Journal
SOCIAL SCIENCE & MEDICINE
Volume 208, Issue -, Pages 180-189Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2018.04.022
Keywords
Child; Depression; Trauma; Prevention; Low-income population; Graduation approach
Funding
- Children and Violence Evaluation Challenge Fund
- Bernard van Leer Foundation
- Oak Foundation
- UBS Optimus Foundation
- Child Protection Working Group (The United Nations Children's Fund/UNICEF)
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Rationale: There is limited evidence about interventions improving child mental health in francophone West Africa. Behavioral mental health interventions alone may have limited effects on children's emotional well-being in families living in abject poverty, especially in low-income countries. Objective: This study tests the effects of economic intervention, alone and in combination with a family-focused component, on the mental health of children from ultra-poor households in rural Burkina Faso. Methods: The three-arm cluster randomized trial included children in the age range of 10-15 years old (N=360), from twelve villages in Nord region of Burkina Faso (ClinicalTrial.gov ID: NCT02415933). Villages were randomized (4 villages/120 households per arm) to the waitlist arm, the economic intervention utilizing the Graduation approach (Trickle Up/TU arm), or to the economic strengthening plus family coaching component (TU + arm). Intervention effects were tested using repeated-measures mixed-effects regressions that account for the clustered nature of the data. Results: Children from the TU + arm showed a reduction in depressive symptoms at 12 months (medium effect size Cohen's d=-0.41, p=.001) and 24 months (d=-0.39, p=.025), compared to the control condition and the economic intervention alone (at 12 months d=-0.22, p=.020). Small effect size improvements in self-esteem were detected in the TU + group, compared to the control arm at 12 months (d=0.21) and to the TU arm at 24 months (d=0.21). Trauma symptoms significantly reduced in the TU + group at 12 months (Incidence Risk Ratio//RR=0.62, 95% CI=0.41, 0.92, p=.042), compared to the control group. Conclusion: Integrating psychosocial intervention involving all family members with economic empowerment strategies may be an innovative approach for improving emotional well-being among children living in extreme poverty.
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