Abstract
We assessed the impacts of Tanzania's Cash Plus adolescent-focused intervention on depression. In this pragmatic cluster-randomized controlled trial, 130 villages were randomly allocated to intervention or control (1:1). Youth aged 14-19 years living in households receiving governmental cash transfers were invited to participate. The intervention included an intensive period (12-session course) and aftercare period (9-months mentoring, productive grants, and strengthened health services). We examined intervention impacts on the 10-item Centre for Epidemiological Studies Depression Scale (0-30) and exhibiting depressive symptomatology (≥10 scale), which were collected at baseline (April-June 2017), midline (May-July 2018), and endline (June-August 2019). Using intention-to-treat methodology, logistic and generalized linear models estimated effects for binary and continuous outcomes, respectively. Quantile regressions (QR) estimated effects acr oss the scale. From 2458 baseline participants, 941 intervention and 992 control adolescents were re-interviewed at both follow-ups. At endline, the intervention reduced the odds of depressive symptomatology (adjusted odds ratio 0.67 [95% CI 0.52 to 0.86]), with an undetectable mean scale difference (effect -0.36 [95%CI -0.84 to 0.11]). QR results demonstrated an intervention effect along the upper distribution of the scale. Integration of multi-sectoral initiatives within existing social protection shows potential to improve mental health among youth in low-resource settings.
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