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A network analysis of the associations between COVID-19-related variables and health across sex, age and educational levels among Ghanaian youths
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  • Published: 05 February 2026

A network analysis of the associations between COVID-19-related variables and health across sex, age and educational levels among Ghanaian youths

  • Jiajia Ye1,2 na1,
  • I-Hua Chen3 na1,
  • Po-Ching Huang4,
  • Emma Sethina Adjaottor5,
  • Frimpong-Manso Addo5,
  • Ishmael Ronald Ahorsu6,
  • Mark D. Griffiths7,
  • Wanqing Lin8,
  • Daniel Kwasi Ahorsu9 &
  • …
  • Chung Ying Lin10,11,12,13 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Anxiety
  • Depression
  • Psychology

Abstract

The COVID-19 pandemic has had far-reaching impacts on global health, affecting not only physical well-being but also exacerbating mental health issues. The present study investigated the associations between COVID-19-related variables and health outcomes across different sex, age, and education levels. The cross-sectional survey study was conducted from June to August 2022, comprising 1,326 participants aged 12 to 28 years in Ghana. Participants completed psychometric measures assessing fear of COVID-19, psychological distress, perceived stigma, self-stigma, preventive behaviors, believing COVID-19 information, vaccination acceptance, and quality of life. Network analysis indicated that COVID-19-related stress was positively associated with fear of COVID-19, psychological distress, and COVID-19-related self-stigma. The fear of COVID-19 was positively associated with preventive COVID-19 behaviors, COVID-19-related self-stigma, and believing COVID-19 information, while psychological distress was positively associated with COVID-19-related self-stigma but negatively associated with both physical and mental quality of life. Physical quality of life was negatively associated with COVID-19-related perceived stigma and COVID-19 vaccine acceptance. These network structures varied across sex, age, and educational levels. COVID-19-related stress had the highest centrality across four indices. In sum, the present study highlighted the interconnectedness of COVID-19-related variables and health factors among young people in Ghana. COVID-19-related stress appeared to be a pivotal determinant of psychological well-being. Stress related to the COVID-19 pandemic served as a key determinant of psychological well-being. The differences in network structures across sex, age, and education levels highlighted the importance of tailored health interventions. Further research employing longitudinal study designs and targeting diverse populations are needed to observe the dynamic associations between health-related variables over time.

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Data availability

The data supporting the findings of the present study are available from the correspondingauthor upon reasonable request.

Abbreviations

COVID-19:

Coronavirus disease 2019

KNUST:

Kwame Nkrumah University of Science and Technology

FCS:

Fear of COVID-19 Scale

BCIS:

Believing COVID-19 Information Scale

SSS:

Self-Stigma Scale from COVID-19

CSS:

COVID-19 Stress Scale

COVID-VA:

Motors of COVID-19 Vaccination Acceptance

PSS:

Perceived Stigma Scale from COVID-19

SF-12:

Short Form-12 Health Survey

SF_PCS12:

Short Form-12 Health Survey physical health domain

SF_MCS12:

Short Form-12 Health Survey mental health domain

DASS-21:

Depression, Anxiety, and Stress Scale-21

PCIBS:

Preventive COVID-19 Infection Behaviors Scale

EBICglasso:

Extended Bayesian information criterion graphical least absolute shrinkage and selection operator

CI:

Confidence interval

JHS:

Junior high school

SHS:

Senior high school

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Acknowledgements

Authors would like to thank all participants who took part in this study.

Funding

This work is supported by the High-Level Key Discipline Construction Project in TCM Rehabilitation under the National Administration of Traditional Chinese Medicine (Ref. zyyzdxk-2023102). Also, by “Key Discipline Construction Program of Traditional Chinese Medicine in Fujian Province”.

Author information

Author notes

  1. Jiajia Ye and I-Hua Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Rehabilitation assessments, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China

    Jiajia Ye

  2. Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China

    Jiajia Ye

  3. Chinese Academy of Education Big Data, Faculty of Education, Qufu Normal University, Qufu, China

    I-Hua Chen

  4. Department of Physiotherapy, School of Nursing and Health Sciences, Hong Kong Metropolitan University, 1, Sheung Shing Street, Homantin,, Kowloon, Hong Kong SAR

    Po-Ching Huang

  5. Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Emma Sethina Adjaottor & Frimpong-Manso Addo

  6. School of Nursing and Midwifery, University of Ghana, Legon, Ghana

    Ishmael Ronald Ahorsu

  7. Psychology Department, Nottingham Trent University, 50 Shakespeare St, Nottingham, NG1 4FQ, UK

    Mark D. Griffiths

  8. Department of Acupuncture and Moxibustion, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China

    Wanqing Lin

  9. Department of Special Education and Counselling, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, N.T., Hong Kong

    Daniel Kwasi Ahorsu

  10. Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1, University Rd., Tainan, 701401, Taiwan

    Chung Ying Lin

  11. Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1, University Rd., Tainan, 701401, Taiwan

    Chung Ying Lin

  12. Department of Public Health, College of Medicine, National Cheng Kung University, 1, University Rd., Tainan, 701401, Taiwan

    Chung Ying Lin

  13. Department of Occupational Therapy, College of Health Sciences, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan

    Chung Ying Lin

Authors
  1. Jiajia Ye
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Contributions

JY: Validation, visualization, writing—original draft, writing—review and editing; IHC: Formal analysis, investigation, validation, visualization, writing—original draft, writing—review and editing; PCH: Formal analysis, investigation, validation, visualization, writing—original draft, writing—review and editing; ESA: Conceptualization, data curation, investigation. Methodology, project administration, supervision, validation, writing—review and editing; FMA: Conceptualization, data curation, investigation, methodology, project administration, supervision, validation, writing—review and editing; IRA: Investigation, methodology, validation, visualization, writing—review and editing; MDG: Investigation, validation, visualization, writing—review and editing; WL: Supervision, validation, visualization, writing—review and editing; DKA: Conceptualization, data curation, investigation, methodology, project administration, validation, visualization, writing—original draft, writing—review and editing; and CYL: Conceptualization, formal analysis, investigation, supervision, validation, visualization, writing—original draft, writing—review and editing. All of the authors have read and agreed to the published version of the manuscript.

Corresponding authors

Correspondence to Emma Sethina Adjaottor, Wanqing Lin or Daniel Kwasi Ahorsu.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The present study was approved by the Committee on Human Research, Publications, and Ethics of the Kwame Nkrumah University of Science and Technology (IRB ref: CHRPE/AP/203/22). All participants provided written informed consent prior to their involvement in the study.

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Ye, J., Chen, IH., Huang, PC. et al. A network analysis of the associations between COVID-19-related variables and health across sex, age and educational levels among Ghanaian youths. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37166-x

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  • Received: 01 March 2025

  • Accepted: 20 January 2026

  • Published: 05 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-37166-x

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Keywords

  • Mental health
  • COVID-19
  • Well-being
  • Network analysis
  • Young population
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