Do Savings Mediate Changes in Adolescents' Future Orientation and Health-Related Outcomes? Findings From Randomized Experiment in Uganda.
OBJECTIVE
This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset accumulation (in this case, by increasing family savings).


METHODS
Using longitudinal data from the cluster-randomized experiment, we ran generalized estimating equation models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents' future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping-to address the assumption of normal distribution.


RESULTS
Results indicate that participation in a matched Child Savings Account (CSA) program improved adolescents' future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents' confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched CSA program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings.


CONCLUSIONS
Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched CSAs, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how?
Silver School of Social Work, McSilver Institute for Poverty Policy and Research, New York, New York. Electronic address: lk1706@nyu.edu.
Leyla
L
Karimli
Columbia University School of Social Work, International Center for Child Health and Asset Development, New York, New York.
Fred M
FM
Ssewamala
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics* / Q000628:therapy*; D000293:Adolescent; D000294:Adolescent Behavior; D000067697:Adolescent Health / Q000191:economics* / Q000639:trends; D054540:Child, Orphaned / Q000193:education* / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D011203:Poverty / Q000191:economics; D011379:Prognosis; D012959:Socioeconomic Factors; D014454:Uganda
AIDS orphans; Adolescents; Child savings accounts; Economic empowerment; Future orientation; Generalized estimating equation model; Mediation analysis; Randomized controlled trials; Sub-Saharan Africa; Uganda