Disability-inclusive graduation programme intervention on social participation among ultra-poor people with disability in North Uganda: a cluster randomized trial

作者：Chen S, Banks LM, Carew MT, Kipchumba E, Davey C, Sulaiman M, Kuper H · 发表于：BMC medicine · 年份：2025 · DOI：10.1186/s12916-025-04100-3 · 被引用次数：32 · 研究领域：Cluster randomized trial、Disability inclusion、Low-income countries、Social participation、Uganda

BACKGROUND: People with disabilities encounter significant barriers to social participation due to inaccessible environments and negative attitudes. This study evaluated the effectiveness of a comprehensive disability-inclusive graduation (DIG) programme in enhancing social participation among ultra-poor people with disabilities in rural Uganda. METHODS: A two-arm, cluster-randomized controlled trial was conducted in four Northern Ugandan districts, involving 96 intervention and 89 control clusters. The DIG intervention encompassed four pillars: Livelihoods, Social Protection, Financial Inclusion, and Social Empowerment. The study identified households with disabilities using the Washington Group Short Set questions, verified by BRAC programme managers, comprising 370 working-age people with disabilities in the intervention group and 321 in the control group at baseline. Treatment clusters received an 18-month DIG intervention from December 2020 to June 2022. Social participation was measured using the SINTEF Participation Question Set at baseline, immediately post-intervention, and 16 months post-intervention, covering household and societal participation domains. Intervention effects were analyzed through linear mixed-effects regression models, reporting minimally adjusted and fully adjusted mean differences (MAMD and FAMD) with 95% confidence intervals. RESULTS: Immediately after the intervention, the DIG programme showed a positive trend in overall social participation ...