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一项基于家庭的经济干预措施对乌干达感染艾滋病毒青少年心理健康的影响:“苏比+坚持治疗”项目的结果

The Impact of a Family-Based Economic Intervention on the Mental Health of HIV-Infected Adolescents in Uganda: Results From Suubi + Adherence.

作者信息

Cavazos-Rehg Patricia, Byansi William, Xu Christine, Nabunya Proscovia, Sensoy Bahar Ozge, Borodovsky Jacob, Kasson Erin, Anako Nnenna, Mellins Claude, Damulira Christopher, Neilands Torsten, Ssewamala Fred M

机构信息

Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.

Brown School, Washington University in St. Louis, St. Louis, Missouri.

出版信息

J Adolesc Health. 2021 Apr;68(4):742-749. doi: 10.1016/j.jadohealth.2020.07.022. Epub 2020 Sep 24.

Abstract

PURPOSE

This study examines the extent to which three mental health measures (hopelessness, depression, and poor self-concept) are improved through a family-based economic intervention implemented among adolescents living with HIV in Uganda.

METHODS

We used repeated measures from Suubi + Adherence, a large-scale 6-year (2012-2018) longitudinal randomized controlled trial. Bivariate analyses were conducted to test for observable group differences between the intervention and control conditions. Multilevel piecewise repeated measure mixed models were then conducted to assess hypothesized time × intervention interaction in changes in hopelessness, depression, and self-concept using participant-specific follow-up intervals.

RESULTS

At 24-month postintervention initiation, adolescents in the intervention condition reported a statistically significant lower hopelessness score than adolescents in the control condition (4.79 vs. 5.56; p = .018; N = 358). At 36-month follow-up, the intervention condition reported a statistically significant lower score on depression in the depression subgroup (N = 344) than the control condition (4.94 vs. 5.81; p = .029).

CONCLUSIONS

The results indicate that family-based economic interventions such as Suubi + Adherence can effectively improve the mental health of adolescents living with HIV who evidenced mental health challenges at baseline. Given the promising positive effects of these interventions, at least in the short term, future studies should investigate strategies to promote the sustainability of these mental health benefits.

摘要

目的

本研究探讨了在乌干达感染艾滋病毒的青少年中实施的一项基于家庭的经济干预措施,在多大程度上改善了三项心理健康指标(绝望感、抑郁和自我概念差)。

方法

我们使用了来自Suubi + 依从性研究的重复测量数据,这是一项为期6年(2012 - 2018年)的大规模纵向随机对照试验。进行双变量分析以检验干预组和对照组之间可观察到的组间差异。然后进行多层次分段重复测量混合模型分析,以使用参与者特定的随访间隔评估绝望感、抑郁和自我概念变化中假设的时间×干预交互作用。

结果

在干预开始后24个月时,干预组的青少年报告的绝望感得分在统计学上显著低于对照组(4.79对5.56;p = 0.018;N = 358)。在36个月随访时,干预组在抑郁亚组(N = 344)中的抑郁得分在统计学上显著低于对照组(4.94对5.81;p = 0.029)。

结论

结果表明,像Suubi + 依从性这样的基于家庭的经济干预措施可以有效改善在基线时存在心理健康挑战的感染艾滋病毒青少年的心理健康。鉴于这些干预措施至少在短期内产生了有前景的积极效果,未来的研究应探讨促进这些心理健康益处可持续性的策略。

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