Peer-reviewed article
Combining Asset Accumulation and Multifamily Group Intervention to Improve Mental Health for Adolescent Girls: A Cluster-Randomized Trial in Uganda
Leyla Karimli, Proscovia Nabunya, Fred M. Ssewamala, Darejan Dvalishvili ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether combining financial asset accounts for adolescent girls with family group counselling improves mental health outcomes in poor households affected by HIV/AIDS in Uganda. Over 24 months, 1,260 girls aged 14–17 were randomly assigned to receive either standard support, asset accounts alone, or asset accounts plus family counselling. The study found that family relationships—particularly family cohesion and quality of parent-child communication—significantly influenced whether the interventions improved girls' mental health. Girls in households with stronger family functioning benefited more from the combined intervention.
Key points
- Family functioning (cohesion, communication quality, and child-caregiver relationship) was significantly associated with adolescent girls' mental health in poor households
- The intervention effect on hopelessness was moderated by family cohesion, frequency of family communication, and quality of child-caregiver relationship
- Intervention effects on depression were moderated by comfort of family communication
- Combining asset accumulation with family strengthening showed promise for improving mental health in poor households affected by HIV/AIDS
- Over 1,260 adolescent girls from 47 schools participated in the 24-month cluster randomized controlled trial
Limitations
The study measures associations between family functioning and mental health but does not isolate the causal mechanisms through which family strengthening improves outcomes. The findings are specific to poor households in southern Uganda affected by HIV/AIDS and may not generalise to other contexts.
Abstract
Purpose The aim of this study is to expand the current knowledge on the relationship between poverty, family functioning, and the mental health of adolescent girls in families affected by poverty and HIV/AIDS in southern Uganda. The study investigates the association between family functioning and mental health and examines whether family functioning moderates the intervention effect on adolescent mental health. Methods Longitudinal data were collected over the course of 24 months in a cluster randomized controlled trial conducted among N=1,260 girls aged 14–17 years in Uganda. Participants were randomized into control group (n=408 girls from n=16 schools), matched youth development accounts treatment, YDA (n=471 girls from n=16 schools), and integrated intervention combining YDA with multiple family group component (n=381 girls from n=15 schools). Results We found a significant positive association between family functioning and mental health of adolescent girls in our sample. Moderator analyses suggests that effect of the intervention on Beck Hopelessness Scale was significantly moderated by family cohesion (χ 2 (4) =21.43; p = .000), frequency of family communication (χ 2 (4) =9.65; p = .047), and quality of child-caregiver relationship (χ 2 (4) =11.12; p = .025). Additionally, the intervention effect on depression was moderated by the comfort of family communication (χ 2 (4) =10.2; p = .037). Discussion The study findings highlight the importance of family functioning when examining the link from poverty to adolescent mental health. The study contributes to the scarce evidence suggesting that asset-accumulation opportunities combined with a family strengthening component may improve parenting practices and adolescent mental health in poor households.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Youth Development Accounts (YDA) for asset accumulation combined with multifamily group intervention for family strengthening
- Population
- 1,260 girls aged 14–17 in poor households affected by HIV/AIDS in southern Uganda, randomly assigned to three arms: control (n=408), YDA only (n=471), and integrated YDA plus family group component (n=381)
Key finding
Family cohesion significantly moderated the intervention effect on Beck Hopelessness Scale (χ² (4) =21.43; p = .000)
Karimli et al. · Prof. Fred M. Ssewamala (OpenAlex works) · 16 Sept 2023