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Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa

Advances in pharmacological treatment and medical management of HIV have resulted in decreases in HIV-associated mortality and morbidity for people living with HIV worldwide. However, many HIV+ individuals continue to experience some degree of neurocognitive impairment, particularly in the domain of...

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Main Author: Harwood, Angela
Other Authors: Schrieff, Leigh
Format: Thesis
Language:English
Published: Department of Psychology 2022
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access_status_str Open Access
author Harwood, Angela
author2 Schrieff, Leigh
author_browse Harwood, Angela
Schrieff, Leigh
author_facet Schrieff, Leigh
Harwood, Angela
author_sort Harwood, Angela
collection Thesis
description Advances in pharmacological treatment and medical management of HIV have resulted in decreases in HIV-associated mortality and morbidity for people living with HIV worldwide. However, many HIV+ individuals continue to experience some degree of neurocognitive impairment, particularly in the domain of executive functioning. HIV-related executive deficits are particularly pertinent in the adolescent population as individuals transition into adulthood and assume greater responsibility for their daily functioning. Despite the high prevalence of HIV in South African adolescents, neuropsychological rehabilitation interventions are largely absent. Currently, metacognitive approaches such as Goal Management Training (GMT) demonstrate the best evidence base for improving executive functions. The main aim of this study was to evaluate the effectiveness of a pGMT intervention for HIV+ adolescents in South Africa. A secondary objective was to provide commentary on the feasibility of conducting cognitive rehabilitation interventions in low resourced settings such as those commonly found in South Africa. This quantitative study used a pre-test post-test quasi experimental research design to investigate the effectiveness of a 7-week pGMT intervention in HIV+ adolescents in South Africa. Participants included 18 HIV+ adolescent (aged 14-17) first language Xhosa speakers from low socio-economic backgrounds. Participants formed two groups: a pGMT intervention (n = 10), and a Control (n = 8) group. A neuropsychological test battery was administered pre- and post- intervention to assess executive functions. Neuropsychological test scores were sorted into four executive function composite domains. To assess the efficacy of the pGMT intervention, these executive function domains were analysed using a mixed-design ANOVA and Mann-Whitney U analysis of difference scores. No significant effects were detected, suggesting that the pGMT intervention demonstrated limited efficacy in the study sample. However, the successful implementation of the intervention supports the use of the GMT protocol in low-resourced settings such as those commonly found in LMICs like South Africa. Findings of the current study contribute valuable insights into the limitations and opportunities relevant not only to research in this field, but also more broadly to the implementation of cognitive rehabilitation interventions in LMICs such as South Africa.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2022
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spelling oai:open.uct.ac.za:11427/35821 Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa Harwood, Angela Schrieff, Leigh Thomas, Kevin Neuropsychology Advances in pharmacological treatment and medical management of HIV have resulted in decreases in HIV-associated mortality and morbidity for people living with HIV worldwide. However, many HIV+ individuals continue to experience some degree of neurocognitive impairment, particularly in the domain of executive functioning. HIV-related executive deficits are particularly pertinent in the adolescent population as individuals transition into adulthood and assume greater responsibility for their daily functioning. Despite the high prevalence of HIV in South African adolescents, neuropsychological rehabilitation interventions are largely absent. Currently, metacognitive approaches such as Goal Management Training (GMT) demonstrate the best evidence base for improving executive functions. The main aim of this study was to evaluate the effectiveness of a pGMT intervention for HIV+ adolescents in South Africa. A secondary objective was to provide commentary on the feasibility of conducting cognitive rehabilitation interventions in low resourced settings such as those commonly found in South Africa. This quantitative study used a pre-test post-test quasi experimental research design to investigate the effectiveness of a 7-week pGMT intervention in HIV+ adolescents in South Africa. Participants included 18 HIV+ adolescent (aged 14-17) first language Xhosa speakers from low socio-economic backgrounds. Participants formed two groups: a pGMT intervention (n = 10), and a Control (n = 8) group. A neuropsychological test battery was administered pre- and post- intervention to assess executive functions. Neuropsychological test scores were sorted into four executive function composite domains. To assess the efficacy of the pGMT intervention, these executive function domains were analysed using a mixed-design ANOVA and Mann-Whitney U analysis of difference scores. No significant effects were detected, suggesting that the pGMT intervention demonstrated limited efficacy in the study sample. However, the successful implementation of the intervention supports the use of the GMT protocol in low-resourced settings such as those commonly found in LMICs like South Africa. Findings of the current study contribute valuable insights into the limitations and opportunities relevant not only to research in this field, but also more broadly to the implementation of cognitive rehabilitation interventions in LMICs such as South Africa. 2022-02-22T07:53:16Z 2022-02-22T07:53:16Z 2021 2022-02-16T05:56:50Z Master Thesis Masters M. A. http://hdl.handle.net/11427/35821 eng application/pdf Department of Psychology Faculty of Humanities
spellingShingle Neuropsychology
Harwood, Angela
Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa
thesis_degree_str Master's
title Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa
title_full Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa
title_fullStr Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa
title_full_unstemmed Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa
title_short Investigating an Executive Function Intervention Using Goal Management Training in HIV+ Adolescents in South Africa
title_sort investigating an executive function intervention using goal management training in hiv adolescents in south africa
topic Neuropsychology
url http://hdl.handle.net/11427/35821
work_keys_str_mv AT harwoodangela investigatinganexecutivefunctioninterventionusinggoalmanagementtraininginhivadolescentsinsouthafrica