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Journal article
The longitudinal impact of an evidence-based multiple family group intervention (Amaka Amasanyufu) on oppositional defiant disorder and impaired functioning among children in Uganda: analysis of a cluster randomized trial from the SMART Africa-Uganda scale-up study (2016-2022)
Journal of child psychology and psychiatry, v 63(11), pp 1252-1260
Nov 2022
PMID: 34989404
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Oppositional Defiant Disorders (ODDs) and other Disruptive Behavior Disorders (DBDs) are common among children and adolescents in poverty-impacted communities in sub-Saharan Africa. Without early intervention, its progression into adulthood can result in dire consequences. We examined the impact of a manualized family strengthening intervention called Amaka Amasanyufu designed to reduce ODDs and other DBDs among school-going children residing in low-resource communities in Uganda.
We used longitudinal data from the SMART Africa-Uganda study (2016-2022). Public primary schools were randomized to: (1) Control condition (receiving usual care comprising generalized psychosocial functioning literature), 10 schools; (2) intervention delivered via parent peers (Amaka-parents), 8 schools or; (3) intervention delivered via community healthcare workers (Amaka-community), 8 schools. All the participants were blinded. At baseline, 8- and 16-weeks postintervention initiation, caregivers completed the Iowa Conners Scale, which measured Oppositional Defiant Disorder (ODD) and Impairment Rating Scale to evaluate children's overall impairment and impaired functioning with peers, siblings, and parents; impaired academic progress, self-esteem, and family functioning. Three-level linear mixed-effects models were fitted to each outcome. Pairwise comparisons of postbaseline group means within each time point were performed using Sidak's adjustment for multiple comparisons. Only children positive for ODD and other DBDs were analyzed.
Six hundred and thirty-six children screened positive for ODDs and other DBDs (Controls: n = 243; Amaka-parents: n = 194; Amaka-community: n = 199). At 8 weeks, Amaka-parents' children had significantly lower mean scores for overall impairment compared to controls, (mean difference: -0.71, p = .001), while Amaka-community children performed better on ODD (mean difference: -0.84, p = .016). At 16 weeks, children in both groups were performing better on ODD and IRS than controls, and there were no significant differences between the two intervention groups.
The Amaka Amasanyufu intervention was efficacious in reducing ODD and impaired functioning relative to usual care. Hence, the Amaka Amasanyufu intervention delivered either by Amaka-community or Amaka-parents has the potential to reduce negative behavioral health outcomes among young people in resource-limited settings and improve family functioning.
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- Title
- The longitudinal impact of an evidence-based multiple family group intervention (Amaka Amasanyufu) on oppositional defiant disorder and impaired functioning among children in Uganda: analysis of a cluster randomized trial from the SMART Africa-Uganda scale-up study (2016-2022)
- Creators
- SMART Africa - Uganda Field Team (Collaboration)Rachel Brathwaite - Washington University in St. LouisFred M Ssewamala - Washington University in St. LouisOzge Sensoy Bahar - Washington University in St. LouisMary M McKay - Washington University in St. LouisTorsten B Neilands - University of California, San FranciscoPhionah Namatovu - Washington University in St. LouisJoshua Kiyingi - Washington University in St. LouisLily Zmachinski - Washington University in St. LouisJosephine Nabayinda - Washington University in St. LouisKeng-Yen Huang - New York University School of MedicineApollo Kivumbi - Reach the Youth-Uganda, Kampala, UgandaArvin Bhana - South African Medical Research CouncilAbel Mwebembezi - Reach the Youth-Uganda, Kampala, UgandaInge Petersen - University of KwaZulu-NatalKimberly Hoagwood - New York University
- Publication Details
- Journal of child psychology and psychiatry, v 63(11), pp 1252-1260
- Number of pages
- 9
- Grant note
- R25 MH118935 / NIMH NIH HHS U19 MH110001 / NIMH NIH HHS D43 TW011541 / FIC NIH HHS R25 MH067127 / NIMH NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; A.J. Drexel Autism Institute
- Web of Science ID
- WOS:000739411100001
- Scopus ID
- 2-s2.0-85122426574
- Other Identifier
- 991022065134204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Psychiatry
- Psychology
- Psychology, Developmental