How Effective Is Help on the Doorstep? A Longitudinal Evaluation of Community-Based Organisation Support

• Published in: PloS one Vol. 11; no. 3; p. e0151305
• Main Authors: Sherr, Lorraine, Yakubovich, Alexa R, Skeen, Sarah, Cluver, Lucie D, Hensels, Imca S, Macedo, Ana, Tomlinson, Mark
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.03.2016; Public Library of Science (PLoS)
• Subjects: Abuse; Acquired immune deficiency syndrome; Adolescent; Adolescent Behavior - psychology; Adults; Aggression; AIDS; Analysis; Behavior problems; Biology and Life Sciences; Caregivers; Child; Child Behavior - psychology; Children; Children & youth; Communities; Community; Demographics; Demography; Domestic violence; Domestic Violence - statistics & numerical data; Families & family life; Family Conflict; Female; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - psychology; HIV patients; Human immunodeficiency virus; Humans; Infections; Intervention; Life assessment; Linear Models; Logistic Models; Longitudinal Studies; Male; Medical societies; Medicine and Health Sciences; Mental depression; Mental disorders; Mental Health; Mortality; Odds Ratio; People and Places; Physical Abuse - statistics & numerical data; Population; Prosocial behavior; Psychiatry; Psychopathology; Random sampling; Regression analysis; Retention; Services; Social aspects; Social policy; Social response; Social Sciences; Social Support; Social Workers; Studies; Suicidal Ideation; Symptoms; Trauma; Violence; South Africa; United Kingdom; United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0151305

Community-based responses have a lengthy history. The ravages of HIV on family functioning has included a widespread community response. Although much funding has been invested in front line community-based organisations (CBO), there was no equal investment in evaluations. This study was set up to compare children aged 9-13 years old, randomly sampled from two South African provinces, who had not received CBO support over time (YC) with a group of similarly aged children who were CBO attenders (CCC). YC baseline refusal rate was 2.5% and retention rate was 97%. CCC baseline refusal rate was 0.7% and retention rate was 86.5%. 1848 children were included-446 CBO attenders compared to 1402 9-13 year olds drawn from a random sample of high-HIV prevalence areas. Data were gathered at baseline and 12-15 months follow-up. Standardised measures recorded demographics, violence and abuse, mental health, social and educational factors. Multivariate regression analyses revealed that children attending CBOs had lower odds of experiencing weekly domestic conflict between adults in their home (OR 0.17; 95% CI 0.09, 0.32), domestic violence (OR 0.22; 95% CI 0.08, 0.62), or abuse (OR 0.11; 95% CI 0.05, 0.25) at follow-up compared to participants without CBO contact. CBO attenders had lower odds of suicidal ideation (OR 0.41; 95% CI 0.18, 0.91), fewer depressive symptoms (B = -0.40; 95% CI -0.62, -0.17), less perceived stigma (B = -0.37; 95% CI -0.57, -0.18), fewer peer problems (B = -1.08; 95% CI -1.29, -0.86) and fewer conduct problems (B = -0.77; 95% CI -0.95, -0.60) at follow-up. In addition, CBO contact was associated with more prosocial behaviours at follow-up (B = 1.40; 95% CI 1.13, 1.67). No associations were observed between CBO contact and parental praise or post-traumatic symptoms. These results suggest that CBO exposure is associated with behavioural and mental health benefits for children over time. More severe psychopathology was not affected by attendance and may need more specialised input.