Links between Household-Level Income-Generating Agricultural Intervention and the Psychological Well-Being of Adolescent Girls in Human Immunodeficiency Virus-Affected Households in Southwestern Kenya: A Qualitative Inquiry.

Autor:	Onono MA; Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya., Frongillo EA; Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States. Electronic address: efrongil@mailbox.sc.edu., Sheira LA; Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California San Francisco, CA, United States., Odhiambo G; Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya., Wekesa P; Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya., Conroy AA; Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States., Cohen CR; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, United States., Bukusi EA; Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya., Weiser SD; Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California San Francisco, CA, United States.
Jazyk:	angličtina
Zdroj:	The Journal of nutrition [J Nutr] 2023 Dec; Vol. 153 (12), pp. 3595-3603. Date of Electronic Publication: 2023 Oct 18.
DOI:	10.1016/j.tjnut.2023.10.008
Abstrakt:	Background: Adolescent girls may experience poor psychological well-being, such as social isolation, shame, anxiety, hopelessness, and despair linked to food insecurity. Objectives: This study aimed to investigate the experiences with and perceived effects of a household-level income-generating agricultural intervention on the psychological well-being of adolescent girls in human immunodeficiency virus (HIV)-affected households in southwestern Kenya. Methods: We conducted 62 in-depth interviews with HIV-affected adolescent girls and caregiver dyads in Adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in Shamba Maisha (NCT01548599), a multisectoral agricultural and finance intervention trial aimed to improve food security and HIV health indicators. Participants were purposively sampled to ensure diversity in terms of age and location. Data were audiotaped, transcribed, translated, and uploaded into Dedoose (Sociocultural Research Consultants, LLC) software for management. Data were analyzed thematically based on reports from Dedoose. Results: We found evidence that a household-level structural intervention aimed at increasing food and financial security among persons living with HIV can contribute to better psychological well-being among adolescent girls residing in these households. The intervention also affected: 1) reduction of social isolation, 2) reduction of shame and stigma, 3) increased attendance and concentration in school, 4) improved caregiver mental health, and 5) reduced parental aggression and improved household communication. These associations were reported more commonly among those in the intervention arm than the control arm. Conclusions: This study extends existing research by demonstrating how multisectoral structural interventions delivered at a household level can improve the psychological well-being of adolescents. We recommend that future research test livelihood interventions designed specifically for adolescent girls that integrate food-security interventions with other elements to address the social and psychological consequences of food insecurity holistically. This trial was registered at clinicaltrials.gov as NCT03741634. Competing Interests: Conflict of interest The authors declare that they have no competing interests (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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