Peer-reviewed article
The Post-intervention Impact of Amaka Amasanyufu on Behavioral and Mental Health Functioning of Children and Adolescents in Low-Resource Communities in Uganda: Analysis of a Cluster-Randomized Trial From the SMART Africa-Uganda Study (2016–2022)
Fred M. Ssewamala, Rachel Brathwaite, Ozge Sensoy Bahar, Phionah Namatovu, Torsten B. Neilands et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated Amaka Amasanyufu, a 16-week family group intervention designed to reduce behavioral and mental health problems in children and adolescents in low-resource communities in Uganda. The intervention was delivered by either trained parent peers or community healthcare workers to 636 school-going children with disruptive behavioral disorders. Six months after the intervention ended, children who received the intervention showed significantly lower symptoms of oppositional defiant disorder, depression, and impaired functioning, and higher self-esteem compared to children in usual care.
Key points
- At 6 months postintervention, children in both intervention groups had significantly lower oppositional defiant disorder symptoms compared to controls (mean differences of -1.08 and -1.35)
- Impaired functioning decreased in intervention groups compared to controls (mean differences of -1.19 and -1.16)
- Depressive symptoms were significantly lower in intervention groups than controls (mean differences of -1.06 and -0.83)
- Self-concept improved more in intervention groups than controls (mean differences of 3.81 and 5.14)
- No significant differences were found between the two intervention delivery methods (parent peers versus community healthcare workers)
Limitations
The study focuses only on school-going children in low-resource communities in Uganda, so findings may not generalize to other settings or out-of-school populations. The mechanism by which the intervention produces sustained effects is not explored.
Abstract
PURPOSE: Disruptive behavioral disorders (DBDs) are common among children/adolescents in sub-Saharan Africa. A 16-week manualized multiple family group (MFG) intervention called Amaka Amasanyufu designed to reduce DBDs among school-going children/adolescents in low-resource communities in Uganda was efficacious in reducing symptoms of poor mental health relative to usual care in the short-term (4 months post-intervention-initiation). We examined whether intervention effects are sustained 6 months postintervention. METHODS: We used longitudinal data from 636 children positive for DBDs: (1) Control condition, 10 schools, n = 243; (2) MFG delivered via parent peers (MFG-PP), eight schools, n = 194 and; (3) MFG delivered via community healthcare workers (MFG-CHW), eight schools, n = 199 from the SMART Africa-Uganda study (2016-2022). All participants were blinded. We estimated three-level linear mixed-effects models and pairwise comparisons at 6 months postintervention and time-within-group effects to evaluate the impact on Oppositional Defiant Disorder (ODD), impaired functioning, depressive symptoms, and self-concept. RESULTS: At 6 months postintervention, children in MFG-PP and MFG-CHW groups had significantly lower means for ODD (mean difference [MD] = -1.08 and -1.35) impaired functioning (MD = -1.19 and -1.16), and depressive symptoms (MD = -1.06 and -0.83), than controls and higher means for self-concept (MD = 3.81 and 5.14). Most outcomes improved at 6 months compared to baseline. There were no differences between the two intervention groups. DISCUSSION: The Amaka Amasanyufu intervention had sustained effects in reducing ODD, impaired functioning, and depressive symptoms and improving self-concept relative to usual care at 6 months postintervention. Our findings strengthen the evidence that the intervention effectively reduces DBDs and impaired functioning among young people in resource-limited settings and was sustained over time.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Amaka Amasanyufu, a 16-week manualized multiple family group intervention delivered by either trained parent peers or community healthcare workers
- Population
- 636 school-going children and adolescents (aged not specified) with disruptive behavioral disorders in low-resource communities in Uganda; control n=243, MFG-PP n=194, MFG-CHW n=199
Key finding
Oppositional Defiant Disorder symptoms: mean difference -1.08 (MFG-PP) and -1.35 (MFG-CHW) versus control at 6 months post-intervention