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

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

doi:10.1016/j.jadohealth.2020.07.022

Cited by 34 publications

(48 citation statements)

References 31 publications

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“…Among the 13 studies, eight focused on AYALH [45‐52], five on AYAAH [53‐57] and one on both [58] (See Table 2). Nine studies took place in sub‐Saharan Africa, three in Asia (China, Myanmar, Thailand), and two in North America (both USA).…”

Section: Resultsmentioning

confidence: 99%

“…Depression was the most common mental health problem studied (N = 9) [45‐48,51,54,56‐58], with various depression scales used, including the Patient Health Questionnaire (PHQ‐9) [45,48], the Center for Epidemiologic Studies Depression Scale for Children [58], the Child Depression Inventory [47,51,54], the Zung Self‐Rating Scale [57] and the Depression Anxiety Stress Scale [56]. Only one study used a formal depression diagnostic tool, the Quick Inventory of Depressive Symptomatology‐Clinician, since depression was an inclusion criterion for study participation [46].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies utilized a general measure of emotional and behavioural symptoms, the Strengths and Difficulties Questionnaire (SDQ) [45,47,48,53,54], two studies assessed hopelessness [51,55], one focused on emotional regulation [49], and one study focused on self‐esteem, self‐worth, stigma (not defined) and quality of life as indicators of mental health [50]. Apart from two studies [46,49], the measures in all others were adapted/translated to suit local needs in terms of language and meaning.…”

Section: Resultsmentioning

confidence: 99%

“…SUUBI+Adherence was adapted for AYALH, and evaluated in a RCT in multiple clinics in Uganda, with both the intervention and comparison groups also receiving bolstered psychosocial support, using a cartoon‐based curriculum on disclosure, adherence and coping similar to that used in CHAMPSA and VUKA in South Africa [60,66,67]. The SUUBI+Adherence trial found significant intervention effects on hopelessness and depression, at 24‐month post intervention [51].…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Specifically, in the Bridges project focused on adolescents who are orphaned by HIV/AIDS, there was decreased levels of depression and hopelessness and improved self-concept and self-efficacy among adolescents in the intervention group 24 months after the intervention initiation ( 55 , 58 , 62 ). The Suubi + Adherence project among adolescents living with HIV, adolescents receiving the intervention reported significantly lower hopelessness score at 24 months following the initiation of the intervention and lower scores of depression at 36 months following the initiation of the intervention compared to those who did not receive the intervention ( 57 ).…”

Section: How To Engage Community Stakeholders and Policy Makers For Sustainable And Impactful Child-focused Research In Ssa Context: Uganmentioning

confidence: 99%

Engaging community and governmental partners in improving health and mental health outcomes for children and adolescents impacted by HIV/AIDS in Uganda

Tumwesige¹,

Namatovu²,

Bahar³

et al. 2021

Pediatr Med

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The African region remains the world’s most affected region in the HIV epidemic. A related consequence of HIV/AIDS in sub-Saharan Africa (SSA), including in Uganda, is the high prevalence of children and adolescents who have lost one or both parents to this virus or who have been perinatally infected. Guided by the Practical, Robust Implementation and Sustainability (PRISM) framework, this paper describes the strategies by which we have engaged community and government partners in research using three NIH-funded randomized clinical trials testing an evidence-based combination intervention aimed at improving health and mental health outcomes among children and adolescents impacted by HIV/AIDS in Uganda. We specifically lay out four strategies that have been used to facilitate stakeholder engagement, namely consultative meetings, stakeholder accountability meetings, training of key players (task-shifting), and policymaker engagement. We emphasize that community collaborations and partnerships are especially critical when implementing combination interventions that require a high level of communication and coordination among multiple implementation partners. We underline that building and sustaining long-term relationships and communication with the stakeholders can allow the researchers to successfully design rigorous studies that are responsive to local needs and can make a difference especially in low-resource settings. Finally, we highlight that the process of engagement and collaboration can be guided by conceptual frameworks.

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The Long-term (5-year) Impact of a Family Economic Empowerment Intervention on Adolescents Living with HIV in Uganda: Analysis of Longitudinal Data from a Cluster Randomized Controlled Trial from the Suubi+Adherence Study (2012–2018)

et al. 2022

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

Cited by 34 publications

References 31 publications

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

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

Engaging community and governmental partners in improving health and mental health outcomes for children and adolescents impacted by HIV/AIDS in Uganda

The Long-term (5-year) Impact of a Family Economic Empowerment Intervention on Adolescents Living with HIV in Uganda: Analysis of Longitudinal Data from a Cluster Randomized Controlled Trial from the Suubi+Adherence Study (2012–2018)

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