Berger Rony, Benatov Joy, Cuadros Raphael, VanNattan Jacob, Gelkopf Marc
Ben Gurion University of the Negev.
University of Haifa, and College of Management and Academic Studies.
Transcult Psychiatry. 2018 Dec;55(6):821-845. doi: 10.1177/1363461518793749. Epub 2018 Aug 9.
Children in Sub-Saharan Africa are living under chronic adversity due to poverty, serious health issues, physical and sexual abuse, and armed conflicts. These highly stressful conditions have deleterious effects on their mental health and socio-emotional adjustment. Since many children lack adequate access to mental health care, culturally adapted school-based resiliency programs could provide a resource to scaffold their development and promote their mental health. This study evaluated the efficacy of a universal school-based intervention in enhancing the resiliency of Tanzanian primary school children and cultivating prosocial behaviors. A total of 183 students from grades 4 to 6 were randomly assigned to either the 16-session "ERSAE-Stress-Prosocial (ESPS)" structured intervention or to a Social Study curriculum (SS) active control group. The original ESPS program was adapted by Tanzanians mental health professionals who modified the program based on local idioms of distress and indigenous practices. Students' resilience was evaluated before, after and 8 months following the intervention by assessing social difficulties, hyperactivity, somatization, level of anxiety, prosocial behaviors and school functioning as well as academic achievements and disciplinary problems. There was significant improvement on all outcome measures for the ESPS group compared to the control group post-intervention and at the 8-month follow up. The ESPS intervention was equally effective on most measures for students experiencing different adversity levels. The results indicate that a culturally adapted universal school-based intervention can be effective in enhancing Tanzanian students' resiliency and promoting prosocial behaviors. Should these results be replicated and found enduring, the modified ESPS could be a valuable mental health-promoting intervention in other low-income countries.
撒哈拉以南非洲地区的儿童因贫困、严重的健康问题、身体和性虐待以及武装冲突而长期生活在逆境中。这些高度紧张的状况对他们的心理健康和社会情感适应产生有害影响。由于许多儿童无法获得足够的心理健康护理，经过文化调适的校本复原力项目可以提供一种资源，以支持他们的发展并促进他们的心理健康。本研究评估了一项基于学校的普及干预措施在增强坦桑尼亚小学生复原力和培养亲社会行为方面的效果。共有183名四至六年级的学生被随机分配到接受为期16节的“ERSAE-压力-亲社会（ESPS）”结构化干预组或社会研究课程（SS）积极对照组。最初的ESPS项目由坦桑尼亚心理健康专业人员进行了改编，他们根据当地的痛苦表述和本土做法对该项目进行了修改。通过评估社交困难、多动、躯体化、焦虑水平、亲社会行为、学校功能以及学业成绩和纪律问题，在干预前、干预后以及干预后8个月对学生的复原力进行了评估。与对照组相比，ESPS组在干预后和8个月随访时的所有结果指标上都有显著改善。ESPS干预对处于不同逆境水平的学生在大多数指标上同样有效。结果表明，经过文化调适的基于学校的普及干预措施可以有效地增强坦桑尼亚学生的复原力并促进亲社会行为。如果这些结果能够被复制并持久有效，那么经过修改的ESPS可能会成为其他低收入国家一项有价值的促进心理健康的干预措施。
