TY - JOUR
T1 - Effects of a Combination Economic Empowerment and Family Strengthening Intervention on Psychosocial Well-being Among Ugandan Adolescent Girls and Young Women
T2 - Analysis of a Cluster Randomized Controlled Trial (Suubi4Her)
AU - Filiatreau, Lindsey M.
AU - Tutlam, Nhial
AU - Brathwaite, Rachel
AU - Byansi, William
AU - Namuwonge, Flavia
AU - Mwebembezi, Abel
AU - Sensoy-Bahar, Ozge
AU - Nabunya, Proscovia
AU - Neilands, Torsten B.
AU - Cavazos-Rehg, Patricia
AU - McKay, Mary
AU - Ssewamala, Fred M.
N1 - Publisher Copyright:
© 2023
PY - 2023/5
Y1 - 2023/5
N2 - Purpose: Economic empowerment and family strengthening interventions have shown promise for improving psychosocial well-being in a range of populations. This study investigates the effect of a combination economic and family strengthening intervention on psychosocial well-being among Ugandan adolescent girls and young women (AGYW). Methods: We harnessed data from a three-arm cluster randomized controlled trial among AGYW aged 14–17 years in 47 Ugandan secondary schools. Schools were randomized to either a youth development account intervention (YDA) [N = 16 schools], YDA plus a multiple family group intervention (YDA + MFG) [N = 15 schools], or bolstered standard of care (BSOC) [N = 16 schools]. We estimated the effect of each intervention (BSOC = referent) on three measures of psychosocial well-being: hopelessness (Beck's Hopelessness Scale), self-concept (Tennessee Self-Concept Scale), and self-esteem (Rosenberg Self-Esteem Scale) at 12 months following enrollment using multi-level linear mixed models for each outcome. Results: A total of 1,260 AGYW (mean age, 15.4) were enrolled—471 assigned to YDA (37%), 381 to YDA + MFG (30%), and 408 to usual care (32%). Over the 12-month follow-up, participants assigned to the YDA + MFG group had significantly greater reductions in hopelessness and improvements in self-esteem outcomes compared to BSOC participants. Those enrolled in the YDA arm alone also had significantly greater reductions in hopelessness compared to BSOC participants. Discussion: Combination interventions, combining economic empowerment (represented here by YDA), and family-strengthening (represented by MFG) can improve the psychosocial well-being of AGYW. The long-term effects of these interventions should be further tested for potential scale-up in an effort to address the persistent mental health treatment gap in resource-constrained settings.
AB - Purpose: Economic empowerment and family strengthening interventions have shown promise for improving psychosocial well-being in a range of populations. This study investigates the effect of a combination economic and family strengthening intervention on psychosocial well-being among Ugandan adolescent girls and young women (AGYW). Methods: We harnessed data from a three-arm cluster randomized controlled trial among AGYW aged 14–17 years in 47 Ugandan secondary schools. Schools were randomized to either a youth development account intervention (YDA) [N = 16 schools], YDA plus a multiple family group intervention (YDA + MFG) [N = 15 schools], or bolstered standard of care (BSOC) [N = 16 schools]. We estimated the effect of each intervention (BSOC = referent) on three measures of psychosocial well-being: hopelessness (Beck's Hopelessness Scale), self-concept (Tennessee Self-Concept Scale), and self-esteem (Rosenberg Self-Esteem Scale) at 12 months following enrollment using multi-level linear mixed models for each outcome. Results: A total of 1,260 AGYW (mean age, 15.4) were enrolled—471 assigned to YDA (37%), 381 to YDA + MFG (30%), and 408 to usual care (32%). Over the 12-month follow-up, participants assigned to the YDA + MFG group had significantly greater reductions in hopelessness and improvements in self-esteem outcomes compared to BSOC participants. Those enrolled in the YDA arm alone also had significantly greater reductions in hopelessness compared to BSOC participants. Discussion: Combination interventions, combining economic empowerment (represented here by YDA), and family-strengthening (represented by MFG) can improve the psychosocial well-being of AGYW. The long-term effects of these interventions should be further tested for potential scale-up in an effort to address the persistent mental health treatment gap in resource-constrained settings.
KW - Adolescent girls and young women
KW - Combination interventions
KW - Economic empowerment
KW - Hopelessness
KW - Multiple family group
KW - Psychosocial well-being
KW - Self-concept
KW - Self-esteem
KW - Suubi intervention
KW - Uganda
UR - http://www.scopus.com/inward/record.url?scp=85151518614&partnerID=8YFLogxK
U2 - 10.1016/j.jadohealth.2022.11.250
DO - 10.1016/j.jadohealth.2022.11.250
M3 - Article
C2 - 37062582
AN - SCOPUS:85151518614
SN - 1054-139X
VL - 72
SP - S33-S40
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 5
ER -