Global Health Engineering (GHE), Department of Mechanical and Process Engineering (D- MAVT), ETH Zurich, Clausiusstrasse 37, Zurich, 8092, Switzerland.
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
BMC Psychol. 2024 Feb 9;12(1):65. doi: 10.1186/s40359-024-01562-7.
In Sub Saharan Africa (SSA), approximately 9 million students are enrolled in tertiary education (TE), which is 4% of the total TE enrolment globally. Barriers to higher education in SSA are numerous: poverty, food insecurity, gender, and disability, while the COVID-19 pandemic has worsened the situation. Little is known about the psychosocial factors and underlying mechanisms associated with students' intention to apply for TE. Using a psychological theory of behaviour change, our study investigated the psychosocial and context factors associated with the application to TE.
In a cross-sectional research study 821 interviews using researcher-administered questionnaires were conducted with secondary school students in rural and urban Blantyre, Malawi. A quantitative questionnaire based on the risks, attitudes, norms, abilities, and self-regulation (RANAS) model was used to assess psychosocial factors underlying application for TE. The Centre for Epidemiological Studies Depression Scale for Children (CES-DC) and household hunger scale were used to assess mental health and hunger respectively.
More than half of the youth were at risk to develop depression (66.5%). Girls reported experiencing more depression symptoms than boys. Around 1 in every 5 interviewed youth lived in a home experiencing moderate or severe hunger. A higher intention to apply for TE was related to perceived vulnerability, affective beliefs (joy, happiness, excitement), injunctive (approval of others) and personal norms, self-efficacy, and commitment to apply. Factual knowledge about TE application was very limited. An intention to apply for TE and self-efficacy was positively associated with regular physical exercise, but negatively associated with mental health and hunger. However, mental health moderated the effects of physical exercise on the intention to apply for TE. We found significant differences between poor and good mental health groups on intention to apply for TE in perceived vulnerability, descriptive (behaviour of others) and personal norms, self-efficacy, maintenance self-efficacy and commitment factors. The results informed a behaviour change intervention strategy to increase students' intention to apply for TE.
Our research findings are an important contribution to the long-term strategy of achieving the Sustainable Development Goals (SDGs) and contribute to the inclusion of vulnerable students with impaired mental health in higher education in Malawi and beyond.
在撒哈拉以南非洲（SSA）地区，约有 900 万学生接受高等教育（TE），占全球 TE 入学总人数的 4%。SSA 地区高等教育存在诸多障碍：贫困、粮食不安全、性别和残疾，而 COVID-19 大流行使情况进一步恶化。人们对与学生申请 TE 相关的社会心理因素和潜在机制知之甚少。本研究使用行为改变心理学理论，调查了与申请 TE 相关的社会心理和背景因素。
在一项横断面研究中，我们对马拉维农村和城市布兰太尔的 821 名中学生进行了 821 次访谈。研究采用了一种基于风险、态度、规范、能力和自我调节（RANAS）模型的定量问卷，以评估申请 TE 的潜在社会心理因素。使用儿童流行病学研究抑郁量表（CES-DC）和家庭饥饿量表分别评估心理健康和饥饿情况。
超过一半的青少年有患抑郁症的风险（66.5%）。女孩报告的抑郁症状比男孩多。接受访谈的青少年中，每 5 人就有 1 人生活在中度或重度饥饿的家庭中。更高的申请 TE 意愿与感知脆弱性、情感信念（喜悦、幸福、兴奋）、规范（他人的认可）和个人规范、自我效能和申请承诺有关。关于 TE 申请的实际知识非常有限。申请 TE 的意愿和自我效能与定期体育锻炼呈正相关，但与心理健康和饥饿呈负相关。然而，心理健康状况调节了体育锻炼对申请 TE 意愿的影响。我们发现，在感知脆弱性、描述性（他人行为）和个人规范、自我效能、维持自我效能和承诺因素上，心理健康状况差和良好的青少年群体之间存在显著差异。研究结果为增加学生申请 TE 的意愿提供了行为改变干预策略。
我们的研究结果是对实现可持续发展目标（SDGs）的长期战略的重要贡献，并有助于将心理健康受损的弱势学生纳入马拉维和其他地区的高等教育。
