Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Zimbabwe

NCT ID: NCT05213182

Last Updated: 2022-02-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 183 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-10-01
• Study Completion Date: 2019-09-30

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.

Conditions

Mental Health Disorder; Social Isolation; Stigma, Social

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Intervention

The intervention arm (n=104 adolescent mothers) participated in the 12 in-person peer support group sessions and completed sociodemographic, base-, mid-, and end-line surveys.

Group Type: EXPERIMENTAL

Young Women of Today

Intervention Type: BEHAVIORAL

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.

Control

The control arm (n=79 adolescent mothers) completed sociodemographic, base-, mid- and end-line surveys.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Young Women of Today

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.

Intervention Type: BEHAVIORAL

Other Intervention Names

Community-based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Harare, Zimbabwe

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.

• Minimum Eligible Age: 14 Years
• Maximum Eligible Age: 18 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Bill and Melinda Gates Foundation

OTHER

Sponsor Role: collaborator

University of South Carolina

OTHER

Sponsor Role: collaborator

Organization for Public Health Interventions and Development

UNKNOWN

Sponsor Role: collaborator

University of Zimbabwe

OTHER

Sponsor Role: collaborator

SpeakUp! Pennsylvania

UNKNOWN

Sponsor Role: collaborator

West Chester University of Pennsylvania

OTHER

Sponsor Role: lead

Responsible Party

Chiwoneso Tinago

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Chiwoneso Tinago, PhD

Role: PRINCIPAL_INVESTIGATOR

West Chester University of Pennsylvania

Locations

West Chester University of Pennsylvania

West Chester, Pennsylvania, United States

Countries

United States

References

Tinago CB, Frongillo EA, Warren AM, Chitiyo V, Jackson TN, Cifarelli AK, Fyalkowski S, Pauline V. Testing the Effectiveness of a Community-Based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Zimbabwe. Matern Child Health J. 2024 Apr;28(4):657-666. doi: 10.1007/s10995-023-03821-2. Epub 2023 Nov 13.

Reference Type: DERIVED

PMID: 37957412 (View on PubMed)

Other Identifiers

20180723A

Identifier Type: -

Identifier Source: org_study_id