Title: The influence of cash transfer programme on mental health and school performance among young people exposed to violence in Brazil
Funder: The Academy of Medical Sciences

Abstract: Introduction: Mental health problems-MHP are a leading cause of disability in children/adolescents worldwide and are linked to poverty and violence, leading to restrictions in income, educational achievement and access to the labour market in a vicious cycle with long-lasting effects. Effective interventions during childhood/adolescence can reduce the impact of poverty and/or prevent MHP, increasing future life-chances. Objective: to examine the impact of a Bolsa Família Cash Transfers Program-BFCTP on mental health and school performance among children/adolescents from a deprived city in Brazil, considering their exposure to violence and stressful life events. Method: secondary data from a cohort study with two waves of data collection (mean interval: 12.9 months), comprising a probabilistic community‐based sample of young people (6-15 years-old) from Itaboraí, Rio de Janeiro-Brazil (N = 1,189). Measurements: In the original study, mothers answered questionnaires to assess the children/adolescents’: 1. age, sex; 2. MHP (total scale with impact supplement of Strength and Difficulties Questionnaire), self-harm/suicidal ideation and/or suicide attempts (two items - Child Behavior Checklist); 3. Exposure to violence at home (WorldSAFE questionnaire), at school (threat/maltreatment/being chase by peers), in the community (Survey of Exposure to Community Violence), and stressful life events (UCLA Posttraumatic Stress Disorder Reaction Index); 4. Adverse educational outcomes: dropout/school failure. Familial exposure to BFCTP, maternal education, maternal mental health (Self-Report questionnaire) were collected. Outcomes: children/adolescent’s MHP; self-harm/suicidality and adverse educational outcomes (at follow-up). Children/adolescent’s mental health profile at baseline, as a control variable. Predictor: familial exposure to BFCTP for at least 12 months. Mediators: children/adolescents’ exposure to violence (home/school/community), stressful life events. Covariates: children/adolescents’ age, sex; maternal schooling and mental health. Statistical models: (1) bivariate analyses to investigate the relationship between the three outcomes, and children/adolescents’ age, sex, exposure to BFCTP (predictor), and all mediators/covariates. (2) collinearity tests among the three types of violence and stressful life events to check for independence. (3) three multivariate logistic regressions adding the predictors, four predictors, four co-variates, and children/adolescent’s mental health profile at baseline (control variable). (4) to explore the potential role of exposure to violence/stressful life events as mediators between exposure to BFCTP at baseline and mental health at follow-up. (5) interactions between the BFCTP and all co-variates will be tested.

Lay abstract: Mental health problems-MHP are leading causes of disability in children/adolescents worldwide, and are linked to poverty and violence, leading to restrictions in income and educational achievement in a vicious cycle with long-lasting effects. On the other hand, antipoverty programs could help reduce the impact of poverty, thus increasing future life chances. Cash transfers are one of the most popular antipoverty programs in Low-Middle-Income countries and the Brazilian Cash Transfers Program-BCTP is one of the largest in the world. Most evaluations of antipoverty interventions and BCTP focus on socioeconomic or general well-being outcomes, but rarely examine the effects on young people’s mental health and life chances. The main objective of this project is to examine the impact of the BCTP on mental health and school performance among children/adolescents from a deprived city in Brazil, considering their exposure to violence. We will analyses data from a previous study that followed for one year 1,189 young people from a city in the metropolitan area of Rio de Janeiro in Brazil, using data from several questionnaires to asses children/adolescents’ age, sex, MHP, suicidality, adverse educational outcomes, exposure to violence at home, at school, in the community, and stressful life events. We will also control for maternal conditions (schooling and mental health). As result, we expect to confirm that young people who received benefits from the BCTP will present less MHP, less self-harm/suicide, and better school performance, controlling for social-emotional covariates and that these outcomes will be mediated by a reduction in exposure to violence.

Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH;DISPUTED AETIOLOGY AND OTHER