Tuesday, March 22, 2016

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.

Purchase full article at:   http://goo.gl/ep2Csq





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