Improving mental health among ultra-poor children: Two-year outcomes of a cluster-randomized trial in Burkina Faso

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. This study t...

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Veröffentlicht in:Social science & medicine (1982) 2018-07, Vol.208, p.180-189
Hauptverfasser: Ismayilova, Leyla, Karimli, Leyla, Sanson, Jo, Gaveras, Eleni, Nanema, Rachel, Tô-Camier, Alexice, Chaffin, Josh
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container_title Social science & medicine (1982)
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creator Ismayilova, Leyla
Karimli, Leyla
Sanson, Jo
Gaveras, Eleni
Nanema, Rachel
Tô-Camier, Alexice
Chaffin, Josh
description 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. 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. 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. 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/IRR = 0.62, 95% CI = 0.41, 0.92, p = .042), compared to the control group. 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. •The first RCT in West Africa combining economic and child protection interventions.•The study tests its effects on mental health of children living in abject poverty.•Integrating family coaching with economic support can reduce depression and trauma.
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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. 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. 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. 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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. 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. 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. 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/IRR = 0.62, 95% CI = 0.41, 0.92, p = .042), compared to the control group. 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family life</subject><subject>Female</subject><subject>Francophones</subject><subject>Graduation approach</subject><subject>Health behavior</subject><subject>Health problems</subject><subject>Health Promotion</subject><subject>Households</subject><subject>Humans</subject><subject>Intervention</subject><subject>LDCs</subject><subject>Low income groups</subject><subject>Low-income population</subject><subject>Male</subject><subject>Mental depression</subject><subject>Mental health</subject><subject>Mental Health - statistics &amp; numerical data</subject><subject>Mental health services</subject><subject>Poverty</subject><subject>Poverty - psychology</subject><subject>Prevention</subject><subject>Program Evaluation</subject><subject>Psychological trauma</subject><subject>Psychosocial factors</subject><subject>Psychosocial intervention</subject><subject>Regression analysis</subject><subject>Relatives</subject><subject>Rural areas</subject><subject>Rural communities</subject><subject>Rural poverty</subject><subject>Self esteem</subject><subject>Symptoms</subject><subject>Trauma</subject><subject>Villages</subject><subject>Well being</subject><issn>0277-9536</issn><issn>1873-5347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkU1vFSEUhonR2NvqX1ASN25mPMB8gLvatNqkiZu6JhTOeLnOwBWYmvrr5ea2Lty44STwnPcADyFvGbQM2PBh1-Zos_ULupYDky10LXD-jGyYHEXTi258TjbAx7FRvRhOyGnOOwBgIMVLcsLV2Akmhg1J18s-xXsfvtMFQzEz3aKZy5aaJda9dS7JNPsYE7VbP7uE4SO9_RWbBzSJxrXYuGCmcaKG2nnNBVOTTHBx8b_R0ZJ8TfSBflrTDx8MvTI5viIvJjNnfP1Yz8i3q8vbiy_NzdfP1xfnN40VSpVGge3knZWDkMOgQDjGnTV8QtsjGtn3TClgapiQoWRM1tJNzCoxuR4sGHFG3h9z6wN_rpiLXny2OM8mYFyz5iBG6FUPQ0Xf_YPu4ppCvZ3mDEDKurBKjUfKpphzwknvk19MetAM9EGL3um_WvRBi4ZOVy21881j_np3OHvqe_JQgfMjgPVD7j0mXVMwWHQ-oS3aRf_fIX8ATgyjQQ</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Ismayilova, Leyla</creator><creator>Karimli, Leyla</creator><creator>Sanson, Jo</creator><creator>Gaveras, Eleni</creator><creator>Nanema, Rachel</creator><creator>Tô-Camier, Alexice</creator><creator>Chaffin, Josh</creator><general>Elsevier Ltd</general><general>Pergamon Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U3</scope><scope>7U4</scope><scope>8BJ</scope><scope>BHHNA</scope><scope>DWI</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>WZK</scope><scope>7X8</scope></search><sort><creationdate>201807</creationdate><title>Improving mental health among ultra-poor children: Two-year outcomes of a cluster-randomized trial in Burkina Faso</title><author>Ismayilova, Leyla ; 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numerical data</topic><topic>Mental health services</topic><topic>Poverty</topic><topic>Poverty - psychology</topic><topic>Prevention</topic><topic>Program Evaluation</topic><topic>Psychological trauma</topic><topic>Psychosocial factors</topic><topic>Psychosocial intervention</topic><topic>Regression analysis</topic><topic>Relatives</topic><topic>Rural areas</topic><topic>Rural communities</topic><topic>Rural poverty</topic><topic>Self esteem</topic><topic>Symptoms</topic><topic>Trauma</topic><topic>Villages</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ismayilova, Leyla</creatorcontrib><creatorcontrib>Karimli, Leyla</creatorcontrib><creatorcontrib>Sanson, Jo</creatorcontrib><creatorcontrib>Gaveras, Eleni</creatorcontrib><creatorcontrib>Nanema, Rachel</creatorcontrib><creatorcontrib>Tô-Camier, Alexice</creatorcontrib><creatorcontrib>Chaffin, Josh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health &amp; 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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. 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. 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. 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/IRR = 0.62, 95% CI = 0.41, 0.92, p = .042), compared to the control group. 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. •The first RCT in West Africa combining economic and child protection interventions.•The study tests its effects on mental health of children living in abject poverty.•Integrating family coaching with economic support can reduce depression and trauma.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29743136</pmid><doi>10.1016/j.socscimed.2018.04.022</doi><tpages>10</tpages></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals Complete; Sociological Abstracts
subjects Adolescent
Burkina Faso
Child
Child & adolescent mental health
Child development
Child poverty
Children
Clinical trials
Cluster Analysis
Coaching
Depression
Developing countries
Economic conditions
Emotional well being
Empowerment
Families & family life
Female
Francophones
Graduation approach
Health behavior
Health problems
Health Promotion
Households
Humans
Intervention
LDCs
Low income groups
Low-income population
Male
Mental depression
Mental health
Mental Health - statistics & numerical data
Mental health services
Poverty
Poverty - psychology
Prevention
Program Evaluation
Psychological trauma
Psychosocial factors
Psychosocial intervention
Regression analysis
Relatives
Rural areas
Rural communities
Rural poverty
Self esteem
Symptoms
Trauma
Villages
Well being
title Improving mental health among ultra-poor children: Two-year outcomes of a cluster-randomized trial in Burkina Faso
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