School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Programme d'Appui aux Initiatives Economiques (PAIDEK), Bukavu, Democratic Republic of Congo.
BMC Public Health. 2020 Feb 4;20(1):170. doi: 10.1186/s12889-020-8219-6.
Adolescence is a critical period of human development, however, limited research on programs to improve health and well-being among younger adolescents living in conflict-affected and humanitarian settings exists. The purpose of this study was to assess the comparative effectiveness of an economic empowerment program on young adolescent outcomes in a complex humanitarian setting.
This longitudinal, mixed methods study examined the relative effectiveness of an integrated parent (Pigs for Peace, PFP) and young adolescent (Rabbits for Resilience, RFR) animal microfinance/asset transfer program (RFR + PFP) on adolescent outcomes of asset building, school attendance, mental health, experienced stigma, and food security compared to RFR only and PFP only over 24 months. A sub-sample of young adolescents completed in-depth qualitative interviews on the benefits and challenges of participating in RFR.
Five hundred forty-two young adolescents (10-15 years) participated in three groups: RFR + PFP (N = 178), RFR only (N = 187), PFP only (N = 177). 501 (92.4%) completed baseline surveys, with 81.7% (n = 442) retention at endline. The group by time interaction (24 months) was significant for adolescent asset building (X = 16.54, p = .002), school attendance (X = 12.33, p = .015), and prosocial behavior (X = 10.56, p = .032). RFR + PFP (ES = 0.31, ES = 0.38) and RFR only (ES-0.39, ES = 0.14) adolescents had greater improvement in asset building and prosocial behavior compared to PFP only, respectively. The odds of missing two or more days of school in the past month were 78.4% lower in RFR only and 45.1% lower in RFR + PFP compared to PFP only. No differences between groups in change over time were found for internalizing behaviors, experienced stigma, or food security. Differences by age and gender were observed in asset building, prosocial behavior, school attendance, experienced stigma, and food security. The voices of young adolescents identified the benefits of the RFR program through their ability to pay for school fees, help their families meet basic needs, and the respect they gained from family and community. Challenges included death of rabbits and potential conflict within the household on how to use the rabbit asset.
These findings underscore the potential for integrating economic empowerment programs with both parents and young adolescents to improve economic, educational, and health outcomes for young adolescents growing up in rural and complex humanitarian settings.
NCT02008695. Retrospectively registered 11 December 2013.
青春期是人类发展的关键时期，然而，针对生活在受冲突影响和人道主义环境中的未成年青少年的健康和幸福计划，相关研究非常有限。本研究的目的是评估在复杂的人道主义环境中，一种经济赋权方案对青少年结果的相对有效性。
本纵向混合方法研究考察了综合父母（和平猪，Pigs for Peace，PFP）和青少年（韧性兔，Rabbits for Resilience，RFR）动物小额信贷/资产转让方案（RFR+PFP）对资产建设、上学、心理健康、经历污名化和粮食安全的青少年结果的相对有效性，与仅接受 RFR 或仅接受 PFP 的方案相比，在 24 个月内进行比较。一小部分青少年完成了关于参与 RFR 的益处和挑战的深入定性访谈。
542 名 10-15 岁的青少年参与了三组：RFR+PFP（n=178）、RFR 组（n=187）、PFP 组（n=177）。501 名（92.4%）完成了基线调查，其中 81.7%（n=442）在终点线时保持。组间时间交互作用（24 个月）在青少年资产建设（X=16.54，p=0.002）、上学出勤率（X=12.33，p=0.015）和亲社会行为（X=10.56，p=0.032）方面具有统计学意义。RFR+PFP（ES=0.31，ES=0.38）和 RFR 组（ES-0.39，ES=0.14）的青少年在资产建设和亲社会行为方面的改善程度均高于仅接受 PFP 的青少年。与仅接受 PFP 的青少年相比，仅接受 RFR 的青少年过去一个月缺课两天或以上的可能性降低了 78.4%，而 RFR+PFP 的青少年则降低了 45.1%。在内部化行为、经历污名化或粮食安全方面，各组之间在随时间变化方面没有差异。在资产建设、亲社会行为、上学出勤率、经历污名化和粮食安全方面，年龄和性别差异显著。青少年的声音通过他们支付学费的能力、帮助家庭满足基本需求以及他们从家庭和社区获得的尊重，确定了 RFR 方案的益处。挑战包括兔子死亡和家庭内部对如何使用兔子资产的潜在冲突。
这些发现强调了将经济赋权方案与父母和青少年结合起来的潜力，以改善农村和复杂人道主义环境中青少年的经济、教育和健康结果。
NCT02008695。于 2013 年 12 月 11 日回顾性注册。
