Session: Working with Families to Solve Complex Problems: Developing and Testing Family-Based Prevention Programs in Kenya, Tanzania, and Uganda (Society for Prevention Research 25th Annual Meeting)

Families in low- and middle-income countries often face multiple adversities that increase the risk of negative child and adult outcomes, including higher rates of intimate partner violence, child maltreatment, and poor mental health. In order to adequately address the impact of cumulative risk factors, prevention strategies require complex social interventions consisting of multiple components nested within multilayered systems of delivery that also take into consideration the diverse sociocultural contexts in which many of these families live.

This symposium fits within the larger theme of Promoting Health Equity and Decreasing Disparities through Public Systems of Care and Policy, as well as the subtheme of the Development and Testing of Interventions. It focuses on three studies from East Africa that are in their early stages of program development and/or testing.

The first paper describes the development and formative evaluation to test the acceptability of a community-based parenting program to prevent gender-based violence in central Uganda. The program was delivered by local facilitators who engaged both mothers and fathers separately, followed by mixed groups to address gendered perceptions of parenting and couple relationship problems.

The second paper presents the adaptation and mixed-methods pilot study of a multicomponent family therapy approach to improving family functioning, parent-child relationships, and mental health in Kenya. The manualized intervention included a mobile phone application that guided lay counselors in the delivery of six family therapy modules specifically tailored to the needs of individual families.

The third paper involved a small-scale cluster randomized controlled trial to test the effectiveness of a community-based intervention designed to reduce the risk of violence against children in farming communities in northern Tanzania. The intervention consisted of 1) an agribusiness training program delivered in partnership with officials from the Ministry of Agriculture, 2) a group-based parenting program delivered by community workers that included three components on parenting skills, child protection, and family budgeting, and 3) a systems-strengthening initiative around child protection and response.

The symposium highlights the importance of building the evidence of effectiveness of culturally relevant, complex family interventions in under-resourced and under-researched communities in East Africa. The presenters will discuss challenges encountered while conducting research in settings characterized by multiple adversities. They will also explore how research in these settings requires innovative and participatory approaches that respect local culture and context, as well as potential ethical issues regarding child protection and mitigating potential harm.