Clinical trial NCT05213182: Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Zimbabwe
Official title: Community-Based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Harare, Zimbabwe
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Mental Health Disorder
Social Isolation
Stigma, Social
Keywords: Adolescent Mothers
Mental Health
Social Isolation
Stigma
Zimbabwe
Peer Support
WhatsApp Messenger
Lead sponsor: West Chester University of Pennsylvania
Sponsor class: OTHER
Collaborators: name: Bill and Melinda Gates Foundation
name: University of South Carolina
name: Organization for Public Health Interventions and Development
name: University of Zimbabwe
name: SpeakUp! Pennsylvania
First posted: 2022-01-28
Enrollment: 183
Sex: FEMALE
Minimum age (years): 14
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
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.
Primary purpose: PREVENTION

Brief 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.

Eligibility criteria: Inclusion Criteria:

* Adolescent mothers (pregnant and/or have a child or children) aged 14-18 years living in the intervention or control communities.

Exclusion Criteria:

* Individuals who are not adolescent mothers aged 14-18 years and who do not live in the intervention or control communities.
* individuals with an acute or severe illness or disability (e.g. psychosis) that results in a functional impairment that substantially interferes with the ability to provide informed consent and participate in the study.

Primary outcomes:
measure: Depressive Symptoms and Suicidal Ideation
timeFrame: 6 months
measure: Perceived Social Support
timeFrame: 6 months
Secondary outcomes:
measure: Common Mental Disorders
timeFrame: 6 months
measure: Peer and Significant Adult Support
timeFrame: 6 months
Other outcomes:
Locations:
city: West Chester
country: United States
facility: West Chester University of Pennsylvania
state: Pennsylvania
Study officials:
affiliation: West Chester University of Pennsylvania
name: Chiwoneso Tinago, PhD
role: PRINCIPAL_INVESTIGATOR
References: