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 - Funding Information:
This work was supported in part by the National Institute of Minority Health and Health Disparities (grant number T37 MD014218 ) and the National Institute of Mental Health (grant number R01MH113486 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Disclaimer: This article was published as part of a supplement supported by the National Institute of Mental Health. The opinions or views expressed in this article are those of the authors and do not necessarily represent the official position of the funder.
Funding Information:
This work was supported in part by the National Institute of Minority Health and Health Disparities (grant number T37 MD014218) and the National Institute of Mental Health (grant number R01MH113486). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Disclaimer: This article was published as part of a supplement supported by the National Institute of Mental Health. The opinions or views expressed in this article are those of the authors and do not necessarily represent the official position of the funder.
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 -