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Psychological Science & Global Health Equity 22 July 2024 EZER KANG Department of Psychology Psychological Science The accumulated body of psychological knowledge -pertaining to brain, behavior, social, or mental processes - that has been generated through the systematic application of the scient...

Psychological Science & Global Health Equity 22 July 2024 EZER KANG Department of Psychology Psychological Science The accumulated body of psychological knowledge -pertaining to brain, behavior, social, or mental processes - that has been generated through the systematic application of the scientific method (Hall, 2013) Health Equity The state in which everyone has a fair and just opportunity to attain their highest level of health by addressing economic, social, and other obstacles to health and health care (US CDC) “Let us not pay tribute to Europe by creating states, institutions and societies which draw their inspiration from her. Humanity is waiting for something other from us than such an imitation, which would be almost an obscene caricature. … But if we want humanity to advance a step farther, if we want to bring it up to a different level than that which Europe has shown it, then we must invent and we must make discoveries. … For Europe, for ourselves and for humanity, comrades, we must turn over a new leaf, we must work out new concepts, and try to set afoot a new [hu]man. (Fanon, The Wretched of the Earth p. 316) 2024 2024 2024 WEIRD Henrich, J., Heine, S. J., & Norenzayan, A. (2010). The weirdest people in the world?. Behavioral and brain sciences, 33(2-3), 61-83. Western v Behavioral scientists, often implicitly – assume that there is little variation across human populations, or that participants in WEIRD societies are representative across populations. Educated v There is substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual Industrialized compared with the rest of the species—frequent outliers. Visual perception Categorization and inferential induction Rich § § § Fairness § Moral reasoning § Cooperation § Reasoning Democratic § Spatial reasoning § Self-concepts § Self-concepts § Heritability of IQ 2024 2024 red:illusions Illusions in psychology are special perceptual experiences in which information from external stimuli leads to an incorrect perception or false impression Segall, Campbell, & Herskovits (1966) 2024 What does being happy mean to you? 2024 Happiness Maximization Is a WEIRD Way of Living Krys et al., 2024 Here happiness is one of the for this components of diagram wellbeing. happiness is the goal policy: condition cash transfer to give people small investment to improve their wellbeing WEIRD SOCIETIES 2024 Happiness Maximization Is a WEIRD Way of Living Krys et al., 2024 environment is welcoming no toxicity. higher the nbr =the less pathogen 2024 Happiness Maximization Is a WEIRD Way of Living Krys et al., 2024 v Ecological conditions in which WEIRD societies emerged afforded them a basis to endorse happiness as a value and to idealize attaining its maximum level. v Societies whose members seek to maximize happiness tend to be characterized as WEIRD, and generalizing this across societies can prove problematic if adopted at the ideological and policy level. 2024  Theories, Methods and Institutions come from WEIRD communities Methods May 2023 Theories Institutions They consider small populations like a college students instead UnWEIRDING of the whole world v Ecological validity of construct v Deep engagement with community throughout all stages of research v Mixed quantitative-qualitative methods v Development and support of local researchers v Unsiloe psychological science – integrate with sociology, medical anthropology, political science. 2024 African Psychology. Systematic and informed study of the complexities of human mental life, culture and experience in the pre- and post-colonial African world …as well as the exploration and adoption, where necessary, of aspects of Western psychology that appear relevant for enabling us to confront the challenges of our present African predicament (Nwoye, 2015). Biopsychosocial-Spiritualist model of explaining sources of psychopathology in human beings is more inclusive and advances the prevailing biopsychosocial model which fails to factor in the impact of religiosity and the place of mystery in peoples’ mental health”  African and Western Psychologies Distinctive (Nwoye, 2015) v Western psychology emphasizes objective, observable, and quantitative measurement often ignoring human religiosity and spirituality which belong in the invisible realm. 2013, Dhlamini, Bomma ba Seaparo, (Dhlamini, 2014) “Mothers of the Church” v African psychology moves beyond the boundaries of Western psychological research and practice. Not intended to displace. extrinsically religious people might exhibit more negative traits and their religious involvement isn't strongly tied to sincere belief, while intrinsically religious people are more likely to have genuine religious beliefs and fewer negative traits “Rather than abandon science as a hopelessly tainted activity of the powerful, the call to de-ideologize everyday realities entails the use of empirical inquiry to collaborate with people to reveal the everyday truth of their experience” (Adams, et al., 2015) Instead of dismissing science as biased, we should use it to work with people and uncover the true nature of their daily experiences.  Know the reason why eg. discovering and documenting deriving specific predictions or conclusions why pipo with HIV don't take new observable events or patterns. to see if the theory meets the observed data medications make the simple and likely explanation about observed phenomena. develop hypothesis biostatistics, Focusing on main and essential ideas numbers (Simplifying and generalizing concepts) Theory that you can measure  Research Formulation Script How will you approach Methodology answering the question? Hook catch their curiosity or interest How will you gather information? From Pique lay interest in a question, 06 01 whom and what setting? How will phenomenon or issue? Have information be analyzed (Method) you sufficiently engaged them to continue listening? What are you asking What do we know? 05 02 already and expecting to find? What does previous research kno To address this gap what question tell us about this interesting are you asking (Hypothesis)? question (Literature Review)? 04 03 Template Couresty: presentationgo.com Why should we know? What don’t we know? Why is it important to fill this What doesn’t research tell us research gap (Rationale)? (Research Gap)? Scientific Posters 2024 2024 "A good poster is not just tacking a standard research paper on poster board. An effective poster helps you engage colleagues in conversation and gets your main points across to as many people as possible.” Kathryn Tosney, PhD, University of Miami 2024 Purpose & Format v Poster sessions allow presenters and attendees to engage in extended discussions about the poster. v Poster boards are in an illustrated 4’ x 6’ format and are placed in rows in a large hall. In-person presenters will be asked to be at their assigned poster during the entire length of the poster session. 2024 How to Draw a Crowd (Price, 2011) v Focus on findings (prioritize the title that invites people into conversation. Keep it simple) v Emphasize graphics (select high quality) v Avoid “chart junk” (unnecessary information that distracts from the main point) v Choose colors wisely (stick with 2-3 colors that stand out against your background). v Leave white space v Aim for symmetry (human preference for symmetry v Design for readers’ eyes v Attend to details (full contact info, printouts) 2024  2024 https://convention.apa.org/blog/rethinking-the-science-poster  2024 https://www.posterpresentations.com/free-poster-templates.html Adapting a Home-Based Task-Shifting Intervention to Improve Adherence to Anti-Depressant Medication in Nigeria: An Example Select key topic in Tasks-shifting to address mental cognitive, clinical, Key Concept and/or community health workforce shortage in psychology Nigeria Identify and describe the Young adults with MDD in Ibadan, contextual lens Context Nigeria through which key topic will be critiqued/ reviewed Home-based visitation by peer Critically review the community health workers. task shifting Application key topic with the Training to problem-solve select lens adherence challenges and strengthen peer support Significance of Training, support, and retention application on are essential to successful peer- addressing health Recommendation led home-based interventions equity 2024 Psychological Science The accumulated body of psychological knowledge -pertaining to brain, behavior, social, or mental processes - that has been generated through the systematic application of the scientific method (Hall, 2013) Health Equity The state in which everyone has a fair and just opportunity to attain their highest level of health by addressing economic, social, and other obstacles to health and health care (US CDC) have distant influence have immmediate influence  Solar & Irwin (2010) Differences in exposure, vulnerability, consequences Distal factors with no immediate impacts Proximal factors since they have an immediate impact on health equity  Macrosystem: Effects of community which affects the family Exosystemic This affects the family and child's mental health Microsystem is proximal as it has direct influence on a child “Child (mental) health cannot be considered outside the broader context of families, culture, communities and environments” (p. 9)  how individuals interact with social and physical environment Social and physical environments that constitute human habitats Economic systems Social v v Political systems Ecology v Religious v Climates v Geography Culture Behavior Patterns of historically derived and selected ideas and their embodiment in institutions, practices, and artifacts (Adam & Markus, 2004) “Children’s early development requires nurturing care—defined as health, nutrition, security and safety, responsive caregiving, and early learning—provided by parent and family interactions, and supported by an environment that enables these interactions.” 2024 Application of Socioecological Approach What are distal factors that affect lead to well- established proximal causes of mind and behavior? What possibly influences a patient’s adherence to treatment? What are distal factors that potentially explain cultural or regional differences in behavior? Do Nigerian family caregivers of persons with serious mental illness experience courtesy stigma differently in the US, Nigeria, and Canada? Informed curiosity about linking distal socioecological to proximal causes of behavior Does climate change that affect crop harvesting associated with increased suicide among rural farmers?  Proximal factors Distal factors v Residential area - walkability v Illness stigma v Access to transportation & v Perceptions of illness and treatment roads v Competing life demands (cognitive v Environmental toxins load) heightening susceptibility to illnesses v High ambient temperatures can increase rates of infections and dehydration in pregnant women v Availability of accessible quality care v Funding priorities v Health care policy priorities – prevention vs. intervention Multilevel problems requires multilevel resolutions Cognitive Psychology (Neuroscience) Scientific study of the relationship between the brain, mind, and behavior with a focus on the central nervous system. v Relationship between poverty and environmental deprivation on neurocognitive development v Cognitive load and decision making Clinical Psychology (Psychopathology & Treatment) Study and practice of behavioral health care that addresses adjustment issues, serious mental illness, interpersonal and social problems, and cognitive and neurological conditions. v Practice-based evidence of culturally tailored behavioral interventions v Illness and social stigma Community Psychology Study of persons within multiple social systems with a broad attention to human resource development and system reform. ”Human is human through other humans” ubuntu v Participatory community activity and leadership v Community-based interventions and prevention Biological and Social Determinants of Mental Health Across the Lifespan cognitive psychology community psychology clinical psychology  Biological and Social Determinants of Mental Health Across the Lifespan Cognitive Psychology (Neuroscience) Biological and Social Determinants of Mental Health Across the Lifespan Clinical Psychology Biological and Social Determinants of Mental Health Across the Lifespan Community Psychology Clinical Psychology If We Build, Will They Come? Decisions About Child Mental Health Service Use Ezer Kang Olayinka Omigbodun Sade Akinkuotu Haleem Abdurahman Meghan Derenocourt Olurotimi Adejumo Woojae Kim Bella-Awusah GiShawn Mance Adeola Oduguwa Jasmine Stevens Olusegun Ogunmola 1R15MH117631-01 Scope of the Problem v Child and adolescent mental health (CAMH) needs in Nigeria outpace the availability of services. v Guardians’ abilities to recognize CAMH symptoms and their willingness to utilize accessible services for their children are critical and are affected by: fear of being socially marginalized for utilizing CAMH services. personal physical and emotional well-being hopelessness about the future and non-urgency to prioritize their children’s immediate mental health care needs v No empirically-based interventions that address specific barriers to securing MH services for children and adolescents in Nigeria. Significance Direct the development of evidence-based programming that optimize CAMH care in regions where services remain absent. Despite the dearth of current CAMH services in Nigeria, an anticipatory understanding of how to address guardians’ willingness to engage services is critical at the initial stages of program development and advocacy. Address the Problem v Empirically test the CAMH Help Seeking Model (Kang & Omigbodun, 2016), that identifies pathways that influence guardian willingness use CAMH services that are available and accessible. v This model will guide the development and evaluation of an intervention co-developed and co-facilitated by guardians and providers that aims to increase guardians’ willingness to utilize CAMH services for their children at an established outpatient mental health clinic. CAMH Help Seeking Model For Guardians Perceived Stigma Perceptions of Stigma Towards Stigma Towards CAMH Etiology CAMH Services Child with CAMH Families Soc1 Soc2 Soc3 Soc4 Hypothesis 1 High CAMH stigma will be associated with guardians’ CAMH Stigma low willingness to use Hypothesis 1 Knowledge of CAMH accessible services at UCH Problems Indiv4 Hypothesis 3 Recognition of Perceived Need for Willingness to CAMH Reported CAMH Problems CAMH Services Use Accessible Symptoms Indiv8 Indiv5 Indiv6 CAMH Services Hypothesis 4 Hypothesis 3 Competing Life Stressors Guardian Indiv7 Wellness Hypothesis 2 Socio-Cultural Individual Global Psychological Subjective Well- Attitude about Function Being the Future Outcome Indiv1 Indiv2 Indiv3 Variable Names CAMH Help Seeking Model For Guardians Perceived Stigma Perceptions of Stigma Towards Stigma Towards CAMH Etiology CAMH Services Child with CAMH Families Soc1 Soc2 Soc3 Soc4 Hypothesis 2 Poor guardian wellness will be associated with their low CAMH Stigma willingness to use accessible Knowledge of CAMH Hypothesis 1 services at UCH. Problems Indiv4 Hypothesis 3 Recognition of Perceived Need for Willingness to CAMH Reported CAMH Problems CAMH Services Use Accessible Symptoms Indiv8 Indiv5 Indiv6 CAMH Services Hypothesis 4 Hypothesis 3 Competing Life Stressors Guardian Indiv7 Wellness Hypothesis 2 Socio-Cultural Individual Global Psychological Subjective Well- Attitude about Function Being the Future Outcome Indiv1 Indiv2 Indiv3 Variable Names CAMH Help Seeking Model For Guardians Perceived Stigma Perceptions of Stigma Towards Stigma Towards CAMH Etiology CAMH Services Child with CAMH Families Soc1 Soc2 Soc3 Soc4 Hypothesis 3 High CAMH stigma and poor guardian wellness will CAMH Stigma be independently Hypothesis 1 associated with guardians’ Knowledge of CAMH Problems poor ability to recognize Indiv4 Hypothesis 3 their children’s’ mental CAMH Reported Recognition of Perceived Need for Willingness to Use Accessible health problems and Symptoms CAMH Problems Indiv5 CAMH Services Indiv6 CAMH Services Indiv8 guardians’ low perceived Hypothesis 4 Hypothesis 3 need for CAMH services. Competing Life Stressors This will in turn will Indiv7 Guardian decrease their willingness Wellness Hypothesis 2 to use accessible services. Socio-Cultural Individual Global Psychological Subjective Well- Attitude about Function Being the Future Outcome Indiv1 Indiv2 Indiv3 Variable Names CAMH Help Seeking Model For Guardians Perceived Stigma Perceptions of Stigma Towards Stigma Towards CAMH Etiology CAMH Services Child with CAMH Families Soc1 Soc2 Soc3 Soc4 Hypothesis 4 Experiencing more competing life stressors for CAMH Stigma guardians will be Hypothesis 1 associated with their low Knowledge of CAMH Problems perceived need for CAMH Indiv4 Hypothesis 3 services which in turn will CAMH Reported Recognition of Perceived Need for Willingness to Use Accessible decrease their willingness Symptoms CAMH Problems Indiv5 CAMH Services Indiv6 CAMH Services Indiv8 to use accessible services. Hypothesis 4 Hypothesis 3 Competing Life Stressors Guardian Indiv7 Wellness Hypothesis 2 Socio-Cultural Individual Global Psychological Subjective Well- Attitude about Function Being the Future Outcome Indiv1 Indiv2 Indiv3 Variable Names CAMH Help Seeking Model For Guardians Perceived Stigma Perceptions of Stigma Towards Stigma Towards CAMH Etiology CAMH Services Child with CAMH Families Soc1 Soc2 Soc3 Soc4 CAMH Stigma Hypothesis 1 Knowledge of CAMH Problems Indiv4 Hypothesis 3 Recognition of Perceived Need for Willingness to CAMH Reported CAMH Problems CAMH Services Use Accessible Symptoms Indiv8 Indiv5 Indiv6 CAMH Services Hypothesis 4 Hypothesis 3 Competing Life Stressors Guardian Indiv7 Wellness Hypothesis 2 Socio-Cultural Individual Global Psychological Subjective Well- Attitude about Function Being the Future Outcome Indiv1 Indiv2 Indiv3 Variable Names CAMH Help Seeking Model For Guardians Perceived Stigma Perceptions of Stigma Towards Stigma Towards CAMH Etiology CAMH Services Child with CAMH Families Soc1 Soc2 Soc3 Soc4 CAMH Stigma Hypothesis 1 Knowledge of CAMH Problems Indiv4 Hypothesis 3 Recognition of Perceived Need for Willingness to CAMH Reported CAMH Problems CAMH Services Use Accessible Symptoms Indiv8 Indiv5 Indiv6 CAMH Services Hypothesis 4 Hypothesis 3 Competing Life Stressors Guardian Indiv7 Wellness Hypothesis 2 Socio-Cultural Individual Global Psychological Subjective Well- Attitude about Function Being the Future Outcome Indiv1 Indiv2 Indiv3 Variable Names Random Purposive Sampling Ibadan Local Government Areas Major communities Areas within 10km of UCH High density Medium density Low density community area community area community area Selected Selected Selected neighbourhoods neighbourhoods neighbourhoods 10 households 10 households 10 households Random Purposive Sampling 3°50'0"E 3°52'0"E 3°54'0"E 3°56'0"E 3°58'0"E ³ 7°28'0"N 7°28'0"N Akinyele University of Ibadan Awotan ! ! Agbowo Akobo Lagelu ! 7°26'0"N 7°26'0"N ! Ido Legend Oluwo ! Akobo Housing Estate ! IkolabaBashorun Ibadan North ! ! Density Mokola 7°24'0"N v 7°24'0"N Ibadan North-West Gbekuba ! ® ! HD ! Jericho ! OlaogunNew Gbagi Market Odo Ona ! Yeosa Oke Offa ! ! ! Egbeda ! MD ! Akinfenwa ! Oluyole Iyaganku GRA Ibadan North-East ! LD ! ! 7°22'0"N 7°22'0"N Isale Jebu Odinjo v ® UCH ! ! Ogbere ! Ibadan South-West Challenge ! Roads Ile Titun Adesina ! Olomi ! ! Ona Ara LGA Boundary 7°20'0"N 7°20'0"N Ibadan South-East 10km Distance 0 1.5 3 4.5 6 Oluyole Kilometers 3°50'0"E 3°52'0"E 3°54'0"E 3°56'0"E 3°58'0"E  community level affects individual v Caregivers were receptive and willing to use outpatient psychiatric services for their children. v Their help-seeking decisions were not influenced by their recognition of CAMH conditions, family competing life stressors, personal wellness, nor stigma. 2024 v Guardian beliefs about the etiology and treatment effectiveness of CAMH conditions shaped how they intended to engage the services. v It is important to scale up a broader spectrum of accessible complementary CAMH intervention and prevention services in Nigeria that extend beyond indigenous or biomedical models. 2024  In closing… v Promoting health equity is a multi-faceted ambition that requires multi- faceted approaches to address questions that matter to intended communities. v Psychological science – with a focus on cognitive, clinical, and community psychology in this class – contribute scientific approaches and findings to begin addressing health inequities. v This requires critical ongoing analyses of studies that narrowly apply to WEIRD settings and the development of new knowledge more fitting to the majority world. v What are shared and distinctive concepts and practices that address health inequities across regions, cultures, and populations? 2024