Community-Based Caregiver and Family Interventions to Support the Mental Health of Orphans and Vulnerable Children: Review and Future Directions.

The goal of this paper was to conduct a review of studies from 2008 to 2019 that evaluated community-based caregiver or family interventions to support the mental health of orphans and vulnerable children (OVC) in sub-Saharan Africa, across four domains: (a) study methodology, (b) cultural adaptation and community participation, (c) intervention strategies, and (d) effects on child mental health. Ten interventions were identified. Findings revealed that the majority of studies used a randomized controlled trial or quasi-experimental design, but few conducted long-term follow-up; that all programs undertook cultural adaptation of the intervention using community participatory methods, or were locally developed; that the majority of interventions targeted caregiving behavior and/or caregiver-child relationships using behavioral and cognitive-behavioral strategies, or were home visiting interventions; and that interventions had mixed effects on OVC mental health. Progress and gaps revealed by these findings are discussed, as are suggestions for possible new directions in this area of intervention science.

[1]  P. Fonagy,et al.  Learning to mentalize: A mediational approach for caregivers and therapists. , 2020, Clinical Psychology: Science and Practice.

[2]  E. Wouters,et al.  Household-focused interventions to enhance the treatment and management of HIV in low- and middle-income countries: a scoping review , 2019, BMC Public Health.

[3]  R. Kassanjee,et al.  Parenting for Lifelong Health for Young Children: a randomized controlled trial of a parenting program in South Africa to prevent harsh parenting and child conduct problems , 2019, Journal of child psychology and psychiatry, and allied disciplines.

[4]  P. Sharps,et al.  Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review , 2018, AIDS and Behavior.

[5]  T. Thurman,et al.  Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa. , 2018, Evaluation and program planning.

[6]  T. Thurman,et al.  Can family-centered programing mitigate HIV risk factors among orphaned and vulnerable adolescents? Results from a pilot study in South Africa , 2018, AIDS care.

[7]  F. Gardner,et al.  Process Evaluation of a Parenting Program for Low-Income Families in South Africa , 2018 .

[8]  F. Gardner,et al.  Randomized controlled trial of a parenting program to reduce the risk of child maltreatment in South Africa. , 2017, Child abuse & neglect.

[9]  T. Mendelson,et al.  Randomized controlled trial of caregiver training for HIV-infected child neurodevelopment and caregiver well being , 2017, AIDS.

[10]  R. Brennan,et al.  Family‐based promotion of mental health in children affected by HIV: a pilot randomized controlled trial , 2017, Journal of child psychology and psychiatry, and allied disciplines.

[11]  Melissa R. Arbuckle,et al.  Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective , 2017, Current Psychiatry Reports.

[12]  M. Tomlinson,et al.  Interventions to improve psychosocial well-being for children affected by HIV and AIDS: a systematic review , 2017, Vulnerable children and youth studies.

[13]  E. Puffer,et al.  A church-based intervention for families to promote mental health and prevent HIV among adolescents in rural Kenya: Results of a randomized trial. , 2016, Journal of consulting and clinical psychology.

[14]  I. S. Hensels,et al.  How Effective Is Help on the Doorstep? A Longitudinal Evaluation of Community-Based Organisation Support , 2016, PloS one.

[15]  I. S. Hensels,et al.  Community-based organizations for vulnerable children in South Africa: Reach, psychosocial correlates, and potential mechanisms , 2016 .

[16]  F. Gardner,et al.  Integrating Evidence and Context to Develop a Parenting Program for Low-Income Families in South Africa , 2016 .

[17]  M. Boivin,et al.  Orphanhood by AIDS-Related Causes and Child Mental Health: A Developmental Psychopathology Approach. , 2015, Journal of HIV and AIDS.

[18]  K. Sikkema,et al.  Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries , 2015, Global Mental Health.

[19]  S. Zuilkowski,et al.  Promoting Education for Vulnerable Children by Supporting Families: A Holistic Intervention in Uganda , 2015 .

[20]  M. Visser,et al.  ISIBINDI, creating circles of care for orphans and vulnerable children in South Africa: post-programme outcomes , 2015, AIDS care.

[21]  L. Richter,et al.  Evidence of impact: health, psychological and social effects of adult HIV on children. , 2014, AIDS.

[22]  Margaret J. Briggs-Gowan,et al.  A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa , 2014, AIDS.

[23]  T. Thurman,et al.  Does investment in home visitors lead to better psychological health for HIV-affected families? Results from a quasi-experimental evaluation in South Africa , 2014, AIDS care.

[24]  C. Sharp,et al.  Community-based mental health support for orphans and vulnerable children in South Africa: a triangulation study , 2014, Vulnerable children and youth studies.

[25]  M. Chhagan,et al.  The VUKA family program: Piloting a family-based psychosocial intervention to promote health and mental health among HIV infected early adolescents in South Africa , 2014, AIDS care.

[26]  M. Boivin,et al.  A year-long caregiver training program improves cognition in preschool Ugandan children with human immunodeficiency virus. , 2013, The Journal of pediatrics.

[27]  Michael J. Boivin,et al.  A Year-long Caregiver Training Program to Improve Neurocognition in Preschool Ugandan HIV-exposed Children , 2013, Journal of developmental and behavioral pediatrics : JDBP.

[28]  E. Puffer,et al.  Developing a Family-Based Hiv Prevention Intervention in Rural Kenya: Challenges in Conducting Community-Based Participatory Research , 2013, Journal of empirical research on human research ethics : JERHRE.

[29]  L. Wild,et al.  Risk and Resilience in Orphaned Adolescents Living in a Community Affected by AIDS , 2013 .

[30]  L. Swartz,et al.  Understanding the local context for the application of global mental health: a rural South African experience. , 2013, International health.

[31]  Ronél Ferreira,et al.  Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa. , 2012, Evaluation and program planning.

[32]  F. Ssewamala,et al.  Extended families and perceived caregiver support to AIDS orphans in Rakai district of Uganda. , 2012, Children and youth services review.

[33]  J. Mukherjee,et al.  Psychosocial support intervention for HIV-affected families in Haiti: implications for programs and policies for orphans and vulnerable children. , 2012, Social science & medicine.

[34]  F. Gardner,et al.  Persisting mental health problems among AIDS-orphaned children in South Africa. , 2012, Journal of child psychology and psychiatry, and allied disciplines.

[35]  F. Ssewamala,et al.  Family support as a mediator of change in sexual risk-taking attitudes among orphaned adolescents in rural Uganda. , 2012, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[36]  J. Shonkoff,et al.  The Lifelong Effects of Early Childhood Adversity and Toxic Stress , 2012, Pediatrics.

[37]  F. Gardner,et al.  Transactional Sex Amongst AIDS-Orphaned and AIDS-Affected Adolescents Predicted by Abuse and Extreme Poverty , 2011, Journal of acquired immune deficiency syndromes.

[38]  B. Stanton,et al.  Parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China , 2011, Psychology, health & medicine.

[39]  L. Cluver Children of the AIDS pandemic , 2011, Nature.

[40]  Michael Onyebuchi Eze Intellectual History in Contemporary South Africa , 2010 .

[41]  K. Schenk,et al.  Community interventions supporting children affected by HIV in sub-Saharan Africa: A review to derive evidence-based principles for programming 1 , 2010 .

[42]  Xiaoming Li,et al.  Family-based care and psychological problems of AIDS orphans: Does it matter who was the care-giver? , 2010, Psychology, health & medicine.

[43]  M. Hindin,et al.  The psychological effect of orphanhood in a matured HIV epidemic: an analysis of young people in Mukono, Uganda. , 2010, Social science & medicine.

[44]  Zunyou Wu,et al.  The Situation of Children Affected by HIV/AIDS in Southwest China: Schooling, Physical Health, and Interpersonal Relationships , 2010, Journal of acquired immune deficiency syndromes.

[45]  D. Operario,et al.  Parental illness, caregiving factors and psychological distress among children orphaned by acquired immune deficiency syndrome (AIDS) in South Africa , 2009 .

[46]  K. Schenk Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence , 2009, AIDS care.

[47]  V. Patel,et al.  Interventions for improving the psychosocial well-being of children affected by HIV and AIDS. , 2009, The Cochrane database of systematic reviews.

[48]  S. Seedat,et al.  Posttraumatic stress in AIDS-orphaned children exposed to high levels of trauma: the protective role of perceived social support. , 2009, Journal of traumatic stress.

[49]  Chunqing Lin,et al.  Child behaviour and parenting in HIV/AIDS-affected families in China , 2008, Vulnerable children and youth studies.

[50]  R. Gibbons,et al.  Building protective factors to offset sexually risky behaviors among black youths: a randomized control trial. , 2008, Journal of the National Medical Association.

[51]  F. Gardner,et al.  The mental health of children orphaned by AIDS: a review of international and southern African research , 2007, Journal of child and adolescent mental health.

[52]  D. Skinner,et al.  Towards a Definition of Orphaned and Vulnerable Children , 2006, AIDS and Behavior.

[53]  G. Foster Children who live in communities affected by AIDS , 2006, The Lancet.

[54]  R. Weiss,et al.  Adolescent adjustment before and after HIV-related parental death. , 2005, Journal of consulting and clinical psychology.

[55]  P. Klein,et al.  Interaction‐oriented Early Intervention in Ethiopia: The MISC Approach , 2004 .

[56]  L. Wild The Psychosocial Adjustment Of Children Orphaned By AIDS , 2001 .

[57]  P. Klein,et al.  Immediate and Sustained Effects of Maternal Mediating Behaviors on Young Children , 1993 .

[58]  Serena Wieder,et al.  A theoretical overview and empirical study of mediated learning experience: Prediction of preschool performance from mother‐infant interaction patterns , 1987 .

[59]  B. Daelmans,et al.  Care for Child Development: an intervention in support of responsive caregiving and early child development , 2018, Child: care, health and development.

[60]  M. Boivin,et al.  Effect of Caregiver Training on the Neurodevelopment of HIV-Exposed Uninfected Children and Caregiver Mental Health: A Ugandan Cluster-Randomized Controlled Trial , 2017, Journal of developmental and behavioral pediatrics : JDBP.

[61]  S. Gregson,et al.  HIV-associated orphanhood and children's psychosocial distress: theoretical framework tested with data from Zimbabwe. , 2008, American journal of public health.