Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Zimbabwe
Condition: Mental Health Disorder; Social Isolation; Stigma, Social
MeSH terms: Mental Disorders
Study type: Interventional
Phase: Phase 2

Summary: 
      A community-based peer support intervention for adolescent mothers aged 14-18 years in
      Harare, Zimbabwe was developed and tested in partnership with adolescent mothers, community
      health workers, and key community stakeholders. The intervention leveraged peer support,
      technology via WhatsApp Messenger, community health workers, peer educators and involvement
      of key community stakeholders to reduce prevalence of loneliness, depressive symptoms and
      common mental disorders, improve perceived social support, and develop coping, parenting, and
      communication skills to mitigate potential stressors and stigma of adolescent motherhood.
    

Detailed description: 
      Adolescent mothers in Zimbabwe often experience stigma and feel isolated due to lack of
      social support with a loss of social networks and educational opportunities. Adolescent
      mothers may also lack coping skills and resources to successfully navigate motherhood. Unless
      addressed, these circumstances may have negative consequences for the mental health of the
      adolescent mother and downstream consequences for their children. A quasi-experimental design
      was used, and the research tested differential changes over base-, mid-, and end-line in
      mental health and social support outcomes among adolescent mothers (14-18 years) in the
      intervention and control arms. The study addressed two objectives:

        1. Understand and describe perceptions and experiences with adolescent motherhood and their
           influence on health.

        2. Explore the acceptability and effectiveness of a community-based peer support
           intervention for adolescent mothers in a high-density low-income community in Harare to
           mitigate potential stressors and stigma of adolescent motherhood.

      Adolescent mothers engaged as active participants in the development (e.g., defining their
      needs) and implementation of the intervention which also involved key community stakeholders
      to address stigma related to mental illness and adolescent motherhood. Existing community
      resources were leveraged such as peer support, health workers, and technology through
      WhatsApp Messenger, a popular and low-cost messaging app, to deliver some intervention
      components and as a platform for communication and training support for peer support group
      facilitators. Community health workers and peer educators in the intervention arm were
      recruited and trained on co-facilitating peer support groups. The intervention arm (n=104
      adolescent mothers) participated in the peer support groups and completed sociodemographic,
      base-, mid-, and end-line surveys. The control arm (n=79 adolescent mothers) completed
      sociodemographic, base-, mid- and end-line surveys. Peer support groups (12 groups with 6-12
      participants in each group) met in-person twice a month and completed 12 peer-group sessions
      from May-August 2019 addressing participant identified topics such as income generation,
      depression, and healthy parenting. WhatsApp Messenger was used for training and
      implementation support. Key community stakeholders met to discuss project progress and
      recommendations to improve the health of adolescent mothers. Data were analyzed using Stata
      13 software.
    

Intervention name(s): Young Women of Today
Intervention type(s): Behavioral
Intervention description(s): Adolescent mothers engaged in the development and implementation of the intervention which also involved key community stakeholders to address stigma related to mental illness and adolescent motherhood. Community health workers and peer educators in the intervention arm were recruited and trained on co-facilitating peer support groups. The intervention arm (n=104 adolescent mothers) participated in the peer support groups and completed sociodemographic, base-, mid-, and end-line surveys. The control arm (n=79 adolescent mothers) completed sociodemographic, base-, mid- and end-line surveys. Peer support groups (12 groups with 6-12 participants in each group) met in-person twice a month and completed 12 peer-group sessions from May-August 2019 addressing participant identified topics such as depression. WhatsApp Messenger was used for training and implementation support. Key community stakeholders met to discuss project progress and recommendations to improve adolescent mothers' health.
Other intervention name(s): Community-based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Harare, Zimbabwe
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: A quasi-experimental design was used, and the research tested differential changes over base-, mid-, and end-line in mental health and social support outcomes among adolescent mothers (14-18 years) in the intervention and control arms.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Adolescent Mothers; Mental Health; Social Isolation; Stigma; Zimbabwe; Peer Support; WhatsApp Messenger