Bridges to the Future: Economic Empowerment for AIDS-Orphaned Children in Uganda

Not Applicable

Completed

• Conditions: Poverty; Orphaned Children; AIDS Orphans
• Interventions: Behavioral: Bridges; Behavioral: Bridges PLUS; Other: Usual Care

• Registration Number: NCT01447615
• Lead Sponsor: Columbia University

Brief Summary

Bridges to the Future: Economic Empowerment for AIDS-Orphaned Children in Uganda, represents the first study that measures medium-term efficacy and cost-effectiveness of a family economic empowerment intervention for AIDS-orphaned children. The usual care provided to AIDS orphans in sub-Saharan Africa consists mainly of informal counseling as well as limited material support (e.g., specifically school lunches, textbooks for the required subjects, and note-books). Given the challenges facing these children and their caregivers, further supports are needed in order to help them successfully make the transition from primary school to secondary school and into adolescence. In the context of resource-poor countries, interventions that improve families' economic capabilities are likely to be particularly consequential. Both theory and prior research indicate that economic instability (including poverty) constitutes one of the primary risk factors for AIDS-orphaned children's risk-taking behaviors (including sexual risk-taking), poor mental health functioning, and poor educational outcomes. Thus, the lack of economic security constitutes an important risk factor for AIDS-orphaned children. Yet, to-date, few interventions aimed at care and support of AIDS-orphaned children have incorporated components to address family-level poverty/economic instability of the children and their caregiving families. Within this context, there is a need for innovative interventions that promote sustainable (more than short-term) economic and behavior change among AIDS-orphaned children and create the supports necessary to sustain these changes.

Detailed Description

The overall goal of the proposed research is to evaluate the efficacy and cost-effectiveness of an innovative family-based economic empowerment intervention for AIDS-orphaned children. This will be accomplished via a three-group cluster randomized control trial (RCT). The three groups are: Bridges, Bridges PLUS, and usual care for AIDS-orphaned children. There will be five assessment points: baseline (pretest), 12, 24, 36, and 48-months post-intervention initiation.

The intervention, "Bridges to the Future" (Bridges) will be guided by asset-theory and both Bridges and Bridges PLUS will include the following intervention components tested in the two earlier pilot studies, SEED-Uganda and SUUBI-Uganda: 1) workshops focused on asset building, future planning, and protection from risks; 2) mentors to reinforce learning and build optimism; 3) a Child Development Account (CDA) that can be used for secondary education by the AIDS-orphaned child; and 4) a family income generating/micro-enterprise promotion component for children enrolled in Bridges and Bridges PLUS, and their families.

Study Timeline

• Study First Submitted: 2011-10-04
• Study First Submitted QC: 2011-10-04
• Study First Posted: 2011-10-06
• Study Start: 2012-02
• Primary Completion: 2018-01-15
• Study Completion: 2018-01-15
• Status Verified: 2018-10
• Last Update Submitted: 2018-10-10
• Last Update Posted: 2018-10-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1410

Inclusion Criteria

• An HIV/AIDS-orphaned child (a child who has lost one or both parents to HIV/AIDS)
• Enrolled in grade 5 or 6 of primary school
• Living within a family

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Exclusion Criteria

• Any child who does not self-identify as an HIV/AIDS-orphan
• Any child who is not enrolled in grade 5 or 6 of primary school
• Any child who is not living within a family at the time of enrollment

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Bridges	Usual Care	-
Bridges PLUS	Usual Care	-
Bridges	Bridges	-
Bridges PLUS	Bridges PLUS	-
Usual Care	Usual Care	-

Primary Outcome Measures

Name	Time	Method
Educational Achievement	48-month post-intervention follow-up assessment	School enrollment and attendance. Educational attainment, plans, and aspirations. Performance on National Primary Leaving Examinations.
Sexual Risk-Taking Behavior	48-month post-intervention follow-up assessment	Ability to negotiate safe sex practices. Decreased intentions to engage in sexual risk behavior. Knowledge about and attitude toward HIV/AIDS and other STDs.
Savings and Asset Accumulation	48-month post-intervention follow-up assessment	Increased confidence in saving ability and stronger financial stability. Accumulation of formal and informal savings and wealth/assets (e.g. livestock, type of housing, land); and change in attitudes toward saving.
Mental Health Functioning	48-month post-intervention follow-up assessment	Degree of hopefulness about the future. Ability to identify specific future goals. Level of mental health functioning. Depressive symptoms.

Trial Locations

Locations (1)

International Center for Child Health and Asset Development; 🇺🇬 Masaka, Rakai And Masaka Districts, Uganda