An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania

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dc.contributor.advisorHarding, Richarden_ZA
dc.contributor.authorMiti, Elvis Josephen_ZA
dc.date.accessioned2016-01-29T11:02:06Z
dc.date.available2016-01-29T11:02:06Z
dc.date.issued2015en_ZA
dc.descriptionIncludes bibliographical referencesen_ZA
dc.description.abstractAim: Evidence shows high burden of psychosocial problems among orphaned children with HIV. Intervention studies have generally been conducted in developed countries. This mixed methods study aimed to determine whether Memory Work (MWT) Therapy 1 week group intervention improves outcomes for this complex population, in terms of their self-esteem, coping and psychological wellbeing compared to standard care, and to establish mechanisms of action. Method/Issue: An RCT Phase II of 48 Adolescents aged 14-18, full-orphaned AIDS on ART in Tanzania, with a waitlist control. Following (T0) baseline interviews, random allocation was for either intervention experimental condition (EC), or Control Condition (CC). All participated in second round of data collection (T1) at two weeks, and a final (T2) a month later. The EC children and caregivers participated in a focus group at T2. The CC then received the intervention 4 months later. Four questionnaires used, Brief Symptom Inventory (BSI), Rosenberg Self Esteem Scale (SES), Strengths and Difficulties Questionnaire (SDQ), and Self Efficacy Questionnaire (SEQ). Groups were compared at each time-point using multivariable linear regression controlling for baseline characteristics and group as independent variable, with change score as dependent variable. Qualitative data were subjected to thematic analysis to describe the experience of the intervention and how to refine it. Results/Comments: Significant differences favoured the EC at T1: BSI P<0.001, B=44.985, CI=25.5, 64.4), SDQ P=0.010, B=4.811, % CI 1.226, 8.396), SEQ both social scale P=0.015, B=-4.539, % CI-8.161,-0.918) and emotional scale P=0.002, B=-5.803 % CI-9.434, 2.171) (no effect for SES). At T2 we found these effects persisted: BSI P=0.001, B=46.668 %CI=21.541, 71.835), SDQ P=0.002, B=5.218 % CI 1.960, 8.476), SEQ both social scale P=<0.001, B=-7.791, % CI-11.320,-4.262) and emotional scale (P=<0.001, B=-9.007, % CI-12.032,-5.983). Additionally, at T2 found an EC effect for SES P<0.001, B=-4.392, %CI=-6.738,-2.046). The children recalled and described enjoying specific tasks within the intervention memory book, (such as "hero book" and the "tree of life") and described becoming "resilient" people. Discussion: The trial demonstrates improved outcomes in all measures for a complex population, i.e., bereaved children on treatment. Importantly, the effect did not attenuate and indeed self-esteem improved over time. The intervention should now be replicated in a fully powered trial.en_ZA
dc.identifier.apacitationMiti, E. J. (2015). <i>An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/16603en_ZA
dc.identifier.chicagocitationMiti, Elvis Joseph. <i>"An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2015. http://hdl.handle.net/11427/16603en_ZA
dc.identifier.citationMiti, E. 2015. An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Miti, Elvis Joseph AB - Aim: Evidence shows high burden of psychosocial problems among orphaned children with HIV. Intervention studies have generally been conducted in developed countries. This mixed methods study aimed to determine whether Memory Work (MWT) Therapy 1 week group intervention improves outcomes for this complex population, in terms of their self-esteem, coping and psychological wellbeing compared to standard care, and to establish mechanisms of action. Method/Issue: An RCT Phase II of 48 Adolescents aged 14-18, full-orphaned AIDS on ART in Tanzania, with a waitlist control. Following (T0) baseline interviews, random allocation was for either intervention experimental condition (EC), or Control Condition (CC). All participated in second round of data collection (T1) at two weeks, and a final (T2) a month later. The EC children and caregivers participated in a focus group at T2. The CC then received the intervention 4 months later. Four questionnaires used, Brief Symptom Inventory (BSI), Rosenberg Self Esteem Scale (SES), Strengths and Difficulties Questionnaire (SDQ), and Self Efficacy Questionnaire (SEQ). Groups were compared at each time-point using multivariable linear regression controlling for baseline characteristics and group as independent variable, with change score as dependent variable. Qualitative data were subjected to thematic analysis to describe the experience of the intervention and how to refine it. Results/Comments: Significant differences favoured the EC at T1: BSI P<0.001, B=44.985, CI=25.5, 64.4), SDQ P=0.010, B=4.811, % CI 1.226, 8.396), SEQ both social scale P=0.015, B=-4.539, % CI-8.161,-0.918) and emotional scale P=0.002, B=-5.803 % CI-9.434, 2.171) (no effect for SES). At T2 we found these effects persisted: BSI P=0.001, B=46.668 %CI=21.541, 71.835), SDQ P=0.002, B=5.218 % CI 1.960, 8.476), SEQ both social scale P=<0.001, B=-7.791, % CI-11.320,-4.262) and emotional scale (P=<0.001, B=-9.007, % CI-12.032,-5.983). Additionally, at T2 found an EC effect for SES P<0.001, B=-4.392, %CI=-6.738,-2.046). The children recalled and described enjoying specific tasks within the intervention memory book, (such as "hero book" and the "tree of life") and described becoming "resilient" people. Discussion: The trial demonstrates improved outcomes in all measures for a complex population, i.e., bereaved children on treatment. Importantly, the effect did not attenuate and indeed self-esteem improved over time. The intervention should now be replicated in a fully powered trial. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania TI - An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania UR - http://hdl.handle.net/11427/16603 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16603
dc.identifier.vancouvercitationMiti EJ. An evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzania. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16603en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPalliative Medicineen_ZA
dc.titleAn evaluation of a psychosocial intervention for orphans on HIV treatment: A phase II RCT of memory work therapy at PASADA, Tanzaniaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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