Growing Stronger Together: A Family Strengthening Approach to Reduce Child Engagement with Armed Forces

Last registered on May 27, 2025

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Pre-Trial

Trial Information

General Information

Title

Growing Stronger Together: A Family Strengthening Approach to Reduce Child Engagement with Armed Forces

RCT ID

AEARCTR-0016067

Initial registration date

May 22, 2025

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published

May 27, 2025, 7:11 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country

Central African Republic

Region

Primary Investigator

Name

Kathryn Falb

Affiliation

Johns Hopkins University

Contact Primary Investigator

Other Primary Investigator(s)

PI Name

PI Affiliation

PI Name

PI Affiliation

PI Name

PI Affiliation

PI Name

PI Affiliation

Additional Trial Information

Status

In development

Start date

2025-06-02

End date

2025-10-31

Keywords

Crime, Violence, & Conflict, Health

Additional Keywords

JEL code(s)

Secondary IDs

Prior work

This trial does not extend or rely on any prior RCTs.

Abstract

Children associated with armed forces and armed groups (CAAFAG) represent an egregious violation of human rights which impedes their long-term wellbeing and overall peacebuilding and development efforts in the aftermath of conflict. Despite the critical importance of addressing this issue, there is scarce rigorous evidence on what works to support caregivers in preventing child recruitment and supporting their reintegration from engagement with armed forces and armed groups in humanitarian settings. Growing Strong Together (GST) is an innovative approach that combines curriculum- and group-based effective parenting programming with tailored support for families who have had children engaged in or at risk of recruitment into armed groups. Our study will undertake a randomized controlled trial (RCT) in Central African Republic (CAR) to answer the following questions:
a) What is the effectiveness of GST in preventing child recruitment by armed forces and armed groups and supporting their reintegration into communities?
b) Through which potential mechanisms does GST operate (e.g., promoting parenting skills, improving caregiver-child relationship quality, child resilience, or mental health)?
c) What are the feasibility, acceptability, and implementation factors needed for successful implementation of GST?

External Link(s)

Registration Citation

Citation

Blackwell, Alexandra et al. 2025. "Growing Stronger Together: A Family Strengthening Approach to Reduce Child Engagement with Armed Forces." AEA RCT Registry. May 27. https://doi.org/10.1257/rct.16067-1.0

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Experimental Details

Interventions

Intervention(s)

GST is a parenting intervention designed to support the reintegration of children and prevent their recruitment by armed forces and armed groups developed by the IRC. GST was informed by formative qualitative research conducted by members of the proposed study team in CAR and the Democratic Republic of Congo (DRC). The GST intervention consists of a parenting curriculum delivered over approximately 3-months through 20 bi-weekly sessions, each lasting between 1 and 3 hours delivered by trained facilitators to groups of parents and caregivers. Parents of at-risk adolescents (approximately 13-17 years) are recruited to take part in the intervention, forming groups of approximately 20 caregivers. Intervention facilitators include IRC child protection staff and trained community volunteers (each group is led by one IRC facilitator supported by one female and one male community volunteers who will receive 8 days of training on GST facilitation). GST session topics include specific topics related to CAAFAG (e.g., providing information on who is at risk, motivations for joining, experiences within armed groups, and consequences for children), improving parenting skills specifically for highly vulnerable children (e.g., communication, listening, managing emotions, and positive discipline), and skills to improve caregiver wellbeing (e.g., self-care practices to reduce stress, grapple with stigma, identifying and addressing their own emotions, and identifying sources of social support).

Intervention (Hidden)

Intervention Start Date

2025-06-09

Intervention End Date

2025-09-01

Primary Outcomes

Primary Outcomes (end points)

Child Outcomes: Risk of recruitment

Caregiver Outcomes:
● Mental health: 25-item, 4-point Likert scale Hopkins Symptoms Checklist (HSCL-25), measuring symptoms of anxiety and depression.
● Stress Management: 10-item continuous Perceived Stress Scale.
● Positive Parenting: 9-item continuous Positive Parenting Scale, which was developed for conflict-affected populations.
● Harsh Discipline: 8-item UNICEF/Multiple Indicator Cluster Survey (MICS) violent discipline module, with both physical and psychological components.
● Knowledge of CAAFAG Risks: 21-item agree or disagree response scale on Child Recruitment Knowledge Index (developed in GST monitoring efforts).

Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)

Child Outcomes:
* Mental Health: RCADS-25 (revised anxiety and depression scale); 25 item; 4-point Likert scale
● Resilience: 10-item, 5-point Likert-based Individual Resilience Subscale of the Child and Youth Resilience Measure (CYRM).
● Relational Resilience: 7-item, 5-point Likert-based Relational Resilience Subscale of the CYRM.
● Perception of Family Social Acceptance: 12-item Likert-based Family Acceptance Scale.
• Child Hope: 6-item, Likert-scale examining children’s hope for the future as a positive dimension of child wellbeing and mental health

Secondary Outcomes (explanation)

Experimental Design

We will conduct a Hybrid Type 1 Effectiveness-Implementation Trial. This design experimentally tests effectiveness, while simultaneously gathering data on implementation factors such as cost, sustainability, acceptability, etc. The quantitative design is a two-arm individual RCT assigning child-caregiver dyads either to the GST intervention or to a waitlisted control group (via computer); (n=225 dyads per arm).

Experimental Design Details

Randomization Method

Randomization done by computer

Randomization Unit

Individual

Was the treatment clustered?

Experiment Characteristics

Sample size: planned number of clusters

Sample size: planned number of observations

450 caregivers and 450 children

Sample size (or number of clusters) by treatment arms

225 dyads per arm

Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

Assuming a Cohen’s d of 0.25, predictive power of covariates of 0.4, drop out and attrition of 30% and 15% respectively, 80% power, and alpha <0.05, a sample size is 450 dyads is needed for the full sample (225 per arm).

Supporting Documents and Materials

IRB