The relationships between resilience, care environment, and social-psychological factors in orphaned and separated adolescents in Western Kenya

The relationships between care environment, resilience, and social factors in orphaned and separated adolescents and youths (OSAY) in western Kenya are complex and under-studied.Survey responses from OSAY living in Charitable Children’s Institutes (CCI) and family-based care settings (FBS) in Uasin Gishu County, Kenya were used to examine the associations between 1) care environment and resilience; 2) care environment and factors thought to promote resilience (e.g. social, family, and peer support); and 3) resilience and these same resilience-promoting factors, using multivariable linear and logistic regressions. This cross-sectional study included 1202 OSAY (50.4% female) aged 10–26 (mean = 16; SD = 3.5). The mean resilience score in CCIs was 71 (95%CI = 69–73) vs. 64 (95%CI = 62–66) in FBS. OSAY in CCIs had higher resilience (β = 7.67; 95%CI = 5.26–10.09), social support (β = 0.26; 95%CI = 0.14–0.37), and peer support (β = 0.90; 95%CI = 0.64–1.17) than those in FBS. OSAY in CCIs were more likely to volunteer than those in FBS (OR = 3.72; 95%CI = 1.80–7.68), except in the male subgroup. Family (β = 0.42; 95%CI = 0.24–0.60), social (β = 4.19; 95%CI = 2.53–5.85), and peer (β = 2.13; 95%CI = 1.44–2.83) relationships were positively associated with resilience in all analyses. Volunteering was positively associated with resilience (β = 5.85; 95%CI = 1.51–10.19). The factor most strongly related to resilience in both fully adjusted models was peer support. This study found a strong relationship between care environment and resilience. Care environment and resilience each independently demonstrated strong relationships with peer support, social support, and participating in volunteer activities. Resilience also had a strong relationship with familial support. These data suggest that resilience can be developed through strategic supports to this vulnerable population. Abbreviations: 95%CI - 95% Confidence intervalAMPATH - Academic Model Providing Access to HealthcareCASSS - Child and Adolescent Social Support ScaleCCI - Charitable Children’s InstitutesCTQ - Childhood Trauma QuestionnaireFBS - Family-based care settingICAST-CH - ISPCAN Child Abuse Screening Tool for Children a HomeMSPSS - Multidimensional Scale of Perceived Social SupportMTRH–Moi Teaching and Referral HospitalMU - Moi UniversityOSAY - Orphaned and separated adolescents and youthsOSCAR - Orphaned and Separated Children’s Assessments Related to Their Health and Well-BeingOR - Odds ratioRS14 - Resilience ScaleSD - Standard deviationSDQ - Strengths and Difficulties QuestionnaireSE - Standard ErrorUG - Uasin Gishu.