Purpose
A community-based economic empowerment and family strengthening intervention (Suubi4Her) has shown positive effects in decreasing depressive symptoms and hopelessness among adolescent girls. However, the specific mechanisms underlying these positive outcomes were unclear. We examined the intervention effects of Suubi4Her on key mediators (including family cohesion, social support, and confidence in saving) and their subsequent influence on two critical psychological outcomes—depressive symptoms and hopelessness—over 24 months.
Methods
We analyzed data from 1,260 Ugandan adolescent girls and employed the Mitchell and Maxwell's cross-lagged auto-regressive approach for mediation assessment. This involved regressing outcome scores at each wave against intervention group assignment and scores from the previous wave. Correlations between residuals for mediators and outcomes at each wave as well as regression pathways from each covariate to the mediators and outcomes at subsequent waves were included in the model as random variables.
Results
The intervention significantly reduced depressive symptoms and hopelessness indirectly. Crucially, family cohesion and social support, but not confidence in saving at 12 months, were identified as significant mediators. Depressive symptoms and hopelessness at 12-month follow-up mediated the intervention's effect on depressive symptoms and hopelessness at 24 months. Additionally, a significant direct effect of the intervention on these outcomes suggested partial mediation.
Discussion
Our findings endorse community-based family group interventions as effective in enhancing mental health among adolescent girls, emphasizing the importance of strong family relationships and social support networks.
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