{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:18:11Z","timestamp":1760145491803,"version":"build-2065373602"},"reference-count":85,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fogarty International Center of the National Institutes of Health","award":["K01TW011480","P30MH062294"],"award-info":[{"award-number":["K01TW011480","P30MH062294"]}]},{"name":"National Institute of Mental Health","award":["K01TW011480","P30MH062294"],"award-info":[{"award-number":["K01TW011480","P30MH062294"]}]},{"name":"Epic Foundation","award":["K01TW011480","P30MH062294"],"award-info":[{"award-number":["K01TW011480","P30MH062294"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai. Methods: We conducted semi-structured interviews with AGYW (aged 15\u201325 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS. Results: Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety. Discussion: Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies.<\/jats:p>","DOI":"10.3390\/ijerph21081007","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T08:02:27Z","timestamp":1722412947000},"page":"1007","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Mixed Methods Exploration of Young Women\u2019s Agency and Mental Health during COVID-19 in Low-Income Communities in Mumbai, India"],"prefix":"10.3390","volume":"21","author":[{"given":"Marie A.","family":"Brault","sequence":"first","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, San Antonio, TX 78229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa F.","family":"Peskin","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6143-4855","authenticated-orcid":false,"given":"Anastasia N.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, San Antonio, TX 78229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrita","family":"Saikia","sequence":"additional","affiliation":[{"name":"Jamsetji Tata School of Disaster Studies, Tata Institute of Social Sciences, Mumbai 400088, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4138-4955","authenticated-orcid":false,"given":"Rinchen O.","family":"Bhutia","sequence":"additional","affiliation":[{"name":"Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai 400088, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai Sammitha","family":"Cheruvu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaishali M.","family":"Jagtap","sequence":"additional","affiliation":[{"name":"Independent Researcher, Mumbai 400074, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajendra","family":"Singh","sequence":"additional","affiliation":[{"name":"International Center for Research on Women (ICRW) Asia Office, New Delhi 110018, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poornima","family":"Nair","sequence":"additional","affiliation":[{"name":"Health and Disability, Apnalaya, Mumbai 400071, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7138-2382","authenticated-orcid":false,"given":"Rajesh","family":"Vedanthan","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7289-8698","authenticated-orcid":false,"given":"Sten H.","family":"Vermund","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubhada","family":"Maitra","sequence":"additional","affiliation":[{"name":"Centre for Health and Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai 400088, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"ref_1","first-page":"277","article-title":"Early adolescent childbearing in low-and middle-income countries: Associations with income inequity, human development and gender equality","volume":"32","author":"Decker","year":"2017","journal-title":"Health Policy Plan."},{"key":"ref_2","unstructured":"Djamba, Y.K., and Kimuna, S.R. 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