Family economic empowerment and mental health among AIDS-affected children living in AIDS-impacted communities: evidence from a randomised evaluation in southwestern Uganda
- 1Department of Social Welfare, Sungkyunkwan University, Seoul, South Korea
- 2School of Social Work, Columbia University, New York, New York, USA
- Correspondence to Fred M Ssewamala, Associate Professor, School of Social Work, Columbia University, 1255 Amsterdam Avenue, Office 1122, New York, NY 10027, USA;
Contributors FMS conceived the study, obtained funding for the study, supervised all aspects of the study design and implementation, including data collection, data entry, cleaning and analysis. C-KH led data analysis and was involved in the interpretation of the study findings. JS-HW was involved in literature reviews, assisted with data cleaning, and involved in the review and formatting of the drafts of the manuscript. All authors contributed equally in the writing of the final manuscript, including interpretation of the study findings for intellectual content.
- Accepted 13 August 2012
Objective The authors examine whether an innovative family economic empowerment intervention addresses mental health functioning of AIDS-affected children in communities heavily impacted by HIV/AIDS in Uganda.
Methods A cluster randomised controlled trial consisting of two study arms, a treatment condition (n=179) and a control condition (n=118), was used to examine the impact of the family economic empowerment intervention on children's levels of hopelessness and depression. The intervention comprised matched children savings accounts, financial management workshops and mentorship. Data were collected at baseline and 12 months post-intervention.
Results Using multivariate analysis with several socioeconomic controls, the authors find that children in the treatment condition (receiving the intervention) report significant improvement in their mental health functioning. Specifically, the intervention reduces hopelessness and depression levels. On the other hand, children in the control condition (not receiving the intervention) report no changes on both measures.
Conclusions The findings indicate that children with poor mental health functioning living in communities affected by HIV/AIDS may benefit from innovative family economic empowerment interventions. As measures of mental health functioning, both hopelessness and depression have long-term negative psychosocial and developmental impacts on children. These findings have implications for public health programmes intended for long-term care and support of children living in resource poor AIDS-impacted communities.
Funding The Suubi-Maka study is supported by the National Institute of Mental Health (grant # RMH081763A). The study is registered in the Clinicaltrials.gov database (ID # NCT01180114).
Competing interests None.
Patient consent Obtained.
Ethics approval The work was conducted with the approval of Columbia University's Morningside Institutional Review Board (AAAD2525) and Uganda National Council of Science and Technology (ref SS 1540).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Sharing of Study Findings: the Principal Investigator (PI) and the entire research team are committed to open, timely and widespread sharing and dissemination of study findings to researchers, funders, service providers, the target population and the general public. The team adheres to the NIH Public Access Policy that requires final peer-reviewed manuscripts to be submitted to the National Library of Medicine's PubMed Central upon acceptance for publication and to be made publicly available no later than 12 months after the official date of publication. Sharing of Participant Data: once all of the data have been de-identified, cleaned, and validated and main findings have been published, the investigators expect to share the data with the scientific community. Data sets will be made available to any individual who makes a direct request to the PI and indicate that the data will be used for the purposes of research (per CFR Title 45 Part 46: ‘Research is defined as a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalisable knowledge’.). In sharing participant data, the team will follow Columbia University's Office of Sponsored Projects' data sharing agreement that specifies the following conditions be met before data are shared: a formal research question is specified a priori; names, affiliations and roles of any other individuals who will access the shared data; the deliverable(s)—for example, manuscript, conference presentation—are specified a priori; proper credit and attribution—for example, authorship, coauthorship and order—for each deliverable are specified a priori; a statement indicating an understanding that the data cannot be further shared with any additional individual(s) or parties without the PI's permission; institutional review board approval for use of the data (or documentation that institutional review board has determined the research is exempt). Shared data will be free of identifiers that would permit linkages to individual research participants and variables that could lead to deductive disclosure of the identity of individual subjects. Data will be shared in electronic format native to the software used by the research team; requestors are expected to handle converting electronic formats. Upon completion of the deliverable(s), the requestor will be instructed to destroy all copies of the data. If deliverables have not been produced yet, the agreement to share data will be revisited annually by the PI and the research team to decide whether to continue sharing or terminate the sharing agreement. If the research team determines that the sharing agreement should be terminated, the requestor will be instructed to destroy all copies of the data.