In many regions globally, including low-resource settings, there is a growing trend towards using mHealth technology, such as wearable sensors, to enhance health behaviors and outcomes. However, adoption of such devices in research conducted in low-resource settings lags behind use in high-resource areas. Moreover, there is a scarcity of research that specifically examines the user experience, readiness for and challenges of integrating wearable sensors into health research and community interventions in low-resource settings specifically. This study summarizes the reactions and experiences of young women (N = 57), ages 18 to 24 years, living in poverty in Kampala, Uganda, who wore Garmin vívoactive 3 smartwatches for five days for a research project. Data collected from the Garmins included participant location, sleep, and heart rate. Through six focus group discussions, we gathered insights about the participants’ experiences and perceptions of the wearable devices. Overall, the wearable devices were met with great interest and enthusiasm by participants. The findings were organized across 10 domains to highlight reactions and experiences pertaining to device settings, challenges encountered with the device, reports of discomfort/comfort, satisfaction, changes in daily activities, changes to sleep, speculative device usage, community reactions, community dynamics and curiosity, and general device comfort. The study sheds light on the introduction of new technology in a low-resource setting and also on the complex interplay between technology and culture in Kampala’s slums. We also learned some insights into how wearable devices and perceptions may influence behaviors and social dynamics. These practical insights are shared to benefit future research and applications by health practitioners and clinicians to advance and enhance the implementation and effectiveness of wearable devices in similar contexts and populations. These insights and user experiences, if incorporated, may enhance device acceptance and data quality for those conducting research in similar settings or seeking to address population-specific needs and health issues.

Racial disparities in breast cancer present a vexing and complex challenge for public health. A diverse array of factors contributes to disparities in breast cancer incidence and outcomes, and, thus far, efforts to improve racial equity have yielded mixed results. Systems theory offers a model that is well-suited to addressing complex issues. In particular, the concept of a systemic leverage point offers a clue that may assist researchers, policymakers, and interventionists in formulating innovative and comprehensive approaches to eliminating racial disparities in breast cancer. Naming systemic racism as a fundamental cause of disparities, we use systems theory to identify residential segregation as a key leverage point and a driver of racial inequities across the social, economic, and environmental determinants of health. We call on researchers, policymakers, and interventionists to use a systems-informed, community-based participatory approach, aimed at harnessing the power of place, to engage directly with community stakeholders in coordinating efforts to prevent breast cancer, and work toward eliminating disparities in communities of color.

Young women in informal settlements in sub-Saharan Africa (SSA) experience significant health disparities. Despite growing understanding that population health outcomes are socially determined, the social determinants of health among young women in the informal settlements of SSA are not well understood. Furthermore, young women’s emic perspectives on the pathways that contribute to health risk are rarely reported in scientific research. This research brief describes findings from a qualitative study and specifically addresses young women’s insights into the social drivers of infectious disease transmission and treatment. We conducted focus groups including 60 young women participants aged 18 to 24 at three sites across Kampala, Uganda. Using thematic analysis, we identified four thematic clusters: (1) intersectional social injustices drive sexual exploitation and HIV transmission; (2) inadequate housing and sanitation contribute to the spread of infectious disease; (3) existing health care resources have limited capacity to address high infectious disease incidence; and (4) participants recommended building health promotion efforts on existing resources and developing community infrastructure to improve outcomes. This study highlights the social influences that contribute to the burden of infectious disease among young women living in Kampala’s informal settlements. Young women named several ecological factors and resources which, if engaged, could promote health and well-being in their communities. Future research should engage young women in SSA’s informal settlements as partners and peers in the development of community-owned research and intervention efforts to better understand community perspectives, address areas of most urgent need, and investigate barriers and facilitators to successful program implementation.

Background: There is a dearth of data on the modifiable factors that contribute to violence in low- and middle-income countries, including attitudes regarding intimate partner violence (IPV) and perceptions of gender identity. We examined these factors using a cross-cultural comparison between young adults in Uganda and the United States. Methods: A cross-sectional survey was distributed to young adults aged 18 to 25 in Uganda (n = 300) and the U.S. (n = 300). Survey questions assessed demographics, attitudes toward IPV, IPV victimization and perpetration, gender discrepancy, discrepancy stress, and alcohol use. We conducted chi-square tests, as well as bivariable and multivariable logistic regression analyses, separately for participants in each country. Results: The prevalence of IPV perpetration differed significantly by country for men (58.06% in the U.S. vs. 42.73% in Uganda; p = 0.03) and women (40.00% in the U.S. vs. 14.00% in Uganda; p < 0.01). IPV victimization differed by country for men (67.74% in the U.S. vs. 51.82% in Uganda; p = 0.02) but not for women. Gender discrepancy and discrepancy stress also varied by country and by sex and were higher in the U.S. for both men and women. IPV victimization was a common risk factor for adults in both Uganda (Adj. OR = 23.47; 95% CI: 7.79, 70.22) and the U.S. (Adj. OR = 27.40; 95% CI: 9.97, 75.32). In Uganda, male sex was significantly associated with IPV perpetration in multivariable analyses (Adj. OR = 6.23; 95% CI: 2.45, 15.86), and so were IPV attitudes (Adj. OR = 2.22; 1.20, 4.10). In the U.S., a likely alcohol use disorder (AUD) was also significantly associated with IPV perpetration (Adj. OR = 7.11; 95% CI: 2.25, 22.54). Conclusions: Permissive IPV attitudes were associated with IPV perpetration among Ugandan participants, while likely AUD was associated with perpetration in U.S. participants. Overall, IPV perpetration was significantly higher for U.S. males compared with Ugandan males. These findings indicate that cultural adaptations to global IPV interventions may be necessary to respond to differing needs in different countries.

Vocational training can lead to higher employment rates and improved incomes, particularly for young women in low-resource settings like Kampala’s slums. Despite these benefits, further research is needed to understand the full impact and mechanisms of vocational training on youth in low-resource environments. In 2022, a focus group project, part of a larger study, involved 60 women aged 18 to 24, recruited from three Youth Support Centers operated by the Uganda Youth Development Link (UYDEL) in Kampala. Six focus groups (about 10 women in each group) were held to explore urban stress and how vocational training might mitigate social and environmental stressors and improve mental health. Data analysis conducted using NVivo software identified five key themes: economic benefits, skill development, building confidence and self-esteem, improved social and behavioral well-being, and enhanced lifestyle and quality of life. This formative research underscores that vocational training benefits young women, highlighting outcomes such as job acquisition, financial empowerment, and skill development. Additionally, self-esteem and confidence development emphasize the training’s role in fostering mental health and agency and addressing gender inequality. These findings underscore the value of vocational training in enhancing the mental health and overall well-being of young women and suggest areas for future research for how to best optimize and scale these programs in low-resource settings.

Mindfulness-based interventions (MBIs) are increasingly used in clinical and community settings and show significant potential to address a broad range of physical and mental health outcomes. This potential has led to calls for ever greater implementation of MBIs internationally, particularly with vulnerable populations and in low-resource settings. However, the effectiveness of MBIs has not been unequivocally demonstrated across populations, contexts, and health outcomes, with some studies failing to show treatment effects or even showing iatrogenic effects. Simultaneously, health care and public health systems globally struggle to address population health needs within a medical paradigm that, in general, individualizes pathology while obscuring the structural causes of health disparities. It is therefore critical to note that most research and practice in the mindfulness space have focused on change processes exclusively at the individual level. In populations lacking access to basic needs such as physical safety, food, shelter, social support, health care, education, and financial stability, change processes at the individual level do not adequately address the conditions that impact human development and produce disease. In this article, we make a call to action urging MBI implementers in global health to (a) center community ownership; (b) attend to inequities in power both within communities and between researchers and communities; (c) engage cross-sector networks of community stakeholders to identify resources, resiliencies, and areas of most urgent need; (d) address community-defined needs and change processes at multiple social-ecological levels; and (e) incorporate complementary interventions that address both basic needs and the social drivers of human development and disease. Drawing on developments in implementation science, social science, and community practice, we provide guidance on directions and methods for future work to achieve these ends. Using this guidance, researchers and interventionists may catalyze the development of a community-owned, materially engaged, relational model of MBI, which has the potential to effect positive social change. (PsycInfo Database Record (c) 2025 APA, all rights reserved).