title: A quasi-experimental evaluation of a community-based art therapy intervention exploring the psychosocial health of children affected by HIV in South Africa.
abstract: OBJECTIVE
  To evaluate the efficacy of the Make A Difference about Art programme, a community art programme in South Africa for children affected by HIV and AIDS, which aims to reduce psychosocial problems by increasing self-esteem, self-efficacy and HIV insight.
  
  
  METHODS
  A quasi-experimental cross-sectional post-intervention survey of 297 children aged 8-18 years (177 programme attendees and a control group of 120). Participants completed an inventory comprising standardized, validated psychosocial measures of depression, emotional and behavioural problems, self-esteem and self-efficacy and key sociodemographic variables potentially relevant as risk and protective factors.
  
  
  RESULTS
  Attending the intervention was predictive of significantly higher self-efficacy, but was not associated with differences in self-esteem, depression, or emotional/behavioural problems. This association remained in the multivariate analysis, controlling for potential confounders. Double parental death exerted a powerful effect on child psychosocial health, eliminating the association between intervention attendance and higher self-efficacy. However, an interaction was found between bereavement status and intervention attendance on child self-efficacy, indicating that the intervention programme may ameliorate some of the psychosocial vulnerabilities associated with becoming an orphan. Other key risk factors for poor psychosocial health in this sample were AIDS-related stigma and community and household violence. Social connection emerged as a key protective factor.
  
  
  CONCLUSIONS
  Our findings suggest that such interventions may offer opportunities to increase the self-efficacy of vulnerable children to protect their psychological health.
authors.affiliation: Research Department of Infection and Population Health, University College London, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Mueller
authors.forename: Collin
authors.initials: C
authors.lastname: Alie
authors.forename: Beatrice
authors.initials: B
authors.lastname: Jonas
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brown
authors.forename: Lorraine
authors.initials: L
authors.lastname: Sherr
mesh_terms: D000293:Adolescent; D001155:Art Therapy / Q000458:organization & administration*; D001601:Bereavement; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000517:prevention & control; D003153:Community Health Services / Q000458:organization & administration*; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D015397:Program Evaluation; D012649:Self Concept; D013019:South Africa