Assessment and validation of youth headed households psychosocial mentoring measures. Bugesera district, Rwanda

Abstract

Background: In Rwanda there are large numbers of child-headed households – more than 65,000 households, consisting of more than 300,000 children in total, are living without adult care and supervision. As a solution to this problem World Vision Rwanda (WVR) in partnership with National University of Rwanda School of Public Health and Tulane School of Public Health has initiated an adult mentorship program, which is a home visitation program utilizing trained adults to provide psychosocial support to Youth Heads of Household (YHH). The objective of this study was to assess and validate youth psychosocial wellbeing measurements. We report on depression, marginalization, grief and quality of mentoring relationship experience outcome in youth participating in the mentorship program in Bugesera district. Methods: We conducted a cross-sectional household survey with youth heads of households in Bugesera District. All YHH who were less than 24 years of age and participating in WVR mentorship program in Bugesera District were included in the survey. We measured rates and severity of depressive symptoms using the Center for Epidemiologic Studies Depression scale, in addition to description of socio demographic factors, a bivariate analysis were done between socialdemographics variables. The psychometrics properties of scale of Quality of mentoring, grief, marginalization, and adults support were reviewed using confirmatory factor analysis (CFA); to verify their validity. In addition to frequency distribution, T test, F fisher, 2 test, one-way ANOVA and linear regression models were used to assess the depression among YHH, marginalization, grief and their association factors. The effect of Quality of mentoring relationship experience on psychosocial outcomes was analyzed using correlation coefficient (r). Results: Of the 201 YHH, 55% were female and 45% male. Age varied between 11 and 24 years. About 54% of them didn‟t achieve primary school, 26% completed 6 years of primary school and 8% reached secondary school. One out of four lives alone in the household. More than half of YHH xi (55%) exceeded the most conservative cutoff score depression score for adolescents. Multivariable analysis revealed that depressive symptoms that exceeded the clinical cutoff were associated with Gender, physical health and adult support. Being female was associated with high level of depressive symptoms (p=0.015). A good or excellent health (p=0.040) or high level of adult support (p=0.005) were associated with lower level of depressive symptoms. Marginalization was measured by 6 items, (alpha=0.77) to explore perceptions of isolation and stigma from the surrounding community. Analysis revealed that high level of adult support was associated with low levels of marginalization (p=0.001) and being currently in school (p=0.007). Gender, physical health and adult support were associated with depression. On one hand, being female was associated with high level of depressive symptoms (p=0.015). On the other hand, a good or excellent health (p=0.040) or high level of adult support (p=0.005) were associated with lower level of depressive symptoms. Conclusion: Multivariable analysis revealed that depressive symptoms that exceeded the clinical cutoff were associated with Gender, physical health and adult support. Being female was associated with high level of depressive symptoms; a good or excellent health or high level of adult support was associated with lower level of depressive symptoms. Marginalization was measured by 6 items, to explore perceptions of isolation and stigma from the surrounding community. Analysis revealed that high level of adult support was associated with low levels of marginalization and being currently in school. Gender, physical health and adult support were associated with depression. Being female was associated with high level of depressive symptoms. And a good or excellent health (p=0.040) or high level of adult support were associated with lower level of depressive symptoms.