Development and Testing of BAJJAJJA: An Intervention to Promote Economic Empowerment and Health of Grandmothers Who Provide Primary Care for Grandchildren in Uganda
University of Utah
Summary
Background: There are an estimated 163 million children worldwide who are under the care of their grandparents or other relatives. In Uganda, social determinants of health (i.e., poverty, wars, and maternal and perinatal conditions) threaten the middle generation (age 15-49) and leave older adults, especially grandmothers (Bajjajja), to become the safety net. Yet, in this region, knowledge about effective interventions that support the health and wellbeing of these GMCs is limited to nonexistent. As such, Dr. Matovu proposes to refine, adapt, and test her BAJJAJJA intervention that she developed. Specific Aims: Dr. Matovu will achieve this goal through three Specific Aims: 1. Refine and adapt the BAJJAJJA intervention components through a collaborative and iterative feedback process with a diverse community group of 18 members; 2. Test the feasibility, acceptability and preliminary efficacy of the BAJJAJJA intervention in improving economic and health outcomes among 24 Ugandan GMCs; and 3. Explore the barriers and facilitators to (3a) maintenance of the BAJJAJJA individual intervention benefits and (3b) sustainability of the income generating activity at 6 months post-intervention. This innovative study will utilize a community-engaged approach that emphasizes the meaningful involvement of community partners to develop an intervention that targets GMCs. Her outcomes will support her future efficacy clinical trial to test a novel multi-component and community-engaged BAJJAJJA intervention to promote the mental, physical, and economic wellbeing of GMCs.
Description
SIGNIFICANCE Caring for children is complex in the best of circumstances. Grandparents take on primary caregiving responsibility when parents are unavailable or unable to rear their children. In sub-Saharan Africa, prevailing reasons for grandparent-caregiving include parental illness/death due to AIDS and other infectious diseases and socioeconomic factors such as chronic poverty.1-8 Although sub-Saharan Africa has seen reductions in new HIV infections compared to other regions, it remains the most affected worldwide. Of the estimated 13.4 million orphans created by the HIV/AIDS epidemic, mor…
Eligibility
- Age range
- 50+ years
- Sex
- Female
- Healthy volunteers
- Yes
Inclusion Criteria: Participants must meet all of the following criteria: * Female, aged 50 years or older (reflecting the post-reproductive age range in Uganda) * Luganda-speaking (commonly spoken language). * Primary caregiver of at least one minor grandchild (under 18 years) for more than six months * Able to independently perform activities of daily living (e.g., cooking, bathing) Exclusion Criteria: Participants will be excluded if they: * Are cohabitating with their adult children * Are grandmothers under the age of 50
Interventions
- BehavioralThe BAJJAJJA intervention
The BAJJAJJA intervention is composed of: The IGA COMPONENT which is intended to promote economic empowerment by improving household income based on available resources. The component will consist of a series of 1-hour sessions with 3 separate GMC participant groups (8 GMCs per group). Two IGA experts will lead these sessions, weekly for the first two months and later monthly for the remaining 10 months of the 12-month intervention period. The HEALTH COACHING COMPONENT will be informed by theChronic Disease Self-Management Education (CDSME) framework.54 This community-based, person-centered care model will be used to empower GMCs to manage their health through goal-setting, problem-solving, and chronic disease self-monitoring. I (PI) will leverage the community networks that I developed during my preliminary work to (1) recruit interventionists (two nurses) and (2) ensure their adequate training and adherence to the intervention manuals and procedures.
Location
- University of Utah College of NursingSalt Lake City, Utah