Transform + Family Academy Randomized Controlled Trial in the Philippines

Integration of Household-Based Interventions With Early Childhood Programming: A Randomized Controlled Trial in the Philippines

This study evaluates the integration of two complementary poverty alleviation programs: Compassion International's (CI) child-focused Survival and Early Childhood Program with International Care Ministries' (ICM) household-level Transform + Family Academy intervention. CI's program provides holistic child development through health support, educational programming, social development, and spiritual formation via local church partners for children aged 3-5 years. ICM's Transform + Family Academy combines a 15-week household intervention targeting health education, livelihood training, and values formation with an 8-week early childhood education component delivered through home visits.

The primary aim of this research is to assess whether integrating household-level interventions with child-focused programming enhances early numeracy and literacy outcomes among children aged 3-5 living in extreme poverty in Western and Southern Mindanao, Philippines. The study also examines the intervention's impact on children's nutritional status and household financial resilience, including savings behaviors and access to social safety nets.

The investigators hypothesize that addressing household-level constraints including caregiver capacity, health, and economic challenges will enhance children's academic and nutritional outcomes alongside household financial resilience compared to child-focused programming alone.

Study Overview

• Status: Not yet recruiting
• Conditions: Child Development; Child Nutrition, Child Neurobehavioral Development; Academic Attainment; Household and Family; Financial Wellbeing
• Intervention / Treatment: Other: Integrated Whole-Household Programming; Other: Standard Child-Focused Programming

Detailed Description

This individual-level randomized controlled trial examines the integration of Compassion International's (CI) child-focused Survival and Early Childhood Program with International Care Ministries' (ICM) household-level Transform + Family Academy intervention among 700 families with children aged 3-5 years across CI's partner communities in Western and Southern Mindanao, Philippines. All participating households are currently registered in CI's Survival and Early Childhood Program, which provides comprehensive child development support through local community partners. Through random assignment, half of the households will additionally receive ICM's household-level intervention targeting the broader family system.

This study examines whether combining ICM's household-level interventions with CI's child-focused programming can improve developmental outcomes for children aged 3-5 years in extreme poverty settings. The research evaluates the effectiveness of ICM's Transform + Family Academy approach to addressing broader family constraints, including caregiver capacity, health challenges, and economic instability, on children's developmental outcomes and household financial resilience when integrated with CI's Survival and Early Childhood Program. Specifically, the outcomes of interest include children's early numeracy and literacy development, alongside secondary outcomes of children's nutritional status and household financial resilience as measured through savings behaviors and social safety net access.

The hypothesis underlying this work suggests that child development programs may achieve greater impact when paired with comprehensive household support that tackles the multidimensional nature of poverty affecting both immediate child needs and the family systems that sustain long-term progress.

ICM's Transform component is a 15-week program delivered through weekly 90-minute community-based group sessions covering three domains: health education (malnutrition prevention, sanitation, respiratory infections, infant care), livelihood training (income diversification, business development, savings group formation), and values formation (personal character, family relationships, decision-making). Health and livelihood sessions are facilitated by trained ICM staff, while optional values components are delivered by community leaders.

The Family Academy component provides 8 weeks of home-based early childhood education through twice-weekly visits delivering separate one-hour sessions for mathematics and phonics instruction. These sessions target both children aged 3-5 and their caregivers, building caregiver capacity to support school readiness through structured learning activities and educational games.

Eligible households must have a child aged 3-5 currently registered in CI's Survival and Early Childhood Program and meet ICM's poverty criteria (poverty score of 50 or above based on asset-based scoring and household income evaluation). Each household must include an adult caregiver aged 18-65 who can provide informed consent. Households with previous participation in ICM interventions are excluded. Households are individually randomly assigned to treatment groups using stratified randomization by community and regional levels to ensure balanced allocation across geographic locations.

Control households continue receiving CI's standard Survival and Early Childhood Program. Treatment households receive the integrated intervention combining CI's programming with ICM's Transform + Family Academy delivered over four months. All data collection is conducted by trained external enumerators at five timepoints: baseline, pre-Family Academy, post-Family Academy, midline (2 months post-intervention), and endline (12 months post-intervention).

The following analyses will be conducted for the research objectives to assess the impact of the integrated intervention:

Primary:

• Linear regression models with cluster-robust standard errors will analyze differences in children's early numeracy competency composite scores between Treatment and Control groups.
• Linear regression models with cluster-robust standard errors will analyze differences in children's phonics and literacy competency composite scores between Treatment and Control groups.

Secondary:

• Linear regression models with cluster-robust standard errors will analyze differences in children's weight-for-height z-scores between Treatment and Control groups.
• Logistic regression models with cluster-robust standard errors will analyze differences in probability of having household savings between Treatment and Control groups.
• Linear regression models with cluster-robust standard errors will analyze differences in total household savings amounts between Treatment and Control groups.
• Linear regression models with cluster-robust standard errors will analyze differences in social safety net access index scores between Treatment and Control groups.

All models will include baseline outcome measures as covariates and strata fixed effects for randomization stratification (community and regional levels). Analyses will be conducted separately for short-term effects (1 week after intervention and 2-month follow-up) and sustained effects at 12-month follow-up.

• Study Type: Interventional
• Enrollment (Estimated): 700
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Lincoln L Lau, PhD; Phone Number: 647-852-0288; Email: LLau@us.ci.org
• Study Contact Backup: Name: Daryn J Go, MSc; Phone Number: +63 9175211103; Email: daryn.go@caremin.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Households must have a child between 3 to 5 years old who is currently registered in CI's Survival and Early Childhood Program.
• Households must meet ICM's poverty criteria with a poverty score of 50 and above as determined through asset-based scoring and household income evaluation. Higher scores indicate poorer households.
• Each participating household must include an adult family member aged 18 to 65 years who serves as a primary caregiver for the target child.

Exclusion Criteria:

• Households with previous participation in ICM's Transform program will be excluded from the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment receiving integrated Survival and Early Childhood Program & Transform + Family Academy; Treatment: Participants will continue receiving Compassion International's Survival and Early Childhood Program and additionally receive International Care Ministries' Transform + Family Academy program. In the treatment arm, the integrated intervention will be delivered over 4 months with participants continuing to receive the Survival and Early Childhood Program. In addition to this, participants receive Transform + Family Academy, with 15 Transform sessions conducted weekly at community locations and 8 weeks of Family Academy sessions delivered through home visits. Each Transform session includes 90-minute health and livelihood training by ICM staff, with optional values components facilitated by community leaders. Family Academy provides home-based early numeracy and phonics lessons for children and their caregivers.	Other: Integrated Whole-Household Programming; Treatment participants receive both Compassion International's Survival and Early Childhood Program (holistic child development through health support, educational programming, social development, and spiritual formation via local community partners) plus International Care Ministries' Transform + Family Academy intervention. The Transform component is a 15-week household-level program including health education covering malnutrition prevention, sanitation, respiratory infections, infant care; livelihood training focused on income diversification and business development with savings group formation; and values formation addressing personal character, family relationships, and decision-making. The Family Academy component provides home-based early numeracy and phonics instruction (one hour per topic) to children aged 3-5 with concurrent caregiver capacity building for school readiness support, delivered over 8 weeks.; Other Names: Whole-household poverty intervention
Active Comparator: Control receiving standard Survival and Early Childhood Program; Control: Participants will continue receiving Compassion International's Survival and Early Childhood Program without additional interventions.	Other: Standard Child-Focused Programming; Compassion International's Survival and Early Childhood Program provides holistic child development through health support, nutritional assistance, educational programming, social development, and spiritual formation delivered via local community partners.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Children's early numeracy competency at post-intervention and 12 months	Children's early numeracy competency is assessed through proctored assessments testing early learning proficiency using eight subtasks to measure preschool children's early math skills. The assessment measures children's mathematical skills across eight components: color recognition (10 points), shape recognition (8 points), rote count (10 points), object count (10 points), numeral identification (10 points), numeral comparison (9 points), missing number (10 points), and simple addition (10 points). The total possible score is 77 points, with higher scores indicating better numeracy skills.	Baseline, 1 week after intervention, and 12 months
Children's phonics and literacy competency at post-intervention and 12 months	Children's phonics and literacy competency is assessed through proctored assessments testing pre-reading skills and phonemic awareness. The assessment measures children's reading and phonics skills across four components: alphabet recitation (10 points), letter name identification (20 points), beginning sound recognition (20 points), and letter sound identification (20 points). The total possible score is 70 points, with higher scores indicating better literacy and phonics skills.	Baseline, 1 week after intervention, and 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Children's malnutrition status at 2 months and 12 months	Children's malnutrition status is evaluated through anthropometric measurements where weight-for-height ratios are transformed into standardized z-scores based on World Health Organization reference standards for pediatric populations. Malnutrition in children under 5 years is defined as weight-for-height z-scores below -2 standard deviations in the absence of edema.	Baseline, 2 months, and 12 months
Household savings at 2 months and 12 months	The household savings measure assesses household financial resources through two indicators: the probability of having savings (binary measure where 0=no savings, 1=has savings) and total household savings amount. This measure evaluates household financial resilience and household capacity to accumulate and maintain financial reserves. Higher values indicate improved wealth accumulation and financial security.	Baseline, 2 months, and 12 months
Social safety net access at 2 months and 12 months	Social safety net access is measured as a composite index assessing access to emergency financial support outside immediate household and close relatives. The index evaluates participants' ability to access 40 Philippine Pesos and 1,000 Philippine Pesos in emergency situations from extended social networks. The index is constructed using standardized methodology following Kling, Liebman, and Katz (2007), normalizing individual components against the control group before standardizing the aggregate measure. Higher scores indicate greater access to financial support networks.	Baseline, 2 months, and 12 months

Collaborators and Investigators

• Sponsor: International Care Ministries, Philippines
• Collaborators: Compassion International, United States of America
• Investigators: Principal Investigator: Lincoln L Lau, PhD, University of Toronto; Principal Investigator: Melinda Kelly Mijares, MD, MPH, International Care Ministries; Principal Investigator: Tommy Lazaro III, MABE, PhD Candidate, Ateneo de Manila University

Publications and helpful links

General Publications

• Bryan G, Choi JJ, Karlan D. Randomizing religion: the impact of Protestant evangelism on economic outcomes. The Quarterly Journal of Economics. 2021 Feb;136(1):293-380.
• "Angrist, N., Kabay, S., Karlan, D., Lau, L., & Wong, K. (2025). Human Capital at Home: Evidence from a Randomized Evaluation in the Philippines (No. w33574). National Bureau of Economic Research.

Study record dates

Study Major Dates

• Study Start (Estimated): November 1, 2025
• Primary Completion (Estimated): May 30, 2027
• Study Completion (Estimated): May 30, 2027

Study Registration Dates

• First Submitted: September 25, 2025
• First Submitted That Met QC Criteria: October 1, 2025
• First Posted (Estimated): October 8, 2025

Study Record Updates

• Last Update Posted (Estimated): October 8, 2025
• Last Update Submitted That Met QC Criteria: October 1, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: Child Development; Child Nutritional Status; Household Financial Resilience
• Other Study ID Numbers: icmcompassionrct (Other Identifier: Compassion)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: We are currently evaluating the feasibility of sharing individual participant data. Considerations include ethical approvals, participant consent, and the ability to sufficiently anonymize sensitive information. A final decision will be made in consultation with our ethics review board and institutional partners.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No