Policy Research Working Paper 9850
Helping Families Help Themselves?
Heterogeneous Effects of a Digital Parenting Program
Sofia Amaral
Lelys Dinarte
Patricio Dominguez
Santiago M. Perez-Vincent
Development Economics
Development Research Group
November 2021
Policy Research Working Paper 9850
Abstract
Parenting practices are crucial for the development of chil- stress and anxiety and lowered caregiver-child interactions.
dren’s brains and social skills. However, parenting styles The effect on males was concentrated among the poorer
may be far from ideal, particularly those of caregivers with and those residing with a partner. In contrast, women’s
high stress levels. Using an individual-level experiment mental health was not impacted. Yet, their use of physical
with male and female caregivers of young children in El violence toward children decreased by 18 percent. These
Salvador, this paper evaluates the impact of a free digital results align with theories linking economic deprivation
stress management and positive parenting intervention. The and family structure to caregivers’ cognitive overload and
results indicate that, for males, the intervention increased mental health.
This paper is a product of the Development Research Group, Development Economics. It is part of a larger effort by the
World Bank to provide open access to its research and make a contribution to development policy discussions around the
world. Policy Research Working Papers are also posted on the Web at http://www.worldbank.org/prwp. The authors may
be contacted at ldinartediaz@worldbank.org.
The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development
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names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those
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Produced by the Research Support Team
Helping Families Help Themselves?
Heterogeneous Effects of a Digital Parenting Program∗
Sofia Amaral† Lelys Dinarte Diaz‡
Patricio Dominguez§ Santiago M. Perez-Vincent¶
Keywords: Mental health, positive parenting, parental stress, child maltreatment
JEL Codes: J13, J22, I24, I12, J12, J16
∗We appreciate the valuable feedback from Kathleen Beegle, Sven Resnjanskij, Victoria Endl-Geyer, Andrew Friedson, Selim
Gulesci, Florencia Lopez Boo, Barbara Petrongolo, and participants at the NBER Winter Development Conference, ifo Institute, IZA,
and Nordic Development Economics Conference. We also thank Miguel Paniagua for his invaluable fieldwork coordination and Stef-
fanny Romero for her superb work as research assistant. We thank Glasswing International, our implementation partner, for their
support in the development and implementation of this program, as well as their trust and commitment to generate rigorous
evidence. This work was supported by the IDB-COVID-19 Call for Research Projects, the World Bank Research Support Budget, and
the COVID-19 Emergency Call Window from the World Bank Early Learning Partnership. This research project’s protocol was
reviewedand approved by the Institutional Review Board (IRB) at the Universidad Francisco Gavidia in El Salvador in April 2020 with
approval ID No. 003-2020. A preanalysis plan was registered at the American Economic Association RCT registry - AEARCTR-
0007096. The authors have no conflicts of interest to report. The findings, interpretations, and conclusions expressed in this report are
entirely thoseof the authors. They do not necessarily represent the views of the Inter-American Development Bank, its Board of
Directors, or the countries they represent; nor those of the World Bank and its affiliated organizations, its Executive Directors, or the
governments they represent.
†ifo Institute at the Ludwig Maximilian University of Munich and CESifo. Email: amaral@ifo.de
‡Development Research Group. The World Bank. Email: ldinartediaz@worldbank.org
§Pontificia Universidad Catolica, Chile. Email: pdomingr@ing.puc.cl
¶Inter-American Development Bank. Email: santiagoper@iadb.org
1 Introduction
Parenting styles and decisions are crucial in driving human capital accumulation (Olivetti and Petrongolo, 2017;
Doepke et al., 2019; Attanasio et al., 2020b). Parental inputs during early life stages influence the development
of children’s cognitive and socioemotional skills, which subsequently influence their health, school
performance, and labor market outcomes in adulthood (Carneiro et al., 2019; Attanasio et al., 2020b,a; Baranov
et al., 2020).1 Despite the importance of parenting to the development of children’s brains and social skills,
parenting styles and practices are far from ideal. UNICEF estimates that nearly three in four children regularly
suffer physical or psychological violence by their caregivers (UNICEF, 2017). This early exposureto violence
can have long-lasting effects. For instance, children raised in a violent or stern environment are more likely
to participate in criminal activities (Doyle Jr and Aizer, 2018; Sviatschi, 2018) and exhibitrisky behaviors
as teenagers (Hamby et al., 2011). Overall, the high prevalence of child maltreatment and its potential long-
term impact on children’s well-being call for innovative and effective strategies. We exploitthe association
between caregivers’ mental health and quality of interactions between parents and children (Cluver et al., 2020;
Renzetti, 2009; UNICEF, 2020, 2017) as a potential avenue to address the prevalence of child maltreatment in
the context of a highly violent country.
In this paper, we evaluate the impact of a digital parenting skills intervention that provided caregivers with
stress-management and positive parenting techniques, using a large-scale, individual-level, randomized
controlled trial (RCT) with 3,103 caregivers2 of children aged 0 to 8 years old in El Salvador3 duringthe
second half of 2020—that is, in the context of the COVID-19 pandemic and stay-at-home orders. We randomly
assigned caregivers to a treatment or control group with equal probability. Caregivers in the treatment group
received up to four SMS/WhatsApp messages per week over eight consecutive weeks.4 Before the
intervention, we collected data on caregivers’ mental health, impulsiveness, caregiver -child interactions,
attitudes towards violent parenting, violence perpetration, and other sociodemographic characteristics. We
combined direct questions and vignettes to reduce potential social desirability bias in responses to sensi-
tive questions, such as those on attitudes toward violent parenting practices. We resurveyed caregivers one
month after the completion of the intervention to measure the short-run impact of the program.
1Growing evidence in medicine and psychology shows that the emotional development of children is
shaped early in life through interactions with caregivers. Emotional development impacts the architecture
of the developing brain and lays the foundations for sound mental health and life experiences (Thompson
and Lagattuta, 2006).
2In our setting, a caregiver can be a parent or a non-parent adult. Throughout the paper we use caregivers
to mean individuals such as mothers, fathers, grandmothers, and others who provide a child’s primary care.
3Violence against children is a major socioeconomic problem in El Salvador. A recent nationally repre-
sentative survey shows that 55% of boys and 50% of girls (1–14 years old) experienced violent discipline in
the past month (WHO, 2020).
4Overall, the intervention consisted of 27 messages containing information, videos, infographics and
exercises on parental stress-management and positive parenting techniques. Section 2 provides a detailed
description of the intervention. Figure A2 in the Appendix shows examples of the materials received.
2
We document three main results. First, we show that the large majority of caregivers opened the SMS/
WhatsApp messages. Importantly, by using knowledge incorporation surveys, we document that caregivers
in the treatment group were more likely to know about stress and parenting techniques than those in the
control group. Second, we find the intervention had an overall negative impact on caregiver mental health.
Contrary to what we had hypothesized in our pre-analysis plan (PAP), our estimations indicate that the
mental health of treated caregivers worsened by 0.057 standard deviation (sd) relative to that of caregivers
in the control group. This effect was driven by a negative impact on stress (0.072 sd). Third, despite the impact
on mental health, we find no evidence that the intervention changed caregiver impulsiveness, the quantity of
caregiver-child interactions, caregiver attitudes towards violent parenting, or children’s behaviorsor socio-
emotional development.
Moreover, we find heterogeneous impacts of the intervention depending on caregiver sex. The overall
unintended effects of the intervention were concentrated among men: treated male caregivers’ stress and
anxiety levels increased relative to those in the control group by 0.108 sd and 0.095 sd, respectively. We observe
no significant impact on women’s mental health. We also observe that the intervention led to fewer interactions
with children among male caregivers (0.137 sd) and had no impact among women. Finally, we find that the
intervention reduced the reported use of physical violence among female caregivers (0.098 sd) and had no effect
among men. This reduction in the use of physical violence amounts to a decrease of 18 percent. The often
observed differential roles and involvement in parenting activities (Hupkau and Petron- golo, 2020; Olivetti
and Petrongolo, 2017) and mental health status (Offer and Schneider, 2011) betweenmale and female
caregivers presaged a heterogeneous impact of the intervention between these groups. 5 Overall, our results
verify the empirical importance of caregiver sex in moderating the impact of a parenting intervention. We
also show that the intervention improved the quality of parenting for female caregivers by reducing the use of
physical violence against children.6 In contrast, for males, the intervention led to more mental distress and a
retraction from parenthood.
To further understand the differential impacts by gender, we show that living in more economically
deprived households and cohabiting with a partner were associated with a greater negative impact of the
intervention on mental health, especially among male caregivers. For example, among male caregivers in
the most economically deprived households, the intervention had a 0.36 sd impact in mental distress (vs. a
non-significant -0.032 sd impact among those in other less-deprived households). These results align with
the literature linking economic deprivation with increased cognitive load (Mullainathan and Shafir, 2013;
Mani et al., 2013; Asadullah et al., 2021; Schilbach et al., 2016; Ridley et al., 2020) and suggest that, for
caregivers burdened by economic deprivation, the intervention may have added to the cognitive overload
5Our
PAP contemplated the estimation of the intervention’s impact by caregiver sex.
6In the
U.S., females are generally the main perpetrators of child maltreatment (Lindo et al., 2018). This is
also the case in our setting – with women having a higher rate of perpetration of violence when comparedto
men. This outcome may be more easily impacted with the intervention for females.
3
and been a source of stress. Also, we find that the negative impact on the frequency of caregiver-child
interactions is concentrated among male caregivers living with a partner. This finding suggests that, when
living as a couple, parenting interventions may make men even more reliant on their partner for parenting
but with a cost for their own mental health.7
We conduct a variety of robustness tests. First, we show that attrition is low in our study and that there
is no selective attrition between treatment and control groups. Second, following Asadullah et al. (2021)
and Aguero and Frisancho (2021), we test the robustness of our results to the inclusion of a social
desirability index that captures individual-level propensity to misreport sensitive items as an additional
control variable. Finally, we verify the robustness of our results to the exclusion of control variables and to
the use of randomization inference to estimate standard p-values. In all cases, our results remain similar in
magnitude and statistical significance.
Our paper contributes to four strands of the literature. First, it contributes to the emerging literature
measuring the impact of digital intervention and low implementation cost parenting programs. Within this
literature, programs that involve group sessions (Carneiro et al., 2019) or text messages (Barrera et al.,
2020) have shown mixed results. On the one hand, Carneiro et al. (2019) find that group sessions improve
caregiver-child interactions and child development, and lower negative parenting attitudes. On the other
hand, Barrera et al. (2020) do not detect effects on child development but show evidence of positive impacts on
parenting skills. Our study adds to this work by offering evidence of the impact of a similar interventionin
content by identifying specific characteristics of the recipient population that might moderate
interventions’ impact – i.e, gender – that is also delivered digitally and during a turbulent period for
families. Our findings illustrate the empirical relevance of targeting and tailoring these interventions based
on caregiverand household characteristics. Theoretically, the impact of parenting policies or interventions like
ours may have an ambiguous impact on children and families. Yet, there is limited understanding of such
effects and the literature suggests such policies may have a heterogeneous effect depending on various
aspects, suchas family structure, as we show (Olivetti and Petrongolo, 2017).
Second, we contribute to the growing and varied evidence on the effect that different parenting-related
policies have on men’s participation in parental responsibilities and other household outcomes. Evidence from
high-income countries shows mixed results of the effects of fathers’ parental leave on parent-child
´ and Gonza
interactions and mothers’ well-being (Farre ´ lez, 2019; Ekberg et al., 2013), while showing positive
impacts on mother’s labor force participation (Bartel et al., 2018).8 Evidence from low-income countries
7For
instance, it is likely that by realizing the importance of being a good parent, males residing with a
partner may have become more distressed by feeling guilty or simply by becoming aware of their own lack of
skills. An increase in mental distress is also plausible if men felt more pressured to perform in other tasks –
presumably more male-oriented tasks - within the household.
8 Farre
´ and Gonza ´ lez (2019) show that Spain’s two weeks of paid paternity leave raised fathers’ interac-
tions with children but lowered fathers’ desired fertility. Also, Ekberg et al. (2013) show that Swedish fathers
4
also paints a mixed picture; some studies show that fathers’ engagement in chi ldcare can reduce violence
toward mothers and children (Doyle et al., 2018), while other evidence depicts null effects on caregiver-
child interactions (Maselko et al., 2019; Justino et al., 2020). Our paper aligns with Rossin-Slater (2017),
who shows that parental leave for fathers in the United States had zero to negative effects on interactions
between fathers and children, with some positive effects among unmarried fathers.
Third, we add to a small but growing economics literature on mental health and its link with parenting
practices. Emotions such as stress, anxiety, and frustration affect children’s health and development and the
quality of interactions between parents and children, potentially leading to violent or harmful interactions
(Persson and Rossin-Slater, 2018; Cluver et al., 2020; Renzetti, 2009; Bendini and Dinarte, 2020; UNICEF,
2020, 2017). Interventions that help parents cope with these emotions can improve the mental health of
mothers (Persson and Rossin-Slater, 2019; Baranov et al., 2020) and the relationship between parents and
children (Knerr et al., 2013; Cluver et al., 2018), as well as reduce the risk of child maltreatment (Doyle et al.,
2018). We add to this body of research by testing the effects of a digital intervention that, leveraging on
previous findings in this literature, seeks to promote better parenting through improved caregiver mental
health. Our results reveal some challenges for this type of intervention and identify contextual variables to
consider in their design.
Finally, we contribute to the evidence on the impact of digital health and education interventions—a policy-
relevant issue worldwide (Crawfurd et al., 2021; Berlinski et al., 2021; Campion et al., 2020; Health, 2021). In
low-income settings, the widespread availability of mobile phones, high social inequalities in access to health
care, and the stigma associated with mental health problems make such tools attractive, but their effectiveness
is not yet well understood (Naslund et al., 2017; Kola, 2020). We provide evidence thatthe net benefits of
health light-touch and low-cost interventions may depend critically on the characteristics of the recipient
population and, in our context, on the family structure. This result contrasts with findings from education
interventions showing positive impacts on learning as a result of nudges and light digital support to students
(Berlinski et al., 2021; Crawfurd et al., 2021; Lichand and Christen, 2020).
The remainder of the paper proceeds as follows. Section 2 documents the intervention we study and
its implementation process. In Section 3, we discuss the design of the experiment and its validity. Section
4 presents the different data categories we collected. Section 5 presents the identification strategy and Section
6 discusses our main findings. Section 7 shows the robustness checks. Section 8 provides possible mechanisms
and Section 9 presents the concluding remarks.
who benefit from parental leave do not improve mothers’ labor supply and fathers are not more likely to
take days off work to assume childcare responsibilities. Moreover, Persson and Rossin-Slater (2019) document
that work flexibility for fathers in Sweden lowers the cost of childbearing for mothers as it lowers the risk of
poor maternal mental health.
5
2 The Intervention: Digital Stress-Management and
Positive Parenting Program in El Salvador
2.1 Intervention structure
We study a program that provided stress management and positive parenting techniques to caregivers of
children in El Salvador. This program was developed by psychologists and early childhood development
experts from the NGO Glasswing International, based on material from its existing in-person programs.9
After the onset of the pandemic, the NGO adapted this material to a digital format compatible with stay-at-
home orders and social distancing requirements. The anticipation of the pandemic’s effects on caregivers’
mental health and child maltreatment, together with the restricted availability of traditional care services,
underscored the importance of an intervention providing caregivers with strategies to improve their mental
health and parenting skills during the pandemic. This motivation is in line with recent evidence showing
that stress, anxiety, and frustration can affect the quality of interactions between parents and children (Cluver
et al., 2020; Renzetti, 2009; UNICEF, 2020, 2017) and confirms the potential of parenting interventions to
improve caregivers’ relationships with their children in low and middle-income countries (Knerr et al.,
2013; Cluver et al., 2018).
The intervention sought to help caregivers recognize their own emotions, use coping strategies to lower
mental distress, promote positive parenting practices and, ultimately, reduce violent relationships between
caregivers and children (Humphreys et al., 2020; Szabo et al., 2020). We partnered with Glasswing
International to evaluate the effectiveness of this intervention. While it was the pandemic that prompted
the redesign of the intervention, its new digital nature makes it an innovative alternative to complement
other more costly parenting policy initiatives, such as home visitations, cognitive behavioral therapy, or
parental leave programs, beyond this context. Its low cost, easy accessibility and scalability make it an
attractive in- tervention for governments willing to expand their supply of social services. Generating
evidence on the effectiveness of this type of policy is essential to determine the real value of these alternatives
and to inform their design and implementation.
The intervention has two intertwined components: (A) stress-management skills development for
caregivers, and (B) positive caregiving techniques. The first component includes materials that show how to
identify and manage physical, cognitive, emotional, and behavioral stress manifestations. It aims to help
participants effectively manage the stressors of daily life and improve their mental well-being. The materials
9Glasswing
International was founded in El Salvador in 2007 and currently works in seven Central Amer-
ica and Caribbean countries on education, health, and community empowerment, as well as an employment and
entrepreneurship program. Glasswing International’s website (https://glasswing.org/) provides more
information on its programs.
6
emphasized the topics that lockdown intensified. The second component includes positive parenting practices
and basic concepts of family life. The intervention’s ultimate objective is to reduce violent relationships between
caregivers and children. As shown in Figure 1, the core of its theory of change is that informationon stress-
management and positive parenting techniques can help caregivers to (i) identify stressors and their effects
on themselves and children in the household, (ii) use the provided strategies to better copewith these
stressors and reduce mental distress, (iii) understand that some actions and attitudes are formsof negative
parenting and learn alternative disciplinary tools, and (iv) adopt positive parenting techniques (Glasswing,
2020). These changes could reduce violent caregiver interactions with children through two channels. First,
better stress-management strategies and improved mental well-being can help caregivers reduce impulsive
violent reactions toward children. Second, increased knowledge on positive parenting techniques can increase
awareness of the harmful effects of violent interactions, and give caregivers alter- native disciplinary tools. We
hypothesized that the program would improve caregivers’ mental distress, change their views about child
maltreatment, and improve the quality of interactions through the use of positive parenting techniques. These
changes would reduce the likelihood that they would abuse and mal- treat their children. It is also worth
mentioning that both components are delivered jointly since the frame of the materials was purposely
developed considering the context of family relations. As a result, both components cannot be separated in
different individual treatments. Below we describe the details of each component of the intervention.
A. Stress-management skills development
This component highlights different ways to manage stress, such as stress-inoculation training and self-
control techniques.10 Existing empirical evidence shows that individualized interventions focused on stress
management—such as mindfulness, meditation, psychosocial programs, and others —can improve individuals’
well-being by reducing their stress levels (Dinarte et al., 2021; Holman et al., 2018).
This first component includes 12 topics with exercises and information aimed at helping participants
understand stress and its effects and learn coping strategies to reduce mental distress. It offers exercises
and techniques for meditation, breathing, self-control, stretching, and emotional freedom. These topics are
grouped into two categories. The first one consists of the identification of stressors. It focuses on helping
participants to identify the types of stressors they experience, including disturbances in the family balance that
come from external factors (e.g., unemployment) or internal problems (e.g., the illness of a family member);
intraindividual transmission of stress from a specific domain (e.g., the workplace) to another (e.g., family
life); and interindividual transmission of stress from one family member to another. The second category
10Stress inoculation aims to make an individual capable of addressing future stressful situations by ana-
lyzing stressful circumstances and learning specific coping skills (Guarino, 2013).
7
consists of relaxation and breathing techniques and includes activities that bolster well-being, producing a
´ ndez et al., 2012). The relaxation techniques help participants to gradually reduce
sense of tranquility (Ferna
their stress and anxiety, contributing to problem solving and producing health benefits and mental balance
´ ndez et al., 2012). The main goal of breathing techniques is to improve people’s mental well-being by
(Ferna
showing how to voluntarily control their breathing and helping their minds to become calm and focus on
the present.
B. Positive parenting techniques
Positive discipline principles posit that caregivers can learn to interact with children through positive
actions and mutual respect. Positive parenting requires the capacity to direct a child’s behavior through
thefrequent use of anticipation, negotiation, and perspective (Nelsen, 2007). This capacity helps caregivers
to avoid using punishment to control children’s conduct and provides a constructive framework to teach
children how to regulate their emotions.
This component combines three main elements developed by Durrant (2013) in 15 topics, which first aim
to promote caregivers’ understanding of how children think, feel, and behave, as well as the ir needs at each
development stage. Next, the intervention materials seek to make caregivers understand that some actions and
attitudes are forms of negative parenting and become aware of the need for warmth and structureduring
interactions with their children.11 Finally, caregivers receive techniques to address children’s needs and
behaviors through warm and structured practices, based on their development stages. The materials include
activities that promote positive management of children’s emotions, better communication, family coexistence,
self-control, and recommendations for an optimal family environment.12
2.2 Intervention delivery and piloting
The 27 topics (12 for stress-management skills development and 15 for positive parenting techniques) were
delivered through three or four SMS/WhatsApp messages per week for two months. These messages explained
the main concepts and exercises. The messages contained the links to videos, animations, audio messages,
quizzes and short essays with recommendations for practicing specific techniques. The messages also offered
a link to a web page (a blog) wherein participants could find additional content for every topic, as shown in
Figure A2 in the Appendix.13 The intervention was free to participants. To do so, we partnered with Tigo, the
11The definition of warmness in the theory of change refers to emotional security, verbal and physical affect,
respect, sensibility, and empathy to respond to children’s needs. The theory of change defines structureas the
ability to state clear instructions to better guide children’s behavior.
12The complete set of intervention materials can be found at this link.
13Access to the blog was restricted to participants in the treatment group.
8
largest mobile phone provider in El Salvador, which gave each participant free access to all content.
We ran a small pilot project to validate understanding and wording of materials. Glasswing
International invited 12 adults who met the eligibility criteria to participate in the pilot. Once they agreed,
the NGO sent these caregivers the materials, asked them to review and implement the program at home,
and invited them to a virtual focus group. During this event, caregivers discussed the materials and
highlighted potential concerns and recommendations. The program was then adjusted based on the
information fromthis process. Pilot participants are not part of the study sample.
3 Experimental Design
3.1 Recruitment and enrollment of participants
We enrolled participants using three alternatives: (i) dissemination through Facebook, (ii) enrollment through
Glasswing International’s communities network, and (iii) dissemination through SMS/WhatsApp messages
sent to customers of Tigo. The main recruitment of participants was done through Tigo’s clients database
(iii). As we show in Table A1, this group constitutes the largest share of our sample. To enroll participants,
we sent a link to an enrollment survey through these three channels. This survey included questions that
helped us to identify our target group. We specified the following eligibility criteria: caregivers had to be 45
years or younger, live in the same house with at least one child eight years old or younger, and provide their
consent to receive digital messages and to participate in the study. We enrolled a total of 4,718 individuals who
met the eligibility criteria and provided consent to participate in the study and intervention.14 We collected
baseline data from 3,103 individuals (66 percent).15
3.2 Randomization
We randomly assigned all enrolled caregivers who met the eligibility criteria and completed the baseline
survey to either the treatment or the control group with equal probability. We stratified the group of 3,103
individuals based on two criteria: gender and enrollment modality. Given usual differences in mental
health and parenting involvement between men and women, we wanted the treatment and control groups
to be balanced in this dimension. In addition, given the different roles women and men take in caregiving,
14The
enrollment survey questions and consent form are available at this link.
15The
remaining 1,615 (34 percent) enrolled individuals did not complete the baseline survey for several
reasons, including: they did not provide a correct phone number, we were not able to reach them after the
maximum number of attempts agreed in the ethics agreement, they changed their mind and decidednot
to participate in the study, among others.
9
we also aimed to assess whether the intervention had heterogeneous effects depending on the gender of
the caregiver.16 Similarly, since individuals contacted through the three enrollment channels could differ in
characteristics potentially relevant to our study, such being participants of Glasswing programs, we wanted
to ensure that the treatment and control groups had an equal proportion of each characteristic. Table A1 in the
Appendix provides the size of each stratum in the sample. We implemented the random assignmentright
after concluding the baseline data collection.
4 Data
To measure our outcomes of interest and gather additional information from caregivers in our study, we
conducted three data-collection processes and used several survey instruments, as we describe below.
4.1 Data-collection stages
Baseline data collection: We contacted all caregivers who provided consent to enroll in the study and
were eligible for the intervention. Each caregiver received a link to an online baseline survey through
SMS/WhatsApp. Participants also received reminders to complete the online survey if they had not done
so within approximately two weeks.17 All data collected at baseline were self-reported. To reduce the risk
of respondent fatigue, we limited the instrument length to approximately 30 minutes. Participants also
received a small monetary incentive to complete the survey.18 We collected data from 3,103 respondents at
baseline. Following information protection protocols, collected data were stored on a private server of the
survey firm. Access was restricted to the project staff and researchers.
The baseline survey included modules on socioeconomic condition of the caregiver and the household;
employment status; mental health; child-parenting interactions; and child maltreatment. Section 4.2 de-
scribes the information collected in more detail.
Viewership rates and knowledge incorporation surveys: The second set of data-collection activities was
carried out during the implementation of the intervention. First, we gathered information on the number of
16This
research question and analysis was pre-specified in the PAP.
17The survey instrument was pretested in a pilot phase. Since self-completed surveys were faster and cheaper
to implement, this was the strategy adopted for the baseline, which we complemented with phone reminders.
Staff responsible for these reminders were trained in two topics: the content and structure ofthe baseline
instrument and the protocol to protect victims of violence. The second topic prepared them to follow ethical
guidelines outlined in the IRB protocol.
18Each participant received US$2.50 in Tigo ”money” as an incentive to complete each survey. In addition, we
motivated participants to remain in the study with raffles of iPads after its completion.
10
opened SMS/WhatsApp messages sent to caregivers in the treatment group. This data was collected by Tigo
and shared with the researchers at the aggregate level. We use this data to monitor the rate of viewership of the
intervention.19
Second, we also conducted four knowledge incorporation survey rounds with a random subset of enrolled
individuals. These surveys evaluated if individuals in the treatment group were more likely to self- report
knowing concepts taught in the intervention, similar to the data collection in (Carneiro et al., 2021).We
surveyed a total of 659 participants —26% of the sample at baseline— split into four survey rounds. Each
survey round contained only four questions and was conducted by phone. In order to avoid saturation of
respondents, we selected a different random sample of participants for each survey round. Thus, our data
constitutes a cross-section of a sub-sample of the study participants.20 In each wave, we surveyed respondents
on how often they had used different stress-management and positive parenting techniquesin the previous
week. The timeline of events was such that participants would be surveyed with a lag oftwo to three weeks
with respect to the contents of the messages in each survey round.21 Table A2 in the appendix shows the topics
of each survey round. We use this information to assess if respondents’ take-upof the intervention’s material
was positive.
Endline data collection: The intervention implementation finished by the end of November 2020. We initiated
the endline data collection at the end of December 2020. The timing of follow-up was designed to testthe
short-term effects of the intervention and to minimize attrition. All 3,103 respondents of the baseline
survey were contacted to complete the endline survey. To minimize the risks of attrition and low response
rates, the endline survey was conducted over the phone. In a companion paper, we study an experiment
that was embedded in the baseline data collection.22 In that paper, we show that the phone survey in
comparison to the SMS survey increased the rate of survey completion by 40 percentage points. For this reason,
at endline all participants were surveyed by phone interviews.
As at baseline, all enumerators were trained in the content and structure of the follow-up instrument
and in the guidelines of the ethics protocol. The structure of the endline survey was similar to that of the
baseline. In addition, we also included a module on observed child behaviors and demand for another parenting
intervention by Glasswing International. We collected follow-up data from 2,280 caregivers.
19Since
the data is at the aggregate level we are unable to compute a treatment-on-the-treated estimator
using the rate of messages opened as a proxy for take-up. Instead, we will use the knowledge incorporation sub-
sample.
20Overall, only 14% of the 659 respondents were included in more than one round.
21For example, in week one treated participants saw a video regarding the turtle technique. Two weeks after
this first content, study participants were surveyed regarding this technique which they could haveonly
learned from watching the video.
22The aim of this experiment was to inform us about what would be the best method of data collection in
order to minimize attrition.
11
4.2 Survey instruments and outcomes
Based on the intervention’s theory of change, and as specified in our PAP, we focus our analysis on the
following main outcomes: mental health, impulsiveness, and the quality of interactions with children.
Appendix A1 presents a detailed description of all outcomes and the survey instruments used to measure
them.
Mental health: We use the Depression, Anxiety, and Stress Scale (DASS-21) instrument to measure mental
distress (Lovibond and Lovibond, 1996). The DASS-21 module includes 21 items organized in three sub- scales:
depression, anxiety, and stress.23 One major advantage of the DASS-21 is that it includes questions on
physiological responses consistent with poor mental health rather than only on perceptions of mental distress,
which are more prone to reporting bias and subjectivity. Our main outcome of interest is the aggregate index
(comprising the three subcategories), but we also separately consider levels of depression, anxiety, and
stress. On average, caregivers in our sample display low levels of mental health: about 34% exhibit an above-
normal level of stress, 54% show high levels of anxiety, and 34% have depressive symptoms(See panel D in
Table 1). Women in our sample exhibit worse mental health when compared to men in thethree subscales
(see panel D in Table 2 in the Appendix). These rates are high, but similar to those observed in other
populations—for example, in Turkey (Altindag et al., 2020), Spain (Rodr´ıguez-Rey et al., 2020), and Ireland
(Burke et al., 2020).
Impulsiveness: We measure caregiver impulsiveness using the Barratt Impulsiveness Scale BIS-11 (Patton
et al., 1995).24 The outcome is the sum of the 15 items in the instrument, with a higher level reflecting a greater
degree of impulsiveness. We use a standardized value of this index as our measure of impulsiveness. On
average, respondents exhibit a low level of impulsiveness with only 2% of caregivers exhibiting above-
normal levels, as shown in Table 1. Relative to men, female caregivers are 5 percentage points more likely
to exhibit high impulsiveness levels (Table 2).
Caregiver-child interactions: We use the 10 items related to support for learning/stimulating environment
and setting limits domains from the Family Care Indicators instrument developed by UNICEF (Kariger
23We
report the instrument in section A1.1 in the Appendix. Following Lovibond and Lovibond (1996),
depression is characterized by hopelessness, devaluation of life, and lack of interest. Anxiety is characterized
by a state of intense, excessive, and persistent worry and nervousness. Stress is the degree to whichan
individual shows nervous arousal, difficulty in relaxing, impatience, and ease in becoming agitated or irritable.
24The instrument is included in section A1.2 in the Appendix. Impulsiveness broadly refers to an
individual’s tendency to act suddenly without careful thought about the consequences of her actions. The
psychology literature links this tendency to difficulties in planning, thinking carefully, enjoying challenging
mental tasks, and focusing on the tasks at hand, as well as inclinations to act on the spur of the moment
and having racing thoughts (Patton et al., 1995). Recent studies have found suggestive evidence on how
behavioral interventions to reduce automatic responses —a form of impulsive behavior—can reduce violent
behaviors (Heller et al., 2017; Dinarte and Egana-delSol, 2019).
12
et al., 2012) to measure the frequency of caregiver-child interactions.25 The items ask about the frequency of
different interactions with the child in the previous week. Our outcome of interest is a standardized index
of these items, constructed following Anderson (2008). On average, caregivers in our study completed 9
out of 10 activities with their children in a week (Table 1). Female caregivers completed more activities
with children when compared to men in our sample (Table 2, standardized index of positive caregiver-child
interactions).
We also measure the quality of caregiver-child interactions through three additional measures. First,
wemeasure tolerance towards violent parenting. Recall that challenging behaviors associated with violent
parenting were also an important component of the intervention. We would expect that such norms of
tolerance of punishment as a tool of parenting to be lower after parents learn of possible alternatives. We
measure tolerance towards violence parenting practices using responses from both direct questions and
vignettes to attenuate potential social desirability bias in the responses. 26 Second, we measure observed
child behavior using the internalizing/externalizing behaviors sections of the parent/caregiver report
survey developed by the World Bank. Third, we measure violence perpetration by a caregiver. This
measure captures both physical and psychological violence towards children. Addressing this form of
abuse and maltreatment was a main priority of the intervention and as such we would expect that the main
perpetrator to be directly impacted by the intervention. To measure this outcome, we use a shortened version
of the International Society for Prevention of Child Abuse and Neglect’s screening tool for caregivers
(ICAST-P) (Meinck et al., 2020). We also combine this measure with an elicitation of perpetration of violence
through vignettes. We create an index of the responses of perpetration of violence using the responses of both
tools following the literature on violence (Cluver et al., 2018; Aguero and Frisancho, 2021). Finally, we
measure child socioemotional development as reported by the caregiver using items from the
parent/caregiverreport survey developed by the World Bank.27
Sociodemographic information and additional covariates: In addition to the outcome measures described
above, we collected information on caregivers’ education, employment status (before and during the lockdown),
marital status, household size and structure (including whether the caregiver lived with a partneror not),
time spent with the children, and number of children in their care. We also gathered information on
economic deprivation by asking if, during the pandemic, the household did not have enough money for
food, health and education, home services, and clothes and gifts. At endline, we collected information on
individual-level propensity to misreport sensitive items (social desirability index), following Crowne and
25The
10 items are listed in section A1.3 in the Appendix.
26Section
A1.4 in the Appendix describes the instruments used in detail.
27We provide more details of the child behavior instrument in the appendix section A1.5, violence
perpetration instrument in appendix section A1.6, and section A1.7 in the appendix describes the child
socioemotional instrument used in this study.
13
Marlowe (1960).28 As shown in Table 1, on average, caregivers in our sample are 32 years old, are mostly
female (60%), have a child enrolled in school, and reside in households with 4 people. Most caregivers
(59%) in our sample do not have tertiary education. They exhibit a high level of economic deprivation (with
25% worrying about not having enough money for food). We also show that 29% of the sample was either
unemployed or has lost their job during the pandemic.
In terms of parenting, we find a high rate of violence and tolerance of it – 78% of caregivers use at least
one form of physical or psychological punishment towards their children, and 29% tolerates of others using
violence as a form of punishment towards children. At the same time, while parents use punitive parenting
tools, this is combined with the use of other positive caregiver-child interactions and parenting techniques.
5 Empirical Strategy
5.1 Econometric model
We rely on the random allocation of participants to treatment or control groups to identify the causal effect
of the intervention on the set of outcomes described above. The main identification assumption is that,
had there been no intervention, our outcomes of interest would be, on average, statistically equal between
caregivers assigned to the treatment and control groups. The intervention’s intention-to-treat (ITT) effect
is estimated as the difference in the post-treatment means of the outcome variables between treatment and
control individuals. Formally, we estimate the following linear regression model by Ordinary Least Squares
(OLS) using information at the caregiver level i:
������������ = ������������������ + ∑������
������ ������������ ������������ + ������������ + ������������ (1)
where Yi is an outcome variable. Di is an indicator variable that takes value 1 if the caregiver was
assigned to the treatment group and zero otherwise. Xi is a vector of covariates measured at baseline,
including the pre-intervention outcome value for those outcomes collected in our baseline survey. 29 Si
corresponds to the strata fixed effects. ������������ is an idiosyncratic error term. Since the randomization occurred
at the individual level and we do not expect clusters in our sample, we report heteroskedasticity-robust
standard errors. δ is our coefficient of interest, which provides the estimate of the intervention’s intention-
28More
details in section A1.8 in the Appendix.
29In
our main specification, we include the following variables as covariates: age (in years), educational
attainment (primary, secondary and tertiary), number of girls and boys at home cared for the respondent.
Following McKenzie (2012), if a respondent has a missing value for a covariate, we impute this value with
the respective mean of the variable. Missing values never exceed 5% of the sample.
14
to-treat impact on the outcome (Yi).30
We also assess how the intervention’s impact varied by the gender of caregivers. To estimate the
heterogeneous impact of the intervention, we estimate the following model:
������������ = ������1 ������������ + ������2 ������������ × ������������������������������ + ∑������
������ ������������ ������������������ + ������������ + ������������ (2)
where Malei is an indicator variable taking value one if the caregiver is a male and zero if female. We
separately estimate this equation for two other different variables: an indicator of extreme economic
deprivation, and an indicator variable taking value of one for caregivers living together with a partner.
In specification 2, δ1 delivers the ITT estimate for female caregivers, and δ2 provides the difference in the
ITT effect between sexes. The ITT estimate for men is given by the sum of δ1 and δ2. The interpretation
of the coefficients is analogous for the other two indicator variables. We estimate equation 2 by OLS, re-
port heteroskedasticity-robust standard errors and we also present randomization inference p-values as an
additional inference test.
5.2 Balance on covariates and pre-intervention outcomes
To support the validity of our identification assumption, we compare caregivers in the treatment and control
groups in terms of sociodemographic characteristics and baseline levels of the outcome variables. Table 1
reports the mean value for these variables for caregivers in the treatment group (column 6) and caregivers
in the control group (column 7), and the p-value of the difference between the two means (columns 8).
There are almost no differences across groups in terms of caregiver, child, and household characteristics.
The only significant differences we detect at baseline pertain to time caregiver spends with the child, which is
larger in the treatment group but does not make an economically meaningful difference, and to economic
deprivation, which is greater in the control group. In the case of the baseline level of outcome variables, we
found no significant differences in all our primary outcomes (mental health —overall, stress, anxiety, and
depression—impulsiveness, and positive caregiver-child interactions). We also found no significant differences
in tolerance of violent parenting and physical violence. We do observe differences that are significant at
conventional levels for the indexes of positive parenting practices, which is larger in the treatment group; negative
parenting practices, more negative in the treatment group; and psychological violence perpetration, lower in the
treatment group. These differences are also not economically meaningful as can be seen by the absolute number
of items in each question. In Figure A3 in Appendix, we also present kernel density estimations and show
30We
do not observe the intervention take-up at the individual level for the full-sample. Therefore, we
estimate an ITT. In Appendix section - Table A23, we present an alternative estimation using a TOT analysis
which we discuss in the robustness section.
15
that the main outcomes are balanced across treatment arms at baseline. Importantly, as we discuss in the
empirical strategy section, whenever possible, we include the baseline level of the dependent variable in all
regression estimates.
In Table 2, we show that indeed male and female caregivers are substantially different – see columns
1 to 3. Male caregivers in comparison to female are older, are more likely to be employed, spend less time with
children, and have better mental health. When it comes to parenting, males are less likely to tolerate violence
but are less likely to perpetrate it. We show that 79 percent of females and 76 percent of males useat least
one tool of violence. This parenting context is consistent with the literature discussed in Section 1 and
highlights the importance of our design – of gender stratification. We also show –in columns 4 to 9 of
Table 2–that the observed characteristics of caregivers in treatment and control at baseline are balanced within
gender.
5.3 Endline survey attrition
We collected information at endline from 2,280 individuals of the 3,103 original caregivers included in the
study. We examine if differential attrition confounds our estimates and report results in Table A3. In column
(1), we examine whether our treatment variable can predict the probability that the endline survey is missing
for a given caregiver. We observe that treatment status is not significant, which indicates that participation
in the program did not affect the probability of completing the endline survey. To further analyze the issue
of differential attrition, we regress an indicator variable taking a value of one if the endline survey is missing on
the treatment status and the treatment status interacted with our key baseline covariates and outcome
variables. Column (2) in Table A3 shows the results of this regression. The objective of this regression is
to assess if baseline characteristics differentially explain the decision to complete the endline survey across
groups. We find that the p-value for the joint significance test for all interactions is 0.947, suggesting no
differential attrition (in terms of baseline characteristics) between the treatment and control groups.
5.4 Power calculation and minimum detectable effect sizes
Our final sample of caregivers who answered both the baseline and endline surveys comprises 2,280
individuals. Most of our outcome variables are based on standardized measures as observed in our final sample
following Anderson (2008). Based on this sample size and using a level of significance (α) of 0.05 and
conventional power (β) level of 0.8, we estimate that the minimum detectable effect (MDE) size of our
survey design ranges from 0.083 to 0.114 sd.31
31We
calculate this by following Raudenbush and Liu’s (2000) guidelines on nondichotomic outcomes
where MDEs depend on the value used for the variation explained by covariates (R2) 0.05 (small) and 0.50
16
6 Results
This section presents the results of the estimation of our available measures of take-up and the intervention’s
impact on our outcomes of interest. It also assesses the extent to which this impact varies by sex.32
6.1 Compliance: Opening of SMS/WhatsApp and Viewership of
Digital Content
For the intervention to be effective we need to first understand its take-up rate. We identify two necessary
conditions that need to be met: i) that participants open the SMS/WhatsApp messages, and ii) that thedifferent
digital content in each message is consumed.33 We assess this in two ways. First, we show in Figure A1 in
Appendix that the rate of message viewership by caregivers assigned to the treatment groupis high. Overall,
we observe that 72% of caregivers in the treatment group opened the SMS/WhatsAppmessages sent to their
mobile phones.34 We also show in Figure A1 that the trend in the viewership rate remained stable for every
SMS/WhatsApp message sent.
Second, using the knowledge incorporation surveys, we test our hypothesis that caregivers in the treat-
ment group were more likely to report knowing about techniques they could only have learned through the
intensity of participation. To test this hypothesis, we estimate the following:
Recalli = β0 + δDti + Xi + γw(i) +������������ (3)
where Recalliw is the dependent variable of interest measured for every participant i responding to survey
wave w. We have four outcomes of interest: the share of stress-management techniques known by respondents
in the past week, the share of positive parenting techniques know by respondents in the past week,35. Di is a
dummy variable indicating that the participant is in the treatment group and δ is the OLS estimator. To improve
the precision of the estimates, we also control for socioeconomic variables measuredat baseline (Xi). These
variables include age, gender, education level, and the number of female and male dependent children. We
(large), respectively.
32This section follows the analysis proposed in our PAP.
33This is essential since it is possible that individuals never open SMS messages or they may even block
the sender.
34Caregivers in the control group did not receive any message so this rate is always zero.
35We generate the share of techniques known by round from categorical variables of the usage of each
technique – a dummy variable taking the value one if respondents say ”Yes” and zero otherwise. This share
was created by summing up the total techniques that respondents reported knowing and dividing this
number by the total techniques that were asked about in a survey round regarding stress managementand
positive parenting.
17
also include as a control variable the number of times an individual responded to a monitoring survey. To
account for the fact that each of the four survey rounds was conducted with different questions, we also
account for survey-round fixed effects (γw(i)). ������������ corresponds to error term. We impose robust standard
errors.
We present the summary statistics of the survey in Table A4. On average, participants report using 50%
and 85% of the stress-management and parenting techniques, respectively. Table A5 in Appendix shows the
results from Equation 3. We find that individuals in the treatment group were 20.6 percentage points more
likely to report using stress-management techniques (column (1)) and 5.7% more likely to use positive
parenting techniques (column (3)). The effect sizes of the estimates described are not impacted by the inclusion
of controls (as expected) given the randomized nature of the intervention.
Overall, during the intervention, we find that caregivers randomly assigned to the treatment group are
more likely to incorporate knowledge of the digital intervention compared to those in the control group.
This result, along with the evidence displayed in Figure A1 in appendix, shows that the intervention had a
first-stage impact on information assimilation and adoption of content.
6.2 Impact of the program on caregiver’s mental health and caregiver-
child interactions
We first estimate the intervention’s impact on the primary outcomes that the program targeted most directly:
mental distress (linked to anxiety, stress, and depression); impulsiveness; and positive caregiver-child
interactions. Table 3 shows these results. Contrary to our hypothesis, we find that the intervention increased
mental distress. On average, treated caregivers reported worse mental health than those in the control
group. The difference is equal to 0.057 sd and is statistically significant at the 10% level. This detrimental
effect on mental health is mainly driven by a 0.072 sd impact on stress (statistically significant at the 5%
level). We find no statistically significant effects on anxiety and depression (the two other components of
the aggregate mental health measure), but the coefficients are also positive. This points to a relatively worse
status among treated caregivers. We find no significant impact on impulsiveness and positive caregiver-child
interactions.
We next assess whether the intervention’s impact differs by caregiver gender. Table 4 shows these results.
We document two main findings. First, we find that the intervention’s negative impact on mental health is
mainly explained by male caregivers. The program led to an increase of 0.093 sd in treated male caregivers’
mental distress relative to those in the control group. This effect is driven by a 0.108 sd relative increase in
18
stress and a 0.095 sd relative increase in anxiety.36 Yet, we find that the intervention had no impacton mental
health among female caregivers. Although differences in treatment effects are not statistically different across
genders, estimates of the intervention’s impact among women are small—always smaller in absolute value than
those for men—and not statistically different from zero.
Second, we find that the intervention had differential effects by sex on positive caregiver-child
interactions.While we do not observe any significant effect on caregiver-child interactions among female
caregivers, treated men reported 0.137 sd fewer positive interactions with their children than those in the
control group. The difference in treatment effects across genders is equal to 0.154 sd.
Overall, these results show the intervention had an unintended impact on mental distress and caregiver-
child interactions, which was concentrated among male caregivers. The intervention had no significant
effect on primary outcomes among female caregivers.
6.3 Impact of the program on caregiver use of violence, attitudes toward
child maltreatment, and observed child behavior
This intervention sought to improve norms regarding tolerance of violent parenting practices and perpetration
of violence against children, and to foster healthier child behavior. These expected effects relied on thefact
that poor mental health is a major trigger for violence (Spencer et al., 2019). Therefore, by improving the
awareness about mental distress and how to address it, reducing impulsiveness (primary outcomes), and
providing information about positive parenting techniques, the intervention could change attitudes about
child maltreatment and promote the use of alternative behavior (secondary outcomes). This change in
parenting quality outcomes could have taken place on its own - since the intervention targets it directly -
but also, as part of a chain of alterations that would take place as a result of changes in mental health.
Table 5 reports the results of the estimation of the intervention’s impact on violence and other child specific
outcomes that reflect additional domains of parental quality. First, Table 5 reports these results for violence
perpetration, norms and observed child behavior. On average, we find no statistically significant effects on any
of these outcomes. Similarly, we show that the intervention had no significant effect on caregiver attitudes
about corporal punishment and children’s observed positive behavior. The absence of significant effects on
these outcomes might result from a combination of the possible negative effects ofthe unintended impact
on mental health and the positive effects of increased information or awarenessabout positive parenting
practices. Overall, the intervention does not appear to have been strong enough to change caregiver norms
regarding violence against children or child behavior.
However, as we present in Table 6, there is an interesting result when considering the intervention’s
36Table
A6 reports these results.
19
impact among male and female caregivers separately. We find a 0.098 sd decrease in the use of physical
violence against children among treated female caregivers relative to women in the control group. 37 This
impact is particularly relevant in the Salvadoran context, where female caregivers spend more time with the
children and tend to exert more violence against their children, as we show in Table 2 in the Appendix.
7 Robustness Checks
This section addresses some potential concerns with the results presented in Section 6. First, the use of
self-reported measures to assess mental health status (as opposed to, for example, interviews or clinical
assessments) might confound changes in mental distress with changes in respondents’ awareness of their
mental health status. Therefore, the intervention’s estimated negative impact on mental health may simply
reflect that it increased caregiver awareness of mental distress. Although it is not possible to fully ruleout
this alternative explanation, our choice of a widely validated survey instrument —namely, the DASS- 21—
that asks about specific physiological responses (such as mouth dryness and trembling) and not aboutself-
perceptions of stress, anxiety, or depression should attenuate this potential concern (Lovibond and Lovi- bond,
1996). 38 We therefore believe that the observed results on mental health likely at least partially reflect actual
changes in distress.
Second, the use of self-reported measures can also be problematic when assessing attitudes and
perpetration of violence. In sensitive topics like this one, responses might be affected by social desirability
bias.This is especially the case for interventions that target those outcomes.39 To address this potential concern,
we use two complementary approaches. First, we complement direct questions with vignettes to indirectly
elicit respondents’ views regarding the use of violent parenting practices. 40 Second, following Asadullah et
al. (2021) and Aguero and Frisancho (2021), we test the robustness of all our results to the inclusion of a
social desirability index that captures individual-level propensity to misreport sensitive items as an
additional control variable. All results remain similar in magnitude and statistical significance (Tables A10–
A13 in the Appendix). It is also worth noticing that the treatment itself did not impact social desirability -
seeTable A14 in Appendix.
37As
we show in the robustness section, this effect is highly robust to various specifications, the inclusion
of controls, and after controlling for a social desirability bias index. This result persists when considering
alternative measures of physical violence perpetration, such as the probability of reporting physical abuse (-
0.038 sd) and the acceptance of hitting with the knuckle or back of the hand (-0.039 sd), as shown in Table A9.
38The American Psychiatric Association also suggests that to diagnose anxiety and depression symptoms,
specialists should include physiological symptoms instead of psychological signs.
39See the meta-analysis conducted by Sugarman and Hotaling (1997). The authors find a low-to-
moderate negative association between social desirability bias and intimate-partner violence (IPV). Also,
reports ofIPV perpetration were more strongly correlated with social desirability scores than were reports
of beingvictimized.
40For a detailed description of each vignette and the index construction, see the outcomes list and descrip-
tion in Appendix A1.
20
Third, in the PAP, we pre-specified the inclusion of some control variables in the regression model to
increase the precision of our estimations. We show that the exclusion of these covariates does not change
our results. As presented in Tables A15–A18 in the Appendix, all results of the estimations remain similar
in magnitude and statistical significance after excluding the control variables.
Fourth, our findings related to heterogeneity by gender remain unchanged when we conduct the
analysis by sample split – these results are presented in Tables A19 and A20 in Appendix. Next, As
mentioned before, the statistical significance of our results is also unchanged when we calculate p-values
through randomization inference – these results are shown in Tables A19 and A20 in Appendix with the
respective p-values shown in squared brackets.
Finally, using the smaller sample of individuals who responded to the KIs (N=659), we conduct a treated-
on-the-treated (TOT) analysis and we show that our results remain stable – see Table A23 in Appendix. Due
to the small sample we can no longer detect significant effects, however, the fact that the first-stage shows a
strong take-up effect, and that the direction of effects is consistent is reassuring.41
8 Mechanisms
This section explores two mechanisms that could explain the detrimental effects of the intervention on
caregivers’ mental health and interactions with their children, and the heterogeneous results by caregiver
gender: economic deprivation and interactions between partners.42
8.1 Limited attention and economic deprivation
The pandemic affected households’ economic security and created a highly stressful environment (Robillard
et al., 2020; Salari et al., 2020; Lakhan et al., 2020). One of the largest comparative studies to examine the
pandemic’s economic impact found that, in nine developing countries, households reported declines in
employment and income in all settings; the median share of households experiencing an income drop was
41Since
we did not want to conduct the KIs with a larger sample – to avoid fatigue of the respondents – we
did not contemplate a TOT analysis in the pre-analysis since we could not detect effects given the sample
size of the KIs. Nonetheless, we display the TOT analysis results in the Appendix.
42The analysis below was not pre-specified in the PAP but it is deemed essential to understanding the
main effects detected. We explored alternative hypotheses, but we did not find consistent evidence of potential
alternative mechanisms that could explain our results. Alternative explanations included the total number
of children, sex ratio of children residing in the household, age of the child, etc. None of these could explain
our results.
21
68% (Egger et al., 2021).43 Economic deprivation can limit cognitive space and bandwidth (Mullainathan
and Shafir, 2013; Mani et al., 2013; Haushofer and Fehr, 2014; Schilbach et al., 2016; Ridley et al., 2020).
In this extremely challenging context, the addition of even a relatively minor task –such as reading the
intervention program’s messages– might have increased stress. Although participants could drop out of the
intervention at any moment or simply not open the messages, their interest in the material or their desire
to improve parenting practices might have prevented them from doing so —thus creating an additional
cognitive burden.
We assess the empirical importance of this mechanism by examining if the intervention’s impact varied
depending on the extent of caregivers’ economic deprivation. To do so, we construct a dummy variable
indicating whether at baseline the respondent replied that, during the pandemic, the household did not have
enough money for food, health and education, home services, and clothes and gifts.44 In our regression model,
we interact this dummy variable with the treatment indicator to estimate the difference in the treatment effect
between those with the highest level of economic deprivation and the rest (as shown in Equation 2). Table 7
reports the results. We observe that the treatment led to a significantly higher increase in mental distress among
those who reported the highest level of economic deprivation. The difference is large (0.248 sd) and statistically
significant (at the 1% level). While the intervention had no effect on mental distress among the least deprived
(the coefficient is actually negative, but not statistically different from zero), it ledto a 0.217 sd increase for
those most deprived (significant at the 1% level).
8.2 Interactions between partners
The presence of a partner in the house might also have moderated the intervention’s impact on our out-
comes of interest. Partner quality is an important determinant of caregiver mental health (Bendini andDinarte,
2020; Pico-Alfonso, 2005; Taylor et al., 2009), and it influences the relationship between a caregiver and their
children. For example, Bendini and Dinarte (2020) show that the presence of a partner in thehouse (heavy
drinkers, particularly) worsens the effect of maternal mental health on child development. The
intervention’s focus on positive parenting, which stresses the importance of sharing quality time with children
and being aware of children’s emotions, might have changed preferences or expectations about the partner’s
43Moreover, these authors document that household coping strategies and government responses were
generally insufficient, leading to generalized food insecurity and deteriorating economic conditions eventhree
months into the crisis.
44Table 1 shows descriptive statistics for each of the questions considered to create this indicator variable.
At baseline, caregivers were asked if, during the pandemic, they had enough money for different household
expenses. Among this group, 75% responded that they did not have enough money for food, 66% indicated
not having enough money for health and education, 38% reported not having enough money for basic
services, and 90% said they lacked money for clothes and gifts. Thirty percent of households indicated not
having enough money for all four categories.
22
role in child-rearing and the distribution of parenting duties. If treated caregivers were unable to
communicate these revised expectations effectively, the intervention could have created a wedge between
partners, increased negative interactions within the household, and affected mental health.
In light of this hypothesis, we assess if the intervention’s impact varied depending on whether the
treated caregivers lived with a partner or not. Table 8 presents the results of this analysis. We find that the
intervention’s impact on caregiver-child interactions was significantly different for caregivers who lived with a
partner and those who did not. The difference in the treatment effect was -0.167 sd (statistically significant
at the 10% level). Although the intervention did not have a clear impact on caregiver-child interactions
among caregivers who did not live with a partner, it significantly reduced caregiver-child interactions among
those who lived with one (-0.091 sd, significant at the 5% level). Moreover, we also find that the negative
impact on caregiver mental health was mainly concentrated among caregivers living with a partner. Among
these caregivers, the intervention increased mental distress by 0.094 sd (statistically significant at the 5% level).
We cannot directly assess the mechanism that explains these heterogeneous effects, but the results emphasize
the importance of the presence of a partner in terms of the intervention’s impact, and they align with the
hypothesis of an increase in negative interactions within the household due to changes in caregivers’
expectations about parenting roles and the distribution of duties.
8.3 What can explain the differential effects by sex?
The analysis presented in Section 6 shows that the intervention’s impacts on mental distress, positive
caregiver-child interactions and violence were mostly driven by the impact among male caregivers. Subsections
8.1 and 8.2 show that the extent of economic deprivation and cohabitation with a partner also moderate the
effect of the intervention. We now assess how the differential effect across genders relates to these two
channels.
First, we assess how the intervention’s impact differed across genders and levels of economic depr ivation
(at baseline) by estimating a triple-difference regression model. We interact the treatment status dummy with
a variable indicating if the caregiver is a male and with an indicator of economic deprivation,and add a triple
interaction term (treatment-male-economic deprivation). This specification allows us to compare the
intervention’s impact across four different groups of caregivers: men in the most economically deprived
households, women in the most economically deprived households, men in less economically deprived
households, and women in less economically deprived households. Figure 2 presents a summary ofthe
results and Table A21 shows all estimated coefficients. Considering the intervention’s impact on mental
distress, results show that among both men and women, the intervention’s impact was worse for caregivers
in the most economically deprived households. The difference in the intervention’s impact in the most
economically deprived households versus the other households is 0.158 sd (not statistically significant at
standard levels) for women and 0.388 sd (significant at the 1% level) for men. The detrimental impact of
23
the intervention on mental health was particularly observed among men in the most economically deprived
households. When considering households with lower levels of economic deprivation, the intervention had
no significant impact on the mental health of either male or female caregivers. The estimated impact is -0.032
sd (that is, suggestive of lower distress among treated caregivers) for both men and women. However, in
these households, the intervention led to significantly fewer positive caregiver-child interactions, especially for
male caregivers.
Then, we assess how the differential impact of the intervention varied depending on whether the caregiver
was living with a partner or not. We estimate an analogous triple-difference model, replacing the economic
deprivation indicator variable with a dummy indicating if the caregiver lived with a partner. This specification
allows us to compare the intervention’s impact across four different caregiver groups: menliving with a
partner, women living with a partner, men not living with a partner, and women not livingwith a partner.
Figure 3 presents a summary of the results and Table A22 shows all estimated coefficients. Results show that,
for female caregivers, the intervention’s impact was very similar for those who livedwith a partner and
those who did not. Instead, for male caregivers, results differ greatly depending on whether they lived with a
partner or not. The intervention led to a 0.157 sd increase (significant at the 10% level) in mental distress
among men living with a partner and to a 0.21 sd decrease (significant at the 10% level) among men not living
with a partner. The difference between treatment effects is 0.368 sd (significant at the 1% level). We also
observe that the intervention led to significantly fewer positive caregiver-child interactions only among men
who lived with a partner (-0.177 sd, significant at the 10% level).
Overall, the results show that characteristics such as caregiver gender, household economic situation,
and cohabitation with a partner shaped the impact of the intervention. We observe that the degree to which
economic and family circumstances moderate the intervention’s impact depends on caregiver gender. The
intervention’s impact on male caregivers varies greatly depending both on the extent of economic
deprivation and whether they live with a partner, even leading to opposite effects. In women, the
differences in the intervention’s impact among different groups (based on economic deprivation and
cohabitation with apartner) are less pronounced.
9 Discussion and Concluding Remarks
Parenting is challenging. Much of the learning about parenting styles and decisions occurs informally
through social and family ties, which can perpetuate suboptimal and violent parenting practices, especially
in violent contexts. The use of these improper practices can have broad negative effects on child
development, as emphasized by a growing literature on the importance of parental investments (Cunha
and Heckman, 2007). This issue has become a central focus of development policy. Decision-making on this
issue requires a better understanding of the effects of early-childhood and parenting interventions that seek
24
to improve the quality of parental interactions (Britto et al., 2017; Doepke and Zilibotti, 2017, 2019).
We study the impact of a program to promote positive parenting and parental stress management de-
livered remotely via SMS/WhatsApp messages to caregivers in El Salvador, and containing a variety of
digital content akin to that of other successful interventions (Cluver et al., 2018; Carneiro et al., 2019). This
mode of delivery offers an attractive option to improve the well-being of caregivers and children given the
widespread availability of mobile phones (even in low-income settings). This is an attractive alternative
in a severely constrained setting such as the COVID-19 lockdown and in non-crisis periods, because of its
scalability and low implementation costs. The program was developed by an NGO with vast experience
administering mental health programs in El Salvador and Central America.
Contrary to what we expected, we find that, on average, the program increased the mental distress of
caregivers. In spite of that, we find no evidence that this deterioration translated to their children or their
relationship with them. We document no significant impact on caregiver-child interactions or child maltreat-
ment, overall. However, we find that the effect of the program differed substantially by sex. We find that
the increase in mental distress was concentrated among male caregivers, and observe no significant change
among females. Furthermore, we find that female caregivers lowered their use of physical violence toward
children. Finally, we document that family structure and the extent of economic deprivation greatly moderated
the impact of the intervention, especially among male caregivers.
We interpret our average results on mental health as a backlash reaction in the context of limited attention
and disrupted family dynamics. As observed in the literature, familial and cultural context can greatly
moderate the impact of shocks and interventions, and lead to unintended consequences.45 In our case, the
backlash reaction is associated with caregiver gender, family structure, and economic deprivation, consistent
with prevailing theories linking the latter to caregivers’ cognitive overload and mental health (Mullainathan
and Shafir, 2013; Mani et al., 2013; Asadullah et al., 2021; Schilbach et al., 2016; Ridley et al., 2020). This result
provides relevant insights for future research and policy interventions. There is a major evidence gap in
knowledge about parenting policies to address child maltreatment (Pundir et al., 2020). We show that
addressing this problem with a one-size-fits-all program can have unintended consequences, but these can
largely be avoided by tailoring the program to the particular context and the specific needs of the beneficiary
group. Caregiver characteristics can substantially shape the effect of the intervention, so they should be
carefully considered in the program design.
45See,
for example, Dahl et al. (2020) and Tur-Prats (2021).
25
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Tables and Figures
Table 1: Summary Statistics and Balance Tests
Variable Obs. Mean Std Min Max Mean Mean P-val.
Dev control treatment Difference
(1) (2) (3) (4) (5) (6) (7) (8)
Panel A. Caregiver characteristics
Age (years) 3103 32.08 6.34 19 50 32.196 31.968 (0.302)
Female (%) 3103 0.60 0.49 0 1 0.599 0.599 (0.994)
Education level
Basic (1-9 grades, %) 3103 0.20 0.40 0 1 0.205 0.205 (0.988)
High school (10-12 grades, %) 3103 0.38 0.49 0 1 0.381 0.386 (0.766)
Bachelor or higher (%) 3103 0.41 0.49 0 1 0.415 0.410 (0.756)
Employment status pre and post pandemic
Always unemployed (%) 3076 0.19 0.40 0 1 0.191 0.197 (0.625)
Always employed (%) 3076 0.48 0.50 0 1 0.482 0.483 (0.963)
Lost job (%) 3076 0.10 0.31 0 1 0.106 0.104 (0.887)
Found job (%) 3076 0.22 0.41 0 1 0.221 0.215 (0.686)
Girls under 9 years cared (N) 3054 0.76 0.66 0 5 0.752 0.765 (0.582)
Boys under 9 years cared (N) 3054 0.77 0.65 0 4 0.782 0.756 (0.265)
Time caregiver spends with the child (hours) 3103 9.64 3.64 0 12 9.803 9.480 (0.012)
Living with a partner (%) 3103 0.70 0.46 0 1 0.699 0.696 (0.833)
Panel B. Child characteristics
Oldest child under 9 is female (%) 3103 0.50 0.50 0 1 0.492 0.503 (0.553)
Child enrolled in school (%) 3103 0.66 0.48 0 1 0.659 0.652 (0.676)
Child video/screen time for fun (hours) 3103 3.64 3.76 0 24 3.735 3.542 (0.151)
Child video/screen time for homework (hours) 3103 3.00 3.45 0 24 3.007 2.986 (0.863)
Panel C. Household characteristics
Household size (N of members) 3102 4.15 1.97 1 20 4.158 4.148 (0.892)
Intergenerational household (%) 3103 0.38 0.49 0 1 0.392 0.373 (0.284)
Income vulnerability index 2953 1.31 1.18 0 4 1.278 1.337 (0.171)
Money for food (%) 3057 0.25 0.44 0 1 0.247 0.260 (0.413)
Money for health and education (%) 3041 0.34 0.47 0 1 0.339 0.344 (0.748)
Money for home services (%) 3058 0.62 0.49 0 1 0.607 0.631 (0.181)
Money for clothes and gifts (%) 3051 0.10 0.30 0 1 0.096 0.106 (0.367)
Economic deprivation (%) 2953 0.33 0.47 0 1 0.343 0.307 (0.032)
Panel D. Outcomes
Mental health index, std. 3103 0.00 1.01 -2 4 0.000 -0.008 (0.817)
Anxiety (high, %) 3103 0.54 0.50 0 1 0.539 0.547 (0.680)
Stress (high, %) 3103 0.34 0.47 0 1 0.336 0.336 (0.999)
Depression (high, %) 3103 0.34 0.47 0 1 0.339 0.336 (0.847)
Impulsiveness index, std. 3103 0.00 1.02 -4 5 0.000 0.006 (0.871)
Positive caregiver-child interactions index, std. 3103 -0.02 1.01 -5 1 0.000 -0.048 (0.182)
Positive caregiver-child interactions (N) 3103 9.20 1.31 1 10 9.239 9.168 (0.131)
Tolerance of violent parenting index, std. 2938 -0.03 0.99 -1 7 -0.027 -0.037 (0.794)
Tolerate at least one item of maltreatment (%) 2991 0.29 0.45 0 1 0.282 0.289 (0.657)
Positive parenting index, std. 3038 0.06 0.96 -6 1 0.025 0.102 (0.027)
Positive practices (N) 3038 9.99 1.19 2 11 9.958 10.026 (0.110)
Negative parenting index, std. 2925 -0.03 0.92 -1 9 0.000 -0.067 (0.049)
Negative practices (N) 2925 2.32 2.22 0 12 2.369 2.276 (0.262)
Physical violence index, std. 3053 0.00 0.98 -1 4 0.005 -0.005 (0.801)
Psychological violence index, std. 2950 -0.03 0.92 -1 8 0.006 -0.069 (0.027)
This table shows baseline characteristics of the sample and the balance of baseline measures, comparing control and treatment groups.
It shows means of each group and p-value for the difference in means. In a test for differences in gender, we exclude strata fixed effects due
to collinearity (gender is the stratification variable). Income vulnerability index is the sum of all subcategories.
33
Table 2: Differences in means by gender (baseline)
Mean Mean P-val. Mean Mean P-val. Mean Mean P-val.
Variable All Male All Female Diff Control Male Treated Male Diff Control Female Treated Female Diff
(1) (2) (3) (4) (5) (6) (7) (8) (9)
Panel A. Caregiver characteristics
Age (years) 32.636 31.711 (0.000)*** 32.921 32.352 (0.111) 31.712 31.711 (0.997)
Education level
Basic (1-9 grades, %) 0.200 0.208 (0.000)*** 0.182 0.217 (0.122) 0.220 0.197 (0.218)
High school (10-12 grades, %) 0.402 0.370 (0.033)** 0.422 0.383 (0.160) 0.353 0.388 (0.118)
Bachelor or higher (%) 0.398 0.422 (0.000)*** 0.396 0.400 (0.882) 0.427 0.416 (0.599)
Employment status pre and post pandemic
Always unemployed (%) 0.081 0.270 (0.000)*** 0.083 0.079 (0.802) 0.262 0.277 (0.500)
Always employed (%) 0.597 0.406 (0.000)*** 0.597 0.598 (0.994) 0.406 0.407 (0.956)
Lost job (%) 0.080 0.121 (0.100)* 0.088 0.071 (0.274) 0.117 0.126 (0.570)
Found job (%) 0.242 0.203 (0.533) 0.232 0.252 (0.399) 0.215 0.191 (0.204)
Girls under 9 years cared (N) 0.748 0.766 (0.000)*** 0.742 0.755 (0.735) 0.759 0.772 (0.664)
Boys under 9 years cared (N) 0.790 0.755 (0.361) 0.806 0.774 (0.396) 0.766 0.744 (0.455)
Time caregiver spends with the child (hours) 8.865 10.160 (0.000)*** 9.055 8.675 (0.077)* 10.302 10.018 (0.076)*
Living with a partner (%) 0.818 0.617 (0.000)*** 0.818 0.818 (1.000) 0.620 0.614 (0.802)
Panel B. Child characteristics
Oldest child under 9 is female (%) 0.471 0.515 (0.071)* 0.457 0.486 (0.319) 0.516 0.515 (0.962)
Child enrolled in school (%) 0.641 0.665 (0.778) 0.643 0.640 (0.919) 0.670 0.660 (0.647)
Child video/screen time for fun (hours) 3.798 3.532 (0.919) 3.944 3.653 (0.179) 3.596 3.467 (0.455)
Child video/screen time for homework (hours) 3.208 2.855 (0.630) 3.122 3.294 (0.423) 2.930 2.781 (0.322)
Panel C. Household characteristics
Household size (N of members) 4.105 4.185 (0.130) 4.166 4.045 (0.265) 4.153 4.217 (0.493)
Intergenerational household (%) 0.338 0.412 (0.022)** 0.354 0.322 (0.228) 0.417 0.407 (0.678)
Income vulnerability index 1.343 1.284 (0.510) 1.315 1.371 (0.412) 1.253 1.314 (0.272)
Money for food (%) 0.258 0.250 (0.087)* 0.259 0.257 (0.954) 0.239 0.262 (0.265)
Money for health and education (%) 0.352 0.334 (0.031)** 0.348 0.357 (0.736) 0.333 0.336 (0.890)
Money for home services (%) 0.623 0.617 (0.843) 0.608 0.637 (0.289) 0.607 0.626 (0.389)
Money for clothes and gifts (%) 0.124 0.086 (0.591) 0.123 0.126 (0.862) 0.079 0.093 (0.279)
Economic deprivation (%) 0.324 0.326 (0.878) 0.343 0.304 (0.140) 0.343 0.309 (0.119)
Panel D. Outcomes
Mental health index, std. -0.210 0.133 (0.000)*** -0.210 -0.210 (0.998) 0.140 0.126 (0.773)
Anxiety (high, %) 0.468 0.593 (0.003)*** 0.465 0.471 (0.841) 0.589 0.597 (0.712)
Stress (high, %) 0.254 0.391 (0.019)** 0.245 0.264 (0.442) 0.397 0.385 (0.574)
Depression (high, %) 0.260 0.390 (0.000)*** 0.258 0.262 (0.860) 0.394 0.386 (0.712)
Impulsiveness index, std. 0.032 -0.017 (0.198) -0.009 0.073 (0.144) 0.006 -0.039 (0.350)
Positive caregiver-child interactions index, std. -0.155 0.063 (0.002)*** -0.160 -0.150 (0.877) 0.107 0.020 (0.046)**
Positive caregiver-child interactions (N) 9.144 9.244 (0.987) 9.134 9.154 (0.788) 9.310 9.177 (0.024)**
Tolerance of violent parenting index, std. 0.017 -0.067 (0.112) 0.034 0.001 (0.602) -0.070 -0.063 (0.908)
Tolerate at least one item of maltreatment (%) 0.301 0.274 (0.066)* 0.300 0.302 (0.910) 0.269 0.280 (0.627)
Positive parenting index, std. -0.007 0.111 (0.096)* -0.050 0.035 (0.138) 0.076 0.148 (0.101)
Positive practices (N) 9.940 10.027 (0.274) 9.895 9.985 (0.205) 10.000 10.054 (0.313)
Negative parenting index, std. -0.070 -0.008 (0.004)*** -0.054 -0.087 (0.553) 0.037 -0.054 (0.040)**
Negative practices (N) 2.288 2.347 (0.026)** 2.315 2.260 (0.689) 2.406 2.287 (0.256)
Physical violence index, std. 0.016 -0.011 (0.014)** 0.025 0.006 (0.754) -0.010 -0.012 (0.954)
Psychological violence index, std. -0.068 -0.006 (0.016)** -0.051 -0.086 (0.503) 0.045 -0.057 (0.022)**
Observations 1,243 1,860 621 622 929 931
Balance table of baseline measures, comparing male and female groups. It shows means of each group and p-value for the difference
in means. Income vulnerability index is the sum of all subcategories. *** p<0.01, ** p<0.05, * p<0.1.
34
Table 3: Effect of the treatment on primary outcomes
(1) (2) (3) (4) (5) (6)
Mental Health Distress
Index Anxiety Stress Depression Impulsiveness Positive
(A + S + D) (A) (S) (D) caregiver-child
interactions
Treatment 0.057* 0.039 0.072** 0.029 -0.007 -0.043
(0.033) (0.034) (0.035) (0.035) (0.039) (0.039)
[0.088] [0.269] [0.037] [0.451] [0.864] [0.295]
Mean of Dep.Var (control) 0.000 0.000 0.000 0.000 0.000 0.000
R-squared 0.348 0.318 0.286 0.267 0.107 0.182
Observations 2,280 2,280 2,280 2,280 2,280 2,280
Strata FE Yes Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes Yes Yes
This table shows the estimated impacts of the intervention on primary outcomes. Treatment is a dummy equal to one if the individual
is randomly assigned to the treatment group and zero if assigned to the control group. The dependent variable in column (1) is
the standardized average of the self-report scales of the emotional states of anxiety, stress, and depression (all items of DASS-21); in
column (2) is the standardized average of the self-report scales of the emotional state of anxiety (7 items of DASS-21); in column (3) is
the standardized average of the self-report scales of the emotional state of stress (7 items of DASS-21); in column (4) is the standardized
average of the self-report scales of the emotional state of depression (7 items of DASS-21); in column (5) is the standardized sum of the
self-report instrument of the Barratt Impulsiveness Scale BIS-11; and in column (6) is the standardized index of the responses to the 10
questions related to support for learning/stimulating environment and setting limits domain. The controls include age in years, girls
and boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
35
Table 4: Heterogeneous effects across genders: Primary outcomes
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child interactions
i. Treatment 0.034 0.037 0.018
(0.045) (0.051) (0.047)
ii. Male x Treatment 0.059 -0.111 -0.154*
(0.067) (0.080) (0.082)
iii. Total effect on men ([i] + [ii]) 0.093* -0.074 -0.137**
(0.050) (0.062) (0.067)
Mean of Dep. Var (control) 0.000 0.000 0.000
R-squared 0.348 0.107 0.183
Observations 2,280 2,280 2,280
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
This table shows the differential impacts of the intervention on primary outcomes by gender. Treatment is a dummy equal to one if the
individual is randomly assigned to the treatment group and zero if assigned to the control group. The dependent variable in column
(1) is the standardized average of the self-report scales of the emotional states of anxiety, stress, and depression (all items of DASS-21);
in column (2) is the standardized sum of the self-report instrument of the Barratt Impulsiveness Scale BIS-11; and in column (3) is the
standardized index of the responses to the 10 questions related to support for learning/stimulating environment and setting limits
domain. All the regressions include interaction between male variable and treatment status. The controls include age in years, girls
and boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
36
Table 5: Effect of the treatment on parental quality outcomes
(1) (2) (3) (4) (5)
Total Physical Psychological Tolerance of Child
violence violence violence violent parenting behavior
Treatment 0.007 -0.050 0.027 -0.020 0.066
(0.039) (0.038) (0.040) (0.039) (0.042)
[0.860] [0.199] [0.513] [0.607] [0.123]
Mean of Dep. Var (control) -0.008 0.002 -0.007 -0.005 0.005
R-squared 0.103 0.131 0.078 0.164 0.006
Observations 2,245 2,270 2,251 2,234 2,226
Strata FE Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of nine items of negative parenting techniques (physical and
psychological violence); in column (2) is the standardized index of the two items of physical abuses; in column (3) is the standardized
index of the seven items of psychological violence (emotional abuses); in column (4) is the standardized index of the responses in the
ICAST-P module and the vignettes; and in column (5) is the standardized index of the seven items that are reported by the caregiver
from the internalizing/externalizing behaviors sections of the Parent/Caregiver Report Survey. The controls include age in years, girls and
boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
37
Table 6: Heterogeneous effects across genders: Parental quality outcomes
(1) (2) (3) (4) (5)
Total Physical Psychological Tolerance of Child
violence violence violence violent parenting behavior
i. Treatment -0.005 -0.098** 0.032 -0.020 0.063
(0.049) (0.049) (0.050) (0.048) (0.056)
ii. Male x Treatment 0.029 0.123 -0.011 0.001 0.008
(0.082) (0.078) (0.084) (0.081) (0.086)
iii. Total effect on men ([i] + [ii]) 0.025 0.025 0.020 -0.019 0.071
(0.065) (0.061) (0.067) (0.066) (0.065)
Mean of Dep. Var (control) -0.008 0.002 -0.007 -0.005 0.005
R-squared 0.103 0.132 0.078 0.164 0.006
Observations 2,245 2,270 2,251 2,234 2,226
Strata FE Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of nine items of negative parenting techniques (physical and
psychological violence); in column (2) is the standardized index of the two items of physical abuses; in column (3) is the standardized
index of the seven items of psychological violence (emotional abuses); in column (4) is the standardized index of the responses in the
ICAST-P module and the vignettes; and in column (5) is the standardized index of the seven items that are reported by the caregiver
from the internalizing/externalizing behaviors sections of the Parent/Caregiver Report Survey. The controls include age in years, girls and
boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
38
Table 7: Heterogeneous effects by economic deprivation: Primary outcomes
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child
interactions
i. Treatment -0.032 0.005 -0.048
(0.040) (0.049) (0.049)
ii. Economic deprivation -0.032 0.075 0.071
(0.053) (0.060) (0.058)
iii. Economic deprivation x Treatment 0.248*** -0.034 -0.049
(0.077) (0.086) (0.086)
iv. Total effect on most deprived ([i] + [iii]) 0.217*** -0.029 -0.097
(0.065) (0.071) (0.071)
Mean of Dep. Var (control) 0.003 -0.004 0.010
R-squared 0.352 0.109 0.182
Observations 2,172 2,172 2,172
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control group.
The dependent variable in column (1) is the standardized average of the self-report scales of the emotional states of anxi-ety, stress,
and depression (all items of DASS-21); in column (2) is the standardized sum of the self-report instrument of the Barratt Impulsiveness
Scale BIS-11. In column (3) is the standardized index of the responses to the 10 questions related to support for learn- ing/stimulating
environment and setting limits domain. The variable Economic deprivation is a dummy equal to one if the individual responded that from
the beginning of the pandemic in their house, there was not enough money for food, home services, education,and others. The controls
include age in years, girls and boys cared for by the respondent, and the educational level of the respondent for primary, high school,
or tertiary education—the omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
39
Table 8: Heterogeneous effects by partner
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child interactions
i. Treatment -0.032 -0.037 0.076
(0.629) (0.605) (0.297)
ii. Living with a partner -0.117** -0.094 0.158**
(0.039) (0.138) (0.010)
iii. Living with a partner x Treatment 0.125 0.043 -0.167*
(0.100) (0.620) (0.052)
iv. Total effect on caregivers living with 0.094** 0.005 -0.091**
a partner ([i] + [iii]) (0.039) (0.047) (0.046)
Mean of Dep. Var (control) 0.000 0.000 0.000
R-squared 0.349 0.108 0.185
Observations 2,280 2,280 2,280
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized average of the self-report scales of the emotional states of anxi- ety,
stress, and depression (all items of DASS-21); in column (2) is the standardized sum of the self-report instrument of the Barratt
Impulsiveness Scale BIS-11; and in column (3) is the standardized index of the responses to the 10 questions related to support for
learning/stimulating environment and setting limits domain. All the regressions include interaction between male variable and treat-
ment status. The controls include age in years, girls and boys cared for by the respondent, and the educational level of the respondent
for primary, high school, or tertiary education—the omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
40
Figure 1: Intervention Theory of Change
Source: Author’s translation from Glasswing (2020)
41
Figure 2: Heterogeneous effects by sex and economic deprivation
Figure 3: Heterogeneous effects by sex and partner
42
Appendix
A1 Outcomes List and Description
Main Outcomes
A1.1 Mental health
We use the Depression, Anxiety and Stress Scale (DASS-21) instrument to measure mental distress (Lovi-
bond and Lovibond, 1996). This instrument includes 21 items organized in three sets of questions measur-
ing the emotional states of depression, anxiety, and stress, respectively. Each set of questions contains seven
items. Each item is measured on a scale of 0 –3 points (Never, Rarely, Almost Always or Always). We com-
pute an index for each set of questions, constructed as the standardized average of the seven items. We also
compute and aggregate index with a standardized average of all 21 items. We use the mean and standard
deviation of the control group for the standardization. The DASS-21 are the following:
No. Item Emotion Original version
1 Le costo´ mucho relajarse Stress I found it hard to wind down
2 Se dio cuenta que ten´ıa la boca seca Anxiety I was aware of dryness of my mouth
3 No pod´ ´ n sentimiento
ıa tener ningu Depression I could not seem to experience any positive feeling at all
positivo
4 ´ respirar
Le costo Anxiety I experienced breathing difficulty (e.g., excessively rapid
breathing, breathlessness in the absence of physical exer-
tion)
5 ´ tomar la iniciativa para
Le costo Depression I found it difficult to work up the initiative to do things
hacer cosas
6 Reacciono ´ de forma exagerada en Stress I tended to over-react to situations
ciertas situaciones
7 Sintio´ que las manos le temblaban Anxiety I experienced trembling (e.g., in the hands)
8 Sintio´ que estaba muy nervioso/a Stress I felt that I was using a lot of nervous energy
9 Estaba preocupado/a por situa- Anxiety I was worried about situations in which I might panic and
ciones en las cuales podr´ıa hacer el make a fool of myself
rid´ıculo
10 Sintio´ que no ten´ıa ninguna razo´n Depression I felt that I had nothing to look forward to
para vivir
11 Noto´ que estaba muy agitado/a Stress I found myself getting agitated
12 Le costo´ mucho calmarse Stress I found it difficult to relax
13 Se sentio´ triste o deprimido/a Depression I felt down-hearted and blue
14 Fue intolarante con las cosas que le Stress I was intolerant of anything that kept me from getting on
distra´ıan o que le desconcentraban with what I was doing
15 ´ que iba a tener un ataque de
Sintio Anxiety I felt I was close to panic
miedo
16 ´ que no pod´
Sintio ıa entusiasmarse Depression I was unable to become enthusiastic about anything
por nada
17 ´ que no val´
Sintio ıa mucho como Depression I felt I was not worth much as a person
persona
18 ´ que estaba muy irritable
Sintio Stress I felt that I was rather touchy
19 ´ que ten´
Sintio ´n
ıa agitado el corazo Anxiety I was aware of the action of my heart in the absence of
a pesar de no haber hecho ningu ´n physical exertion (e.g., sense of heart rate increase, heart
esfuerzo f´ısico missing a beat)
43
20 Tuvo miedo sin razo´ n aparente Anxiety I felt scared without any good reason
21 Sintio
´ que la vida no ten´ ´n
ıa ningu Depression I felt that life was meaningless
sentido
44
A1.2 Impulsiveness
We use the Barratt Impulsiveness Scale BIS-11 (Patton et al., 1995) to measure impulsiveness. It includes
15 items, each measured on a scale of 1–4 points (Never, Rarely, Almost Always or Always). We construct
as index as the standardized sum of the 15 items. We use the mean and standard deviation of the control
group for the standardization. The BIS-11 items are the following:
No. Item Original version
1 Actue ´ impulsivamente I act on impulse
2 Hice las cosas en el momento que se me ocurrieron I act on the spur of the moment
3 Hice las cosas sin pensarlas I do things without thinking
4 Dije las cosas sin pensarlas I say things without thinking
5 Compre ´ cosas impulsivamente I buy things on impulse
6 Busque ´ un mejor trabajo I change jobs
7 Hice planes para el futuro I am future oriented
8 Ahorre ´ con regularidad I save regularly
9 Planifique ´ mis tareas con cuidado I plan tasks carefully
10 Pense´ las cosas cuidadosamente I am a careful thinker
11 Me sent´ı muy inquieto/a al tener que escuchar hablar a alguien I am restless at the theater or lectures
12 Se me hizo dif´ıcil estar quieto/a por largos periodos de tiempo I squirm at plays or lectures
13 Me concentre ´ facilmente I concentrate easily
14 Pude enfocar mi mente en una sola cosa por mucho tiempo I can only think about one thing at a time
15 Me aburrio ´ pensar en algo por demasiado tiempo I get easily bored when solving thought problems
A1.3 Positive caregiver-child interactions
We use the 10 questions related to support for learning/stimulating environment and setting limits domains
from the Family Care Indicators instrument developed by UNICEF (Kariger et al., 2012) to measure posi-
tive caregiver-child interactions. We construct an standardized index using inverse covariance weighting,
following Anderson (2008). We use the mean and standard deviation of the control group for the standard-
ization. The items used to measure this outcome are the following (response categories are never, one day,
two or three days and four or more days):
No. Item Original version
1 Leyo´ libros o ima ´ genes en libros last week someone read books/showed images to kid
2 Conto ´ cuentos last week someone told stories/tales to kid
3 Le canto ´ canciones last week someone sang songs to kid
4 Jugaron last week someone played with kid
5 Usaron tiempo en actividades de aprendizaje, como contar, nombrar objetos o dibujar last week someone shared learning time with kid
6 Hicieron labores de la casa como cocinar, limpiar, cuidar a los animales, u otras similares last week someone did chores with kid
7 Le ensen ˜o´ lecciones de la iglesia, leyeron la biblia, etc. last week someone gave biblical lessons/read bible to kid
8 Se sento´ con el nin ˜ a a comer juntos durante el almuerzo o cena
˜ o o nin last week someone sat to have meal with kid
9 Alimento ˜o
´ al nin last week someone fed the kid
10 Hablaron durante las comidas last week someone spoke with kid during meals
Secondary outcomes
45
A1.4 Tolerance towards violent parenting
We measure tolerance towards violence parenting practices using responses from two sets of questions.
First, we elicited tolerance through two fictional stories about typical violent practices that could take place
in the studied context. After each story, we asked respondents two questions about how justifiable they
think the behavior of the fictional caregiver was (the rating scale in each vignette is: inadequate, little
adequate, neutral, slightly adequate, and adequate). Second, we asked direct questions about tolerance of child
abuse perpetrated by fathers, mothers, and teachers, and whether respondents think physical punishment
is an effective disciplinary tool (in each question response options are yes or no). Our main outcome is a
standardized index using inverse covariance weighting, following (Anderson, 2008). We used the mean and
standard deviation of the control group for the standardization. The items used to measure this trait are the
following:
46
No. Item Original version
Vignettes baseline
1 Es un d´ıa normal de cuarentena y la familia se prepara para Considerando lo que paso ´ en este How do you consider Roberto’s re-
almorzar. Todos esta ´ n sentados a la mesa excepto Rebecca ´mo considera que fue la
relato ¿Co action to the behavior of his daugh-
quien tiene 8 an ˜ os. Roberto su padre, quien ha estado de- ´n de Roberto ante el compor-
reaccio ter Rebecca?
sempleado desde hace un par de meses, la llama varias ve- tamiento de su hija Rebecca?
ces, pero ella no le escucha o decide no obedecer, por lo que
no responde a sus llamadas durante casi 30 minutos para
ir al comedor y almorzar. Roberto se altera mucho y, como
cree que la actitud de su hija debe ser corregida, le da una
palmada y la lleva al comedor para hacerle entender que
su desobediencia no puede repetirse.
2 Marcos y Stephanie son hermanos y esta ´ n jugando dentro Considerando lo que paso´ en este How do you consider Ana’s reac -
de la casa. Sus padres esta ´ n cansados e irritables por el ´mo considera que fue la
relato ¿Co tion to the behavior of her children
ruido que hacen los nin ˜ os, ya que la casa es pequen ˜ a, pero ´n de Ana ante el compor-
reaccio Marcos and Stephanie?
los aguantan ya que prefieren que sus hijos este ´ n dentro tamiento de sus hijos Marcos y
y no fuera de la casa. De repente el juego se sale de con- Stephanie?
trol y Marcos le pega con la pelota al televisor, lo bota y lo
arruina. Su madre, Ana, se enfurecio ´ much´ ısimo, ya que
recie ıan comprado el televisor y todav´
´ n hab´ ıa lo segu´ ıan
pagando en cuotas. Ana se molesto ´ tanto que perdio ´ el
control y empezo ´ a gritarle a sus hijos, dicie ´ ndoles que ya
no los soportaba, los agarro ´ de los brazos y los tiro ´ al piso.
Vignette endline
1 Ya es la hora de cenar en la casa de Paco. Paco estuvo traba- Considerando lo que paso ´ en este How do you consider Paco’s reac -
jando todo el d´ıa y Mar´ıa su esposa estuvo todo el d´ıa con ´mo considera que fue la
relato ¿Co tion to the behavior of his daughter
los nin˜ os. Todos esta´ n sentados a la mesa excepto Ana, ´n de Paco ante el compor-
reaccio Ana?
la hija de Paco y Mar´ ıa. Ana tiene 10 an˜ os y a veces no tamiento de su hija Ana?
hace todo lo que sus padres le piden. Maria y Paco esta ´n
cansados por todo lo que esta ´ pasando con la pandemia,
y hoy Mar´ ´ algo rico para que todos pudieran re-
ıa cocino
lajarse un poco. Ana se ha quedado viendo la tele y no se
acerca a comer, a pesar de que sus padres le han estado
llamando. Paco se comienza a alterar mucho, ya que esta ´
muy cansado. El cree que la actitud de su hija no esta´ bien,
por lo que le grita, le da una palmada y la lleva a la mesa
para hacerle entender que no debe ser desobediente.
Direct questions
1 ¿Cree usted que es aceptable que Do you think it is acceptable for a
un padre, madre o encargado(a), caregiver to use violence to disci-
cuidador(a) castigue f´ısicamente a pline a kid?
un nin ˜ o(a) cuando e´ l(ella) se porta
mal?
2 ¿Cree usted que es aceptable que Do you think it is acceptable for a
el(la) docente castigue f´ısicamente a teacher to use violence to discipline
un nin ˜ o(a) cuando e´ l(ella) se porta a kid?
mal?
3 ¿Piensa que el castigo f´ısico es un Do you think physical punishment
me´ todo de correccio´n efectivo? is an effective method to discipline
children?
A1.5 Child behavior
We measure child behavior using the internalizing/externalizing behaviors sections of the parent/caregiver
report survey developed by the World Bank. This module includes seven items reported by the caregiver,
in each question response options are yes or no. The questions relate to negative behaviors (i.e. an high
outcome indicates bad child behavior), were framed with respect to the last three months, and were only
administered to parents with children aged three or older following the recommendations of the module
developers. This module was collected at endline only. We construct a standardized index (we used the
mean and standard deviation of the control) using inverse covariance weighting, as in Anderson (2008).
The items included are the following:
47
No. Item Original version
1 Llorando mucho Crying a lot
2 Hablando con mayor dificultad de la habitual Speaking with greater difficulty than usual
3 Aislado(a) o muy callado(a) Isolated or very quiet
4 Irritable (se ha molestado o enojado fa´ cilmente por cosas que le pasan) Irritable (easily upset or angry about things that happen to you)
5 Rebelde (no respeta las reglas de la casa) Rebel (does not respect the house rules)
6 Destruyendo o dan ˜ ando cosas Destroying or damaging things
7 Tranquilo/a. No nota ningu ´ n cambio de comportamiento (Revertido) Quiet. You do not notice any change in behavior (reversed)
Exploratory outcomes
A1.6 Parenting practices and violence perpetration
We use an adapted version of the International Society for Prevention of Child Abuse and Neglect’s screen-
ing tool for caregivers (ICAST-P) to measure child abuse.1 The original instrument contains 38 items of
violence. We shortened this instrument to eight items. To improve our measure of child abuse, we com-
plemented this self-reported instrument with responses to hypothetical perpetration of violence elicited
through vignettes. We presented caregivers two fictional stories about regular caregiver-child interactions. We
use the same vignettes as in the module on tolerance towards violent parenting practices. After each story,
we surveyed respondents on eight items of abuse that they might use with the child in their carein that
hypothetical scenario. Each item of abuse included in this module was also selected following the ICAST-
P. The scale of responses is a five-point Likert scale. We explore four outcomes in this line. First, weestimate
a standardized index of the seven items of positive parenting techniques. Second, a standardizedindex of
nine items of negative parenting techniques including physical and psychological violence. We an- alyze
negative parenting in two separate aspects. Third, a standardized index of the two items of physical abuse,
and finally a standardized index of the seven items of psychological violence (emotional abuse). All the
outcomes using inverse covariance weighting, following Anderson (2008). The items included are the
following:
1This is an internationally validated tool to measure child abuse (Meinck et al., 2020). When this module was
developed, the scientific understanding of the best approaches to surveying parents remotely on sucha
sensitive topic were limited. Due to this uncertainty, we include this item as an exploratory outcome. The
module follows the Conflict Tactics Scale methodology, and therefore the coding of each item is a dummy
that equals one if the respondent uses an item of violence.
48
No. Item Form of Parenting Original version
Direct Caregiver Questions
1 Prohibirle que se mueva de lugar Psychological violence Forced him or her to hold a position that caused pain or
humiliated him or her as a means of punishment?
2 Pegarle en la mano cuando toca algo Physical violence Hit on head with knuckle or back of the hand?
que no debe
3 Decirle ”no” y explicarle por que Positive parenting Explained to him/her why something s/he did was wrong?
4 Hacer que se siente o mandarlo Psychological violence Locked him or her up in a small place or in a dark room?
a otro cuarto para que tenga un P37 a
tiempo a solas
5 Gritarle Psychological violence Shouted, yelled, or screamed at him/her very loud and ag-
gressively?
6 Quitarle los objetos y ponerlos en un Positive parenting Took away his/her pocket money or other privileges? For-
lugar donde no los alcance bade him/her of something he/she liked? Gave him/her
something else to do in order to distract his/her attention?
7 Distraerlo con otras actividades Positive parenting Took away his/her pocket money or other privileges? For-
bade him/her of something he/she liked? Gave him/her
something else to do in order to distract his/her attention?
8 Ofenderlo(a) o humillarlo(a) Psychological violence Insulted him/her by calling him/her dumb, lazy, or other
names like that?
Vignettes
9 Quitar los juguetes o cualquier cosa Positive parenting Took away his/her pocket money or other privileges? For-
que la nina o el nino le guste bade him/her of something he/she liked? Gave him/her
something else to do in order to distract his/her attention?
10 Gritarle para que obedezca Psychological violence Shouted, yelled, or screamed at him/her very loud and ag-
gressively?
11 Llamarla ” desobediente” ,” malcri- Psychological violence Insulted him/her by calling him/her dumb, lazy or other
ada” o ” torpe” names like that?
12 Pegarle con la palma de la mano o Physical violence Hit elsewhere (not buttocks) with an object such as a stick,
un objeto broom, cane, or belt?
13 Encerrarla o dejarla sin alimentos Psychological violence Did not get enough to eat (went hungry) and/or drink
por un tiempo (were thirsty) even though there was enough for everyone,
as a means of punishment?
14 Explicarle por que el compor- Positive parenting Explained to him/her why something s/he did was wrong?
tamiento no es el adecuado
15 Pedirle que no lo haga nuevamente Positive parenting Told her/him to start or stop doing something ?
16 Preguntar por que la nina actuo de Positive parenting Explained to him/her why something him/her did was
esa manera wrong?
A1.7 Child socioemotional development
To measure child behavior and socioemotional development, we follow the parent/caregiver report survey
developed by the World Bank. The data collection was framed with respect to the last three months and was
only asked of parents with children aged three or more. 2 We construct an index of the frequency with which
caregivers observe certain behaviors in their child. We use nine items, each item is measured on a scale of
49
2
The socioemotional development variable was not included initially in the PAP, and therefore is consid-
ered an exploratory outcome.
50
1–4 points (Never, Rarely, Almost Always or Always). The outcome is a standardized index (we used the mean
and standard deviation of the control) using inverse covariance weighting, as in (Anderson, 2008) ofthe
responses to the following items of typical socioemotional development. An high outcome indicatesbetter
socioemotional development.
No. Item Original version
1 ¿Tuvo una buena concentracio ´ n? Did the child have good concentration?
2 ¿Recordo ´ todas las instrucciones que recibio ´ para hacer varias cosas? Did the child remember all the instructions he received to do various things?
3 ¿Planifico´ lo que ten´ıa que hacer antes de hacerlo? Did the child plan what he had to do before doing it?
4 ¿Dejo´ de hacer algo cuando se le pidio ´ que lo hiciera? Did the child stop doing something when asked to do it?
5 ¿Continuo ´ trabajando en una actividad hasta que la termino ´? Did the child keep working on an activity until he finished it?
6 ¿Asumio ´ la responsabilidad de sus actos? Did the child take responsibility for his actions?
7 ´ bien con otros nin
¿Se llevo ˜ os? Did the child get along with other children?
8 ¿Se ajusto ´ cilmente a las transiciones? (Por ejemplo, ir al doctor, cambiarse de cuarto, pasar jugar a descansar)
´ fa Did the child adjust easily to transitions?
9 ¿Se tranquilizo ´ despue´ s de haber estado muy activo/a? Did the child calm down after being very active?
A1.8 Social desirability
We use the short form of 13 questions to measure the individual-level propensity to misreport sensitive
items, following Crowne and Marlowe (1960) and Dhar et al. (2018). We included the social desirability
module at endline (due to time limitations in the baseline survey instrument). Each question allowed two
possible answers: yes or no. The outcome is the sum of positive answers to all the following items:
No. Item Original version
1 A veces se me hace dif´ıcil ponerme a trabajar sin que me pidan que lo haga (Revertido) It is sometimes hard for me to go on with my work if I am not encouraged
2 A veces me siento frustrado(a) o triste porque las cosas no salen como yo quiero (Revertido) I sometimes feel resentful when I don’t get my way
3 En alguna ocasiones, he dejado de intentar hacer algo porque he pensado que soy poco capaz de hacerlo (Revertido) On a few occasions, I have given up doing something because I thought too little of my ability
4 ´ n (Revertido)
En ocasiones quiero llevarle la contraria a la gente con autoridad, aunque sepa que tienen razo There have been times when I felt like rebelling against people in authority even though I knew they were right
5 Sin importar con quien este ´ hablando siempre escucho con atencio ´n No matter who I’m talking to, I’m always a good listener
6 Han habido ocasiones en que me he aprovechado de alguna persona (Revertido) There have been occasions when I took advantage of someone
7 Siempre estoy dispuesto/a a aceptar cuando cometo un error I’m always willing to admit it when I make a mistake
8 En ocasiones trato de desquitarme o vengarme en lugar de perdonar u olvidar (Revertido) I sometimes try to get even rather than forgive and forget
9 Siempre soy amable, aun con la gente que no es tan agradable I am always courteous, even to people who are disagreeable
10 Nunca me molesto cuando la gente tiene ideas que son muy distintas a las m´ıas I have never been irked when people expressed ideas very different from my own
11 A veces he sentido muchos celos de la buena suerte de otras personas (Revertido) There have been times when I was quite jealous of the good fortune of others
12 Algunas veces me irrito por que la gente me pida favores (Revertido) I am sometimes irritated by people who ask favors of me
13 De forma consciente he dicho cosas que han herido los sentimientos de otra persona (Revertido) I have deliberately said something that hurt someone’s feelings
51
A1.9 Sociodemographic information and additional covariates
Categorias de respuesta
Fecha de nacimiento Dia/Mes/Ano
Sexo Mujer Hombre
´ s alto que ha alcanzado
Nivel educativo ma Kinder (4-5)
Preparatoria
1er grado
2do grado
3er grado
4to grado
5to grado
6to grado
7mo grado
8vo grado
9no grado
1er ano bachto
2do ano bachto
3er ano bachto
Tecnico superior incompleto
Tecnico superior completo
Universitario incompleto
Universitario completo
´ ltimos 6 meses, ha desempen
Durante los u ´ n trabajo, ya sea como
˜ ado algu S´ı, empleado S´ı, empleado por cuenta propia No No sabe
empleado o por cuenta propia
Realizaba algu´ n trabajo/ocupacin ´ /oficio remunerado al momento que Si No No sabe No responde
el gobierno declaro ´ la cuarentena obligatoria por COVID-19 el 22 de Marzo
˜ os que estan bajo su cuidado o responsabilidad
Nin
Nin˜ as ´ mero
Nu
Nin˜ os ´ mero
Nu
Horas en promedio que el nin ˜ a pasa con usted ahora que las clases
˜ o o nin
´ n suspendidas
presenciales esta ´ ero (0-12)
Nm
´ s edad que tenga 8 an
Sexo del hijo/hija con ma ˜ os o menos ˜ o/nin
Sexo del nin ˜a
˜ o/a esta
El nin ´ matriculado/a en alguna escuela o colegio Si No
Horas al d´ ´ n o videos
ıa que su hijo o hija vio programas en la televisio
en el celular para divertirse ´ mero (0-24)
Nu
Horas al d´ıa que su hijo o hija vio programas en la television o videos
en el celular para estudiar/hacer tareas ´ mero (0-24)
Nu
Personas que viven en su casa ´ mero
Nu
´ mero de personas al lado del parentesco que aplique para las
Escriba el nu
personas que viven en su hogar
Esposo/a o companero/a de vida ´ mero
Nu
Hijas o hijos solo de su pareja ´ mero
Nu
Hija o hijo ´ mero
Nu
Papa ´ mero
Nu
Mama ´ mero
Nu
Suegro ´ mero
Nu
Suegra ´ mero
Nu
Hermana o ´ mero
Nu
Nuera / yerno ´ mero
Nu
Nieta o ´ mero
Nu
Sobrina a ´ mero
Nu
Otros ´ mero
Nu
Desde el inicio de la cuarentena, considera que en su casa hay dinero suficiente para:
Comida/alimentacio ´n Si No No sabe No responde
Servicios importantes como salud, gastos educativos Si No No sabe No responde
Servicios ba ´ sicos como agua, electricidad, gas Si No No sabe No responde
Otros bienes o servicios como ropa, recreacio ´ n, regalos Si No No sabe No responde
52
A2 Appendix Tables and Figures
Figure A1: Message Viewership
Notes: Calculation of user-opened messages by message received. Viewership rates calculated for the treat-
ment group only (N=2,663).
Table A1: Summary of stratification sample
Mode of Data Collection
Total
Facebook Glasswing Communities SMS/WhatsApp
Female Caregiver
747 78 1035 1860
Male Caregiver
312 11 920 1243
Total 1,059 89 1,955 3,103
This table provides the size of each stratum in the sample recruitment by mode and gender.
53
Table A2: Recall and Knowledge Incorporation Survey Rounds
Stress Management Positive Parenting N
Wave 1 Short breathing exercise Storytelling
Turtle technique 204
Deep breathing exercise
Wave 2 Drop technique Listen attentively
Deep breathing exercise Rapport Child 204
Wave 3 Lemon technique Conflict management
Short breathing exercise 100
Sleep well
Wave 4 Relaxation technique Let win
Manual activities 151
This table shows an overview of the techniques surveyed by knowledge incorporation (KI) rounds.
54
Table A3: Individual characteristics and attrition
(1) (2)
Attrition
Treatment 0.020 0.081
(0.016) (0.126)
Age x Treatment -0.002
(0.003)
Female x Treatment 0.024
(0.038)
High school (10-12 grades) x Treatment -0.046
(0.051)
Bachelor or higher x Treatment -0.038
(0.052)
Always employed x Treatment 0.038
(0.050)
Lost job x Treatment -0.000
(0.069)
Found job x Treatment 0.028
(0.056)
Girls under 9 years cared x Treatment -0.014
(0.036)
Boys under 9 years cared x Treatment -0.039
(0.035)
Oldest child under 9 is female x Treatment 0.002
(0.050)
Child enrolled in school x Treatment 0.071*
(0.040)
Child video/screen time for fun x Treatment -0.001
(0.006)
Child video/screen time for homework x Treatment -0.002
(0.006)
Household members x Treatment 0.001
(0.010)
Intergenerational household x Treatment 0.000
(0.040)
Income vulnerability index x Treatment 0.006
(0.015)
Mental health index, std. x Treatment 0.001
(0.019)
Impulsiveness index, std. x Treatment -0.021
(0.019)
Positive caregiver-child interactions, std. x Treatment -0.002
(0.018)
Tolerance norms index, std. x Treatment -0.011
(0.021)
Parenting positive index, std. x Treatment -0.017
(0.019)
Parenting negative index, std. x Treatment 0.303*
(0.169)
Physical violence, std. x Treatment -0.064
(0.046)
Psychological violence, std. x Treatment -0.290*
(0.155)
Individual controls No Yes
Strata fixed effects Yes Yes
Number of observations 3103 2589
P-value for F-test (interactions) 0.947
The dependent variable in columns (1)–(2) is a dummy equal to one if the individual did not respond to the follow-up survey. The regression
in column (2) includes the interactions between individual characteristics/ outcomes from the baseline survey and treatment (all the
individual variables are included, coefficients are omitted. The reduction in sample size in column two is because it contains missing values).
We use the F-statistics (interactions) to test the hypothesis of nondifferential attrition between treatment and control groups.
55
Table A4: Summary Statistics - Knowledge Incorporation Surveys
Variable N Mean Std Dev Min Max
Pooled Waves
% known stress-management techniques 659 0.50 0.40 0 1
Known stress-management technique (dummy) 659 0.69 0.46 0 1
% known parenting techniques 659 0.81 0.37 0 1
Known parenting technique (dummy) 659 0.85 0.36 0 1
=1 if stressed or very stressed, =0 if little or not stressed 659 0.51 0.50 0 1
=1 if quality of interaction is very easy or easy, =0 if hard or very hard 659 0.62 0.49 0 1
Treatment Group 659 0.47 0.50 0 1
No. of monitor surveys 659 1.15 0.39 1 3
Wave 1
% known stress-management techniques 204 0.57 0.37 0 1
Known stress-management technique (dummy) 204 0.77 0.42 0 1
% known parenting techniques 204 0.63 0.48 0 1
Known parenting technique (dummy) 204 0.63 0.48 0 1
=1 if stressed or very stressed, =0 if little or not stressed 204 0.57 0.50 0 1
=1 if quality of interaction is very easy or easy, =0 if hard or very hard 204 0.79 0.41 0 1
Treatment Group 204 0.48 0.50 0 1
No. of monitor surveys 204 1.00 0.00 1 1
Wave 2
% known stress-management techniques 204 0.58 0.36 0 1
Known stress-management technique (dummy) 204 0.81 0.39 0 1
% known parenting techniques 204 0.95 0.15 1 1
Known parenting technique (dummy) 204 1.00 0.00 1 1
=1 if stressed or very stressed, =0 if little or not stressed 204 0.45 0.50 0 1
=1 if quality of interaction is very easy or easy, =0 if hard or very hard 204 0.10 0.30 0 1
Treatment Group 204 0.48 0.50 0 1
No. of monitor surveys 204 1.09 0.28 1 2
Wave 3
% known stress-management techniques 100 0.59 0.31 0 1
Known stress-management technique (dummy) 100 0.92 0.27 0 1
% known parenting techniques 100 0.76 0.43 0 1
Known parenting technique (dummy) 100 0.76 0.43 0 1
=1 if stressed or very stressed, =0 if little or not stressed 100 0.57 0.50 0 1
=1 if quality of interaction is very easy or easy, =0 if hard or very hard 100 0.93 0.26 0 1
Treatment Group 100 0.45 0.50 0 1
No. of monitor surveys 100 1.28 0.51 1 3
Wave 4
% known stress-management techniques 151 0.25 0.44 0 1
Known stress-management technique (dummy) 151 0.25 0.44 0 1
% known parenting techniques 151 0.91 0.21 0 1
Known parenting technique (dummy) 151 0.99 0.11 0 1
=1 if stressed or very stressed, =0 if little or not stressed 151 0.46 0.50 0 1
=1 if quality of interaction is very easy or easy, =0 if hard or very hard 151 0.88 0.33 0 1
Treatment Group 151 0.45 0.50 0 1
No. of monitor surveys 151 1.34 0.54 1 3
This table shows variables of the four knowledge incorporation (KI) survey rounds with a subset of individuals who enrolled in the
study at baseline.
56
Table A5: Effect of the treatment on caregiver’s knowledge incorporation
(1) (2) (3) (4)
Stress Techniques Parenting Techniques
Treatment 0.206*** 0.161*** 0.057** 0.094**
(0.029) (0.047) (0.026) (0.039)
Treatment x Female 0.078 -0.063
(0.059) (0.053)
Female -0.000 -0.037 -0.004 0.026
(0.030) (0.038) (0.027) (0.039)
Mean of Dep. Var 0.5 0.81
N 659 658 659 659
Adjusted R-squared 0.181 0.182 0.140 0.182
Wave FE Yes Yes Yes Yes
No. of Surveys Taken Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes
This table presents results from Equation 3. Treatment is a dummy equal to one if the individual is randomly assigned to the treatment
group and zero if assigned to the control group. The dependent variable in columns (1)-(2) is the share of stress-management techniques
used by the caregiver in the last week; and in columns (3)-(4) is the share of positive parenting techniques used by the caregiver in the
last week. All regressions include wave fixed effects. The controls include the number of surveys taken by a respondent, age in years,
household-size dummies for average, big or small household, a dummy for intergenerational household, sex of the respondent, and
the educational level of the respondent for primary, high school—the omitted category—or tertiary education. We also control for the
baseline level of mental health using the standardized index of the DASS score in columns (1)-(4) and the standardized index of the
quality of caregiver child interactions. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
57
Table A6: Heterogeneous effects across genders: Mental health outcomes
(1) (2) (3)
Anxiety Stress Depression
(A) (S) (D)
i. Treatment 0.004 0.049 0.022
(0.046) (0.046) (0.047)
ii. Male x Treatment 0.091 0.059 0.016
(0.069) (0.071) (0.070)
iii. Total effect on men ([i] + [ii]) 0.095* 0.108** 0.039
(0.051) (0.053) (0.052)
Mean of Dep. Var (control) 0.000 0.000 0.000
Adjusted R-squared 0.315 0.282 0.263
Observations 2,280 2,280 2,280
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control group.
The dependent variable in column (1) is the standardized average of the self-report scales of the emotional state of anxiety (7 items of
DASS-21); in column (2) is the standardized average of the self-report scales of the emotional state of stress (7 items of DASS- 21); and in
column (3) is the standardized average of the self-report scales of the emotional state of depression (7 items of DASS-21).All the
regressions include interaction between male variable and treatment status. The controls include age in years, girls and boyscared for
by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the omitted category. Robust
standard errors. *** p<0.01, ** p<0.05, * p<0.1.
58
Table A7: Effect of the treatment on additional outcomes
(1) (2) (3)
Positive Interest in Child
parenting additional materials socioemotional development
Treatment 0.004 -0.011 -0.088
(0.041) (0.015) (0.059)
[0.931] [0.454] [0.133]
Mean of Dep. Var (control) 0.007 0.841 3.779
R-squared 0.043 0.028 0.020
Observations 2,265 2,280 1,094
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes No No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of the seven items of positive parenting techniques; in column
(2) is a dummy equal to one if the individual is interested in additional materials; and in column (3) is the standardized index of the
nine items of typical socioemotional development. The controls include age in years, girls and boys cared for by the respondent, and
the educational level of the respondent for primary, high school, or tertiary education—the omitted category. Robust standard errors.
*** p<0.01, ** p<0.05, * p<0.1.
59
Table A8: Heterogeneous effects across genders: Additional outcomes
(1) (2) (3)
Positive Interest in Child
parenting additional materials socioemotional development
i. Treatment -0.008 -0.022 -0.089
(0.052) (0.019) (0.075)
ii. Male x Treatment 0.031 0.028 0.004
(0.083) (0.033) (0.121)
iii. Total effect on men ([i] + [ii]) 0.023 0.006 -0.085
(0.065) (0.027) (0.095)
Mean of Dep. Var (control) 0.007 0.841 3.779
R-squared 0.043 0.028 0.020
Observations 2,265 2,280 1,094
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes No No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of the seven items of positive parenting techniques; in column
(2) is a dummy equal to one if the individual is interested in additional materials; and in column (3) is the standardized index of the
nine items of typical socioemotional development. The controls include age in years, girls and boys cared for by the respondent, and
the educational level of the respondent for primary, high school, or tertiary education—the omitted category. Robust standard errors.
*** p<0.01, ** p<0.05, * p<0.1.
60
Table A9: Robustness check: Physical results
(1) (2) (3) (4) (5)
Physical violence Social desirability Physical violence Hit Hit
index controlling dummy (perpetration) (vignettes)
i. Treatment -0.098** -0.094* -0.038* -0.039* -0.013
(0.049) (0.048) (0.023) (0.020) (0.019)
ii. Male x Treatment 0.123 0.116 0.044 0.038 0.027
(0.078) (0.077) (0.037) (0.032) (0.030)
iii. Social desirability score -0.073***
(0.013)
iv. Total effect on men ([i] + [ii]) 0.025 0.022 0.007 -0.002 0.014
(0.061) (0.061) (0.029) (0.025) (0.024)
Mean of Dep. Var (control) 0.002 0.002 0.305 0.222 0.154
Adjusted R-squared 0.127 0.145 0.145 0.163 0.061
Observations 2,270 2,270 2,270 2,270 2,280
Strata FE Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control group.
The dependent variable in columns (1)-(2) is the standardized index of the two items of physical abuses; in column (3) isa dummy
equal to one if the individual reports at least one item of physical abuse; in column (4) is a dummy equal to one if theindividual
reports the Hit with knuckle or back of the hand item; and in column (5) is a dummy equal to one if the individual reportsthe Hit with
knuckle or back of the hand or with an object item. The controls include age in years, girls and boys cared for by the respondent, and the
educational level of the respondent for primary, high school, or tertiary education—the omitted category. Social desirability score captures
individual-level propensity to misreport sensitive items as an additional control variable in column (2).Robust standard errors. ***
p<0.01, ** p<0.05, * p<0.1.
61
Table A10: Effect of the treatment on primary outcomes including the SDB as control
(1) (2) (3) (4) (5) (6)
Mental Health Distress
Index Anxiety Stress Depression Impulsiveness Positive
(A + S + D) (A) (S) (D) caregiver-child
interactions
Treatment 0.060* 0.042 0.074** 0.032 -0.005 -0.045
(0.057) (0.208) (0.026) (0.335) (0.893) (0.246)
Social desirability score -0.146*** -0.115*** -0.154*** -0.134*** -0.054*** 0.073***
(0.000) (0.000) (0.000) (0.000) (0.000) (0.000)
Mean of Dep. Var (control) 0.000 0.000 0.000 0.000 0.000 0.000
Adjusted R-squared 0.407 0.355 0.351 0.318 0.111 0.193
Observations 2,280 2,280 2,280 2,280 2,280 2,280
Strata FE Yes Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized average of the self-report scales of the emotional state of anxiety (7
items of DASS-21); in column (2) is the standardized average of the self-report scales of the emotional state of stress (7 items of
DASS-21); in column (3) is the standardized average of the self-report scales of the emotional state of depression (7 items of DASS-21);
in column (4) is the standardized average of the self-report scales of the emotional states of anxiety, stress, and depression (all items
of DASS-21); in column (5) is the standardized sum of the self-report instrument of the Barratt Impulsiveness Scale BIS-11; and in
column (6) is the standardized index of the responses to the 10 questions related to support for learning/stimulating environment and
setting limits domain. The controls include age in years, girls and boys cared for by the respondent, and the educational level of the
respondent for primary, high school, or tertiary education—the omitted category. Social desirability score captures the individual-level
propensity to misreport sensitive items as an additional control variable. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
62
Table A11: Heterogeneous effects across gender including the SDB as control: Primary
outcomes
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child interactions
i. Treatment 0.044 0.040 0.012
(0.298) (0.429) (0.793)
ii. Male x Treatment 0.041 -0.115 -0.146*
(0.516) (0.147) (0.072)
iii. Social desirability -0.146*** -0.054*** 0.073***
(0.000) (0.000) (0.000)
iv. Total effect on men ([i] + [ii]) 0.085* -0.075 -0.134**
(0.047) (0.062) (0.066)
Mean of Dep. Var (control) 0.000 0.000 0.000
Adjusted R-squared 0.407 0.111 0.194
Observations 2,280 2,280 2,280
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if to the control group.
The dependent variable in column (1) is the standardized average of the self-report scales the emotional states of anxiety, stress and
depression (all items of DASS-21); in column (2) is the standardized sum of the self-report instrument of Barratt Impulsiveness Scale
BIS-11; and in column (3) is the standardized index of the responses to the ten questions related to support for learning/stimulating
environment and setting limits domain. The controls include age in years, girls and boys cared for by the respondent and the educa-
tional level of the respondent for primary, high-school or tertiary education -the omitted category-. Social desirability score capturing
individual-level propensity to misreport sensitive items as an additional control variable. Robust standard errors-. *** p<0.01, **
p<0.05, * p<0.1.
63
Table A12: Effect of the treatment on secondary outcomes including the SDB as control
(1) (2)
Tolerance of Child
violent parenting behavior
Treatment -0.020 0.068*
(0.038) (0.041)
Social desirability score -0.073*** -0.153***
(0.012) (0.012)
Mean of Dep. Var (control) -0.005 0.005
Adjusted R-squared 0.176 0.077
Observations 2,234 2,226
Strata FE Yes Yes
Baseline Controls Yes Yes
Dep. Var Baseline Level Yes No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of the responses in the ICAST-P module and the vignettes. The
dependent variable in column (2) is the standardized index of the seven items that are reported by the caregiver from the internaliz-
ing/externalizing behaviors sections of the Parent/Caregiver Report Survey. The controls include age in years, girls and boys cared for
by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the omitted category.
Social desirability score captures the individual-level propensity to misreport sensitive items as an additional control variable. Robust
standard errors. *** p<0.01, ** p<0.05, * p<0.1.
64
Table A13: Effect of the treatment on exploratory outcomes including the SDB as control
(1) (2) (3) (4) (5) (6)
Positive Negative Physical Psychological Interest in Child
parenting parenting violence violence additional socioemotional
materials development
Treatment 0.004 0.008 -0.048 0.028 -0.011 -0.106*
(0.040) (0.038) (0.038) (0.039) (0.015) (0.057)
Social desirability score -0.043*** -0.121*** -0.074*** -0.116*** -0.001 0.141***
(0.011) (0.015) (0.013) (0.015) (0.004) (0.017)
Observations 2,265 2,245 2,270 2,251 2,280 1,094
Adjusted R-squared 0.043 0.146 0.144 0.115 0.023 0.077
Mean of Dep. Var (control) 0.007 -0.008 0.002 -0.007 0.841 3.779
Strata FE Yes Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes No No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of the seven items of positive parenting techniques; in column
(2) is the standardized index of nine items of negative parenting techniques (physical and psychological violence); in column (3) is the
standardized index of the two items of physical abuses; in column (4) is the standardized index of the seven items of psychological
violence (emotional abuses); in column (5) is a dummy equal to one if the individual is interested in additional materials; and in
column (6) is the standardized index of the nine items of typical socioemotional development. The controls include age in years, girls
and boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Social desirability score captures the individual-level propensity to misreport sensitive items as an additional control
variable. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
65
Table A14: Effect of the treatment on social desirability
(1)
Social desirability score
Treatment 0.019
(0.076)
Mean of Dep. Var (control) 0.005
Adjusted R-squared 0.009
Observations 2,280
Strata FE Yes
Baseline Controls Yes
Dep. Var Baseline Level No
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) captures the individual-level propensity to misreport sensitive items. Robust standard
errors. *** p<0.01, ** p<0.05, * p<0.1.
66
Table A15: Effect of the treatment on primary outcomes without individual controls
(1) (2) (3) (4) (5) (6)
Mental Health Distress
Index Anxiety Stress Depression Impulsiveness Positive
(A + S + D) (A) (S) (D) caregiver-child
interactions
Treatment 0.054 0.036 0.070** 0.025 -0.005 -0.042
(0.033) (0.034) (0.035) (0.035) (0.039) (0.039)
Mean of Dep. Var (control) 0.000 0.000 0.000 0.000 0.000 0.000
Adjusted R-squared 0.341 0.312 0.281 0.258 0.101 0.177
Observations 2,280 2,280 2,280 2,280 2,280 2,280
Strata FE Yes Yes Yes Yes Yes Yes
Baseline Controls No No No No No No
Dep. Var Baseline Level Yes Yes Yes Yes Yes Yes
This table shows the estimated impacts of the intervention on primary outcomes. Treatment is a dummy equal to one if the individual
is randomly assigned to the treatment group and zero if assigned to the control group. The dependent variable in column (1) is
the standardized average of the self-report scales of the emotional states of anxiety, stress, and depression (all items of DASS-21); in
column (2) is the standardized average of the self-report scales of the emotional state of anxiety (7 items of DASS-21); in column (3) is
the standardized average of the self-report scales of the emotional state of stress (7 items of DASS-21); in column (4) is the standardized
average of the self-report scales of the emotional state of depression (7 items of DASS-21); in column (5) is the standardized sum of the
self-report instrument of the Barratt Impulsiveness Scale BIS-11; and in column (6) is the standardized index of the responses to the 10
questions related to support for learning/stimulating environment and setting limits domain. Robust standard errors. *** p<0.01, **
p<0.05, * p<0.1.
67
Table A16: Heterogeneous effects across genders without individual controls
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child interactions
i. Treatment 0.031 0.040 0.015
(0.045) (0.051) (0.048)
ii. Male x Treatment 0.058 -0.114 -0.145*
(0.067) (0.080) (0.082)
iii. Total effect on men ([i] + [ii]) 0.089* -0.074 -0.130*
(0.050) (0.062) (0.067)
Mean of Dep. Var (control) 0.000 0.000 0.000
Adjusted R-squared 0.341 0.101 0.178
Observations 2,280 2,280 2,280
Strata FE Yes Yes Yes
Baseline Controls No No No
Dep. Var Baseline Level Yes Yes Yes
This table shows the differential impacts of the intervention on primary outcomes by gender. Treatment is a dummy equal to one
if the individual is randomly assigned to the treatment group and zero if assigned to the control group. The dependent variable in
column (1) is the standardized average of the self-report scales of the emotional states of anxiety, stress, and depression (all items of
DASS-21); in column (2) is the standardized sum of the self-report instrument of the Barratt Impulsiveness Scale BIS-11; and in column
(3) is the standardized index of the responses to the 10 questions related to support for learning/stimulating environment and setting
limits domain. All the regressions include interaction between male variable and treatment status. Robust standard errors. *** p<0.01,
** p<0.05, * p<0.1.
68
Table A17: Effect of the treatment on secondary outcomes without individual controls
(1) (2)
Tolerance of Child
violent parenting behavior
Treatment -0.021 0.067
(0.039) (0.042)
Mean of Dep. Var (control) -0.005 0.005
Adjusted R-squared 0.157 0.002
Observations 2,234 2,226
Strata FE Yes Yes
Baseline Controls No No
Dep. Var Baseline Level Yes No
This table shows the impacts of the intervention on secondary outcomes. Treatment is a dummy equal to one if the individual
is randomly assigned to the treatment group and zero if assigned to the control group. The dependent variable in column (1) is
the standardized index of the responses in the ICAST-P module and the vignettes. The dependent variable in column (2) is the
standardized index of the seven items that are reported by the caregiver from the internalizing/externalizing behaviors sections of
the Parent/Caregiver Report Survey. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
69
Table A18: Effect of the treatment on exploratory outcomes without individual controls
(1) (2) (3) (4) (5) (6)
Positive Negative Physical Psychological Interest in Child
parenting parenting violence violence additional socioemotional
materials development
Treatment 0.005 0.007 -0.050 0.027 -0.013 -0.100*
(0.041) (0.039) (0.038) (0.040) (0.016) (0.059)
Mean of Dep. Var (control) 0.007 -0.008 0.002 -0.007 0.841 3.779
Adjusted R-squared 0.038 0.099 0.127 0.073 0.023 0.010
Observations 2,265 2,245 2,270 2,251 2,280 1,094
Strata FE Yes Yes Yes Yes Yes Yes
Baseline Controls No No No No No No
Dep. Var Baseline Level Yes Yes Yes Yes No No
This table shows the impacts of the intervention on secondary outcomes. Treatment is a dummy equal to one if the individual is randomly
assigned to the treatment group and zero if assigned to the control group. The dependent variable in column (1) is the standardized index
of the seven items of positive parenting techniques; in column (2) is the standardized index of nine items of negative parenting techniques
(physical and psychological violence); in column (3) is the standardized index of the two items of physical abuses; in column (4) is the
standardized index of the seven items of psychological violence (emotional abuses); in column (5)is a dummy equal to one if the individual
is interested in additional materials; and in column (6) is the standardized index of the nine items of typical socioemotional development.
Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
70
Table A19: Heterogeneous effects across genders: Primary outcomes
(1) (2) (3) (4) (5) (6)
Mental Health Distress
Index Anxiety Stress Depression Impulsiveness Positive
(A + S + D) (A) (S) (D) caregiver-child
interactions
Panel A: Male observations
Treatment 0.089* 0.091* 0.102* 0.035 -0.071 -0.129*
(0.050) (0.051) (0.053) (0.052) (0.062) (0.067)
[0.084] [0.076] [0.067] [0.514] [0.261] [0.071]
Mean of Dep. Var (control) -0.209 -0.181 -0.199 -0.169 0.020 -0.078
R-squared 0.288 0.250 0.216 0.229 0.090 0.175
Observations 892 892 892 892 892 892
Panel B: Female observations
Treatment 0.032 0.002 0.046 0.022 0.034 0.020
(0.045) (0.046) (0.046) (0.047) (0.051) (0.047)
[0.500] [0.962] [0.305] [0.657] [0.514] [0.665]
Mean of Dep. Var (control) 0.133 0.115 0.126 0.108 -0.013 0.050
R-squared 0.354 0.339 0.299 0.266 0.122 0.185
Observations 1,388 1,388 1,388 1,388 1,388 1,388
This table shows the estimated impacts of the intervention on primary outcomes. Treatment is a dummy equal to one if the individual
is randomly assigned to the treatment group and zero if assigned to the control group. The dependent variable in column (1) is
the standardized average of the self-report scales of the emotional states of anxiety, stress, and depression (all items of DASS-21); in
column (2) is the standardized average of the self-report scales of the emotional state of anxiety (7 items of DASS-21); in column (3) is
the standardized average of the self-report scales of the emotional state of stress (7 items of DASS-21); in column (4) is the standardized
average of the self-report scales of the emotional state of depression (7 items of DASS-21); in column (5) is the standardized sum of the
self-report instrument of the Barratt Impulsiveness Scale BIS-11; and in column (6) is the standardized index of the responses to the 10
questions related to support for learning/stimulating environment and setting limits domain. The controls include age in years, girls
and boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
71
Table A20: Effect of the treatment on parental quality outcomes
(1) (2) (3) (4) (5)
Total Physical Psychological Tolerance of Child
violence violence violence violent parenting behavior
Panel A: Male observations
Treatment 0.019 0.023 0.015 -0.015 0.063
(0.065) (0.061) (0.067) (0.066) (0.065)
[0.780] [0.708] [0.832] [0.792] [0.302]
Mean of Dep. Var (control) -0.073 -0.047 -0.061 0.070 -0.052
R-squared 0.097 0.142 0.071 0.172 0.009
Observations 878 886 881 877 866
Panel B: Female observations
Treatment -0.008 -0.095* 0.027 -0.018 0.060
(0.049) (0.049) (0.050) (0.048) (0.056)
[0.890] [0.061] [0.602] [0.696] [0.290]
Mean of Dep. Var (control) 0.034 0.034 0.028 -0.053 0.041
R-squared 0.108 0.131 0.083 0.155 0.007
Observations 1,367 1,384 1,370 1,357 1,360
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control
group. The dependent variable in column (1) is the standardized index of nine items of negative parenting techniques (physical and
psychological violence); in column (2) is the standardized index of the two items of physical abuses; in column (3) is the standardized
index of the seven items of psychological violence (emotional abuses); in column (4) is the standardized index of the responses in the
ICAST-P module and the vignettes; and in column (5) is the standardized index of the seven items that are reported by the caregiver
from the internalizing/externalizing behaviors sections of the Parent/Caregiver Report Survey. The controls include age in years, girls and
boys cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the
omitted category. Robust standard errors. *** p<0.01, ** p<0.05, * p<0.1.
72
Table A21: Heterogeneous effects by economic deprivation and gender: Primary out-
comes
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child
interactions
Economic deprivation 0.035 0.066 0.190***
(0.072) (0.077) (0.068)
Treatment -0.032 0.050 0.036
(0.053) (0.063) (0.060)
Male x Treatment -0.000 -0.114 -0.215**
(0.081) (0.101) (0.103)
Economic deprivation x Male -0.174* 0.024 -0.304**
(0.102) (0.122) (0.121)
Economic deprivation x Treatment 0.158 -0.025 -0.124
(0.104) (0.113) (0.104)
Economic deprivation x Male x Treatment 0.230 -0.022 0.197
(0.152) (0.174) (0.181)
Treatment effects
Without economic deprivation women -0.032 0.050 0.036
With economic deprivation women 0.126 0.025 -0.088
Without economic deprivation men -0.032 -0.064 -0.178**
With economic deprivation men 0.356* -0.111 -0.106
Differences in treatment effects
Men - Women, Without economic deprivation -0.000 -0.114 -0.215**
Men - Women, With economic deprivation 0.230* -0.136 -0.018
With economic deprivation - Without economic deprivation, Women 0.158 -0.025 -0.124
With economic deprivation - Without economic deprivation, Men 0.388*** -0.047 0.072
Mean of Dep. Var (control) 0.003 -0.004 0.010
Adjusted R-squared 0.348 0.103 0.179
Observations 2,172 2,172 2,172
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if assigned to the control group.
The dependent variable in column (1) is the standardized average of the self-report scales of the emotional states of anxi-ety, stress,
and depression (all items of DASS-21); in column (2) is the standardized sum of the self-report instrument of the Barratt Impulsiveness
Scale BIS-11. In column (3) is the standardized index of the responses to the 10 questions related to support for learn- ing/stimulating
environment and setting limits domain. The variable Economic deprivation is a dummy equal to one if the individual responded that from
the beginning of the pandemic in their house, there was not enough money for food, home services, education,and others. The controls
include age in years, girls and boys cared for by the respondent, and the educational level of the respondent for primary, high school,
or tertiary education—the omitted category. Robust standard errors-. *** p<0.01, ** p<0.05, * p<0.1.
73
Table A22: Heterogeneous effects by partner: Primary outcomes
(1) (2) (3)
Mental Health Impulsiveness Positive
Distress caregiver-child interactions
Living with a partner -0.049 -0.071 0.083
(0.068) (0.075) (0.069)
Treatment 0.022 0.048 0.082
(0.077) (0.082) (0.079)
Male x Treatment -0.232* -0.379** -0.034
(0.141) (0.174) (0.191)
Living with a partner x Male -0.226* -0.127 0.219
(0.121) (0.142) (0.153)
Living with a partner x Treatment 0.019 -0.021 -0.102
(0.094) (0.104) (0.099)
Living with a partner x Male x Treatment 0.349** 0.332* -0.123
(0.161) (0.198) (0.212)
Treatment effects
Women not living with a partner 0.022 0.048 0.082
Women living with a partner 0.040 0.027 -0.020
Men not living with a partner -0.210* -0.331** 0.048
Men living with a partner 0.157* -0.020 -0.177*
Differences in treatment effects
Men - Women, Not living with a partner -0.232 -0.379** -0.034
Men - Women, Living with a partner 0.117 -0.047 -0.157*
Living with a partner - Not living with a partner, Women 0.019 -0.021 -0.102
Living with a partner - Not living with a partner, Men 0.368*** 0.311* -0.225
Adjusted R-squared 0.346 0.103 0.180
Observations 2,280 2,280 2,280
Strata FE Yes Yes Yes
Baseline Controls Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes
Treatment is a dummy equal to one if the individual is randomly assigned to the treatment group and zero if to the control group.
The dependent variable in column (1) is the standardized average of the self-report scales the emotional states of anxiety (7 items of
DASS-21); in column (2) is the standardized average of the self-report scales the emotional states of stress (7 items of DASS-21); in
column (3) is the standardized average of the self-report scales the emotional states of depression (7 items of DASS-21). The controls
include age in years, girls and boys cared for by the respondent and the educational level of the respondent for primary, high-school
or tertiary education -the omitted category-. Robust standard errors-. *** p<0.01, ** p<0.05, * p<0.1.
74
Table A23: Instrumental variable regression
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Mental Health Distress
Index Anxiety Stress Depression Impulsiveness Positive Total Physical Psychological Tolerance of Child
(A + S + D) (A) (S) (D) caregiver-child violence violence violence violent behavior
interactions parenting
% known management techniques 0.480 0.519 0.881 -0.545 -0.725 -0.006 -1.006 -1.645** -0.610 -2.389*** 0.686
(0.558) (0.573) (0.584) (0.589) (0.687) (0.615) (0.672) (0.663) (0.701) (0.744) (0.627)
Treatment for fist-stage 0.126*** 0.124*** 0.127*** 0.127*** 0.129*** 0.132*** 0.128*** 0.130*** 0.129*** 0.124*** 0.136***
(0.023) (0.023) (0.023) (0.023) (0.023) (0.023) (0.023) (0.023) (0.023) (0.024) (0.023)
Kleibergen-Paap rk Wald F statistic 29.88 29.27 30.32 30.17 31.40 33.72 31.19 32.22 31.72 27.75 35.77
R-squared 0.328 0.347 0.243 0.177 0.072 0.221 0.073 0.052 0.059 -0.068 -0.042
Observations 529 529 529 529 529 529 523 526 525 516 517
Strata FE Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Baseline Controls Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Dep. Var Baseline Level Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No
The dependent variable in column (1) is the standardized average of the self-report scales of the emotional states of anxiety, stress,
and depression (all items of DASS-21); in column (2) is the standardized average of the self-report scales of the emotional state of
anxiety (7 items of DASS-21); in column (3) is the standardized average of the self-report scales of the emotional state of stress (7
items of DASS-21); in column (4) is the standardized average of the self-report scales of the emotional state of depression (7 items of
DASS-21); in column (5) is the standardized sum of the self-report instrument of the Barratt Impulsiveness Scale BIS-11; in column
(6) is the standardized index of the responses to the 10 questions related to support for learning/stimulating environment and setting
limits domain; in column (7) is the standardized index of nine items of negative parenting techniques (physical and psychological
violence); in column (8) is the standardized index of the two items of physical abuses; in column (9) is the standardized index of the
seven items of psychological violence (emotional abuses); in column (10) is the standardized index of the responses in the ICAST-P
module and the vignettes; and in column (11) is the standardized index of the seven items that are reported by the caregiver from the
internalizing/externalizing behaviors sections of the Parent/Caregiver Report Survey. The controls include age in years, girls and boys
cared for by the respondent, and the educational level of the respondent for primary, high school, or tertiary education—the omitted
category.*** p<0.01, ** p<0.05, * p<0.1.
75
Figure A2: Example SMS/WhatsApp Messages
76
Figure A3: Variation of primary outcomes (Baseline)
77
Figure A4: Variation of parental quality outcomes (Baseline)
78