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Intervention to Improve Developmental and Health Outcomes for Female Adolescents

Not Applicable
Completed
Conditions
Independent Child Migration
Interventions
Behavioral: Anzansi Family Program
Registration Number
NCT04231669
Lead Sponsor
Washington University School of Medicine
Brief Summary

The primary goal of this pilot study (R21) is to address the urgent need for theoretically and empirically informed interventions that prevent poor female youth's rural-to-urban migration for child labor in low and middle-income countries. The study will address the following specific aims: Aim 1: Pilot test the (i) feasibility and acceptability of ANZANSI; and (ii) preliminary impact of ANZANSI by comparing the control arm to the treatment arm on specific child development outcomes; Aim 2: Explore multi- level factors (individual, family, and programmatic) impacting participation in and experiences with the ANZANSI.

Detailed Description

The primary goal of this pilot study (R21) is to address the urgent need for theoretically and empirically informed interventions that prevent poor female youth's rural-to-urban migration for child labor in low and middle-income countries. The International Labor Organization (ILO) estimates that 11% of children (ages 5 to 17) worldwide are child laborers. ILO recently drew attention to migrant child laborers as an underreported, but more vulnerable group to adverse outcomes relative to children working locally. Sub-Saharan Africa (SSA) continues to be the continent with the highest rates of child labor, with Ghana registering one of the highest incidence rates at 22%, including unaccompanied child migrants engaged in labor. Adolescent girls make up the majority of unaccompanied rural-to-urban migrants in search of better economic opportunities. Studies document the myriad of serious threats to health and emotional well-being experienced by female adolescent migrants engaged in child labor. These threats underline the urgent need for theoretically-informed preventive interventions, specifically tailored to address the root causes of female child migrant labor and the needs of girls from economically insecure families and communities. Hence, this application titled ANZANSI Family Program focuses on girls before they drop out of school, but as they begin exhibiting possibility of dropping out. Specifically, ANZANSI is an innovative combination intervention program, combining an evidence-informed family-level economic empowerment (EE) aimed at creating and strengthening financial stability through the use of matched children savings accounts (CSA) and microfinance in poor households with a multiple family group (MFG) intervention addressing family functioning and parental beliefs around gender and child labor/ education. Informed by asset theory, parental ethnotheories framework; and the investigative team's research in SSA on child-wellbeing and poverty, the study uses a cluster randomized control design (N=10 schools; n=100 girls ages 11-14 at risk of dropping out of school and their caregivers), assigned to two study conditions (N= 5 schools; n=50 children at risk of dropping out of school and their caregivers in each condition). The control group will receive bolstered usual care, including books and school lunch and treatment group will receive a combination intervention (Family EE+MFG) called ANZANSI, to address the following specific aims: Aim 1: Pilot test the (i) feasibility and acceptability of ANZANSI; and (ii) preliminary impact of ANZANSI by comparing the control arm to the treatment arm on specific child development outcomes; Aim 2: Explore multi- level factors (individual, family, and programmatic) impacting participation in and experiences with the ANZANSI. This study is aligned with NICHD's mission to support research relevant to the psychological, behavioral, and educational development and health of children worldwide. Ultimately, our findings may guide approaches to address youth's unaccompanied rural-to-urban migration and involvement in child labor in SSA, and the associated negative consequences.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria

Adolescent girls' inclusion criteria are:

  • Enrolled in school and living within a family (defined broadly -not necessarily biological parents)
  • Ages 11 to 14
  • Capable of giving assent
  • Skipping school in the past academic term (with at least 10% of unexcused absences).

The caregiver inclusion criteria are:

  • Self-identified as primary caregiver of the adolescent girl
  • Capable of providing informed consent.
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Exclusion Criteria
  • Participants (girls and caregivers) that do not meet the criteria or exhibit a lack of understanding of the study procedures and hence not able to provide informed consent will be excluded.
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Anzansi Family ProgramAnzansi Family ProgramIn addition to bolstered care, participants(adolescent girls and caregivers) in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Primary Outcome Measures
NameTimeMethod
Intention to Migratepost-test (9 months)

Change in intention to migrate will be measured by one question: How likely do you (the adolescent girl) see yourself migrating? The question uses a likert scale ranging from 1 (very unlikely) to 5 (very likely).

Secondary Outcome Measures
NameTimeMethod
Attitudes Towards Schoolbaseline, post-test (9 month), 6 month follow-up (6-month post intervention completion)

Change in attitudes towards school will be measured by School attitude assessment survey. The range is 20 to 100, with higher scores representing a more positive attitude towards school.

School Attendancebaseline, post-test (9 month), 6 month follow-up (6-month post intervention completion)

Change in school attendance will be measured by school attendance reports. Number of missed days will be collected

Self-conceptbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in self-concept will be measured by Tennessee Self-Concept Scale Short Form

Life Satisfactionbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

change in life satisfaction will be measured by Multidimensional Student Life Satisfaction Scale

Stressbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in stress levels will be measured by Adolescent Stress Questionnaire

Family Relationshipsbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in family relations will be measured by Family Environment Scale

Family Functioningbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in family functioning will be measured by Family Assessment Measure

Social Supportbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in social support will be measured by Social Support Behavior Scale

Perceived Social Supportbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in perceived social support will be measured by Multidimensional Scale of Perceived Social Support

Gender Attitudesbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Gender attitudes will be measured by attitudes towards women and gender norm attitudes scales

Attitude Towards Workbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Attitudes towards work will be measured by Attitudes towards youth employment scale

Savingsbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in savings will be measured by Bank statements

Future Orientationbaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in future orientation will be measured by Thinking about the future measure

Self-esteembaseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)

Change in self-concept will be measured by Rosenberg self-esteem measure

Trial Locations

Locations (1)

University of Ghana

🇬🇭

Accra, Ghana

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