NCT01447615

Brief Summary

Bridges to the Future: Economic Empowerment for AIDS-Orphaned Children in Uganda, represents the first study that measures medium-term efficacy and cost-effectiveness of a family economic empowerment intervention for AIDS-orphaned children. The usual care provided to AIDS orphans in sub-Saharan Africa consists mainly of informal counseling as well as limited material support (e.g., specifically school lunches, textbooks for the required subjects, and note-books). Given the challenges facing these children and their caregivers, further supports are needed in order to help them successfully make the transition from primary school to secondary school and into adolescence. In the context of resource-poor countries, interventions that improve families' economic capabilities are likely to be particularly consequential. Both theory and prior research indicate that economic instability (including poverty) constitutes one of the primary risk factors for AIDS-orphaned children's risk-taking behaviors (including sexual risk-taking), poor mental health functioning, and poor educational outcomes. Thus, the lack of economic security constitutes an important risk factor for AIDS-orphaned children. Yet, to-date, few interventions aimed at care and support of AIDS-orphaned children have incorporated components to address family-level poverty/economic instability of the children and their caregiving families. Within this context, there is a need for innovative interventions that promote sustainable (more than short-term) economic and behavior change among AIDS-orphaned children and create the supports necessary to sustain these changes.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,410

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2012

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 4, 2011

Completed
2 days until next milestone

First Posted

Study publicly available on registry

October 6, 2011

Completed
4 months until next milestone

Study Start

First participant enrolled

February 1, 2012

Completed
6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 15, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 15, 2018

Completed
Last Updated

October 12, 2018

Status Verified

October 1, 2018

Enrollment Period

6 years

First QC Date

October 4, 2011

Last Update Submit

October 10, 2018

Conditions

PovertyOrphaned ChildrenAIDS Orphans

Keywords

Orphaned children and youthEconomic empowermentUgandaHIV/AIDSSub-Saharan Africa

Outcome Measures

Primary Outcomes (16)

  • Savings and Asset Accumulation

    Increased confidence in saving ability and stronger financial stability. Accumulation of formal and informal savings and wealth/assets (e.g. livestock, type of housing, land); and change in attitudes toward saving.

    12-month post-intervention follow-up assessment

  • Educational Achievement

    School enrollment and attendance. Educational attainment, plans, and aspirations. Performance on National Primary Leaving Examinations.

    12-month post-intervention follow-up assessment

  • Mental Health Functioning

    Degree of hopefulness about the future. Ability to identify specific future goals. Level of mental health functioning. Depressive symptoms.

    12-month post-intervention follow-up assessment

  • Sexual Risk-Taking Behavior

    Ability to negotiate safe sex practices. Decreased intentions to engage in sexual risk behavior. Knowledge about and attitude toward HIV/AIDS and other STDs.

    12-month post-intervention follow-up assessment

  • Savings and Asset Accumulation

    Increased confidence in saving ability and stronger financial stability. Accumulation of formal and informal savings and wealth/assets (e.g. livestock, type of housing, land); and change in attitudes toward saving.

    24-month post-intervention follow-up assessment

  • Educational Achievement

    School enrollment and attendance. Educational attainment, plans, and aspirations. Performance on National Primary Leaving Examinations.

    24-month post-intervention follow-up assessment

  • Mental Health Functioning

    Degree of hopefulness about the future. Ability to identify specific future goals. Level of mental health functioning. Depressive symptoms.

    24-month post-intervention follow-up assessment

  • Sexual Risk-Taking Behavior

    Ability to negotiate safe sex practices. Decreased intentions to engage in sexual risk behavior. Knowledge about and attitude toward HIV/AIDS and other STDs.

    24-month post-intervention follow-up assessment

  • Savings and Asset Accumulation

    Increased confidence in saving ability and stronger financial stability. Accumulation of formal and informal savings and wealth/assets (e.g. livestock, type of housing, land); and change in attitudes toward saving.

    36-month post-intervention follow-up assessment

  • Educational Achievement

    School enrollment and attendance. Educational attainment, plans, and aspirations. Performance on National Primary Leaving Examinations.

    36-month post-intervention follow-up assessment

  • Mental Health Functioning

    Degree of hopefulness about the future. Ability to identify specific future goals. Level of mental health functioning. Depressive symptoms.

    36-month post-intervention follow-up assessment

  • Sexual Risk-Taking Behavior

    Ability to negotiate safe sex practices. Decreased intentions to engage in sexual risk behavior. Knowledge about and attitude toward HIV/AIDS and other STDs.

    36-month post-intervention follow-up assessment

  • Savings and Asset Accumulation

    Increased confidence in saving ability and stronger financial stability. Accumulation of formal and informal savings and wealth/assets (e.g. livestock, type of housing, land); and change in attitudes toward saving.

    48-month post-intervention follow-up assessment

  • Educational Achievement

    School enrollment and attendance. Educational attainment, plans, and aspirations. Performance on National Primary Leaving Examinations.

    48-month post-intervention follow-up assessment

  • Mental Health Functioning

    Degree of hopefulness about the future. Ability to identify specific future goals. Level of mental health functioning. Depressive symptoms.

    48-month post-intervention follow-up assessment

  • Sexual Risk-Taking Behavior

    Ability to negotiate safe sex practices. Decreased intentions to engage in sexual risk behavior. Knowledge about and attitude toward HIV/AIDS and other STDs.

    48-month post-intervention follow-up assessment

Study Arms (3)

Bridges

EXPERIMENTAL
Behavioral: BridgesOther: Usual Care

Bridges PLUS

EXPERIMENTAL
Behavioral: Bridges PLUSOther: Usual Care

Usual Care

OTHER
Other: Usual Care

Interventions

BridgesBEHAVIORAL

Each child participant in the Bridges Arm will receive the usual care in addition to a Child Development Account (CDA) to be used for secondary education by the AIDS-orphaned child. The CDA will be a matched savings account held in the child's name in a financial institution registered by the Central Bank (Bank of Uganda). The account will be matched with money from the program at a match rate of 1:1. Additionally, participants will receive: 1) twelve 1-2 hour workshops focused on asset building, future planning, and protection from risks; 2) mentorship sessions to reinforce learning and build optimism; and 3) a family income-generating /micro-enterprise promotion component for children enrolled in Bridges and their families.

Also known as: Child Development Account
Bridges
Bridges PLUSBEHAVIORAL

Each child participant in the Bridges PLUS Arm will receive the usual care in addition to a Child Development Account (CDA) to be used for secondary education by the AIDS-orphaned child. The CDA will be a matched savings account held in the child's name in a financial institution registered by the Central Bank (Bank of Uganda). The account will be matched with money from the program at a match rate of 2:1. Additionally, participants will receive: 1) twelve 1-2 hour workshops focused on asset building, future planning, and protection from risks; 2) mentorship sessions to reinforce learning and build optimism; and 3) a family income-generating /micro-enterprise promotion component for children enrolled in Bridges PLUS and their families.

Also known as: Child Development Account
Bridges PLUS
Usual CareOTHER

Participants in the usual care condition will receive usual care for AIDS-orphaned children in the study area. This includes: counseling, school lunches, and scholastic materials (textbooks and notebooks). Counseling will be provided by priests in the community (as is currently done).

Also known as: Usual Services
BridgesBridges PLUSUsual Care

Eligibility Criteria

Age11 Years - 17 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17)

You may qualify if:

  • An HIV/AIDS-orphaned child (a child who has lost one or both parents to HIV/AIDS)
  • Enrolled in grade 5 or 6 of primary school
  • Living within a family

You may not qualify if:

  • Any child who does not self-identify as an HIV/AIDS-orphan
  • Any child who is not enrolled in grade 5 or 6 of primary school
  • Any child who is not living within a family at the time of enrollment

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

International Center for Child Health and Asset Development

Masaka, Rakai and Masaka Districts, Uganda

Location

Related Publications (3)

  • Nabayinda J, Kizito S, Nabunya P, Namuyaba OI, Ssentumbwe V, Bahar OS, Torstein N, McKay M, Ssewamala FM. The Impact of an Economic Empowerment Intervention on Economic Security among AIDS-Orphaned Adolescents in Southern Uganda: the Moderating Role of Depression. AIDS Behav. 2026 Jan;30(1):242-252. doi: 10.1007/s10461-025-04862-0. Epub 2025 Aug 14.

    PMID: 40810883DERIVED

  • Ssewamala FM, Shu-Huah Wang J, Brathwaite R, Sun S, Mayo-Wilson LJ, Neilands TB, Brooks-Gunn J. Impact of a Family Economic Intervention (Bridges) on Health Functioning of Adolescents Orphaned by HIV/AIDS: A 5-Year (2012-2017) Cluster Randomized Controlled Trial in Uganda. Am J Public Health. 2021 Mar;111(3):504-513. doi: 10.2105/AJPH.2020.306044. Epub 2021 Jan 21.

    PMID: 33476237DERIVED

  • Nabunya P, Padgett D, Ssewamala FM, Courtney ME, Neilands T. Examining the nonkin support networks of orphaned adolescents participating in a family-based economic-strengthening intervention in Uganda. J Community Psychol. 2019 Apr;47(3):579-593. doi: 10.1002/jcop.22139. Epub 2018 Nov 5.

    PMID: 30394541DERIVED

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV InfectionsBlood-Borne InfectionsCommunicable DiseasesInfectionsSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesSlow Virus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System Diseases

Study Officials

  • Fred M Ssewamala, PhD

    Columbia University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

October 4, 2011

First Posted

October 6, 2011

Study Start

February 1, 2012

Primary Completion

January 15, 2018

Study Completion

January 15, 2018

Last Updated

October 12, 2018

Record last verified: 2018-10

Locations

UG(1)