Transforming Health and Resilience in Vulnerable Environments: Mental Health, Psychosocial Support, and Climate-Smart Farming in Nakivale
- Conditions
- Psychological DistressMental HealthMalnutritionMalnutrition, ChildDietary Deficiency
- Interventions
- Behavioral: Enhanced Usual Care (EUC)Behavioral: Home Gardening Intervention (HGI)Behavioral: Self-Help Plus (SH+)
- Registration Number
- NCT06425523
- Lead Sponsor
- Uppsala University
- Brief Summary
The study aims to evaluate if enhancing the mental health of refugee mothers can make them better able to implement new farming methods that are meant to improve food security in the face of climate change. It is a cluster-randomized controlled trial involving 900 pairs consisting of refugee mothers and their children aged 36-59 months, living in Nakivale refugee settlement in Uganda. The mothers will be randomly assigned to one of three groups:
* Control group: Mothers will receive Enhanced Usual Care (EUC).
* HGI group: Mothers will receive the Home Gardening Intervention, consisting of training and supplies for home gardening.
* HGI/SH+ group: Mothers will receive both the Home Gardening Intervention and the Self-Help Plus mental health intervention.
The main goal is to see if the gardening program alone can reduce food insecurity after 12 months compared to the EUC control group. It also aims to see if reducing psychological distress by adding the mental health component boosts the effects of the gardening intervention.
Secondary goals are to look at impacts on dietary diversity, child malnutrition, and mothers' mental health levels across all three groups.
The study also gathers survey data on participant mothers' migration history, social capital, exposure to potentially traumatic events, exposure to natural hazards and environmental stressors, mental health, and parenting style. Both mothers and their children will furthermore play incentivized economic games to measure their economic preferences (time, risk, social preferences). Additionally, the study will assess children's well-being and functioning. Children will also be asked to carry out gamified tasks designed to measure their cognitive development.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Female
- Target Recruitment
- 904
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description EUC Enhanced Usual Care (EUC) Enhanced Usual Care HGI Home Gardening Intervention (HGI) Home Gardening Intervention HGI Enhanced Usual Care (EUC) Home Gardening Intervention SH+/HGI Enhanced Usual Care (EUC) Self-Help Plus in combination with Home Gardening Intervention SH+/HGI Home Gardening Intervention (HGI) Self-Help Plus in combination with Home Gardening Intervention SH+/HGI Self-Help Plus (SH+) Self-Help Plus in combination with Home Gardening Intervention
- Primary Outcome Measures
Name Time Method Food insecurity 12 months Food insecurity will be assessed using the Food Insecurity Experience Scale (FIES). The FIES was developed by the FAO, and consists of 8 questions regarding the availability of sufficient food in the past thirty days. The questions form a scale calibrated against a global reference from the 2014-2016 Gallup World Poll for comparability across countries. Responses are analyzed as a scale using Item Response Theory (IRT) models, ensuring comparability of food insecurity prevalence rates.
- Secondary Outcome Measures
Name Time Method Dietary diversity 12 months Dietary diversity will be assessed using the Household Dietary Diversity Score (HDDS). The HDDS is a measure of food consumption that reflects a household's access to a variety of foods. It's based on households' self-reporting of the 12 food groups consumed in the previous 24 hours.
Child malnutrition 12 months Child malnutrition will be assessed using the Height-for-Age Z-score (HAZ). The HAZ is a standard statistical measurement that represents how a child's height compares to a reference population of the same age and sex. It's used to assess long-term nutritional status and can indicate chronic malnutrition or stunting. A HAZ score below -2 is considered stunted, indicating that the child is significantly shorter than the average height for their age. A score above +2 would suggest the child is taller than the average height for their age.
Psychological distress 12 months Psychological distress will be measured using the Kessler Psychological Distress Scale (K6). The K6 is a concise tool used to screen for psychological distress. It assesses general psychological distress through six questions that inquire about symptoms of depression and anxiety experienced in the past month. Each of the six questions is scored from 0 (none of the time) to 4 (all of the time), providing a total score range from 0 to 24. Higher scores indicate greater psychological distress.
Trial Locations
- Locations (1)
Kabale University
🇺🇬Kabale, Western Region, Uganda