Background
Study setting
Methods
Study design
Primary explanatory variables1
| |||
---|---|---|---|
Household infrastructure function. Two measures: Number of HLP components required for healthy living practices failed; Overall Surveyor Function Score | |||
Secondary explanatory variables
| |||
Carer socio-demographic
|
Child health and health behaviour and hygiene
|
Carer socioeconomic status
and financial stress
3
|
Psychosocial and health
|
Community of residence2
|
Child Health
4
| Carer highest level of schooling | Other people from tribal group live in community2
|
Carer socio-demographic
3
| Number of illnesses in carer’s children in past two weeks | Frequency of visits to traditional land3
| |
• sex | Carer labour force status | Number of people get help from if has serious worries2,3
| |
• age | Carer self-reported health7
| ||
• cohabitation with spouse |
Health behaviour, hygiene and day care
| Household material wealth |
Carer Negative Life Events
2,3
|
• Worried about someone sick/disabled | |||
Carer relationship to householder | Householder holds important position in community | • Know someone who had a bad accident | |
Time that carer has lived in the house | Broom, mop and bucket in house4
| • Death of family member or close friend | |
Carer mobility between communities (lived in other community for more than 4 weeks) | Soap in bathroom, kitchen5
| ||
Number of children cared for | Household hygienic condition (surveyor condition score)6
|
Financial security
| • Member of family in jail or sent to jail |
• aged less than one year | • Ran out of money in last 2 weeks | ||
• aged 1–3 years | Number of children in day-care3
| • Too many people living in one house | |
• aged 4–7 years | • Ran out of money in last year | ||
• aged 8 to 15 years | • Worried about divorce/separation | ||
Number of adults in house | • Number of things did to get money if ran out | ||
• Not able to get a job | |||
• Raise $2000 in a week for emergency | • Lost their job/sacked | ||
• Alcohol or drug problems | |||
• Seeing fights and people beaten up | |||
• Someone being abused or victim of violent crime | |||
• Trouble with police | |||
• Gambling problems | |||
• Racism |
Measures of carer’s mental health
Primary explanatory variables
Secondary explanatory variables
Statistical analyses
Cross-sectional analysis
Follow-up analysis
Understanding community level influences
Results
Cross sectional analysis
Unadjusted associations
Primary explanatory variables | High negative affect | High risk of depression | ||||
---|---|---|---|---|---|---|
Missing | Carers | |||||
n (%) | n (%) | n (%)1
| OR (95% CI) | n (%)1
| OR (95% CI) | |
All carers
|
328 (100)
|
75 (22.9)
| - |
53 (16.2)
|
-
| |
Number of HLP components failed
2
| ||||||
0-4 (better function) | 44 (13.4) | 94 (33.1) | 25 (26.6) | 1.0 | 8 (8.5) | 1.0 |
5-8 (poorer function) | 190 (66.9) | 39 (20.5) | 0.71 (0.42-1.22) | 40 (21.1) |
2.87 (1.18-6.94)
| |
Overall Surveyor Function Score
2
| ||||||
Better (scores 1–2) | 17 (5.2) | 88 (28.3) | 20 (22.7) | 1.0 | 13 (14.4) | 1.0 |
Worse (scores 3–7) | 223 (71.7) | 49 (22.0) | 0.96 (0.54-1.69) | 38 (17.2) | 1.23 (0.59-2.55) |
Multivariate models
Explanatory variable | High negative affect OR (95% CI) | High risk of depression OR (95% CI) |
---|---|---|
Number of HLPs not met
| ||
0-4 | ns | 1.0 |
5-8 | ns |
2.23 (0.98-5.07)
|
Community ID
| ||
1 | 1.0 | ns |
2 | 1.82 (0.47-7.05) | ns |
3 |
9.84 (3.10-31.2)
| ns |
4 | 2.37 (0.64-8.84) | ns |
5 |
3.29 (1.22-8.90)
| ns |
6 | 1.28 (0.14-11.7) | ns |
7 | 1.21 (0.33-4.44) | ns |
8 | 2.41 (0.91-6.42) | ns |
9 | 2.49 (0.66-9.37) | ns |
10 | 1.17 (0.20-6.73) | ns |
Number of children cared for aged 8–15 years
| ||
None | 1.0 | ns |
One | 0.45 (0.20-1.02) | ns |
Two or more |
0.26 (0.12-0.58)
| ns |
Number of children in day-care
| ||
No | 1.0 | ns |
One to three |
2.85 (1.17-6.91)
| ns |
Carer ran out of money in the last 2 weeks
| ||
No | 1.0 | ns |
Yes |
2.64 (1.36-5.14)
| ns |
Carer NLES quartiles (number of stressors reported)
| ||
0 to 3 | 1.0 | ns |
4 to 5 | 2.38 (0.87-6.52) | ns |
6 to 8 |
3.50 (1.34-9.14)
| ns |
9 to 13 |
6.07 (2.39-15.5)
| ns |
Sacked or made redundant
1
| ||
No | ns | 1.0 |
Yes | ns |
4.43 (1.24-15.9)
|
Death of a family member/close friend in the last year1
| ||
No | na | 1.0 |
Yes | na |
3.67 (1.49-9.06)
|
Adjusted R
2
|
18.9%
|
7.5%
|
Follow-up analysis
Unadjusted associations
Multivariate models
Explanatory variable |
Model 1
|
Model 2
|
Model 3
|
---|---|---|---|
∆ Negative affect1
β(95% CI) | ∆ Negative affect1
β(95% CI) | ∆ Risk of depression2
β(95% CI) | |
Community ID
| |||
1 | ni | -0.28 (-1.13, 0.58) | ns |
2 | ni | -0.74 (-1.52, 0.03) | ns |
3 | ni | 0.17 (-0.50, 0.84) | ns |
4 | ni | 0.81 (-0.31, 1.92) | ns |
5 | ni |
1.78 (1.00, 2.56)
| ns |
6 | ni | -0.15 (-1.13, 0.84) | ns |
7 | ni | -0.82 (-1.65, 0.01) | ns |
8 (median change in negative affect) | ni | 0.0 | ns |
9 | ni | 0.35 (-1.06, 1.77) | ns |
10 | ni | 1.26 (-0.21, 2.72) | ns |
Carer age at baseline
| |||
<20 yrs | ns | ns |
-9.70 (-15.58, -3.83)
|
20-34 yrs | ns | ns | 0.0 |
35 + yrs | ns | ns | 0.76 (-2.28, 3.80) |
Change in carer ran out of money last year
| |||
Other | 0.0 | ns | ns |
From had money to ran out of money last year |
-0.62 (-1.18, -0.05)
| ns | ns |
Change in child day care attendance
| |||
No change | ns | ns | 0.0 |
Change from No to Yes | ns | ns |
-4.03 (-6.37, -1.68)
|
Change from Yes to No | ns | ns | -1.66 (-9.55, 6.23) |
∆ in number of people carer could get help from not in house
| |||
Other | 0.0 | 0.0 | ns |
From none to able to get help from one or more |
0.86 (0.26, 1.45)
|
0.65 (0.05, 1.26)
| ns |
Change in carer’s has clan/kin in community
| |||
Other | ns | ns | 0.0 |
Had clan/kin in community to did not | ns | ns |
-3.55 (-5.46, -1.64)
|
NLES: ∆ in knowing someone who had a serious accident
| |||
Other | 0.0 | 0.0 | 0.0 |
From yes to no |
1.18 (0.59, 1.78)
|
0.98 (0.48, 1.47)
|
9.38 (3.44, 15.31)
|
NLES: ∆ in knowing someone sent to jail
| |||
Other | 0.0 | ns | ns |
From yes to no |
1.13 (0.53, 1.73)
| ns | ns |
Adjusted R
2
|
22.6%
|
35.1%
|
22.1%
|