Trial Outcomes & Findings for Intervention to Improve Developmental and Health Outcomes for Female Adolescents (NCT NCT04231669)
NCT ID: NCT04231669
Last Updated: 2026-01-21
Results Overview
Change in intention to migrate will be measured by one question: How likely do you (the adolescent girl) see yourself migrating? The question uses a likert scale ranging from 1 (very unlikely) to 5 (very likely).
COMPLETED
NA
200 participants
Baseline, post-test (9 months), 6-months follow-up
2026-01-21
Participant Flow
Unit of analysis: schools
Participant milestones
| Measure |
Control: Bolstered Care
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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|---|---|---|
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Overall Study
STARTED
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100 5
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100 5
|
|
Overall Study
COMPLETED
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100 5
|
94 5
|
|
Overall Study
NOT COMPLETED
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0 0
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6 0
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Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
Baseline characteristics by cohort
| Measure |
Control: Bolstered Care
n=100 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=94 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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Total
n=194 Participants
Total of all reporting groups
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|---|---|---|---|
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Age, Categorical
adolescents · <=18 years
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50 Participants
n=50 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
47 Participants
n=47 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
97 Participants
n=97 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
|
Age, Categorical
adolescents · Between 18 and 65 years
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0 Participants
n=50 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
0 Participants
n=47 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
0 Participants
n=97 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
|
Age, Categorical
adolescents · >=65 years
|
0 Participants
n=50 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
0 Participants
n=47 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
0 Participants
n=97 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
|
Age, Categorical
caregivers · <=18 years
|
0 Participants
n=50 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
0 Participants
n=47 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
0 Participants
n=97 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
|
Age, Categorical
caregivers · Between 18 and 65 years
|
48 Participants
n=50 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
46 Participants
n=47 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
94 Participants
n=97 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
|
Age, Categorical
caregivers · >=65 years
|
2 Participants
n=50 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
1 Participants
n=47 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
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3 Participants
n=97 Participants • The numbers reported in the overall number of baseline participants correspond to caregivers and adolescents together.
|
|
Sex: Female, Male
adolescents · Female
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50 Participants
n=50 Participants • The total number is the sum of caregivers and adolescent girls.
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47 Participants
n=47 Participants • The total number is the sum of caregivers and adolescent girls.
|
97 Participants
n=97 Participants • The total number is the sum of caregivers and adolescent girls.
|
|
Sex: Female, Male
adolescents · Male
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0 Participants
n=50 Participants • The total number is the sum of caregivers and adolescent girls.
|
0 Participants
n=47 Participants • The total number is the sum of caregivers and adolescent girls.
|
0 Participants
n=97 Participants • The total number is the sum of caregivers and adolescent girls.
|
|
Sex: Female, Male
caregivers · Female
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27 Participants
n=50 Participants • The total number is the sum of caregivers and adolescent girls.
|
30 Participants
n=47 Participants • The total number is the sum of caregivers and adolescent girls.
|
57 Participants
n=97 Participants • The total number is the sum of caregivers and adolescent girls.
|
|
Sex: Female, Male
caregivers · Male
|
23 Participants
n=50 Participants • The total number is the sum of caregivers and adolescent girls.
|
17 Participants
n=47 Participants • The total number is the sum of caregivers and adolescent girls.
|
40 Participants
n=97 Participants • The total number is the sum of caregivers and adolescent girls.
|
|
Race and Ethnicity Not Collected
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—
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—
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0 Participants
Race and Ethnicity were not collected from any participant.
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PRIMARY outcome
Timeframe: Baseline, post-test (9 months), 6-months follow-upPopulation: Adolescent girls. One participant was lost to follow-up at 9 months
Change in intention to migrate will be measured by one question: How likely do you (the adolescent girl) see yourself migrating? The question uses a likert scale ranging from 1 (very unlikely) to 5 (very likely).
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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|---|---|---|
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Intention to Migrate
post-test (9 months)
|
1.42 Score on a scale
Standard Deviation 0.84
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1.28 Score on a scale
Standard Deviation 0.72
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Intention to Migrate
Baseline
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1.6 Score on a scale
Standard Deviation 1.05
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1.64 Score on a scale
Standard Deviation 1.21
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Intention to Migrate
6-months follow-up
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1.72 Score on a scale
Standard Deviation 1.21
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1.15 Score on a scale
Standard Deviation 0.751
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SECONDARY outcome
Timeframe: baseline, post-test (9 month), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
Change in attitudes towards school were measured by School attitude assessment survey (SAAS; McCoach, 2002). The survey consists of 20 items rated on a 5-point Likert scale (1 = not at all, 2 = a little bit, 3 = pretty well, 4 = well, and 5 = very well; range 20 to 100). The scale measures aspects of students' lives that predict their academic achievement, including peer attitudes, attitudes toward school, self-motivation, and self-regulation. The items were coded and summed, with the higher values representing higher positive attitudes toward school (Cronbach's alpha = 0.92).
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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|---|---|---|
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Attitudes Towards School
6 month follow-up
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90.23 score on a scale
Standard Deviation 6.83
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85.12 score on a scale
Standard Deviation 9.64
|
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Attitudes Towards School
post-test (9 month
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80.28 score on a scale
Standard Deviation 10.46
|
75.9 score on a scale
Standard Deviation 10.85
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Attitudes Towards School
Baseline
|
87.47 score on a scale
Standard Deviation 10.61
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84.76 score on a scale
Standard Deviation 9.46
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SECONDARY outcome
Timeframe: baseline, post-test (9 month), 6 month follow-up (6-month post intervention completion)Population: This outcome only applies to adolescent girls.
Change in school attendance will be measured by school attendance reports. Number of missed days will be collected
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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|---|---|---|
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School Attendance
Baseline Baseline · Less than 10%
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23 Participants
|
20 Participants
|
|
School Attendance
Baseline Baseline · Equal to or more than 10%
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27 Participants
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27 Participants
|
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School Attendance
post-test · Less than 10%
|
24 Participants
|
27 Participants
|
|
School Attendance
post-test · Equal to or more than 10%
|
26 Participants
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20 Participants
|
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School Attendance
6-month follow-up · Less than 10%
|
27 Participants
|
32 Participants
|
|
School Attendance
6-month follow-up · Equal to or more than 10%
|
23 Participants
|
15 Participants
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
Change in self-concept was measured by the Tennessee Self-Concept Scale Short Form (TSCS). The 20-item short version of the original 100-item TSCS scale assesses adolescents' perception of self-identity and self-satisfaction. The items are rated on a 5-point Likert scale ranging from 1 = always false to 5 = always true. The theoretical range for the TSCS is 20-100, with higher scores representing a more positive self-concept.
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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|---|---|---|
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Self-concept
6-months follow-up
|
73.09 score on a scale
Standard Deviation 9.17
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72.74 score on a scale
Standard Deviation 9.78
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Self-concept
post-test (9 months)
|
76.5 score on a scale
Standard Deviation 10.92
|
74.94 score on a scale
Standard Deviation 12.58
|
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Self-concept
Baseline
|
80.36 score on a scale
Standard Deviation 9.94
|
81.02 score on a scale
Standard Deviation 7.83
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SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
change in life satisfaction was measured by Multidimensional Student Life Satisfaction Scale (MSLSS) (Wilson, 2015). The scale includes 40 items assessing life satisfaction on 5 specific aspects while maintaining an overall life satisfaction score (Huebner et al., 1998). Responses are rated on a 6-point Likert scale with 1 = strongly disagree, 2 = moderately disagree, 3 = slightly disagree, 4 = slightly agree, 5 = moderately agree, and 6 = strongly agree (theoretical range 40-240). To avoid the potential for type I error, the total score was summed up and used in the analysis, with the higher values representing higher satisfaction in student life.
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
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|---|---|---|
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Multidimensional Student Life Satisfaction
Baseline
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189.49 score on a scale
Standard Deviation 15.20
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186.98 score on a scale
Standard Deviation 15.75
|
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Multidimensional Student Life Satisfaction
6 month follow-up
|
189.83 score on a scale
Standard Deviation 19.48
|
183.24 score on a scale
Standard Deviation 21.15
|
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Multidimensional Student Life Satisfaction
post-test (9 months)
|
191.74 score on a scale
Standard Deviation 23.42
|
182.92 score on a scale
Standard Deviation 23.82
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SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
Change in stress levels was measured by the Adolescent Stress Questionnaire (ASQ) (Byrne et al., 2007). The ASQ consists of 48 items, each measuring different stressors on a 5-point Likert scale ranging from 1 (not at all stressful) to 5 (very stressful). The questionnaire includes eight subscales: stress of home, stress of school performance, stress of school attendance, stress of peer pressure, stress of teacher interaction, stress about future uncertainty, stress of school or leisure conflict, and stress of financial pressure. We calculated a composite score by summing the responses, with higher scores indicating greater stress levels (theoretical range 48-240).
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
The Adolescent Stress Questionnaire (ASQ)
6 month follow-up
|
174.34 score on a scale
Standard Deviation 38.37
|
163.84 score on a scale
Standard Deviation 42.70
|
|
The Adolescent Stress Questionnaire (ASQ)
post-test (9 months)
|
148.52 score on a scale
Standard Deviation 49.30
|
164.48 score on a scale
Standard Deviation 37.56
|
|
The Adolescent Stress Questionnaire (ASQ)
Baseline
|
113.40 score on a scale
Standard Deviation 46.97
|
117.38 score on a scale
Standard Deviation 56.15
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
We assessed family cohesion using seven items (theoretical range: 7-35, Cronbach alpha = 0.84) adapted from both the Family Environment Scale (Moos, 1994) and the Family Assessment Measure (Skinner et al., 1983). The items measured the degree of commitment, help and support family members provide for one another. Participants were asked to rate how often each item occurred in their family using a 5-point scale (with 1 = 'never' and 5 = 'always'). Items included 'Do your family members ask each other for help before asking nonfamily members for help?', and 'Do you listen to what other family members have to say, even when you disagree?' Summary scores were created, with higher scores indicating higher levels of family cohesion.
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Family Cohesion
6 month follow-up
|
29.57 score on a scale
Standard Deviation 7.12
|
29.04 score on a scale
Standard Deviation 6.04
|
|
Family Cohesion
Baseline
|
26.55 score on a scale
Standard Deviation 6.74
|
28.34 score on a scale
Standard Deviation 6.40
|
|
Family Cohesion
post-test (9 months)
|
30.98 score on a scale
Standard Deviation 5.52
|
27.5 score on a scale
Standard Deviation 6.36
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: We analyzed adolescent participant data. One participant was lost to follow-up at 9 months.
The perceived child-caregiver relationship scale was adapted from the Family Assessment measure and assessed relationships on two dimensions: (1) acceptance and warmth - the extent to which the caregiver perceives as involved in their child's life; and (2) psychological autonomy - the extent to which the caregiver employs a non-coercive, democratic discipline and encourages the child to express individuality within the family. Participants were asked to rate the adults they live with, on each of the 16 items (range: 16-80), on a 5-point scale (1 = 'never' and 5 = 'always'). Sample items include: "Can you count on your parents to help her if she has a problem?" and "Do your parents keep challenging you to do the best in whatever you do?" Summary mean scores were created, with higher scores indicating a more positive child-caregiver relationship.
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Child-caregiver Relationship
post-test (9 months)
|
60.44 score on a scale
Standard Deviation 6.14
|
62.98 score on a scale
Standard Deviation 6.74
|
|
Child-caregiver Relationship
Baseline data
|
61.92 score on a scale
Standard Deviation 8.82
|
61.40 score on a scale
Standard Deviation 10.01
|
|
Child-caregiver Relationship
6 month follow-up (6-month post intervention completion)
|
60.56 score on a scale
Standard Deviation 6.38
|
61.45 score on a scale
Standard Deviation 4.27
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent data were analyzed from baseline to 15 months. One participant was lost to follow-up at 9 months.
Change in social support was measured by the Social Support Behavior Scale. The SS-B measure consists of 45 items designed to tap five modes of support: emotional support, socializing, practical assistance, financial assistance, and advice/guidance. The Likert scale is from 1=strongly disagree to 5=strongly agree. The theoretical range is 45-225, with higher scores indicating higher social support.
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Social Support
Baseline
|
163.26 score on a scale
Standard Deviation 26.53
|
149.83 score on a scale
Standard Deviation 30.0
|
|
Social Support
post-test (9 months)
|
171.43 score on a scale
Standard Deviation 21.99
|
183.5 score on a scale
Standard Deviation 17.74
|
|
Social Support
6 month follow-up (6-month post intervention completion)
|
164.44 score on a scale
Standard Deviation 23.30
|
183.28 score on a scale
Standard Deviation 22.95
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
Change in perceived social support was measured by the Multidimensional Scale of Perceived Social Support. The MSPSS is a self-report measure to assess participants' social support. The 12-item scale had statements such as, "there is a special person who is around when I am in need," rated on a 5-point Likert scale ranging from strongly agree to strongly disagree, with 5=strongly agree, 4=agree, 3=neutral, 2=disagree, 1=strongly disagree. Responses were coded and added up. The theoretical range was 12-60, with higher scores indicating greater social support.
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Perceived Social Support
6 month follow-up
|
36.62 score on a scale
Standard Deviation 3.75
|
34.32 score on a scale
Standard Deviation 5.68
|
|
Perceived Social Support
Baseline
|
32.51 score on a scale
Standard Deviation 4.86
|
32.32 score on a scale
Standard Deviation 4.44
|
|
Perceived Social Support
post-test (9 months),
|
35.54 score on a scale
Standard Deviation 4.11
|
30.18 score on a scale
Standard Deviation 6.38
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Caregiver data
We assessed gender norms among caregivers using a 10-item scale adapted from the Gender Norm Attitudes Scale (Waszak et al., 2001), which measures participants' understanding of the appropriateness of behaviors as they relate to being female and male. The items in the scale encompass aspects related to educational performance, future expectations for both genders, family support, encouragement, decision-making, and involvement in intimate relationships and behaviors. The scale items featured binary responses (Agree = 1 and Disagree = 0). To create a summation score, items in the reverse direction were appropriately reverse-coded (theoretical range 0-10). Higher scores denote more egalitarian gender norms and beliefs.
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Gender Attitudes
6 month follow-up
|
2.7 score on a scale
Standard Deviation 2.18
|
3.04 score on a scale
Standard Deviation 1.77
|
|
Gender Attitudes
post-test (9 months)
|
2.84 score on a scale
Standard Deviation 2.72
|
3.39 score on a scale
Standard Deviation 2.91
|
|
Gender Attitudes
Baseline
|
2.06 score on a scale
Standard Deviation 2.19
|
2.44 score on a scale
Standard Deviation 2.17
|
SECONDARY outcome
Timeframe: post-test (9 months)Population: We analyzed bank savings information from the ANZANSI group. The control group had no bank data. We report the average bank savings for only the ANZANSI Family Program at 9 months in Ghana Cedis.
the average bank savings as measured by Bank statements
Outcome measures
| Measure |
Control: Bolstered Care
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Savings
|
—
|
401 Ghana cedis
Standard Deviation 175
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent Change in future orientation will be measured by the Thinking about the future measure. One participant was lost to follow-up at 9 months
Change in future orientation was measured by two items evaluating adolescents' expectations and optimism regarding their educational goals. The first item asked participants, How sure are you that you will achieve your educational plans? with response options ranging from 1 = Not at all sure to 5 = Extremely sure. The second item asked, How hopeful are you that you will achieve your educational plans? with parallel response options ranging from 1 = Not at all hopeful to 5 = Extremely hopeful (theoretical range 2-10). For both items, higher scores indicated greater perceived likelihood of achieving educational goals and stronger optimism about the future. A composite future orientation score was created by summing the two items, with higher scores reflecting greater optimism and confidence in achieving educational aspirations. Only participants with non-missing values for both items were included in the composite measure.
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Future Orientation
Baseline
|
8.34 score on a scale
Standard Deviation 1.49
|
8.32 score on a scale
Standard Deviation 1.14
|
|
Future Orientation
post-test (9 months)
|
8.8 score on a scale
Standard Deviation 1.37
|
9.17 score on a scale
Standard Deviation 1.06
|
|
Future Orientation
6 month follow-up (6-month post intervention completion)
|
9.16 score on a scale
Standard Deviation 1.33
|
9.21 score on a scale
Standard Deviation 1.25
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6 month follow-up (6-month post intervention completion)Population: Adolescent girls. One participant was lost to follow-up at 9 months.
Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES) (Rosenberg, 1965). The scale is a common measure of self-esteem (Sinclair et al., 2010) and has been used across different cultural contexts with high internal consistency, including in Ghana (α = 0.83-0.85) (Ahulu et al., 2020; Glozah, 2014). The scale comprises 10 statements about general feelings of self-worth or self-acceptance rated on a 4-point Likert scale response option (strongly agree to strongly disagree, with 4 = strongly agree, 3 = agree, 2 = disagree, 1 = strongly disagree). The items were scored on a theoretical range of 10-40 and summed, with higher scores representing higher self-esteem.
Outcome measures
| Measure |
Control: Bolstered Care
n=47 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=50 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Self-Esteem
6 month follow-up
|
34.02 score on a scale
Standard Deviation 3.58
|
33.48 score on a scale
Standard Deviation 4.34
|
|
Self-Esteem
post-test (9 months)
|
33.15 score on a scale
Standard Deviation 2.80
|
32.78 score on a scale
Standard Deviation 5.51
|
|
Self-Esteem
Baseline
|
29.96 score on a scale
Standard Deviation 4.55
|
31.3 score on a scale
Standard Deviation 4.10
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6-month follow-up (15 months)Population: At 9 months follow-up, one person was lost during interviews in the treatment arm. However, this participants was interviewed at 15 months follow-up.
Emotional self-efficacy was assessed using the Emotional self-efficacy scale (ESE; Valois \& Zulig, 2013), an 8-item scale to measure an individual's perceived ability to manage emotions effectively. This scale has been widely used to evaluate emotional self-regulation across different contexts. Participants responded to each item on a 5-point Likert scale ranging from 1 (not at all well) to 5 (very well) (theoretical range 8-40). Sample items included, "How well do you succeed in cheering yourself up when an unpleasant event has happened?" and "How well do you succeed in becoming calm again when you are very scared?" Scores were summed, with higher scores reflecting greater emotional self-efficacy
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Emotional Self-efficacy
baseline
|
31.44 score on a scale
Standard Deviation 4.99
|
30.53 score on a scale
Standard Deviation 7.10
|
|
Emotional Self-efficacy
post-test (9 months)
|
29.44 score on a scale
Standard Deviation 6.33
|
33.91 score on a scale
Standard Deviation 4.97
|
|
Emotional Self-efficacy
6-month follow-up (15 months)
|
32.28 score on a scale
Standard Deviation 6.95
|
33.94 score on a scale
Standard Deviation 4.96
|
SECONDARY outcome
Timeframe: baseline, post-test (9 months), 6-month follow-up (15 months)Population: One participant was lost to follow-up at 9 months
Social self-efficacy was measured using the Social self-efficacy scale (Zullig, Teoli, Valois, 2011), a 8-item scale to evaluate an individual's confidence in handling social situations and interactions. Participants rated their responses on a 5-point Likert scale, ranging from 1 (not at all well) to 5 (very well). Sample items included "How well can you express your opinions when other classmates disagree with you?" and "How well can you become friends with other children?" The items were summed, with higher scores indicating greater social self-efficacy (theoretical range 8-40).
Outcome measures
| Measure |
Control: Bolstered Care
n=50 Participants
Female adolescents in the bolstered care will receive services/education as usual in their respective schools. The usual care will be bolstered by providing school notebooks and lunch in the control arm (bolstered care will also be provided to treatment arm). Primary school education is universal and free in Ghana. Yet notebooks and lunch are costly expenses for families that create a barrier to school attendance. Hence, these will be provided to participants in all study schools.
|
Anzansi Family Program
n=47 Participants
In addition to bolstered care, participants in this arm will receive the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG).
Anzansi Family Program: the ANZANSI that combines Family Economic Empowerment (EE) with Multiple Family Groups (MFG). Family EE includes: 1) Workshops on asset building, future planning, and protection from risks; 2) Child Development Account (CDA); and 3) Family income-generating/microenterprise promotion (IGA) component:
MFG a family-centered, group-delivered, evidence-informed intervention designed for children and adolescents whose families struggle with poverty and associated stressors. The MFG is based on building family support through opportunities for parents and children to communicate in a safe setting with other families who have shared experiences, and allow each family to learn from one another. MFG builds protective factors for healthy parent-child relationships while addressing familial, social and community stressors and barriers to adolescent girls' well-being.
|
|---|---|---|
|
Social Self-efficacy
post-test (9 months)
|
30.18 score on a scale
Standard Deviation 6.38
|
35.54 score on a scale
Standard Deviation 4.12
|
|
Social Self-efficacy
baseline
|
32.32 score on a scale
Standard Deviation 4.44
|
32.51 score on a scale
Standard Deviation 4.86
|
|
Social Self-efficacy
6-month follow-up (15 months
|
34.32 score on a scale
Standard Deviation 5.68
|
36.62 score on a scale
Standard Deviation 3.75
|
Adverse Events
Control: Bolstered Care
Anzansi Family Program
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Dr. Ozge Sensoy Bahar
Washington University in St. Louis
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place