292181
Family-based prevention of mental health problems among children affected by HIV/AIDS in rural Rwanda: A pilot feasibility study
Tuesday, November 5, 2013
: 5:00 p.m. - 5:15 p.m.
Theresa Betancourt, ScD, MA,
FXB Center for Health and Human Rights; Department of Global Health and Population, Harvard University / Harvard School of Public Health, Boston, MA
Felix Cyamatare, MD,
Family Strengthening Intervention, Partners in Health - Rwanda / Inshuti Mu Buzima, Rwinkwavu, Rwanda
Lauren Ng, PhD,
FXB Center for Health and Human Rights, Harvard University, Boston
Christina Mushashi, BA,
Family Strengthening Intervention, Partners in Health-Rwanda / Inshuti Mu Buzima, Rwinkwavu, Rwanda
Charles Ingabire, BA,
Family Strengthening Intervention, Partners in Health Rwanda / Inshuti Mu Buzima, Rwinkwavu, Rwanda
Sharon Teta, BA,
Family Strengthening Intervention, Partners in Health - Rwanda / Inshuti Mu Buzima, Rwinkwavu, Rwanda
Background: HIV-affected children are at increased risk for a range of mental health problems including depression, anxiety, and social withdrawal. Prevention-focused, family-based interventions have important public health applications in preventing mental health problems, including behavioral problems that may increase risk of HIV infection. Methods: The Family Strengthening Intervention-Rwanda (FSI-R) consists of four core components: 1) Building parenting skills and improved family communication; 2) Developing a family narrative; 3) Providing psychoeducation on HIV and its effects on families; and 4) Strengthening problem solving skills and the ability to access formal and non-formal support. Twenty families (N=39 children) that had at least one HIV+ caregiver and one child between the ages of 7 and 17 were enrolled in the FSI-R. Children and caregivers were administered locally-adapted and validated measures of child depression, anxiety, irritability, conduct problems, and functioning, as well as measures of prosocial behavior, resilience/self-esteem, hopefulness, social support, family support, positive parenting, and harsh parenting. Quantitative assessments were administered pre and post intervention. Multi-level models accounting for clustering by families were used to test for pre to post-intervention change in outcomes of interest. Results: Results indicated that children participating in the FSI-R reported significantly less depression and irritability symptoms, and significantly less harsh punishment from caregivers post-intervention. Caregivers reported that their children displayed significantly more resilience/self-esteem and pro-social behaviors post-intervention (ps < .05). Conclusions: The FSI-R is a promising intervention that may improve mental health symptoms, strengthen protective factors, and improve parent-child relationships among children and families affected by HIV.
Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Learning Objectives:
Describe a family-based approach to mental health prevention for children and adolescents in Rwanda.
Discuss post-intervention mental health symptoms and protective processes among children who received the Family Strengthening Intervention-Rwanda.
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have been the Principal Investigator of multiple federally funded grants focusing on the developmental and psychosocial consequences of concentrated adversity on children and families, resilience and protective processes in child and adolescent mental health, and applied cross-cultural mental health research. My research aims to provide effective protections and services for children and families affected by communal violence/armed conflict, HIV/AIDS, and other forms of adversity.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
