Family-based promotion of mental health in children affected by HIV: a pilot randomized controlled trial
Theresa S Betancourt, Lauren C Ng, Catherine M Kirk, Robert T Brennan, William R Beardslee, Sara Stulac, Christine Mushashi, Estella Nduwimana, Sylvere Mukunzi, Beatha Nyirandagijimana, Godfrey Kalisa, Cyamatare F Rwabukwisi, Vincent Sezibera, Theresa S Betancourt, Lauren C Ng, Catherine M Kirk, Robert T Brennan, William R Beardslee, Sara Stulac, Christine Mushashi, Estella Nduwimana, Sylvere Mukunzi, Beatha Nyirandagijimana, Godfrey Kalisa, Cyamatare F Rwabukwisi, Vincent Sezibera
Abstract
Background: 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.
Methods: 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.
Trial registration: NCT01509573, 'Pilot Feasibility Trial of the Family Strengthening Intervention in Rwanda (FSI-HIV-R).' https://ichgcp.net/clinical-trials-registry/NCT01509573" title="See in ClinicalTrials.gov">NCT01509573?term=Pilot+Feasibility+Trial+of+the+Family+Strengthening+Intervention+in+Rwanda+%28FSI-HIV-R%29&rank=1.
Results: 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.
Conclusions: 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.
Keywords: HIV; Rwanda; adolescents; depression.
Conflict of interest statement
The authors have declared that they have no competing or potential conflicts of interest in relation to this work.
© 2017 Association for Child and Adolescent Mental Health.
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Source: PubMed