An Evaluation of a theory-based support group intervention for children affected by maternal HIV / Aids

Abstract

The aim of this study was to evaluate a 24-week support group intervention programme which was designed to enhance adaptive behaviour of latent-phase children affected by maternal HIV/Aids. The meta-theoretical paradigms underlying the study were pragmatism and realism. The study was embedded in a concurrent nested (QUALquan) mixed-method design. The quantitative approach in the main study followed a quasi-experimental research design whereas the qualitative approach in this study, contributing to the largest part of the analysis in the study, followed a nested multiple case study design. The theory-driven outcome programme evaluation model applied in this study was the integrative process/outcome evaluation approach. The participants (n=139) were purposefully selected from among previously identified HIV-positive women (n=220) with children between the ages of 6 and 10 years at clinics in the Tshwane region, South Africa. Data were collected over a period of five years in multiple waves of intervention implementation. Prolonged, in-depth engagement by the researcher with participants was prioritized. The data collection strategies comprised of mother-and-child psychological questionnaires, group process notes, careworker focus groups, quality assurance questionnaires and field notes. The data were quantitatively analysed by means of a paired-sample t-test for within-group comparisons and descriptive statistics were furthermore applied. The qualitative text and narration obtained through the interviews, documents and focus groups were coded and analysed for themes. The themes of the emergent concepts were re-coded to establish improved defined categories. The different data sampling strategies assisted the researcher in triangulating the data for increased evaluation reliability. The PhD-study was conducted within a broader longitudinal study on resilience in South African mothers and children affected by HIV/Aids – the Promoting Resilience in Young Children Study. The findings of the Child Support Group Evaluation Study (e.g. PhD) showed that the content, methods and processes employed in the group-based sessions were effective and culturally sensitive. The intervention sessions enhanced the children’s coping skills, internalised and externalised behaviour and daily living, communication and socialisation skills. The group provided a buffer for the children and supported them in coping with their mothers’ illness. The children displayed normative values through their religious coping styles, their quest for and display of respect and their unambiguous assertion of right and wrong. A specific finding of this study was that the children created a sphere or space in which to order their thoughts, behaviours and emotions within the intervention. This provided them with parameters in their adverse circumstances to display adaptive behaviour or resilience which they could use to function adequately. The study suggests that the use of support groups should be incorporated into intervention programmes dealing with latent-phase children affected by HIV/Aids.