The impact of school support on depression among adolescent orphans: a cluster-randomized trial in Kenya
The impact of school support on depression among adolescent orphans: a cluster-randomized trial in Kenya
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DOI：
10.1111/jcpp.12955
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发表时间：
2019-01-01
影响因子：
7.6
通讯作者：
Puffer, Eve S.
中科院分区：
文献类型：
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作者：
Green, Eric P.;Cho, Hyunsan;Puffer, Eve S.
背景 本研究的目的是确定对肯尼亚青少年孤儿的学校支持干预是否对心理健康（次要结果）产生影响。方法在本文中，我们分析了一项为期 4 年整群随机试验的数据，该试验对肯尼亚西部锡亚县即将过渡到中学的孤儿青少年进行了学校支持干预（校服、学费和护士探访）。 26 所小学被随机 (1:1) 分为干预组（410 名学生）或对照组（425 名学生）。该研究是纵向的，从 2011 年到 2014 年的 4 年间每年重复收集测量结果。我们使用了流行病学研究中心抑郁量表修订版（一种自我报告的抑郁症筛查工具）中的 20 项抑郁量表中的 5 个项目。结果干预措施防止了从干预学校招募的青少年抑郁严重程度评分随着时间的推移而增加。没有证据表明治疗的异质性因性别或基线抑郁状态而异。对抑郁症的干预效果部分是由干预组中较高的继续入学率所介导的，但这种介导效应很小。结论 学校对孤儿的支持可能有助于缓解抑郁症状随时间的发作或恶化，从而提高重要高危人群的恢复能力。
Background The objective of this study was to determine if a school support intervention for adolescent orphans in Kenya had effects on mental health, a secondary outcome. Methods In this paper, we analyzed data from a 4-year cluster-randomized trial of a school support intervention (school uniforms, school fees, and nurse visits) conducted with orphaned adolescents in Siaya County, western Kenya, who were about to transition to secondary school. 26 primary schools were randomized (1:1) to intervention (410 students) or control (425 students) arms. The study was longitudinal with annual repeated measures collected over 4 years from 2011 to 2014. We administered five items from the 20-item Center for Epidemiologic Studies Depression Scale Revised, a self-reported depression screening instrument. Results The intervention prevented depression severity scores from increasing over time among adolescents recruited from intervention schools. There was no evidence of treatment heterogeneity by gender or baseline depression status. The intervention effect on depression was partially mediated by higher levels of continuous school enrollment among the intervention group, but this mediated effect was small. Conclusions School support for orphans may help to buffer against the onset or worsening of depression symptoms over time, promoting resilience among an important at-risk population.