Trial Outcomes & Findings for Sibling-Support for Adolescent Girls (SSAGE) (NCT NCT06078124)

NCT ID: NCT06078124

Last Updated: 2025-11-21

Results Overview

This measure initially includes 25 items and assesses the presence and severity of several psychiatric symptom domains in children and adolescents over the last two weeks. 19 of the items are rated on a 5-point scale (0=none/never; 1=slight/rare; 2=mild/several days; 3=moderate/more than half the days; and 4=severe/almost daily). Questions on suicide ideation, suicide attempts, and substance use are rated on a 2-point scale of yes/no. The included symptoms represent 12 domains of mental disorders: somatic symptoms, sleep problems, inattention, depression, anger/irritability (measured together), mania, anxiety, psychosis, repetitive thoughts and behaviors, substance use, and suicide ideation/attempts. Generally, a respondent is flagged as requiring further inquiry for a given domain if they answered '2' or higher on at least one of the symptoms in each respective domain. As such, this outcome is operationalized as 12 dichotomous variables reflecting the 12 domains.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

186 participants

Primary outcome timeframe

Up to 2 weeks following the end of the 12 week intervention

Results posted on

2025-11-21

Participant Flow

Participant milestones

Participant milestones
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
Care as usual
Overall Study
STARTED
93
93
Overall Study
COMPLETED
79
79
Overall Study
NOT COMPLETED
14
14

Reasons for withdrawal

Reasons for withdrawal
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
Care as usual
Overall Study
Lost to Follow-up
14
14

Baseline Characteristics

Sibling-Support for Adolescent Girls (SSAGE)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
n=93 Participants
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls.
Control Arm
n=93 Participants
Care as usual
Total
n=186 Participants
Total of all reporting groups
Age, Continuous
15.84 years
STANDARD_DEVIATION 1.96 • n=68 Participants
15.82 years
STANDARD_DEVIATION 1.79 • n=76 Participants
15.83 years
STANDARD_DEVIATION 1.87 • n=48 Participants
Sex: Female, Male
Female
93 Participants
n=68 Participants
93 Participants
n=76 Participants
186 Participants
n=48 Participants
Sex: Female, Male
Male
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
93 Participants
n=68 Participants
93 Participants
n=76 Participants
186 Participants
n=48 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
Asian
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
White
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=68 Participants
0 Participants
n=76 Participants
0 Participants
n=48 Participants
Race (NIH/OMB)
Unknown or Not Reported
93 Participants
n=68 Participants
93 Participants
n=76 Participants
186 Participants
n=48 Participants
Region of Enrollment
Colombia
93 Participants
n=68 Participants
93 Participants
n=76 Participants
186 Participants
n=48 Participants
Nationality
Colombian
9 Participants
n=68 Participants
7 Participants
n=76 Participants
16 Participants
n=48 Participants
Nationality
Venezuelan
84 Participants
n=68 Participants
86 Participants
n=76 Participants
170 Participants
n=48 Participants
Currently in school
77 Participants
n=68 Participants
76 Participants
n=76 Participants
153 Participants
n=48 Participants

PRIMARY outcome

Timeframe: Up to 2 weeks following the end of the 12 week intervention

Population: Outcomes for the 158 adolescent girls measured at endline. All girls are 13-19 years old and are forcibly displaced.

This measure initially includes 25 items and assesses the presence and severity of several psychiatric symptom domains in children and adolescents over the last two weeks. 19 of the items are rated on a 5-point scale (0=none/never; 1=slight/rare; 2=mild/several days; 3=moderate/more than half the days; and 4=severe/almost daily). Questions on suicide ideation, suicide attempts, and substance use are rated on a 2-point scale of yes/no. The included symptoms represent 12 domains of mental disorders: somatic symptoms, sleep problems, inattention, depression, anger/irritability (measured together), mania, anxiety, psychosis, repetitive thoughts and behaviors, substance use, and suicide ideation/attempts. Generally, a respondent is flagged as requiring further inquiry for a given domain if they answered '2' or higher on at least one of the symptoms in each respective domain. As such, this outcome is operationalized as 12 dichotomous variables reflecting the 12 domains.

Outcome measures

Outcome measures
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
n=79 Participants
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
n=79 Participants
Care as usual
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Sleep problems
24 Participants
28 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Somatic symptoms
44 Participants
42 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Inattention
50 Participants
41 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Depression
39 Participants
43 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Anger/irritability
38 Participants
40 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Mania
31 Participants
22 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Anxiety
38 Participants
40 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Psychosis
22 Participants
18 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
repetitive thoughts and behaviors
57 Participants
47 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Substance use
21 Participants
17 Participants
Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Level 1 Cross-Cutting Symptom
Suicide ideation/attempts
31 Participants
30 Participants

PRIMARY outcome

Timeframe: Up to 2 weeks following the end of the 12 week intervention

Population: Participants are forcibly displaced adolescent girls ages 13-19 years old. Measures were taken at endline (post-intervention) for 79 treatment and 79 control participants.

This scale assesses symptoms of depression and anxiety over the past two weeks in children and adolescents using 25 items. Items are scored on a 4-point scale (0-never; 1-sometimes; 2-often; and 3-always) for the last two weeks. The sum of all item scores are then converted into t-scores based on gender and age. Ranges are as follows: t-score\<65 is normal range; \>=65 and \<=69 is borderline clinical; and \>=70 is clinical range.

Outcome measures

Outcome measures
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
n=79 Participants
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
n=79 Participants
Care as usual
Revised Children's Anxiety and Depression Scale (RCADS)-25
Normal range
58 Participants
61 Participants
Revised Children's Anxiety and Depression Scale (RCADS)-25
Borderline clinical
6 Participants
4 Participants
Revised Children's Anxiety and Depression Scale (RCADS)-25
Clinical range
15 Participants
14 Participants

SECONDARY outcome

Timeframe: Up to 2 weeks following the end of the 12 week intervention

Population: Note to ClinicalTrials.gov: Unfortunately, this scale was not found to be valid or reliable with our study population and we therefore did conduct any analysis with this measure. As such, we do not feel it is appropriate for others to derive any conclusions from the results for these measures.

We employed a modified version of the FACI8. The FACI8 is traditionally a 16-item scale where each item is scored using a 4-point Likert scale of how frequently the event occurs in the last 2 weeks (1-Never; 2-Sometimes; 3-Most of the time; 4-Always). During baseline training, it was determined that four of the items in the traditional FACI8 were not reliable or valid in our study setting. As such, a 12-item version was employed. The modified FACI8 consists of two subscales: Attachment and Changeability. The attachment subscale includes 7 items and the changeability subscale comprises 5 items. Subscale scores are created by summing the relevant item responses. Unfortunately, there was a tech issue with one of the changeability items at endline and data were not collected for that item. As such, we removed that item from the changeability subscale to preserve comparability with baseline. The final score for attachment can be 7-28 and changeability from 4-16. Higher scores are better.

Outcome measures

Outcome measures
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
n=79 Participants
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
n=79 Participants
Care as usual
Family Attachment and Changeability Index (FACI-8) (Modified)
Attachment subscale
20.23 units on a scale
Standard Deviation 3.17
20.67 units on a scale
Standard Deviation 2.94
Family Attachment and Changeability Index (FACI-8) (Modified)
Changeability subscale
11.18 units on a scale
Standard Deviation 2.74
11.16 units on a scale
Standard Deviation 2.66

SECONDARY outcome

Timeframe: Up to 2 weeks following the end of the 12 week intervention

Population: 158 adolescent girls who participated in a pilot-RCT of SSAGE. Participants are 13-19 years old and are forcibly displaced within Colombia.

The Rosenberg Self-Esteem Scale is a 10-item scale that measures positive and negative feelings about the self to create a measure of overall self-worth. Items are scored using a 4-point Likert scale signaling level of agreement with each statement, from strongly agree to strongly disagree. Five items are reverse coded. The final score can take a value from 10 to 40, with higher scores indicating greater self-esteem. The scale asks about the last two weeks and the measure was taken up to 2 weeks following the end of the 12 week intervention.

Outcome measures

Outcome measures
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
n=79 Participants
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
n=79 Participants
Care as usual
Rosenberg Self-Esteem Scale
30.09 units on a scale
Standard Deviation 3.16
29.87 units on a scale
Standard Deviation 3.16

SECONDARY outcome

Timeframe: A stressor that occurred in the last two weeks; measurement taken up to 2 weeks following the end of the 12 week intervention

Population: 13-19 year-old girls, half of whom participated in the SSAGE intervention. All participants are forcibly displaced.

Kidcope is a 15-item checklist designed to measure cognitive and behavioural coping in children and adolescents. It measures the frequency of 15 coping strategies, including: problem-solving, distraction, social support, social withdrawal, cognitive restructuring, self-criticism, blaming others, emotional expression, wishful thinking and resignation. Items rare scored on a 4-point scale (0 = "Not at all" to 3 = "Almost all the time"). The final measure is operationalized as 15 dichotomous indicators, where a '1' signals the participant used that coping strategy at least sometimes in the last two weeks for a stressor and a '0' means the participant never used the coping mechanism in the last two weeks.

Outcome measures

Outcome measures
Measure
Sibling Support for Adolescent Girls in Emergencies (SSAGE)
n=79 Participants
Participants in this arm will participate in the Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention, along with three family members, for twelve weeks. Sibling Support for Adolescent Girls in Emergencies: The Sibling Support for Adolescent Girls in Emergencies (SSAGE) intervention is a gender-transformative, 12-week program utilizing a "whole family approach" wherein an adolescent girl, her male sibling, and a male and female caregiver participate in sessions that are age- and gender-specific and combined with family-wide discussions of session learnings. The sessions are interactive, engaging, and promote self-reflection and discussion on topics such as power, gender, interpersonal communication, and healthy relationships. Given the whole-family approach, SSAGE addresses intersections between spousal relationships, caregiver-child relationships, and relationships between siblings, as they pertain to supporting the mental health and psychosocial well-being of adolescent girls. Although multiple family members may participate in the program, the study only enrolls adolescent girls. Family members are not part of the study and data are only collected from adolescent girls.
Control Arm
n=79 Participants
Care as usual
Kidcope
Thought about som ething else or tried to forget
67 Participants
64 Participants
Kidcope
Stayed away from people and kept feelings to self
57 Participants
66 Participants
Kidcope
Tried to see bright side of things and/or focus on something good
72 Participants
75 Participants
Kidcope
Did something to distract self like watch TV or play a game
67 Participants
72 Participants
Kidcope
Handled the situation on own
66 Participants
65 Participants
Kidcope
Blamed self for causing problem
36 Participants
39 Participants
Kidcope
Blamed someone else for putting through problem
27 Participants
23 Participants
Kidcope
Thought of ways to solve problem
75 Participants
71 Participants
Kidcope
Tried to solve problem on own
67 Participants
69 Participants
Kidcope
Screamed, cried, or hit something
37 Participants
40 Participants
Kidcope
Tried to calm down byt talking to self, praying, taking a walk
70 Participants
73 Participants
Kidcope
Kept thinking and wishing stressor never happened
57 Participants
54 Participants
Kidcope
Kept wishing could change what had happened
60 Participants
59 Participants
Kidcope
Turned to family, friends, or other adults to help feel better
60 Participants
56 Participants
Kidcope
Just accepted the problem because knew there was nothing to do about it
64 Participants
60 Participants

Adverse Events

Sibling Support for Adolescent Girls in Emergencies (SSAGE)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Lindsay Stark

Washington University in St. Louis

Phone: 314-935-4747

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place