Socioenvironmental Determinants of Psychological Functioning, Mental Health and AIDS in Mali
Condition: AIDS; Stress
Study type: Observational

Summary: 
      This project is a collaboration between the Centre Regional de Medecine Traditionnelle (CRMT)
      of the Malian National Institute of Public Health Research (INRSP) and the Section on
      Socioenvironmental Studies (SSES). These units developed a three-pronged protocol reflecting
      their joint and individual concerns:

        1. Effects of occupational complexity on psychological functioning. The project tests a
           theory derived from previous SSES research demonstrating that in industrialized
           societies doing relatively self-directed, substantively complex work increases
           self-directed orientations to self, society and family and promotes effective
           intellectual functioning. It uses sociological survey methodology to determine the
           generalizability of this theory to an essentially pre-literate, preindustrial society.

        2. Effects of work-related stress on mental health. Earlier SSES work demonstrated that
           stressful work conditions lead to distress in industrialized societies. This project
           extends the investigation of these effects to a non-industrialized setting. It also
           extends the investigation of work-related stress to include work-related migration,
           resting a hypothesis that relates equally to SSES and CRMT concerns: that individuals
           from rural ethnic groups with a cultural tradition of work-related migration will show
           fewer mental health problems when migrating for nontraditional work than those from
           cultures without such a tradition. Mental health problems are assessed through: a)
           adaptations of standard survey-based psychological measures of components of distress,
           b) general and culture-specific survey-based psychiatric screening questions, and c) a
           psychiatric interview conducted by a CRMT psychiatrist trained in internationally
           accepted diagnostic procedures and knowledgeable about local cultures.

        3. The effects of migration and cultural and socioeconomic factors on AIDS-related
           knowledge, attitudes and behaviors. The survey addresses concern regarding the degree of
           knowledge about the nature of AIDS among rural Malians who are relatively isolated from
           urban oriented sources of information about culturally non-traditional issues. It also
           examines how socio-cultural background and migration for work affect AIDS related
           attitudes and self-reported behaviors in an African society where estimates of HIV
           prevalence are still relatively low (less than 2%), compared to those of other
           sub-Saharan African countries.

      Although these prongs are distinguishable, each requires a longitudinal design, a
      representative sample, extensive information about responders' social and cultural
      backgrounds, occupational histories, work conditions, and personal orientations and beliefs.
      Because of their overlapping theoretical approaches and methodological requirements,
      combining them in one project increases the richness and efficiency of the data collected for
      each.
    

Detailed description: 
      This project is a collaboration between the Centre Regional de Medecine Traditionnelle (CRMT)
      of the Malian National Institute of Public Health Research (INRSP) and the Section on
      Socioenvironmental Studies (SSES). These units developed a three-pronged protocol reflecting
      their joint and individual concerns:

        1. Effects of occupational complexity on psychological functioning. The project tests a
           theory derived from previous SSES research demonstrating that in industrialized
           societies doing relatively self-directed, substantively complex work increases
           self-directed orientations to self, society and family and promotes effective
           intellectual functioning. It uses sociological survey methodology to determine the
           generalizability of this theory to an essentially pre-literate, preindustrial society.

        2. Effects of work-related stress on mental health. Earlier SSES work demonstrated that
           stressful work conditions lead to distress in industrialized societies. This project
           extends the investigation of these effects to a non-industrialized setting. It also
           extends the investigation of work-related stress to include work-related migration,
           testing a hypothesis that relates equally to SSES and CRMT concerns: that individuals
           from rural ethnic groups with a cultural tradition of work-related migration will show
           fewer mental health problems when migrating for nontraditional work than those from
           cultures without such a tradition. Mental health problems are assessed through: a)
           adaptations of standard survey-based psychological measures of components of distress,
           b) general and culture-specific survey-based psychiatric screening questions, and c) a
           psychiatric interview conducted by a CRMT psychiatrist trained in internationally
           accepted diagnostic procedures and knowledgeable about local cultures.

        3. The effects of migration and cultural and socioeconomic factors on AIDS-related
           knowledge, attitudes and behaviors. The survey addresses concern regarding the degree of
           knowledge about the nature of AIDS among rural Malians who are relatively isolated from
           urban oriented sources of information about culturally non-traditional issues. It also
           examines how socio-cultural background and migration for work affect AIDS related
           attitudes and self-reported behaviors in an African society where estimates of HIV
           prevalence are still relatively low (less than 2%), compared to those of other
           sub-Saharan African countries.

      Although these prongs are distinguishable, each requires a longitudinal design, a
      representative sample, extensive information about responders' social and cultural
      backgrounds, occupational histories, work conditions, and personal orientations and beliefs.
      Because of their overlapping theoretical approaches and methodological requirements,
      combining them in one project increases the richness and efficiency of the data collected for
      each.

      The division of responsibility between SSES and CRMT is as follows:

        1. The survey questionnaire is the product of SSES/CRMT collaboration. It has been check by
           Malian linguists, extensively pretested by CRMT, and found feasible to administer and
           likely to provide highly reliable data with sufficient variance to permit the testing of
           our hypotheses. The project has been independently review and approved by the relevant
           Malian IRB the Ethics Committee and the Medical School of the University of Mali.

        2. Data Collection involves conducting structured sociological interviews with
           representative rural samples from three Malian ethnic groups, carrying out psychiatric
           interviews with respondents who fail the psychiatric screen. The collection, processing
           and coding of the data is the responsibility of CRMT.

        3. Data Analysis is primarily the responsibility of the SSES, which receives the data in a
           form in which individual respondents cannot be identified.
    

Observational model: Cohort
Time perspective: Other
Keywords: Adjustment; Environmental Complexity; Mental Illness; Non-literate; West Africa; Stress; Knowledge; Mental Health; AIDS