Pathways to improved adolescent mental health via an economic and gender equality intervention with conflict affected families

项目概要/摘要 在刚果民主共和国，家庭经历了20多年的暴力， 流离失所和政治不稳定导致极端贫困， 机会儿童贫困和遭受创伤的情况普遍存在，尤其集中在冲突中， 受影响地区和农村。童年时期暴露于多种逆境可能导致一生的精神不佳 健康在刚果民主共和国农村，我们发现父母的自我报告精神健康状况不佳， 亲密伴侣暴力（IPV）对青少年心理健康有显著的负面影响， 对男孩和女孩有不同的影响。男性权威和女性地位的潜在意识形态 家庭中的性别歧视导致了限制机会的性别规范，对心理影响的关注有限。 健康这项研究提供了一个独特的机会，与一个久经考验的刚果合作伙伴一道， 和两个已被证明的结构性干预措施的协同效应; 1）兔子恢复力（RFR），青年领导的 经济赋权方案; 2）Indashyikirwa（IK），一个基于夫妇/父母的两性平等方案 青少年心理健康计划。使用三组（RFR）的随机分组对照试验 仅IK，仅RFR + IK），我们检查了干预措施的组合和协同作用， RFR和IK改善青少年心理健康的途径。我们将测试两个假设：1） RFR + IK和仅RFR家庭的青少年将报告心理健康的更大改善， 改善自我效能、入学率、粮食安全和同伴关系的途径， 仅IK家庭中的青少年;和2）RFR + IK和仅IK家庭中的青少年将报告更多 通过改善父母关系质量和权力分享的途径改善心理健康， 减少IPV暴露，改善父母心理健康，支持性别平等规范， 仅RFR家庭中的青少年。干预效应途径的差异将通过以下方式进行检查： 青春期的性鉴于近五分之一的儿童生活在冲突中，其重要性不容低估- 受影响的地区，世界各地-并面临着终身精神健康状况不佳，教育机会不平等 和经济机会。

Project Summary/Abstract In the Democratic Republic of Congo, families have experienced more than two decades of violence, displacement and political instability resulting in extreme poverty with limited educational and economic opportunities. Child poverty and exposure to trauma is widespread and particularly concentrated in conflict- affected and rural areas. Childhood exposure to multiple adversities can lead to a lifetime of poor mental health. In rural DRC, we found parent’s self-report of poor mental health and victimization or perpetration of intimate partner violence (IPV) had a significant negative impact on their young adolescents’ mental health, with different impacts for boys and girls. The underlying ideologies of male authority and women’s place being in the home has led to gender norms that restrict opportunities with limited attention to effects on mental health. The study provides a unique opportunity with a proven Congolese partner to examine the combined and synergistic effects of two proven structural interventions; 1) Rabbits for Resilience (RFR), youth-led economic empowerment program; and 2) Indashyikirwa (IK), a couples/parents-based gender equality program on adolescent mental health. Using a clustered randomized controlled trial with three groups (RFR only, IK only, RFR + IK), we examine the combined and synergistic effects of the interventions and the pathways through which RFR and IK improves adolescent mental health. We will test two hypotheses: 1) Adolescents in the RFR + IK and RFR only households will report greater improvement in mental health via pathway of improved self-efficacy, school attendance, food security and peer relationships compared to adolescents in IK only households; and 2) Adolescents in RFR + IK and IK only households will report greater improvement in mental health via the pathway of improved parent relationship quality and power sharing, reduced exposure to IPV, improved parental mental health and support of gender equitable norms compared to adolescents in RFR only households. Differences in pathways of the intervention effect will be examine by sex of adolescent. The significance cannot be underestimated given nearly 1 in 5 children live in conflict- affected areas, worldwide - and are facing a lifetime of poor mental health with inequitable access to education and economic opportunities.