Key Social Norms Take-aways This study highlights the role of family and church-based relationships in shaping social norms around adolescent mental health and HIV prevention. The intervention fostered shifts in injunctive norms by reinforcing open communication, gender-equitable attitudes, and joint problem-solving within families. By situating the program within trusted church settings and engaging both adolescents and caregivers, the intervention challenged the normative silence and stigma surrounding sex, HIV, and emotional health, suggesting that shifting family and faith-based norms is key to sustainable prevention.
Objectives The study aimed to evaluate the effects of a family-focused, church-based intervention on mental health and HIV-related outcomes among adolescents in rural Kenya, with an emphasis on strengthening protective family processes.
Methods A stepped wedge cluster randomized trial was conducted across four churches with 124 families including 237 adolescents aged 10 to 16 and 203 caregivers. Surveys were administered at baseline, midline, and post-intervention to assess changes in parenting, communication, gender norms, and adolescent mental health and sexual health outcomes. Quantitative data were supplemented with qualitative feedback and observations to assess feasibility and acceptability.
Intervention Details The READY (Religious Education to Strengthen and Develop Youth) program was developed through community-based participatory research and delivered in nine sessions following Sunday services. It combined modules on economic empowerment, parenting and communication skills, emotional and behavioral health, and HIV education. Sessions were interactive and included both adolescents and caregivers, facilitated by trained lay church members. Religious leaders also supported the intervention by reinforcing key messages during sermons and family events.
Results The intervention led to significant improvements in caregiver-child communication, parenting practices, and caregiver-child relationships. Adolescents in the intervention group reported fewer depressive symptoms and higher self-esteem. Caregivers demonstrated more supportive behaviors and improved gender equitable attitudes. The intervention also enhanced families’ comfort discussing sensitive topics such as HIV and sexuality. Although direct measures of social norms were not used, the design and outcomes suggest meaningful shifts in family-level norms related to communication, discipline, and openness.
Conclusions Embedding a family-focused intervention within religious institutions can effectively shift social expectations around parenting, gender roles, and adolescent sexual health. By promoting caregiver-adolescent dialogue and modeling supportive relationships, the program challenged stigmatizing and silence-based norms, creating safer environments for adolescent mental and reproductive health. This approach offers a scalable model for norm change in settings where faith and family are central to community life.