Using Mixed-Methods Research to Adapt and Evaluate a Family Strengthening Intervention in Rwanda.

Journal: African journal of traumatic stress

Volume: 2

Issue: 1

Year of Publication: 

Affiliated Institutions:  Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights. Partners In Health, Rwanda/ Inshuti Mu Buzima. Children's Hospital Boston.

Abstract summary 

Research in several international settings indicates that children and adolescents affected by HIV and other compounded adversities are at increased risk for a range of mental health problems including depression, anxiety, and social withdrawal. More intervention research is needed to develop valid measurement and intervention tools to address child mental health in such settings.This article presents a collaborative mixed-methods approach to designing and evaluating a mental health intervention to assist families facing multiple adversities in Rwanda.Qualitative methods were used to gain knowledge of culturally-relevant mental health problems in children and adolescents, individual, family and community resources, and contextual dynamics among HIV-affected families. This data was used to guide the selection and adaptation of mental health measures to assess intervention outcomes. Measures were subjected to a quantitative validation exercise. Qualitative data and community advisory board input also informed the selection and adaptation of a family-based preventive intervention to reduce the risk for mental health problems among children in families affected by HIV.. Community-based participatory methods were used to ensure that the intervention targeted relevant problems manifest in Rwandan children and families and built on local strengths.Qualitative data on culturally-appropriate practices for building resilience in vulnerable families has enriched the development of a Family-Strengthening Intervention (FSI). Input from community partners has also contributed to creating a feasible and culturally-relevant intervention. Mental health measures demonstrate strong performance in this population.The mixed-methods model discussed represents a refined, multi-phase protocol for incorporating qualitative data and community input in the development and evaluation of feasible, culturally-sound quantitative assessments and intervention models. The mixed-methods approach may be applied to research in other parts of sub-Saharan Africa and beyond.

Authors & Co-authors:  Betancourt Theresa S TS Meyers-Ohki Sarah E SE Stevenson Anne A Ingabire Charles C Kanyanganzi Fredrick F Munyana Morris M Mushashi Christina C Teta Sharon S Fayida Ildephonse I Cyamatare Felix Rwabukwisi FR Stulac Sara S Beardslee William R WR

Study Outcome 

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Statistics
Citations :  Benjet C. Childhood adversities of populations living in low-income countries: prevalence, characteristics, and mental health consequences. Current Opinion in Psychiatry. 2010 Jul;23(4):356–62.
Authors :  12
Identifiers
Doi : 
SSN : 2218-4937
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Study Approach
Quantitative,Qualitative
Country of Study
Rwanda
Publication Country
Uganda