The dynamic effects of a resilience‐based intervention on mental health from baseline to 6‐month follow‐up among children affected by HIV: A network approach

Extensive research has established that children affected by HIV face significantly elevated risks for chronic mental health challenges. To address this critical need, we systematically developed the ChildCARE intervention to improve mental health outcomes. However, the potential mechanisms by which it dynamically reshapes psychological elements remain unclear. Using network analysis with data from 595 participants aged 6-17 years (mean age = 10.47) receiving the child intervention, we examined change patterns between well-being and psychological distress domains from baseline to 6-month follow-up. Network comparison revealed significant reorganization of psychological elements following the intervention. Notably, global network connectivity significantly inc,reased among children affected by HIV aged 11-17 years. Further Bayesian network analysis identified a shift in the primary driver from depressive symptoms at baseline to self-esteem as the key upstream predictor post-intervention. Moreover, the intervention integrated two interconnected yet segregated subnetworks into a unified directed architecture, reflecting a transition toward a stable mental health state. This study demonstrates that self-esteem, as a central indicator, can serve as the primary focus of interventions aimed at reconfiguring psychological networks. The findings suggest that targeting self-esteem systematically in mental health interventions could effectively promote recovery and resilience among disadvantaged children.