title: How Effective Is Help on the Doorstep? A Longitudinal Evaluation of Community-Based Organisation Support.
abstract: Community-based responses have a lengthy history. The ravages of HIV on family functioning has included a widespread community response. Although much funding has been invested in front line community-based organisations (CBO), there was no equal investment in evaluations. This study was set up to compare children aged 9-13 years old, randomly sampled from two South African provinces, who had not received CBO support over time (YC) with a group of similarly aged children who were CBO attenders (CCC). YC baseline refusal rate was 2.5% and retention rate was 97%. CCC baseline refusal rate was 0.7% and retention rate was 86.5%. 1848 children were included-446 CBO attenders compared to 1402 9-13 year olds drawn from a random sample of high-HIV prevalence areas. Data were gathered at baseline and 12-15 months follow-up. Standardised measures recorded demographics, violence and abuse, mental health, social and educational factors. Multivariate regression analyses revealed that children attending CBOs had lower odds of experiencing weekly domestic conflict between adults in their home (OR 0.17; 95% CI 0.09, 0.32), domestic violence (OR 0.22; 95% CI 0.08, 0.62), or abuse (OR 0.11; 95% CI 0.05, 0.25) at follow-up compared to participants without CBO contact. CBO attenders had lower odds of suicidal ideation (OR 0.41; 95% CI 0.18, 0.91), fewer depressive symptoms (B = -0.40; 95% CI -0.62, -0.17), less perceived stigma (B = -0.37; 95% CI -0.57, -0.18), fewer peer problems (B = -1.08; 95% CI -1.29, -0.86) and fewer conduct problems (B = -0.77; 95% CI -0.95, -0.60) at follow-up. In addition, CBO contact was associated with more prosocial behaviours at follow-up (B = 1.40; 95% CI 1.13, 1.67). No associations were observed between CBO contact and parental praise or post-traumatic symptoms. These results suggest that CBO exposure is associated with behavioural and mental health benefits for children over time. More severe psychopathology was not affected by attendance and may need more specialised input.
authors.affiliation: Department of Infection & Population Health, University College London, London, United Kingdom.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Sherr
authors.affiliation: Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, Oxford, United Kingdom.
authors.forename: Alexa R
authors.initials: AR
authors.lastname: Yakubovich
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.|Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Sarah
authors.initials: S
authors.lastname: Skeen
authors.affiliation: Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, Oxford, United Kingdom.|Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Lucie D
authors.initials: LD
authors.lastname: Cluver
authors.affiliation: Department of Infection & Population Health, University College London, London, United Kingdom.
authors.forename: Imca S
authors.initials: IS
authors.lastname: Hensels
authors.affiliation: Department of Infection & Population Health, University College London, London, United Kingdom.
authors.forename: Ana
authors.initials: A
authors.lastname: Macedo
authors.affiliation: Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology; D003710:Demography; D017579:Domestic Violence / Q000706:statistics & numerical data; D054541:Family Conflict; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D016017:Odds Ratio; D000066550:Physical Abuse / Q000706:statistics & numerical data; D012944:Social Support; D000068217:Social Workers; D059020:Suicidal Ideation