Development of the Pediatric Type 2 Diabetes Impact Measure (P-TIM).

Globally, depression remains a prevalent mental health disorder affecting a staggering 264 million individuals, as reported by the World Health Organization (WHO) []. Women are disproportionately affected, experiencing a higher prevalence of depression compared to men, with low- and middle-income countries (LMICs) bearing the impact of this burden []. In Uganda, the recent reviews have showed that pooled prevalence of depression ranges between 20.8% − 30.2% the general population [, ]. It is further shown that vulnerable groups show higher rates, including refugees (67.6%), war victims (36%), people living with HIV (28.2%), pregnant/postpartum women (26.9%), university students (26.9%), and children/adolescents (23.6%) [–]. Parental stress and depression are significant concerns globally, with various studies indicating increasing prevalence and associated factors [, ]. Over the past decade, parents have consistently reported higher levels of stress compared to other adults []. This heightened stress can negatively impact parental mental health, leading to poorer psychological and physical well-being, and can also adversely affect their children’s developmental and health outcomes []. For instance, distressed parents may not engage effectively in stimulating interactions with their children, thereby elevating the risk of maltreatment and adverse childhood experiences []. In this study, we distinguish between probable depression and stress as two distinct yet interacting pathways that influence caregiving []. While stress represents the immediate psychological strain resulting from the daily demands of caregiving often manifesting as irritability or overwhelm, depression refers to a more persistent state of low mood and withdrawal []. Within the conceptual framework of the Parenting for Respectability (PfR) program, these constructs are critical because they impair different parenting dimensions: stress often leads to reactive, harsh discipline [], while depression is more closely linked to parental neglect, lack of emotional warmth, and disengagement [, ]. Understanding the unique predictors of each is essential for tailoring the PfR intervention to ensure that caregivers possess the emotional regulation necessary for positive parenting []. Systematic reviews in LMICs have generally linked depression and stress to limited healthcare access, social norms, food insecurity and IPV [, ]. Factors contributing to parental depression worldwide include socioeconomic challenges, limited social support, and exposure to adverse life events [].Additionally, cultural beliefs, conflict, and prevalent infectious diseases like HIV/AIDS significantly impact parental mental health within African communities [].