Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States.
J Nutr. 2023 Dec;153(12):3595-3603. doi: 10.1016/j.tjnut.2023.10.008. Epub 2023 Oct 18.
Adolescent girls may experience poor psychological well-being, such as social isolation, shame, anxiety, hopelessness, and despair linked to food insecurity.
This study aimed to investigate the experiences with and perceived effects of a household-level income-generating agricultural intervention on the psychological well-being of adolescent girls in human immunodeficiency virus (HIV)-affected households in southwestern Kenya.
We conducted 62 in-depth interviews with HIV-affected adolescent girls and caregiver dyads in Adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in Shamba Maisha (NCT01548599), a multisectoral agricultural and finance intervention trial aimed to improve food security and HIV health indicators. Participants were purposively sampled to ensure diversity in terms of age and location. Data were audiotaped, transcribed, translated, and uploaded into Dedoose (Sociocultural Research Consultants, LLC) software for management. Data were analyzed thematically based on reports from Dedoose.
We found evidence that a household-level structural intervention aimed at increasing food and financial security among persons living with HIV can contribute to better psychological well-being among adolescent girls residing in these households. The intervention also affected: 1) reduction of social isolation, 2) reduction of shame and stigma, 3) increased attendance and concentration in school, 4) improved caregiver mental health, and 5) reduced parental aggression and improved household communication. These associations were reported more commonly among those in the intervention arm than the control arm.
This study extends existing research by demonstrating how multisectoral structural interventions delivered at a household level can improve the psychological well-being of adolescents. We recommend that future research test livelihood interventions designed specifically for adolescent girls that integrate food-security interventions with other elements to address the social and psychological consequences of food insecurity holistically. This trial was registered at clinicaltrials.gov as NCT03741634.
青少年女孩可能会经历不良的心理健康状况，例如社交孤立、羞耻感、焦虑、绝望和绝望，这些都与粮食不安全有关。
本研究旨在调查肯尼亚西南部受艾滋病毒影响家庭中，一项针对家庭一级创收农业干预措施对青少年女孩心理健康的影响，这些女孩受到艾滋病毒的影响。
我们对来自青少年沙巴玛希萨（NCT03741634）的受艾滋病毒影响的青少年女孩和照顾者对子进行了 62 次深入访谈，这是一项针对有家庭成员参加沙巴玛希萨的青少年女孩和照顾者的子研究（NCT01548599），该研究是一项多部门农业和金融干预试验，旨在改善粮食安全和艾滋病毒健康指标。参与者是根据年龄和地点的多样性进行有目的抽样的。数据被录音、转录、翻译，并上传到 Dedoose（Sociocultural Research Consultants，LLC）软件中进行管理。根据 Dedoose 的报告，对数据进行了主题分析。
我们有证据表明，一项旨在增加艾滋病毒感染者粮食和经济安全的家庭一级结构干预措施，可以促进居住在这些家庭中的青少年女孩的心理健康状况得到改善。该干预措施还影响了以下方面：1）减少社会孤立，2）减少羞耻感和耻辱感，3）提高出勤率和注意力集中在学校，4）改善照顾者的心理健康，5）减少父母的攻击行为，改善家庭沟通。这些关联在干预组中比对照组中更为常见。
本研究通过证明如何在家庭一级实施多部门结构干预措施可以改善青少年的心理健康状况，扩展了现有研究。我们建议未来的研究测试专门为青少年女孩设计的生计干预措施，将粮食安全干预措施与其他要素结合起来，全面解决粮食不安全的社会和心理后果。这项试验在 clinicaltrials.gov 上注册为 NCT03741634。
