250 - Associations between paternal engagement and child development outcomes in Lebanon: A multi-level cross-sectional analysis of national data

Publication Number: 1237.250

Lama Charafeddine, American University of Beirut, Beirut, Beyrouth, Lebanon; Junita M. Henry, Harvard University, Boston, MA, United States; Alya Al Sager, Harvard University, Boston, MA, United States; Luke W. Miratrix, Harvard Graduate School of Education, Cambridge, MA, United States; Amirhossein Yarparvar, unicef, kabul, Kabol, Afghanistan; Joelle Najjar, UNICEF, Achrafiyeh, Beyrouth, Lebanon; Pamela Zgheib, AdventHealth for Children, beyrouth, Beyrouth, Lebanon; Aisha K. Yousafzai, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States

Background: Fathers’ caregiving and stimulation are increasingly recognized as contributors to early childhood development (ECD), yet evidence from crisis-affected, socioeconomically diverse settings is limited. Lebanon’s ongoing “polycrisis” emphasizes the need to understand how paternal engagement relates to children’s development and whether associations vary by community socioeconomic status (SES).

Objective: To estimate the association between paternal engagement and standardized ECD outcomes among children 0-59 months in Lebanon, and to test moderation by cluster-level SES

Design/Methods: We analyzed nationally representative cross-sectional data from the 2023 Lebanon Integrated Micronutrient, Anthropometric, and Child Development Survey. Children/caregivers/households were nested within primary sampling units. The outcome was age-standardized ECD z-scores using GSED-HF (0-23 months) and ECDI2030 (24-59 months), pooled after age standardization. Paternal engagement was a composite of five stimulation and three caregiving activities (α=0.73). Hierarchical linear models with PSU random intercepts and stratum fixed effects estimated: (M0) variance partitioning; (M1) individual-level association; (M2) cross-level interaction with cluster SES; (M3) decomposition into within- and between-cluster engagement. Primary analyses applied decomposed design weights and multiple imputation for covariates. The study received IRB approval.

Results: The analytic sample included 1,181 children from 360 PSUs across 10 strata. Baseline clustering of ECD was low (ICC≈0.02). Higher paternal engagement was associated with better ECD (β=0.22 SD per 1-unit increase; SE=0.11; p<.05), independent of maternal stimulation and other covariates. The engagement×cluster-SES interaction was small and not statistically significant. Decomposition showed positive but non-significant within-cluster and between-cluster associations, and the cross-level interaction with SES was near zero. Sensitivity analyses yielded directionally consistent effects (+0.13 to +0.32 SD per unit of engagement), with significance varying by weighting/imputation; random-effects magnitudes remained small across specifications.

Conclusion(s): In a national Lebanese sample, fathers’ engagement in caregiving and stimulation was modestly yet consistently associated with higher ECD, with minimal between-community variance and no evidence that benefits were confined to higher-SES clusters. These findings suggest that engaging fathers is a broadly relevant, potentially scalable strategy to enrich early learning environments even amid systemic adversity