CHAMP+ Thailand: Pilot Randomized Control Trial of a Family-Based Psychosocial Intervention for Perinatally HIV-Infected Early Adolescents

Nestadt, Danielle Friedman; Saisaengjan, Chutima; McKay, Mary M.; Bunupuradah, Torsak; Pardo, Gisselle; Lakhonpon, Sudrak; Gopalan, Priya; Leu, Cheng-Shiun; Petdachai, Witaya; Kosalaraksa, Pope; Srirompotong, Ussanee; Ananworanich, Jintanat; Mellins, Claude A.

doi:10.1089/apc.2019.0021

Cited by 22 publications

(34 citation statements)

References 48 publications

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“…Twelve studies used a randomised control trial (RCT) design. 9,[26][27][28][29][30][31][32][33][34][35][36] Five of these were cluster RCTs, clustered by village, 34 township, 32 school 33,36 and church. 35 One study used a quasi-experimental post-intervention design.…”

Section: Study Design Of Included Evaluationsmentioning

confidence: 99%

“…37 Two studies used a pre-post design, without control groups. [38][39][40] Nine studies employed a single follow-up period of either 3 or 6 months; 9,26,28,29,32,33,[37][38][39] six studies variously used two follow-up periods that ranged from 2, 3, 6, 9, 12 and 24 months, 27,30,[34][35][36]40 and one study used three follow-up periods of 6, 12 and 18 months. 31 The median follow-up period was 3 months.…”

Section: Study Design Of Included Evaluationsmentioning

confidence: 99%

“…Scales used to assess this included Communication Comfort and Frequency 9,28,29 and Family Connectedness. 30,40 In addition, 11 studies also measured parenting practices using adapted measures of parenting behaviour 9,[26][27][28][29][30][31]34,35,39,40 or scales such as the Alabama Parenting Questionnaire 35 and Parental Bonding Instrument. 34 Seven studies measured knowledge related to HIV/AIDS using scales such as the HIV Knowledge Questionnaire, 35,36,38 AIDS Myth Knowledge 28,29 and the South African Demographic Health Survey.…”

Section: Measurement Characteristicsmentioning

confidence: 99%

“…One study used nongovernmental organisation, community development, agricultural and financial officers 36 and another used trained youth ambassadors. 37 Intervention sites varied with five studies delivering the intervention at clinics or hospitals, 9,26,27,31,38 four were school based, 28,29,33,37 two studies were community based (with one delivering the intervention after weekly church services), 32,35 two studies both community and home based 34,36 and three were only home based. 30,39,40 Interventions were broadly grouped into family-level and group-based interventions.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

“…9,[26][27][28][29][30][31][34][35][36]39,40 They all described culturally adapted parenting interventions. For example, the content and delivery of five studies (CHAMP, VUKA and VUKA Thailand) used the same methodology to meet the needs of the local context 9,[26][27][28][29] as did the two Family-Strengthening Interventions (FSI-HIV) 30,40 and an intervention delivered at local churches. 35 The most common elements of the family-strengthening parenting interventions broadly encompassed narratives of sources of family resilience and protective influences for the child.…”

Section: Family-level Interventions For Adolescents and Caregiversmentioning

confidence: 99%

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Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review

et al. 2020

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Background Mental health difficulties and mental disorders are common in adolescents living with HIV or who are affected by HIV because of living in HIV-affected households in low- and middle-income (LMICs) countries, but little is known about the interventions that target these individuals and whether they are effective. Aims This systematic review aims to address these gaps by examining what has worked and what has not worked to support the mental health of adolescents living with HIV or affected by HIV in low- and middle-income contexts (PROSPERO Number: CRD42018103269). Method A systematic literature review of online databases from the year 2000 to 2018, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, included English-language publications of quantitative evaluations of psychosocial interventions aiming to improve mental health among adolescents living with HIV and adolescents from HIV-affected households (aged 10–24 years) in LMICs. Results Out of 2956 articles, 16 studies from 8 LMICs met the inclusion criteria. Thirteen studies focused on adolescents affected by HIV and only three studies on adolescents living with HIV. Only five studies included were from Sub-Saharan Africa. Interventions most often used a family-strengthening approach strengthening caregiver–adolescent relationships and communication and some problem-solving in groups or individually. Five studies reported statistically significant changes in adolescent and caregiver mental health or mental well-being, five among adolescents only and two among caregivers only. Conclusions Research on what works to improve mental health in adolescents living with HIV in LMIC is in its nascent stages. Family-based interventions and economic strengthening show promise.

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Section: Study Design Of Included Evaluationsmentioning

confidence: 99%

Section: Study Design Of Included Evaluationsmentioning

confidence: 99%

Section: Measurement Characteristicsmentioning

confidence: 99%

Section: Intervention Characteristicsmentioning

confidence: 99%

Section: Family-level Interventions For Adolescents and Caregiversmentioning

confidence: 99%

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Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review

et al. 2020

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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Interventions to address the mental health of adolescents and young adults living with or affected by HIV: state of the evidence

et al. 2021

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Introduction Adolescents and young adults (AYA) remain vulnerable to HIV‐infection and significant co‐morbid mental health challenges that are barriers to treatment and prevention efforts. Globally millions of AYA are living with HIV (AYALH) and/or have been affected by HIV in their families (AYAAH), with studies highlighting the need for mental health programmes. With no current guidelines for delivering mental health interventions for AYALH or AYAAH, a scoping review was undertaken to explore current evidence‐based mental health interventions for AYALH and AYAAH to inform future work. Methods The review, targeting work between 2014 and 2020, initially included studies of evidence‐based mental health interventions for AYALH and AYAAH, ages 10 to 24 years, that used traditional mental health treatments. Given the few studies identified, we expanded our search to include psychosocial interventions that had mental health study outcomes. Results and discussion We identified 13 studies, seven focused on AYALH, five on AYAAH, and one on both. Most studies took place in sub‐Saharan Africa. Depression was targeted in eight studies with the remainder focused on a range of emotional and behavioural symptoms. Few studies used evidence‐based approaches such as Cognitive Behaviour Therapy; psychosocial approaches included mental health treatments, group‐based and family strengthening interventions, economic empowerment combined with family strengthening, group‐based mindfulness and community interventions. Eleven studies were randomized control trials with four pilot studies. There was variation in sample size, treatment delivery mode (individual focus, group‐based, family focus), and measures of effectiveness across studies. Most used trained lay counsellors as facilitators, with few using trained mental health professionals. Eleven studies reported positive intervention effects on mental health. Conclusions Despite the need for mental health interventions for AYALH and AYAAH, we know surprisingly little about mental health treatment for this vulnerable population. There are some promising approaches, but more work is needed to identify evidence‐based approaches and corresponding mechanisms of change. Given limited resources, integrating mental health treatment into healthcare settings and using digital health approaches may support more standardized and scalable treatments. Greater emphasis on implementation science frameworks is needed to create sustainable mental health treatment for AYALH and AYAAH globally.

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CHAMP+ Thailand: Pilot Randomized Control Trial of a Family-Based Psychosocial Intervention for Perinatally HIV-Infected Early Adolescents

Cited by 22 publications

References 48 publications

Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review

Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Interventions to address the mental health of adolescents and young adults living with or affected by HIV: state of the evidence

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