Principal Investigator: Fred M. Ssewamala, PhD

Project Team Members: Mary McKay, PhD; Claude Mellins, PhD (Columbia University); Irwin Garfinkel, PhD (Columbia University); Proscovia Nabunya, PhD; Torsten Neilands, PhD (University of California – San Francisco); Ozge Sensoy Bahar, PhD 

Field Coordinator: Flavia Namuwonge 

Research Collaborators: Abel Mwebembezi (Reach the Youth-Uganda), Fr. Kato Bakulu (Masaka Diocese), Gertrude Nakigozi (Rakai Health Sciences Program)

Suubi4Her is longitudinal study (2017-2023) funded by the National Institute of Mental Health (NIMH). It examines the impact and cost associated with Suubi (hope) for Girls (hereafter, Suubi4Her), which is an innovative combination intervention that aims to prevent HIV risk behavior in communities heavily affected by poverty and HIV/AIDS in Southern Uganda. This is done through economic empowerment and promotion of behavioral health. This study combines two evidence-based approaches:

1. a youth monetary savings program that supports adolescent girls in secondary school education and family small-business/microenterprises development

2. a 16 session manualized MFG intervention that strengthens family relationships to address mental health challenges which frequently accompany adolescent girls’ transition to adulthood.

mHealth Component

This study seeks to examine access and utilization of mobile phones (technology) and acceptability of mhealth interventions among adolescent girls. Specifically, the study assesses behavioral health and psychosocial functioning, cell phone access, as well as beliefs and attitudes about tobacco, alcohol, substance use, sexual decision-making, and HIV-risk factors.

Qualitative Component

With this additional support, the team will qualitatively examine participants’ experiences with the intervention and explore multi-level factors that may have impacted participants’ observable behaviors and decision-making in regards to savings, mental health, and sexual risk-taking. The team will also interview the multiple family group facilitators and school head teachers in treatment schools to examine factors that may influence system-level sustainability.

Diversity Supplement

This administrative supplement will assess the impact of antiretroviral therapy (ART) and attitudes on HIV testing behavior and adherence among the study participants. The study findings will enrich extant literature about the attitudes and perceptions of adolescent girls (an HIV vulnerable population) towards ART and provide insight which will be useful in informing the development of interventions, diagnosis, treatment and management of HIV, including adherence to ART.

SUUBI4Her Publications

Brathwaite R, Namuwonge F, Magorokosho N, Tutlam N, Neilands TB, Namirembe R, Ssentumbwe V, Ssewamala FM. Impact of Economic and Family Intervention on Adolescent Girls’ Education Performance, School Absenteeism, and Behavior in School: The Suubi4Her Study. J Adolesc Health. 2023 Oct 8:S1054-139X(23)00455-X. doi: 10.1016/j.jadohealth.2023.08.043. Science Direct

Namuwonge F, Kizito S, Ssentumbwe V, Kabarambi A, Magorokosho N, Nabunya P, Namuli F, Namirembe R, Ssewamala FM. Peer Pressure and Risk-taking Behaviors among Adolescent Girls in a region impacted by HIV/AIDS in Southwestern Uganda. J Adolesc Health. 2023 Oct 5: Science Direct

Karimli L, Nabunya P, Ssewamala FM, Dvalishvili D. Combining Asset Accumulation and Multifamily Group Intervention to Improve Mental Health for Adolescent Girls: A Cluster-Randomized Trial in Uganda. J Adolesc Health. 2023 Sep 16:S1054-139X(23)00422-6. doi: 10.1016/j.jadohealth.2023.08.012. Science Direct

Byansi W, Ssewamala FM, Neilands TB, Mwebembezi A, Nakigozi G. Patterns of and Factors Associated With Mental Health Service Utilization Among School-Going Adolescent Girls in Southwestern Uganda: A Latent Class Analysis. J Adolesc Health. 2023 May;72(5S):S24-S32. doi: 10.1016/j.jadohealth.2022.09.037. PMID: 37062580. Science Direct

Filiatreau LM, Tutlam NT, Brathwaite R, Byansi W, Namuwonge F, Mwebembezi A, Sensoy Bahar O, Nabunya P, Neilands TB, Cavazos-Rehg P, McKay MM, Ssewamala FM. Effects of a combination economic empowerment and family strengthening intervention on psychosocial well-being among Ugandan adolescent girls and young women: analysis of a cluster randomized controlled trial from the Suubi4Her study. J Adolesc Health. 2023 May;72(5S):S33-S40. doi: 10.1016/j.jadohealth.2022.11.250. Science Direct

Sensoy Bahar O, Nabunya P, Namuwonge F, Samtani S, Ssentumbwe V, Namuli F, Magorokosho N, Ssewamala FM. “It gives you a road map of what to do to solve your problems”: Acceptability of a Combination HIV Prevention Intervention Among Adolescent Girls in Uganda. BMC Public Health23, 249 (2023). BMC Public Health

Byansi W, Howell TH, Filiatreau L, Nabunya P, Kaiser N, Kasson E, Ssewamala FM, Cavazos-Rehg P. Sexual and Health Behaviors and Knowledge among Uganda Adolescent Girls: Implications for Advancing Comprehensive Sexual Health Education. Child and Youth Care Forum. 2023 Jan 31. Springer

Ssewamala FM, Brathwaite R, Neilands TB. Economic Empowerment, HIV Risk Behavior, and Mental Health Among School-Going Adolescent Girls in Uganda: Longitudinal Cluster-Randomized Controlled Trial, 2017‒2022. Am J Public Health. 2023 Jan 5: e1-e10. doi: 10.2105/AJPH.2022.307169. AJPH

Nabunya P, Byansi W, Muwanga J, Sensoy Bahar O, Namuwonge F, Ssentumbwe V, Ssewamala FM. Family Factors and Gender Norms as Protective Factors against Sexual Risk-taking Behaviors among Adolescent Girls in Southern Uganda. Global Social Welfare. 2022 Aug 11. Springer

Byansi W, Ssewamala FM, Neilands TB, Sensoy Bahar O, Nabunya P, Namuwonge F, McKay MM. The short-term impact ofa combination intervention on depressive symptoms among adolescent girls in Uganda: The Suubi4Her cluster randomized trial. Journal of Adolescent Health. 2022 June 1. Science Direct

Nabunya, P., Damulira, C., Byansi, W., Muwanga, J., Sensoy Bahar, O., Namuwonge, F., Ighofose, E., Brathwaite, R., Tumwesige, W., & Ssewamala, F. M. (2020). Prevalence and correlates of depressive symptoms among high school adolescent girls in southern Uganda. BMC Public Health, 20(1), 1792. BMC Public Health

Ssewamala, F. M., Bermudez, L. G., Neilands, T. B., Mellins, C. A., McKay, M. M., Garfinkel, I., … & Damulira, C. (2018). Suubi4Her: A study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda. BMC Public Health18(1), 693. BMC Public Health