All ETDs from UAB

Advisory Committee Chair

David C Schwebel

Advisory Committee Members

Fred Biasini

Robin Lanzi

Leann Long

Document Type

Thesis

Date of Award

2019

Degree Name by School

Master of Arts (MA) College of Arts and Sciences

Abstract

Objective: Unintentional childhood injury is a significant global health burden particularly in low and middle income countries (LMIC). Effective supervision can reduce risk of injury to supervisees. Frequently, older siblings assist in supervising younger siblings, but may not be as effective as adult caregivers at preventing supervisee injury. The current investigation had three primary objectives: 1) Assess Ugandan adult caregivers’ self-reported expectations for children to provide sibling supervision; 2) Assess sixth-grade students’ self-reported experiences providing supervision; 3) Determine whether students’ supervision knowledge and skill improve through participation in the Super Siblings program, a novel classroom-based, culturally-adapted intervention. Methods: Adult caregivers and sixth grade students from rural Uganda completed self-report questionnaires on sibling supervision expectations and experiences. Students then participated in an 11-lesson, school-based, manualized intervention (Super Siblings) to improve child supervision skills. Program outcomes were assessed using mixed methods. Results: Caregivers in 82% of households expected children under age 2 to be supervised by older siblings on a daily basis. Frequency and duration of expected sibling supervision increased with supervisor age. Approximately half of students and supervisees experienced at least one medically-attended injury in the past year. Student history of injury increased supervisee risk of injury 2.25 times. Students demonstrated improvement in supervision knowledge and skill following participation in the Super Siblings program. Teacher support for the program was strong. Conclusion: Sibling supervision is a widespread practice in rural Uganda, and supervisee injuries are common. Interventions to improve child supervision in LMIC are warranted, as are attempts to disseminate promising programs like Super Siblings.

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