From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.-based Evidence-Based Intervention to the Uganda Context

In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children’s drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process.     

Exploring Processes in Day-to-Day Parent–Adolescent Conflict and Angry Mood: Evidence for Circular Causality

Parent–adolescent conflict has been studied both as a precursor of long-term macrolevel developmental risks and as an outcome of microlevel, moment-to-moment interaction patterns. However, the family-level processes underlying the maintenance or regulation of conflict in daily life are largely overlooked. A meso-level understanding of parent–adolescent conflict offers important practical insights that have direct implications for interventions. The present study explores day-to-day reciprocal processes and carryover in parents’ and adolescents’ experiences of anger and conflict. Daily diary data provided by parent–adolescent dyads (N = 151) from two-caregiver households (adolescents: 61.59% female, mean age = 14.60 years) over 21 days were examined using a multivariate Poisson multilevel model to evaluate the circular causality principle in parents’ and adolescents’ daily conflict and anger. Findings offer empirical support for the theory, suggesting that parents’ and adolescents’ anger and conflict exist together in a feedback loop wherein conflict is both a consequence of past anger and also an antecedent of future anger, both within and across persons. Increased understanding of the daily interaction patterns and maintenance of parent–adolescent conflict can guide more informed, targeted, and well-timed interventions intended to ameliorate the consequences of problematic parent–adolescent conflict sequences.