Impact evaluation of the father engagement intervention in the humanitarian play lab (HPL) in Rohingya camps and host community in Cox’s Bazar, Bangladesh
| ISRCTN | ISRCTN13510859 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN13510859 |
| Research on Educational Effectiveness (REES) at Inter-university Consortium for Political and Social Research (ICPSR) | 13880.1v2 |
| Sponsor | Global TIES for Children - NYU |
| Funder | LEGO Foundation |
- Submission date
- 18/11/2025
- Registration date
- 20/11/2025
- Last edited
- 19/11/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Early childhood is a critical period for children’s learning and development, and research has shown that when fathers are actively involved, children benefit in many ways — they develop stronger language, thinking, and social skills, and grow up with better emotional wellbeing. However, most parenting programs focus on mothers, especially in low- and middle-income countries. This leaves a gap in understanding how to support fathers, particularly in difficult settings such as refugee camps.
This study evaluates a six-month father engagement program added to BRAC’s existing Humanitarian Play Lab (HPL) initiative for mothers of children aged 0–3 years. The program was developed by BRAC Institute of Educational Development (BRAC-IED) with research led by New York University’s Global TIES for Children, in collaboration with the University of Pennsylvania and ARCED Foundation.
The study focuses on the Rohingya refugee camps and nearby host communities in Cox’s Bazar, Bangladesh, where hundreds of thousands of Rohingya families have been displaced due to violence in Myanmar. It examines whether the father-focused program can improve fathers’ mental wellbeing, strengthen the father's engagement with the family and parenting, and promote children’s early learning and social-emotional development.
The main goal of the research is to find out whether involving fathers directly through home visits and group sessions can lead to better outcomes for fathers and young children.
Who can participate?
The study involves fathers and mothers with children under the age of three who live either in the Rohingya refugee camps or in nearby host communities (Cox’s Bazar Sadar, Ukhiya, Ramu, and Teknaf). To be able to participate, the family needs to have a child aged 0-3, agree to being part of the study, and the father needs to intend to live with the family for the duration of the study (8 months). The program and study are open to both fathers and mothers from these communities regardless of education level or employment status.
What does the study involve?
Groups of families are randomly assigned to one of two groups:
Control group: mothers received BRAC’s regular parenting sessions for mothers only.
Treatment group: mothers received the same sessions, and fathers received an additional program designed specifically for them.
The father engagement intervention is six months long. Fathers receive weekly home visits and monthly group sessions, both led by trained male volunteers from their own communities. Group sessions are scheduled at times convenient for each father and each session lasted about 30–60 minutes and covered topics such as: understanding emotions and managing stress, building positive relationships with children and spouses, the importance of play and early stimulation for children, practicing self-care and problem-solving, and learning to support children’s emotional and social growth.
Mothers continued to participate in BRAC’s existing group based parenting program, which met weekly and focused on child development, mothers’ wellbeing, and the use of play to strengthen the parent-child bond.
Both programs were supported by trained paracounselors, who supported volunteers and helped ensure quality delivery.
To measure impact, researchers conducted surveys with both fathers and mothers before and after the program, and used a child development assessment (Bayley -4) with a sample of children at the end of the program.
What were the possible benefits and risks of participating?
The benefits of participating in the program include:
1. Fathers gain new knowledge and skills about child development, emotional wellbeing, and positive parenting.
2. Mothers benefit from increased emotional and practical support from their partners.
3. Children may experience improved learning and social-emotional growth through more responsive care and play from both parents.
4. The program provides psychosocial support which might help families strengthen relationships in stressful environments.
The risks of participating in the program:
There were minimal risks to participating. The sessions involved discussions about family life and emotions, which may sometimes feel sensitive, particularly for men. However, all volunteers were trained to create a respectful and supportive environment, and paracounselors were available for any participant needing extra support.
Participation in the study was completely voluntary, and families could withdraw at any time without any consequences for their access to BRAC services.
Where is the study run from?
The study was led by New York University’s Global TIES for Children in collaboration with:
1. BRAC-IED who created and implemented the intervention in Bangladesh.
2. ARCED Foundation who led data collection and field supervision.
3. Center for Benefit-Cost Studies of Education at the University of Pennsylvania who conducted the cost-effectiveness analysis.
4. International Centre for Diarrhoeal Disease Research, Bangladesh who supported the training and quality assurance for child development assessments.
When Is the study starting and how long is it expected to run for?
September 2022 to August 2023.
Data collection included:
1. Baseline surveys: September–December 2022
2. Midline data collection to assess the quality of the father home visit in June 2023
3. Endline data collection: July-August 2023
Who is funding the study?
The project was part of the Play to Learn initiative, funded by the LEGO Foundation and implemented through a global partnership between Sesame Workshop, BRAC, the International Rescue Committee (IRC), and New York University.
Funding supports program delivery, training, data collection, and research activities in both Rohingya camps and host communities.
Who is the main contact?
1. Hirokazu Yoshikawa (Principle Investigator), Courtney Sale Ross University Professor of Globalization and Education
NYU Steinhardt, hiro.yoshikawa@nyu.edu
2. Yeshim Iqbal (Assistant Professor of Behavioral Science), Duke Kunshan University, yeshim.iqbal@dukekunshan.edu.cn
Contact information
Principal investigator
627 Broadway, Room 815
New York
10012
United States of America
| Phone | +1 (212) 998-5107 |
|---|---|
| hiro.yoshikawa@nyu.edu |
Public, Scientific
No 8 Duke Avenue
Duke Kunshan University
Kunshan
215316
China
| Phone | +86 17821456514 |
|---|---|
| yeshim.iqbal@dukekunshan.edu.cn |
Study information
| Primary study design | Interventional | |
|---|---|---|
| Allocation | Randomized controlled trial | |
| Masking | Blinded (masking used) | |
| Control | Placebo | |
| Assignment | Parallel | |
| Purpose | Supportive care | |
| Scientific title | Impact evaluation of a father engagement model in the home visiting humanitarian play lab (HPL) Program in Rohingya camps and host community in Cox’s Bazar, Bangladesh | |
| Study acronym | IEFE-Bangladesh | |
| Study objectives | The intervention assessed in this study is an added component to an intervention implemented by BRAC- IED that has been working with mothers of 0-3 year old children to maximize positive outcomes of child development and develop positive family relationships. The new component is a father engagement program for fathers with children below three years of age. The objectives of this added component are to promote fathers’ wellbeing by improving their emotional literacy, encourage fathers to develop relationships with their spouses and children, and encourage responsive caregiving practices among fathers (BRAC & Sesame Workshop, 2022). The primary research questions are: what is the added impact of father home visits and groups on child development, father engagement (e.g. activities with their children), perceptions of learning and play, and attitudes and well-being, above and beyond group visits conducted with only mothers? | |
| Ethics approval(s) |
Approved 07/11/2022, The Institutional Review Board of the Institute of Health Economics (IHE-IRB), University of Dhaka, Bangladesh (Institute of Health Economics, Arts Faculty Building, University of Dhaka, Dhaka, 1000, Bangladesh; +88 01675915701; n_ifteakhar@ihe.du.ac.bd), ref: IHE/IRB/DU/49/2022/Final | |
| Health condition(s) or problem(s) studied | Early Childhood Education, child development, caregiver mental health, and father engagement in parenting | |
| Intervention | This was a multisite (blocked) interventional cluster randomized trial. The study evaluates the added impact of a father-focused parenting intervention implemented by BRAC-IED in Cox’s Bazar, Bangladesh, across both refugee camps and host communities. The intervention builds upon an existing mother-focused group program designed for mothers of children aged 0–3 years by adding a father-focused home visit and group session component. Treatment arms: 1) Comparison group (mother-only program): Mothers participate in the standard BRAC-IED group-based parenting sessions, delivered by trained mother volunteers. Fathers in these households do not receive any additional intervention. 2) Treatment Group (mother + father program): In the treatment group, fathers receive a home-based and group-based intervention delivered by trained father volunteers addition to the mother-focused sessions. This component focuses on enhancing fathers’ emotional wellbeing, strengthening family relationships, and promoting responsive caregiving practices. Dosage and Administration: Fathers in the treatment arm receive approximately 6 months of intervention, consisting of three home visits and one group session per month. Home visits take roughly 30 minutes each, focusing on topics such as the importance of father engagement in child development, emotional literacy, stress responses in children, and the role of play. Group sessions take 45–60 minutes each, reinforcing similar content through peer discussion and guided activities. Randomization: the unit of randomization is a mother volunteer's caseload. Each mother volunteer oversees four pockets of households, with two groups per pocket. The entire caseload of a mother volunteer was randomly assigned randomly to either the comparison or treatment condition. Baseline data was collected prior to randomization and families were randomized into treatment and control conditions based on the below procedure (The implementing organization, BRAC, was provided with a spreadsheet listing which families were in the treatment and which were in the control group based on the below procedure). Randomization was assumed at mother volunteer level, with each mother volunteer (and her full caseload) randomly allocated to treatment or control. In the camps, the caseloads of 125 mother volunteers were allocated to treatment; this means that the husbands of the mothers assigned to these mother volunteers received the intervention, delivered by father volunteers. In the host, the caseloads of 63 mother volunteers were assigned to treatment. The camp and host baseline data were randomized immediately to provide BRAC with treatment and control allocations; this information was vital to them to begin the intervention as father volunteers would be recruited and trained based on the locations of the treatment condition households. In the host community, simple randomization was performed given the large baseline sample. Balance checks on potential confounders indicate that the randomization was successful. In the camps, constrained randomization was performed to ensure covariate balance between arms on all potential confounders. Constrained randomization involves generating many possible allocation schemes and calculating a balance score that assesses covariate imbalance for each of those schemes. It then limits the randomization space to a pre-specified percentage of candidate allocations before randomly selecting one scheme to implement. For this study, the 12-balance metric was used, which was first introduced by Raab and Butcher (2001), and constrained the randomization space to the 10% of schemes that provided the best balance. The covariates that were used included camp number/location, mother volunteer characteristics (age and tenure at BRAC), caseload characteristics (mother health, education, literacy, and age; father education, literacy, and age; the number of children under 2 in the household; whether the mother is pregnant, and whether the mother suffered a serious injury in the last year) and baseline versions of the outcomes aggregated to the caseload level. All of the primary outcome(s) are considered primary because the RQs related to them are confirmatory. The secondary outcome measures related to the exploratory research questions are the same as the ones listed under primary outcome(s), but explore moderation by community (camp/host) , parental education, baseline household resources (using PREI - perceived refugee environment index items), baseline parental physical health, child age/gender, and mother-report of mother-child stimulating behaviors at baseline(from a measure created for this study). | |
| Intervention type | Behavioural | |
| Primary outcome measure(s) |
1. Father engagement with child and family (6 subdomains) measured using a group of likert-scale items created for this study at baseline and endline via both father and mother report. | |
| Key secondary outcome measure(s) |
1. Moderation by community (camp/host) measured using data on whether the participant lives in the camps or in the host community is known a priori at one time point | |
| Completion date | 15/08/2023 |
Eligibility
| Participant type(s) | Carer, Service user |
|---|---|
| Age group | Mixed |
| Lower age limit | 0 Months |
| Upper age limit | 35 Months |
| Sex | All |
| Target sample size at registration | 4000 |
| Total final enrolment | 3998 |
| Key inclusion criteria | 1. Family has a child between ages 0-3 2. Father intending to reside with family for the duration of the intervention 3. Family consents to being part of the study 4. In host community, being in or near BRAC’s existing pockets (households that are geographically proximal to early childhood development programs situated in government primary schools). |
| Key exclusion criteria | Some families were pre-determined for exclusion . These were those who were: 1. In particular camps that received the intervention on a delayed schedule and were dropped from the study (camp 8w and 22; a total of 124 families) 2. The half of the host sample that we did not include at endline |
| Date of first enrolment | 25/09/2022 |
| Date of final enrolment | 25/09/2022 |
Locations
Countries of recruitment
- Bangladesh
Study participating centre
-
4700
Bangladesh
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan summary | Stored in publicly available repository |
| IPD sharing plan | The datasets generated and analyzed during the study will be stored in a publicly available repository (https://dataverse.harvard.edu or isrctn) by the end of November 2025. This will include all the (de-identified) data relevant to replicating answers to the confirmatory research questions of the study, along with the scripts used to obtain the reported estimates. Data will be shared under an open license - it can be accessed and downloaded by anyone without restriction. Study consent forms obtained by participants allow the researchers to share the anonymized data publicly. |
Editorial Notes
18/11/2025: Study’s existence confirmed by the The Institutional Review Board of the Institute of Health Economics (IHE-IRB), University of Dhaka, Bangladesh. Please note that the study was originally designed for the Rohingya camp community, and a first IRB approval (August 5, 2022) covered only this population. Due to restrictions on data collection in the camps, the design was expanded to include the host community, requiring a second IRB approval; this later approval date in this record covers the full sample and is attached for registration purposes.
