A Church-Based Intervention for Families to Promote Mental Health and Prevent HIV among Adolescents in Rural Kenya
OBJECTIVE:
To
evaluate a family- and church-based intervention for adolescents and caregivers
in rural Kenya to improve family relationships, reduce HIV risk, and promote
mental health.
METHOD:
The
intervention was developed using community-based participatory methods and
focused on strengthening family communication. Modules addressed economic,
relationship, and HIV-related topics using evidence-based behavioral strategies
alongside culturally grounded content. A stepped wedge cluster randomized trial
was conducted with 124 families (237 adolescents ages 10 to 16; 203 caregivers)
from 4 churches. Participants completed interviewer-administered surveys over 5
rounds. Primary outcomes included family communication, HIV risk knowledge,
self-efficacy, and beliefs. Secondary outcomes included parenting, social
support, mental health, and adolescent sexual behavior. We estimated
intent-to-treat effects via ordinary least squares regression with clustered
standard errors.
RESULTS:
Relative
to controls, the intervention group reported better family communication across
domains at 1- and 3-months post-intervention and higher self-efficacy for risk
reduction skills and HIV-related knowledge at 1-month post-intervention.
Sexually active youth in the intervention reported fewer high-risk behaviors at
1-month post-intervention, including unprotected sex or multiple partners. Male
caregivers in the intervention reported higher parental involvement at both
time points, and youth reported more social support from male caregivers at
3-months post-intervention. No effects on secondary outcomes of parenting,
social support, and mental health were detected.
CONCLUSIONS:
This
intervention holds promise for strengthening positive family processes to
protect against negative future outcomes for adolescents. Implementation with
religious congregations may be a promising strategy for improving
sustainability and scalability of interventions in low-resource settings.
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