Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
J Adolesc Health. 2021 Nov;69(5):797-805. doi: 10.1016/j.jadohealth.2021.04.033. Epub 2021 Jul 10.
Cash transfer interventions broadly improve the lives of the vulnerable, making them exceedingly popular. However, evidence of impacts on mental health is limited, particularly for conditional cash transfer (CCT) programs. We examined the impacts of Tanzania's government-run CCT program on depressive symptoms of youth aged 14-28.
We utilized cluster randomized controlled trial data of 84 communities (48 intervention; 36 control). The intervention administered bimonthly CCTs to eligible households, while control communities were assigned to delayed intervention. The analysis included youth with measurements of depression (10-item Centre for Epidemiological Studies Depression Scale) at baseline and 18 months later. We determined impacts using analysis of covariance models, adjusting for youth characteristics (including baseline depression), district-level fixed effects, and community-level random effects. Differential effects by sex and baseline social support were also estimated.
Although no evidence was found to suggest that the intervention impacted depressive symptoms among the full sample (n = 880) (effect -.20, 95% confidence interval [CI] -.88 to .48, p = .562), subsample results indicated that depressive symptoms were reduced 1.5 points among males (95% CI -2.56 to -.04, p = .007) and increased 1.1 points among females (95% CI .11-2.09, p = .029). Females 18+ years old (effect 1.55, 95% CI .27-2.83, p = .018) and females with children (effect 1.32, 95% CI -.13 to 2.78, p = .074) drove this negative impact. Social support did not moderate impacts.
Despite no overall intervention effects, results suggest that receiving a CCT has differential effects on mental health by sex. Although males benefited from the intervention, conditions which rely on stereotypically female roles may result in negative consequences among women.
现金转移干预措施广泛改善了弱势群体的生活，使其广受欢迎。然而，关于现金转移干预对心理健康影响的证据有限，特别是对于有条件的现金转移（CCT）计划。我们研究了坦桑尼亚政府运行的 CCT 计划对 14-28 岁青年抑郁症状的影响。
我们利用了 84 个社区的集群随机对照试验数据（48 个干预组；36 个对照组）。干预组向符合条件的家庭每两个月发放一次 CCT，而对照组社区则被分配到延迟干预组。分析包括在基线和 18 个月后有抑郁测量（10 项中心流行病学研究抑郁量表）的青年。我们使用协方差分析模型确定影响，调整了青年特征（包括基线抑郁）、地区固定效应和社区随机效应。还估计了性别和基线社会支持的差异影响。
虽然没有证据表明干预措施对全样本（n=880）的抑郁症状有影响（效应-.20，95%置信区间[-0.88，0.48]，p=0.562），但亚组结果表明，男性的抑郁症状减少了 1.5 分（95%置信区间[-2.56，-0.04]，p=0.007），女性增加了 1.1 分（95%置信区间[0.11，2.09]，p=0.029）。18 岁及以上的女性（效应 1.55，95%置信区间[0.27，2.83]，p=0.018）和有孩子的女性（效应 1.32，95%置信区间[-0.13，2.78]，p=0.074）推动了这一负面影响。社会支持没有调节影响。
尽管没有总体干预效果，但结果表明，接受 CCT 对心理健康有性别差异的影响。虽然男性从干预中受益，但依赖传统女性角色的条件可能会给女性带来负面影响。
