Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa

Visser, Maretha; Thurman, Tonya R.; Spyrelis, Alexandra; Taylor, Tory M.; Nice, Johanna; Finestone, Michelle

doi:10.1016/j.evalprogplan.2018.03.002

Cited by 13 publications

(20 citation statements)

References 54 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies of the independent or contributory role of caregiver mental health parameters remain poorly elucidated. The importance of instrumental support of caregivers through the treatment of depression, alleviation of caregiving stress by means of cash transfer programmes to meet material caregiving needs and through specific training to enhance caregiving quality has been described among HIV‐affected caregivers . By delineating these specific child psychosocial adjustment indices that are negatively impacted by poor caregiver social support, depression and anxiety, we provide additional data on the importance of caregiver mental health as a modifiable risk factor for improving the well‐being of vulnerable children.…”

Section: Discussionmentioning

confidence: 99%

Caregiver socioemotional health as a determinant of child well‐being in school‐aged and adolescent Ugandan children with and without perinatal HIV exposure

Webster

Bruyn

Zalwango

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

Objective Caregiver socio‐emotional attributes are major determinants of child well‐being. This investigation in vulnerable school‐aged Ugandan children estimates relationships between children's well‐being and their caregiver's anxiety, depression and social support. Methods Perinatally HIV‐infected, HIV‐exposed uninfected and HIV‐unexposed Ugandan children and their caregivers were enrolled. Perinatal HIV status was determined by 18 months of age using DNA‐polymerase chain‐reaction test; status was confirmed via HIV rapid diagnostic test when children were 6–18 years old. Five indicators of child well‐being (distress, hopelessness, positive future orientation, esteem and quality of life (QOL)) and caregivers’ socioemotional status (depressive symptoms, anxiety and social support) were measured using validated, culturally adapted and translated instruments. Categories based on tertiles of each caregiver psychosocial indicator were defined. Linear regression analyses estimated percent differences (β) and corresponding 95% confidence intervals (CI) for child well‐being in relation to caregiver's psychosocial status. Results As per tertile increment, caregiver anxiety was associated with 2.7% higher distress (95%CI:0.2%, 5.3%) and lower self‐esteem/QOL (β = −1.3%/−2.6%; 95%CI: −5.0%,‐0.2%) in their children. Child distress/hopelessness increased (β = 3.3%/7.6%; 95%CI:0.4%, 14.7%) and self‐esteem/QOL decreased 2.3% (β = −2.3%/−4.4%; 95%CI: −7.2%, −1.3%) as per tertile increment in caregiver depression. Higher caregiver social support was associated with lower distress and higher positive outlook (β = 3%; 95%CI:1.4%, 4.5%) in their children. HIV‐infected/exposed children had most caregiver depression‐related QOL deficit (β = −5.2%/−6.8%; 95%CI: −12.4%, −0.2%) and HIV‐unexposed children had most caregiver social support‐related enhancements in positive outlook (β=4.5%; 95%CI:1.9%, 7.1%). Conclusions Caregiver anxiety, depressive symptoms and low social support were associated with worse well‐being in school‐aged and adolescent children. Improvement of caregiver mental health and strengthening caregiver social support systems may be a viable strategy for improving well‐being of vulnerable children and adolescents in this setting.

show abstract

Section: Discussionmentioning

confidence: 99%

Caregiver socioemotional health as a determinant of child well‐being in school‐aged and adolescent Ugandan children with and without perinatal HIV exposure

Webster

Bruyn

Zalwango

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

“…CBO recruitment efforts targeted caregivers, and adolescents' participation was likely contingent on their caregiver's commitment to the program. Findings from the formative evaluation conducted alongside the pilot suggest the program's length and job and childcare responsibilities inhibited caregivers' optimal participation (Visser et al, 2018). Caregivers available to engage in the program likely differ in important ways from those with competing priorities that prohibited participation.…”

Section: Discussionmentioning

confidence: 99%

“…The measures employed were sensitive to change and mediational analyses among a larger sample could elucidate which theoretical components have the greatest predictive power for reducing adolescent risk behavior. Further, program improvements have been enacted pursuant to the pilot findings, including shortening the program and introducing strategies to encourage attendance (Visser et al, 2018). Future research should investigate if and how the revised Let's Talk model results in sustainable, reduced sexual risk behavior and HIV incidence for young people using a longer follow-up period and a credible counterfactual.…”

Section: Discussionmentioning

confidence: 99%

“…These social and self-regulatory strategies are coupled with knowledge and technical skills for condom use and pregnancy and HIV prevention. The guiding theoretical frameworks, program theory of change, and formative evaluation process for Let's Talk are described in detail elsewhere (Visser et al, 2018).…”

Section: Interventionmentioning

confidence: 99%

“…Attendance was generally high in the analytical sample with adolescents attending an average of 10.3 sessions (out of 14 possible) and caregivers attending an average of 14.6 sessions (out of 19 possible). Further details on participant attendance patterns is available elsewhere (Visser et al, 2018). Table 2 presents descriptive statistics for adolescents and caregivers at baseline.…”

Section: Participationmentioning

confidence: 99%

See 2 more Smart Citations

Can family-centered programing mitigate HIV risk factors among orphaned and vulnerable adolescents? Results from a pilot study in South Africa

et al. 2018

Self Cite

View full text Add to dashboard Cite

Let's Talk is a structured, family-centered adolescent HIV prevention program developed for use in South Africa using key components adapted from programs successfully implemented in the US and South Africa. It is designed to address individual HIV transmission risk factors common among orphaned and vulnerable adolescents, including elevated risk for poor psychological health and sexual risk behavior. These efforts are accentuated through parallel programing to support caregivers' mental health and parenting skills. Twelve Let's Talk groups, each serving approximately 10 families, were piloted by two local community-based organizations in Gauteng and Kwa-Zulu Natal provinces, South Africa. Face-to-face interviews were conducted among participating caregivers and adolescents at baseline and three months post-intervention to explore the potential effects of the program on intermediate outcomes that may support HIV preventive behavior. Specifically, generalized estimation equations were used to estimate average change on HIV prevention knowledge and self-efficacy, caregiver and adolescent mental health, and family dynamics. Among the 105 adolescents and their 95 caregivers who participated in Let's Talk and completed both surveys, statistically significant improvements were found for adolescents' HIV and condom use knowledge as well as condom negotiation self-efficacy, but not sexual refusal self-efficacy. Both caregivers and adolescents demonstrated significantly better mental health at post-test. Adolescent/caregiver connection and communication about healthy sexuality also improved. These preliminary results highlight the potential of HIV prevention interventions that engage caregivers alongside the vulnerable adolescents in their care to mitigate adolescent HIV risk factors. A more rigorous evaluation is warranted to substantiate these effects and identify their impact on adolescents' risk behavior and HIV incidence.

show abstract

Community‐Based Caregiver and Family Interventions to Support the Mental Health of Orphans and Vulnerable Children: Review and Future Directions

Penner

Sharp

Marais

et al. 2020

New Directions for Child and Adolescent Development

View full text Add to dashboard Cite

The goal of this paper was to conduct a review of studies from 2008 to 2019 that evaluated community‐based caregiver or family interventions to support the mental health of orphans and vulnerable children (OVC) in sub‐Saharan Africa, across four domains: (a) study methodology, (b) cultural adaptation and community participation, (c) intervention strategies, and (d) effects on child mental health. Ten interventions were identified. Findings revealed that the majority of studies used a randomized controlled trial or quasi‐experimental design, but few conducted long‐term follow‐up; that all programs undertook cultural adaptation of the intervention using community participatory methods, or were locally developed; that the majority of interventions targeted caregiving behavior and/or caregiver–child relationships using behavioral and cognitive‐behavioral strategies, or were home visiting interventions; and that interventions had mixed effects on OVC mental health. Progress and gaps revealed by these findings are discussed, as are suggestions for possible new directions in this area of intervention science.

show abstract

Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa

Cited by 13 publications

References 54 publications

Caregiver socioemotional health as a determinant of child well‐being in school‐aged and adolescent Ugandan children with and without perinatal HIV exposure

Caregiver socioemotional health as a determinant of child well‐being in school‐aged and adolescent Ugandan children with and without perinatal HIV exposure

Can family-centered programing mitigate HIV risk factors among orphaned and vulnerable adolescents? Results from a pilot study in South Africa

Community‐Based Caregiver and Family Interventions to Support the Mental Health of Orphans and Vulnerable Children: Review and Future Directions

Contact Info

Product

Resources

About