The Short-Term Impact of a Combination Intervention on Depressive Symptoms Among School-Going Adolescent Girls in Southwestern Uganda: The Suubi4Her Cluster Randomized Trial

Abstract

Purpose: This study aims to examine the short-term impact of a combined intervention consisting of evidence-based family economic empowerment (FEE) and multiple family group (MFG) interventions on depressive symptoms among school-going adolescent girls in southwestern Uganda.

Methods: We analyzed longitudinal data from a cluster randomized trial. The sample consisted of 1,260 adolescent girls (aged 14-17 years at enrollment) recruited from senior one and senior two classes across 47 secondary schools in the southwestern region of Uganda. Participants were randomized at the school level to either the control condition receiving bolstered standard of care or one of the two treatment conditions-the treatment one condition receiving the FEE intervention or the treatment two conditions receiving both the FEE plus MFG interventions. Descriptive statistics and a three-level mixed-effects model were conducted to examine the effect of a combination intervention on depressive symptoms.

Results: At baseline, there were no significant differences between the control condition and both treatment conditions. While all three groups experienced a substantial reduction in depressive symptoms from baseline to 12 months, the reductions were stronger for the two intervention groups. However, FEE + MFG was not significantly different from FEE at 12 months.

Discussion: Results imply that the FEE intervention may be a promising tool in addressing depressive symptoms among adolescent girls. Therefore, to reduce the long-term implications of adverse psychosocial health during adolescence, policymakers and program implementers should explore scaling up economic empowerment interventions in similar settings to bridge the mental health treatment gap for adolescent girls.

Trial registration: ClinicalTrials.gov NCT03307226.

Keywords: Adolescent girls; Adolescent mental health; Depression; Evidence-based intervention; Family economic empowerment; Interventions; Multiple family group; Sub-Saharan Africa.

Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interest to declare that are relevant to the content of this article.

Copyright © 2022 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1.

Depressive symptoms total score from baseline to 12 months.