Family-based promotion of mental health in children affected by HIV: a pilot randomized controlled trial.

Journal: Journal of child psychology and psychiatry, and allied disciplines

Volume: 58

Issue: 8

Year of Publication: 2018

Affiliated Institutions:  Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA. Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA. Brigham and Women's Hospital, Boston, MA, USA. Partners In Health/Inshuti MuBuzima, Rwinkwavu, Rwanda. College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.

Abstract summary 

Children affected by HIV are at risk for poor mental health. We conducted a pilot randomized controlled trial (RCT) of the Family Strengthening Intervention (FSI-HIV), a family home-visiting intervention to promote mental health and improve parent-child relationships in families with caregivers living with HIV, hypothesizing that child and family outcomes would be superior to usual care social work services.Eighty two families (N = 170 children, 48.24% female; N = 123 caregivers, 68.29% female) with at least one HIV-positive caregiver (n = 103, 83.74%) and school-aged child (ages 7-17) (HIV+ n = 21, 12.35%) were randomized to receive FSI-HIV or treatment-as-usual (TAU). Local research assistants blind to treatment conducted assessments of child mental health, parenting practices, and family functioning at baseline, post-intervention, and 3-month follow-up. Multilevel modeling assessed effects of FSI-HIV on outcomes across three time points.NCT01509573, 'Pilot Feasibility Trial of the Family Strengthening Intervention in Rwanda (FSI-HIV-R).' https://clinicaltrials.gov/ct2/show/;NCT01509573?term=Pilot+Feasibility+Trial+of+the+Family+Strengthening+Intervention+in+Rwanda+%28FSI-HIV-R%29&rank=1.At 3-month follow-up, children in FSI-HIV showed fewer symptoms of depression compared to TAU by both self-report (β = -.246; p = .009) and parent report (β = -.174; p = .035) but there were no significant differences by group on conduct problems, functional impairment, family connectedness, or parenting.Family-based prevention has promise for reducing depression symptoms in children affected by HIV. Future trials should examine the effects of FSI-HIV over time in trials powered to examine treatment mediators.

Authors & Co-authors:  Betancourt Theresa S TS Ng Lauren C LC Kirk Catherine M CM Brennan Robert T RT Beardslee William R WR Stulac Sara S Mushashi Christine C Nduwimana Estella E Mukunzi Sylvere S Nyirandagijimana Beatha B Kalisa Godfrey G Rwabukwisi Cyamatare F CF Sezibera Vincent V

Study Outcome 

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Statistics
Citations :  Akresh R, De Walque D. Armed conflict and schooling: Evidence from the 1994 Rwandan genocide. World Bank Policy Research Working Paper Series 2008
Authors :  13
Identifiers
Doi : 10.1111/jcpp.12729
SSN : 1469-7610
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
HIV;Rwanda;adolescents;depression
Study Design
Study Approach
Country of Study
Rwanda
Publication Country
England