [46,47]. Mental health was measured using the 20-item Center for Epidemiological Studies Depression scale (CES-D) [48] 1 and hopefulness was measured using a 13-item Hope scale developed and validated for this population [49]. Each of the scales were scored on a fourpoint Likert scale, summed, and rebased to zero.…”