Responsible Engaged and Loving (REAL) Fathers Intervention Evaluation

NCT06100679 | Active Not Recruiting

• 1 other identifier: 808321
• Study Type: interventional
• Target: 4,728
• Locations: 1 country
• Sites: 4

Brief Summary

The goal of this stepped-wedge cluster randomized control trial is to assess whether a Ugandan community-based intervention for young fathers (ages 18-25 years) of children ages 0-3 years impacts fathers' knowledge, attitudes, and behaviors surrounding positive parenting practices, father-child interaction, harsh physical punishment of children, and intimate partner violence.

Conditions

Violence, Gender-Based; Violence, Domestic; Violence, Sexual; Violence, Physical; Contraception Behavior; Child Development; Child Abuse; Communication, Partner; Conflict Resolution; Parent-Child Relations

Keywords

Violence Prevention; Early Childhood Development; Couples Communication; Father Engagement; Gender Norms

Outcome Measures

Primary Outcomes (5)

• Reduced Intimate Partner Violence Perpetration (IPV-P)

  Proportion of young fathers and their wives reporting perpetrating physical, sexual, and/or emotional IPV in the past three months. Assessed via six measures: whether you shouted or yelled at your \[wife/husband\]; slapped your \[wife/husband\]; pushed or shoved your \[wife/husband\]; threw something at your \[wife/husband\] that could hurt \[her/him\]; physically forced your \[wife/husband\] to have sex with you when \[she/he\] did not want to; or insulted your \[wife/husband\]. Response options: never, once, a few times, many times, don't know/remember, refused.

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Reduced Intimate Partner Violence Victimization (IPV-V)

  Proportion of young fathers and their wives reporting being a victim of physical, sexual, and/or emotional IPV in the past three months. Six measures include: whether your spouse shouted or yelled at you; slapped you; pushed or shoved you; threw something at you that could hurt you; physically forced you to have sex with you when you did not want to; or insulted you. Response options: never, once, a few times, many times, don't know/remember, refused.

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Reduced Unmet Need for Family Planning

  Proportion of men and women with unmet need for healthy timing and spacing of children. Assessed via those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child for 2 or more years.

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Early Child Development (ECD) - CREDI

  Scores on the short-form version of the Caregiver Reported Early Development Instruments (CREDI).

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Father engagement in child immunization

  Proportion of fathers reporting that they took their child(ren) for rounds of immunization(s).

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

Secondary Outcomes (8)

• Fathers' knowledge of positive parenting and discipline skills

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Fathers' attitudes towards positive parenting and discipline

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Father engagement at home

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Couple communication and conflict resolution

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

• Fathers' positive parenting and discipline behaviors

  1) Baseline to Wave 2 (Endline) = 8 months; and 2) Baseline to Wave 3 (Follow-Up) = 16 months

Study Arms (2)

Control

NO INTERVENTION

Standard of care. Participants will have access to existing health centers and early childhood development centers.

Intervention

EXPERIMENTAL

Participants will engage in the Responsible, Engaged and Loving (REAL) Fathers Intervention-an evidence-based community mentoring education program for young fathers and their spouses. Over 7 months, fathers receive monthly home visits from a community-identified male mentor. Mentors share information and skills-building tools on conflict resolution, non-violent discipline, family planning, and couple communication. At the end of each month, pairs or trios of mentors hold group reflection sessions with all mentored fathers. In months 5 and 6 of the intervention, spouses join the home visits and group sessions. Community-level intervention components include: 1) monthly educational poster campaigns that showcase nonviolent discipline and conflict resolution strategies; 2) community-hosted celebrations at the end of the intervention to acknowledge the accomplishments of the young fathers.

Behavioral: Responsible Engaged and Loving (REAL) Fathers Initiative

Interventions

Responsible Engaged and Loving (REAL) Fathers Initiative BEHAVIORAL

REAL Fathers is a multilevel norms-shifting intervention among: young fathers (ages 16-25 whose oldest child is under the age of 3); couple dyads (fathers and wives); mentoring dyads and groups; and communities. Respected men in the community are identified by participating young fathers, their partners and community members to become mentors. Mentors participate in a training and mentor young fathers through home and group sessions on conflict resolution, non-violent discipline, family planning, and couple communication. Mentoring is supplemented with a monthly poster campaign designed to reinforce messages from the home and group mentoring sessions and a community celebration. REAL Fathers aims to build positive partnerships and parenting practices among young fathers to: 1) reduce incidence of intimate partner violence; 2) reduce harsh physical punishment of children; 3) improve early childhood development; 4) decrease unmet need for family planning.

Also known as: REAL Fathers

Intervention

Eligibility Criteria

• Age: 16 Years - 25 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Living in one of the six selected regions and districts across each region
• Being male aged between aged 16-25 years
• Being biological father to a child(ren) who is younger than 3 years old
• Living in union and in the same household with the mother or guardian of the child(ren)
• Living in union and in the same household as the young father

Sponsors & Collaborators

• NaNa Development Consultants Ltd, Uganda: collaborator
• LEGO Foundation: collaborator
• Impact and Innovations Development Centre (IIDC), Uganda: collaborator
• University of California, San Diego: lead

Study Sites (4)

All Nations

Lira, Dokolo, Uganda

Location

Forum for African Women Educationalists (FAWE) - Uganda Chapter

Mbarara, Isingiro, Uganda

Location

Somero Uganda

Kampala, Kayunga, Bugiri, Luweero, Uganda

Location

Bantwana Initiatives Uganda

Kampala, Masindi, Kiryandongo and Katakwi, Uganda

Location

Related Publications (1)

• Barker KM, Wandiembe S, Wandega A, Jeong J, Ojamuge D, Lundgren R, Yiga D, Nabembezi D. Testing the effectiveness of the Responsible, Engaged, and Loving Fathers (REAL Fathers) intervention for improving early childhood development and reducing family violence in Uganda: Study protocol for a cluster-randomized controlled trial. Trials. 2025 Sep 29;26(1):372. doi: 10.1186/s13063-025-09061-9.

  PMID: 41024259 DERIVED

MeSH Terms

Conditions

Coitus; Contraception Behavior; Communication; Negotiating

Condition Hierarchy (Ancestors)

Sexual Behavior; Behavior; Reproductive Behavior

Study Officials

• Kathryn M Barker, PhD, MPH

  University of California, San Diego

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Trained enumerators will be blinded to the treatment conditions from the beginning of the study (i.e., at baseline data collection) and before entering clusters (i.e., villages/communities) at mid-term and endline.
• Purpose: PREVENTION
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Division of Infectious Diseases and Global Public Health

Model Details: Stepped-wedge cluster randomized controlled trial-sequential transition of clusters from control to intervention conditions in randomized order, until all clusters are exposed.

Study Record Dates

• First Submitted: October 6, 2023
• First Posted: October 25, 2023
• Study Start: October 18, 2023
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2027
• Last Updated: June 3, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF
• Time Frame: Baseline data will become available Summer 2024; Endline data will become available Summer 2026.
• Access Criteria: Appropriate IRB approvals and data safety guidelines.

Locations

UG (4)