Kivumbi Apollo, Byansi William, Ssewamala Fred M, Proscovia Nabunya, Damulira Christopher, Namatovu Phionah
International Center for Child Health and Development, P.O. Box 1988, Circular Rd, Masaka, Uganda.
3Brown School, Washington University in St. Louis, St. Louis, USA.
Child Adolesc Psychiatry Ment Health. 2019 Mar 11;13:14. doi: 10.1186/s13034-019-0273-4. eCollection 2019.
It is estimated that almost 20% of the world's adolescents have experienced or are experiencing a mental health problem. Several factors have been associated with the onset of adolescent mental health disorders, including poverty, child abuse and violence, particularly among adolescent girls. This paper examines the effect of participating in a family-based economic strengthening intervention on the mental health well-being of female adolescent orphans impacted by HIV/AIDS in rural Uganda.
Data utilized in this study was from the Bridges to the Future Study (2011-2016), an economic empowerment intervention aimed at improving health outcomes of orphaned children. Adolescents were randomly assigned to either the control condition receiving bolstered standard of care services for orphaned adolescents; or one of two treatment conditions receiving bolstered standard of care as well as an economic empowerment intervention comprising of a child development account, a mentorship program and workshops on financial management and microenterprise development. Data was collected at baseline, 12- and 24-months post intervention initiation. Multilinear regression analyses were conducted to examine the impact of an economic empowerment intervention on mental health functioning of female participants over time. Mental health functioning was measured by: (1) the Child Depression Inventory; (2) Beck Hopelessness Scale; and (3) Tennessee Self Concept Scale.
Analysis results show an improvement in mental health functioning over time among female participants receiving the intervention compared to their control counterparts. Specifically, compared to participants in the control condition, participants receiving the intervention reported a reduction in depressive symptoms from baseline to 12-months follow-up (b = - 1.262, 95% CI - 2.476, - 0.047), and an additional 0.645-point reduction between baseline and 24-months follow-up (b = - 1.907, 95% CI - 3.192, - 0.622). Participants receiving the intervention reported significant improvement in their reported self-concept from baseline to 24 months follow-up (b = 3.503 (95% CI 1.469, 5.538) compared to participants in the control condition.
Empowerment of young girls, either in the form of peer mentorship and/or economic strengthening seems to significantly improve the overall mental health functioning of adolescent girls impacted by HIV and AIDS in low-income settings.
据估计，全球近20%的青少年曾经历或正在经历心理健康问题。青少年心理健康障碍的发病与多种因素相关，包括贫困、虐待儿童和暴力，在青春期女孩中尤为突出。本文探讨参与一项基于家庭的经济强化干预措施对乌干达农村地区受艾滋病毒/艾滋病影响的女性青少年孤儿心理健康状况的影响。
本研究使用的数据来自“通向未来的桥梁研究”（2011 - 2016年），这是一项旨在改善孤儿健康状况的经济赋权干预措施。青少年被随机分配到对照组，接受针对孤儿青少年强化的标准护理服务；或两个治疗组之一，接受强化的标准护理以及一项经济赋权干预措施，该措施包括儿童发展账户、指导计划以及财务管理和微型企业发展研讨会。在干预开始后的基线、12个月和24个月收集数据。进行多线性回归分析，以研究经济赋权干预措施随时间对女性参与者心理健康功能的影响。心理健康功能通过以下方式衡量：（1）儿童抑郁量表；（2）贝克绝望量表；（3）田纳西自我概念量表。
分析结果显示，与对照组相比，接受干预的女性参与者的心理健康功能随时间有所改善。具体而言，与对照组参与者相比，接受干预的参与者从基线到12个月随访时报告抑郁症状有所减轻（b = -1.262，95%置信区间 -2.476，-0.047），从基线到24个月随访时又额外减轻了0.645分（b = -1.907，95%置信区间 -3.192，-0.622）。与对照组参与者相比，接受干预的参与者从基线到24个月随访时报告自我概念有显著改善（b = 3.503（95%置信区间1.469，5.538））。
以同伴指导和/或经济强化形式赋予年轻女孩权力似乎能显著改善低收入环境中受艾滋病毒和艾滋病影响的青春期女孩的整体心理健康功能。
