Author:
Ssewamala Fred M.,Sauceda John A.,Brathwaite Rachel,Neilands Torsten B.,Nabunya Proscovia,Brown Derek,Sensoy Bahar Ozge,Namuwonge Flavia,Nakasujja Noeline,Mugarura Allan,Mwebembezi Abel,Nartey Portia,Mukasa Barbara,Gwadz Marya
Abstract
AbstractBackgroundSuubi is an evidenced based multi-component intervention that targets psychosocial and economic hardships to improve ART adherence, viral suppression, mental health, family financial stability, and family cohesion for adolescents living with HIV (ALHIV) in Uganda. Suubi was originally tested as a combined package of four components: 1) Financial Literacy Training; 2) incentivized matched Youth Savings Accounts with income-generating activities; 3) a manualized and visual-based intervention for ART adherence and stigma reduction; and 4) engagement with HIV treatment-experienced role models. However, it is unknown if each component in Suubi had a positive effect, how the components interacted, or if fewer components could have produced equivalent effects. Hence, the overall goal of this new study is to identify the most impactful and sustainable economic and psychosocial components across 48 health clinics in Uganda.MethodsA total of 576 ALHIV (aged 11–17 years at enrollment) will be recruited from 48 clinics and each clinic will be randomized to one of 16 study conditions. Each condition represents every possible combination of the 4 components noted above. Assessments will be conducted at baseline, 12, 24, 36 and 48- months post-intervention initiation. Using the multi-phase optimization strategy (MOST), we will identify the optimal combination of components and associated costs for viral suppression, as well as test key mediators and moderators of the component-viral suppression relationship.DiscussionThe study is a shift in the paradigm of research to use new thinking to build/un-pack highly efficacious interventions that lead to new scientific knowledge in terms of understanding what drives an intervention’s success and how to iterate on them in ways that are more efficient, affordable and scalable. The study advances intervention science for HIV care outcomes globally.Trial RegistrationThis project was registered at clinicaltrials.gov (NCT05600621) on October, 31, 2022.https://clinicaltrials.gov/ct2/show/NCT05600621
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference150 articles.
1. Sherraden M. Assets and the poor: A new American welfare policy. New York: ME Sharpe; 1991. p. 344.
2. Ssewamala FM, et al. A Novel Economic Intervention to Reduce HIV Risks Among School-Going AIDS Orphans in Rural Uganda. J Adolesc Health. 2008;42(1):102–4.
3. Shobe M, Page-Adams D. "Assets, Future Orientation, and Well-Being: Exploring and Extending Sherraden's Framework". J Sociol Soc Welf. 2001;28(3):7. Available at: https://scholarworks.wmich.edu/jssw/vol28/iss3/7.
4. Yadama GN, Sherraden M. Effects of assets on attitudes and behaviors: Advance test of a social policy proposal. Social Work Research. 1996;20(1):3–11.
5. McKay MM, et al. The Development and Implementation of Theory-Driven Programs Capable of Addressing Poverty-Impacted Children’s Health, Mental Health, and Prevention Needs: CHAMP and CHAMP+, Evidence-Informed, Family-Based Interventions to Address HIV Risk and Care. J Clin Child Adolesc Psychol. 2014;43(3):428–41.