An Evaluation of a Family Counseling Intervention ("Tuko Pamoja") in Kenya
- Conditions
- ParentingMental Health IssueAdolescent - Emotional ProblemChild BehaviorParent-Child RelationsFamily RelationsFamily ConflictAdolescent Problem BehaviorChild AbuseMarital Conflict
- Interventions
- Behavioral: Tuko Pamoja, "We are Together" in Kiswahili
- Registration Number
- NCT06417918
- Lead Sponsor
- Duke University
- Brief Summary
The purpose of this study is to evaluate a family counseling intervention, entitled "Tuko Pamoja" (Translation "We are Together" in Kiswahili). The intervention, delivered by lay counselors and through existing community social structures, is expected to improve family functioning and individual mental health among members. The sample includes families with a child or adolescent (ages 8-17) experiencing problems in family functioning.
- Detailed Description
The purpose of this study is to evaluate a family counseling intervention, entitled "Tuko Pamoja" (Translation "We are Together" in Kiswahili), using a pilot randomized control trial design.
The intervention, delivered by lay counselors and through existing community social structures, focuses on improving family relationships and mental health with content derived from evidence-based practices; these include family systems and solution-focused family therapies and cognitive behavioral strategies. It is components based, with modules delivered based on need. The content and structure has been adapted in both content and implementation model based on formative research in this context. Primary hypotheses include achieving improvements in outcomes related to:
1. Family functioning, including elements such as communication, emotional closeness, structure and organization, and satisfaction for the overall family; this also includes indicators of functioning at dyadic levels (i.e., parent-child and couples functioning)
2. Mental health of both children and caregivers.
The investigators also hypothesize feasibility and acceptability, including high fidelity and adequate clinical competency by the non-specialist counselors, based on a previous evaluation of the program.
The study will follow a randomized controlled design with a target sample size of 60 families, including up to 2 caregivers per family (who hold primary responsibility for the child whether biological or non-biological) and a target child identified either through caregiver-report of the child about whom they are most concerned or randomly, if there is no child with particular concerns. Families will be recruited in two rounds of 30 families due to logistical limitations of enrolling all 60 at the same time.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 240
- Family with self-reported elevated distress (e.g., high levels of conflict) that also has a child/adolescent (ages 8-17) with caregiver-reported emotional or behavioral concerns
- Families without reported distress and/or without reported adolescent distress.
- Families with children older than 17 or younger than 8 years of age.
- Families in which primary caregivers or children are living too far outside of the community to participate in treatment.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention: Tuko Pamoja Tuko Pamoja, "We are Together" in Kiswahili The intervention, Tuko Pamoja, is in-home family counseling delivered by lay counselors and through existing community social structures, focuses on improving family relationships and mental health with content derived from evidence-based practices including family systems and solution-focused family therapy and cognitive behavioral strategies. It is components based, with modules delivered based on need. The content and structure has been adapted based on formative research in this context. Tuko Pamoja is manualized and includes a tablet-based manual material and video content to support psychoeducation components and data collection.
- Primary Outcome Measures
Name Time Method Harsh Parenting (Caregiver and Child Report) Baseline, 1 month, and 3 month post-intervention 15 self-report items from the Parent Adolescent Relationship Questionnaire (PARQ) Hostility/Aggression Subscale. One composite score is calculated (range: 0 - 45); higher scores represent more harsh parenting characteristics.
Child Mental Health (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 20 self-report items from the Child Behavior Checklist (CBCL) and 6 locally-developed items. One composite score is calculated (range: 20 - 60); higher scores represent worse child mental health.
Parent-Child Communication (Caregiver and Child Report) Baseline, 1 month, and 3 month post-intervention 20 self-report items from the Parent-Adolescent Communication Scale (PACS). Each include caregiver and child/adolescent report versions. Participants are asked to respond based on the past month. Children report on each caregiver separately. One composite score is calculated (range: 0 - 60); higher scores represent better parent-child communication.
Parent-Child Relationship Quality (Caregiver and Child Report) Baseline, 1 month, and 3 month post-intervention 20 self-report items from the Parent Adolescent Relationship Questionnaire (PARQ) Warmth Subscale. One composite score is calculated (range: 0 - 60); higher scores represent better parent-child relationship quality.
Couples Relationship Quality (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 13 self-report items from the Dyadic Adjustment Scale (DAS) Cohesion and Satisfaction subscales and 9 locally-developed items. One composite score is calculated (range: 22 - 132); higher scores represent better couples relationship quality.
Caregiver Mental Health (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 9 self-report items from the Patient Health Questionnaire (PHQ-9), 14 self-report items from the General Health Questionnaire (GHQ), and 6 locally-developed items. One composite score is calculated (range: 0 - 87); higher scores represent worse caregiver mental health.
Family Functioning (Caregiver and Child Report) Baseline, 1 month, and 3 month post-intervention 30 self-report items developed for the local context based on formative research (Family Togetherness Scale, FTS). Responses are endorsed on a 10-point scale and refer to the past month. One composite score is calculated (range: 0 - 30); higher scores represent more family distress.
Child Mental Health (Child Report) Baseline, 1 month, and 3 month post-intervention 19 self-report items from the Youth Self-Report (YSR) and 7 locally-developed items. One composite score is calculated (range: 0 - 52); higher scores represent worse child mental health.
- Secondary Outcome Measures
Name Time Method Social Support (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 28 self-report items from the Inventory of Socially Supportive Behaviors (ISSB), 12 self-report items from the Multidimensional Scale of Perceived Social Support (MSPSS), and 7 locally-developed items. One composite score is calculated (range: 29 - 147); higher scores represent more social support.
Physical Maltreatment (Caregiver and Child Report) Baseline, 1 month, and 3 month post-intervention 2 items from the Multiple Indicator Cluster Survey (MICS) and 2 items from the Discipline Interview. One composite score is calculated (range: 0 - 12); higher scores represent more physical maltreatment.
Couples Violence (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 3 locally-developed items. One composite score is calculated (range: 0 - 12); higher scores represent more couples violence.
Child Hope (Child Report) Baseline, 1 month, and 3 month post-intervention 6 self-report items from the Children's Hope Scale. One composite score is calculated (range: 6 - 36); higher scores represent higher hope levels.
Child Prosocial Behavior (Caregiver and Child Report) Baseline, 1 month, and 3 month post-intervention 6 locally-developed items. One composite score is calculated (range: 0 - 12); higher scores represent more prosocial behaviors.
Caregiver Hope (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 12 self-report items from the Children's Hope Scale. One composite score is calculated (range: 6 - 48); higher scores represent higher hope levels.
Child Belongingness in Family (Child Report) Baseline, 1 month, and 3 month post-intervention 5 locally-developed items. One composite score is calculated (range: 0 - 10); higher scores represent more child belongingness in the family.
Adult Well-being (Adult Report) Baseline, 1 month, and 3 month post-intervention 7 self-report items from the Short Warwick Edinburgh Well-being Scale. One composite score is calculated (range: 7 - 35); higher scores represent better adult well-being.
Child Well-being (Child Report) Baseline, 1 month, and 3 month post-intervention 7 self-report items from the Short Warwick Edinburgh Well-being Scale. One composite score is calculated (range: 7 - 35); higher scores represent better child well-being.
Caregiver Coping (Caregiver Report) Baseline, 1 month, and 3 month post-intervention 28 self-report items from the Brief-COPE. One composite score is calculated (range: 28 - 112); higher scores represent better coping skills.
Trial Locations
- Locations (1)
Moi University
🇰🇪Eldoret, Kenya