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30-01-2024 | Original Paper

Psychosocial Health Outcomes of Children Following Family Reunification: Longitudinal Analysis of Randomised Controlled Trial Data

Auteurs: Eddy J. Walakira, Helen P. M. Natukunda, Jaffer Byawaka, Francis Kato, Nanmathi Manian, Lucie Cluver, Lorraine Sherr, Karen Megazzini, Lindsey Lange, Daniel Oliver

Gepubliceerd in: Journal of Child and Family Studies | Uitgave 3/2024

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Abstract

This longitudinal study examined the psychosocial health trajectories of children following reunification from residential care and the associated contextual factors. Data were drawn from a randomised controlled trial evaluating the effects of a parenting programme on the successful reunification and reintegration of 1–13-year-old children with their families, in nine districts in Uganda. Families were randomised to receive either a basic reintegration package consisting of a reunification grant and case management (standard intervention) or an enhanced package consisting of the basic package plus 13 bi-weekly training sessions of a parenting programme (enhanced intervention). Data were collected from caregivers at home and the residential care facilities, as well as the children (n = 55 dyadic pairs) through prospective interviews at baseline (before reunification), and at 6- and 12-months post-reunification. Predictive growth curve analyses assessed longitudinal changes in child psychosocial problems (externalizing, internalizing, total behavioural problems) and associated contextual factors. In age, sex, and study arm stratified analyses, we found declining linear trajectories in children’s psychosocial problem scores at 6 and 12 months post-reunification. Taking covariates into account, persistent externalizing, internalizing, and total behavioural problems at endline were associated with children’s depressive symptoms, caregiver characteristics and quality of caregiving. Our findings suggest that children who are reunified from residential to family-based care have fewer psychosocial problems post-reunification compared to their time in residential care. These findings did not differ by age and sex of the child or type of reintegration package received. Although findings from our small single study have limited generalizability and should be interpreted with caution for policy and programming, they underscore the potential benefits of reunification programmes for children’s psychosocial well-being.
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Literatuur
go back to reference Akister, J., Owens, M., & Goodyer, I. M. (2010). Leaving care and mental health: Outcomes for children in out-of-home care during the transition to adulthood. In Health Research Policy and Systems (Vol. 8, Issue 1, p. 10). BioMed Central. https://doi.org/10.1186/1478-4505-8-10. Akister, J., Owens, M., & Goodyer, I. M. (2010). Leaving care and mental health: Outcomes for children in out-of-home care during the transition to adulthood. In Health Research Policy and Systems (Vol. 8, Issue 1, p. 10). BioMed Central. https://​doi.​org/​10.​1186/​1478-4505-8-10.
go back to reference Bangirana, P., Nakasujja, N., Giordani, B., Opoka, R. O., John, C. C. & & Boivin, M. J. (2009). Reliability of the Luganda version of the Child Behaviour Checklist in measuring behavioural problems after cerebral malaria. Child and Adolescent Psychiatry and Mental Health, 3(1), 1–7. https://doi.org/10.1186/1753-2000-3-38.CrossRef Bangirana, P., Nakasujja, N., Giordani, B., Opoka, R. O., John, C. C. & & Boivin, M. J. (2009). Reliability of the Luganda version of the Child Behaviour Checklist in measuring behavioural problems after cerebral malaria. Child and Adolescent Psychiatry and Mental Health, 3(1), 1–7. https://​doi.​org/​10.​1186/​1753-2000-3-38.CrossRef
go back to reference Brensilver, M., Negriff, S., Mennen, F. E. & Trickett, P. K. (2017). Longitudinal relations between depressive symptoms and externalizing behavior in adolescence: moderating effects of maltreatment experience and gender. The Journal of Clinical Child & Adolescent Psychology, 40(4), 607–617. https://doi.org/10.1080/15374416.2011.581618.CrossRef Brensilver, M., Negriff, S., Mennen, F. E. & Trickett, P. K. (2017). Longitudinal relations between depressive symptoms and externalizing behavior in adolescence: moderating effects of maltreatment experience and gender. The Journal of Clinical Child & Adolescent Psychology, 40(4), 607–617. https://​doi.​org/​10.​1080/​15374416.​2011.​581618.CrossRef
go back to reference Carter, R. (2005). Family Matters: A Study of institutional Childcare in Central and Eastern Europe and the Former Soviet Union. www.wave.coop. Carter, R. (2005). Family Matters: A Study of institutional Childcare in Central and Eastern Europe and the Former Soviet Union. www.​wave.​coop.
go back to reference Cluver, L., Boyes, M., Orkin, M., Pantelic, M., Molwena, T., Sherr, L., UNAIDS, Seeley, J., Watts, C., Kippax, S., Russell, S., Heise, L., Whiteside, A., Temin, M., Karim, Q., Pettifor, A., MacPhail, C., Nguyen, N., & Rosenberg, M., et al. (2013a). Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study. The Lancet Global Health, 1(6), e362–e370. https://doi.org/10.1016/S2214-109X(13)70115-3.CrossRefPubMed Cluver, L., Boyes, M., Orkin, M., Pantelic, M., Molwena, T., Sherr, L., UNAIDS, Seeley, J., Watts, C., Kippax, S., Russell, S., Heise, L., Whiteside, A., Temin, M., Karim, Q., Pettifor, A., MacPhail, C., Nguyen, N., & Rosenberg, M., et al. (2013a). Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study. The Lancet Global Health, 1(6), e362–e370. https://​doi.​org/​10.​1016/​S2214-109X(13)70115-3.CrossRefPubMed
go back to reference Cluver, L., Boyes, M., Orkin, M., & Sherr, L. (2013b). Poverty, AIDS and child health: Identifying highest-risk children in South Africa. South African Medical Journal, 103(12), 910–915.CrossRefPubMed Cluver, L., Boyes, M., Orkin, M., & Sherr, L. (2013b). Poverty, AIDS and child health: Identifying highest-risk children in South Africa. South African Medical Journal, 103(12), 910–915.CrossRefPubMed
go back to reference Cluver, L., Meinck, F., Yakubovich, A., Doubt, J., Redfern, A., Ward, C., Salah, N., Stone, S. de, Petersen, T., Mpimpilashe, P., Romero, R. H., Ncobo, L., Lachman, J., Tsoanyane, S., Shenderovich, Y., Loening, H., Byrne, J., Sherr, L., Kaplan, L., & Gardner, F. (2016). Reducing child abuse amongst adolescents in low- and middle-income countries: A pre-post trial in South Africa. BMC Public Health, 16(1). https://doi.org/10.1186/S12889-016-3262-Z. Cluver, L., Meinck, F., Yakubovich, A., Doubt, J., Redfern, A., Ward, C., Salah, N., Stone, S. de, Petersen, T., Mpimpilashe, P., Romero, R. H., Ncobo, L., Lachman, J., Tsoanyane, S., Shenderovich, Y., Loening, H., Byrne, J., Sherr, L., Kaplan, L., & Gardner, F. (2016). Reducing child abuse amongst adolescents in low- and middle-income countries: A pre-post trial in South Africa. BMC Public Health, 16(1). https://​doi.​org/​10.​1186/​S12889-016-3262-Z.
go back to reference Ddumba-Nyanzi, I., & Li, M. (2018). Assessing Alternative Care for Children in Uganda. Ddumba-Nyanzi, I., & Li, M. (2018). Assessing Alternative Care for Children in Uganda.
go back to reference Furberg, C. D., & Friedman, L. M. (2012). Approaches to data analyses of clinical trials. Progress in Cardiovascular Diseases, 54(4), 330–334.CrossRefPubMed Furberg, C. D., & Friedman, L. M. (2012). Approaches to data analyses of clinical trials. Progress in Cardiovascular Diseases, 54(4), 330–334.CrossRefPubMed
go back to reference Kovacs, M. (1992). Children’s Depression Inventory. In Niagara Falls, NY: Multi-Health Systems. Kovacs, M. (1992). Children’s Depression Inventory. In Niagara Falls, NY: Multi-Health Systems.
go back to reference Lansford, J. E., Godwin, J., Bornstein, M. H., Chang, L., Deater-Deckard, K., Giunta, L., di, Dodge, K. A., Malone, P. S., Oburu, P., Pastorelli, C., Skinner, A. T., Sorbring, E., Steinberg, L., & Tapanya, S. (2018). Parenting, culture, and the development of externalizing behaviors from age seven to 14 in nine countries HHS Public Access. Dev Psychopathol, 30(5), 1937–1958. https://doi.org/10.1017/S0954579418000925.CrossRefPubMedPubMedCentral Lansford, J. E., Godwin, J., Bornstein, M. H., Chang, L., Deater-Deckard, K., Giunta, L., di, Dodge, K. A., Malone, P. S., Oburu, P., Pastorelli, C., Skinner, A. T., Sorbring, E., Steinberg, L., & Tapanya, S. (2018). Parenting, culture, and the development of externalizing behaviors from age seven to 14 in nine countries HHS Public Access. Dev Psychopathol, 30(5), 1937–1958. https://​doi.​org/​10.​1017/​S095457941800092​5.CrossRefPubMedPubMedCentral
go back to reference Loening-Voysey, H., Doubt, J., Nzima, D., Shenderovich, Y., Steinert, J., Byrne, J., & Cluver, L. (2018). Relevance, Implementation and Impact of the Sinovuyo Teen Parenting Programme in South Africa Relevance, Implementation and Impact of the Sinovuyo Teen Parenting Programme in South Africa Summary of findings. Loening-Voysey, H., Doubt, J., Nzima, D., Shenderovich, Y., Steinert, J., Byrne, J., & Cluver, L. (2018). Relevance, Implementation and Impact of the Sinovuyo Teen Parenting Programme in South Africa Relevance, Implementation and Impact of the Sinovuyo Teen Parenting Programme in South Africa Summary of findings.
go back to reference Mackes, N. K., Golm, D., Sarkar, S., Kumsta, R., Rutter, M., Fairchild, G., Mehta, M. A., & Sonuga-Barke, E. J. S. (2020). Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment. Proceedings of the National Academy of Sciences of the United States of America, 117(1), 641–649. https://doi.org/10.1073/pnas.1911264116.CrossRefPubMedPubMedCentral Mackes, N. K., Golm, D., Sarkar, S., Kumsta, R., Rutter, M., Fairchild, G., Mehta, M. A., & Sonuga-Barke, E. J. S. (2020). Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment. Proceedings of the National Academy of Sciences of the United States of America, 117(1), 641–649. https://​doi.​org/​10.​1073/​pnas.​1911264116.CrossRefPubMedPubMedCentral
go back to reference Meinck, F., Boyes, M. E., Cluver, L., Ward, C. L., Schmidt, P., DeStone, S., & Dunne, M. P. (2018). Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers. Child Abuse & Neglect, 82, 45–58. https://doi.org/10.1016/J.CHIABU.2018.05.022.CrossRef Meinck, F., Boyes, M. E., Cluver, L., Ward, C. L., Schmidt, P., DeStone, S., & Dunne, M. P. (2018). Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers. Child Abuse & Neglect, 82, 45–58. https://​doi.​org/​10.​1016/​J.​CHIABU.​2018.​05.​022.CrossRef
go back to reference Mutumba, M., Bauermeister, J. A., Elkington, K. S., Bucek, A., Dolezal, C., Leu, C.-S., & Mellins, C. A. (2016). A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 58(4), 460–466. https://doi.org/10.1016/j.jadohealth.2015.12.014.CrossRefPubMed Mutumba, M., Bauermeister, J. A., Elkington, K. S., Bucek, A., Dolezal, C., Leu, C.-S., & Mellins, C. A. (2016). A Prospective Longitudinal Study of Mental Health Symptoms Among Perinatally HIV-Infected and HIV-Exposed but Uninfected Urban Youths. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 58(4), 460–466. https://​doi.​org/​10.​1016/​j.​jadohealth.​2015.​12.​014.CrossRefPubMed
go back to reference Natukunda, H. P. M., Mubiri, P., Cluver, L. D., Ddumba-Nyanzi, I., Bukenya, B., & Walakira, E. J. (2019). Which factors are associated with adolescent reports of experiencing various forms of abuse at the family level in post-conflict Northern Uganda? Journal of Interpersonal Violence. https://doi.org/10.1177/0886260519888526. Natukunda, H. P. M., Mubiri, P., Cluver, L. D., Ddumba-Nyanzi, I., Bukenya, B., & Walakira, E. J. (2019). Which factors are associated with adolescent reports of experiencing various forms of abuse at the family level in post-conflict Northern Uganda? Journal of Interpersonal Violence. https://​doi.​org/​10.​1177/​0886260519888526​.
go back to reference Politi, D. (2012). Education and clinical assessment consultant Children’s Depres- sion Inventory 2nd Edition (CDI-2): introduction and application (Multi-Health Systems (MHS) (Second). Politi, D. (2012). Education and clinical assessment consultant Children’s Depres- sion Inventory 2nd Edition (CDI-2): introduction and application (Multi-Health Systems (MHS) (Second).
go back to reference Sonuga-Barke, E. J. S., Kennedy, M., Kumsta, R., Knights, N., Golm, D., Rutter, M., Maughan, B., Schlotz, W., & Kreppner, J. (2017). Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study. The Lancet, 389, 1539–1548. https://doi.org/10.1016/S0140-6736(17)30045-4.CrossRef Sonuga-Barke, E. J. S., Kennedy, M., Kumsta, R., Knights, N., Golm, D., Rutter, M., Maughan, B., Schlotz, W., & Kreppner, J. (2017). Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study. The Lancet, 389, 1539–1548. https://​doi.​org/​10.​1016/​S0140-6736(17)30045-4.CrossRef
go back to reference Thylstrup, B., Schrøder, S., Fridell, M. & Hesse, M. (2017). Did you get any help? A post-hoc secondary analysis of a randomized controlled trial of psychoeducation for patients with antisocial personality disorder in outpatient substance abuse treatment programs. BMC Psychiatry, 17(1), 1–10. https://doi.org/10.1186/S12888-016-1165-2. Thylstrup, B., Schrøder, S., Fridell, M. & Hesse, M. (2017). Did you get any help? A post-hoc secondary analysis of a randomized controlled trial of psychoeducation for patients with antisocial personality disorder in outpatient substance abuse treatment programs. BMC Psychiatry, 17(1), 1–10. https://​doi.​org/​10.​1186/​S12888-016-1165-2.
go back to reference van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., Duschinsky, R., Fox, N. A., Goldman, P. S., Gunnar, M. R., Johnson, D. E., Nelson, C. A., Reijman, S., Skinner, G. C. M., Zeanah, C. H., & Sonuga-Barke, E. J. S. (2020). Institutionalisation and deinstitutionalisation of children: a systematic and integrative review of evidence regarding effects on development. The Lancet Psychiatry, 7(8), 703–720. https://doi.org/10.1016/S2215-0366(19)30399-2.CrossRefPubMed van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., Duschinsky, R., Fox, N. A., Goldman, P. S., Gunnar, M. R., Johnson, D. E., Nelson, C. A., Reijman, S., Skinner, G. C. M., Zeanah, C. H., & Sonuga-Barke, E. J. S. (2020). Institutionalisation and deinstitutionalisation of children: a systematic and integrative review of evidence regarding effects on development. The Lancet Psychiatry, 7(8), 703–720. https://​doi.​org/​10.​1016/​S2215-0366(19)30399-2.CrossRefPubMed
go back to reference Walakira, E. J., Ddumba-Nyanzi, I., & Bukenya, B. (2015). Child Care Institutions in Selected Districts in Uganda and the Situation of Children in Child Care Institutions in Selected Districts in Uganda and the Situation of Children in Care: A Baseline Survey Report for the Strong Beginnings Project. Walakira, E. J., Ddumba-Nyanzi, I., & Bukenya, B. (2015). Child Care Institutions in Selected Districts in Uganda and the Situation of Children in Child Care Institutions in Selected Districts in Uganda and the Situation of Children in Care: A Baseline Survey Report for the Strong Beginnings Project.
go back to reference Whetten, K., Ostermann, J., Whetten, R. A., Pence, B. W., O’Donnell, K., Messer, L. C., & Thielman, N. M. (2009). A comparison of the wellbeing of orphans and abandoned children ages 6-12 in institutional and community-based care settings in 5 less wealthy nations. PLoS ONE, 4(12). https://doi.org/10.1371/journal.pone.0008169. Whetten, K., Ostermann, J., Whetten, R. A., Pence, B. W., O’Donnell, K., Messer, L. C., & Thielman, N. M. (2009). A comparison of the wellbeing of orphans and abandoned children ages 6-12 in institutional and community-based care settings in 5 less wealthy nations. PLoS ONE, 4(12). https://​doi.​org/​10.​1371/​journal.​pone.​0008169.
go back to reference Zeanah, C. H., Egger, H. L., Smyke, A. T., Nelson, C. A., Fox, N. A., Marshall, P. J., & Guthrie, D. (2009). Institutional Rearing and Psychiatric Disorders in Romanian Preschool Children. In American Journal of Psychiatry (Vol. 166). Zeanah, C. H., Egger, H. L., Smyke, A. T., Nelson, C. A., Fox, N. A., Marshall, P. J., & Guthrie, D. (2009). Institutional Rearing and Psychiatric Disorders in Romanian Preschool Children. In American Journal of Psychiatry (Vol. 166).
go back to reference Zolotor, A. J., Runyan, D. K., Dunne, M. P., Jain, D., Péturs, H. R., Ramirez, C., Volkova, E., Deb, S., Lidchi, V., Muhammad, T., & Isaeva, O. (2009). ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-C): Instrument development and multi-national pilot testing. Child Abuse & Neglect, 33(11), 833–841. https://doi.org/10.1016/j.chiabu.2009.09.004.CrossRef Zolotor, A. J., Runyan, D. K., Dunne, M. P., Jain, D., Péturs, H. R., Ramirez, C., Volkova, E., Deb, S., Lidchi, V., Muhammad, T., & Isaeva, O. (2009). ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-C): Instrument development and multi-national pilot testing. Child Abuse & Neglect, 33(11), 833–841. https://​doi.​org/​10.​1016/​j.​chiabu.​2009.​09.​004.CrossRef
Metagegevens
Titel
Psychosocial Health Outcomes of Children Following Family Reunification: Longitudinal Analysis of Randomised Controlled Trial Data
Auteurs
Eddy J. Walakira
Helen P. M. Natukunda
Jaffer Byawaka
Francis Kato
Nanmathi Manian
Lucie Cluver
Lorraine Sherr
Karen Megazzini
Lindsey Lange
Daniel Oliver
Publicatiedatum
30-01-2024
Uitgeverij
Springer US
Gepubliceerd in
Journal of Child and Family Studies / Uitgave 3/2024
Print ISSN: 1062-1024
Elektronisch ISSN: 1573-2843
DOI
https://doi.org/10.1007/s10826-023-02773-z

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