Paternal involvement and caregiving outcomes at three years: A study using municipal data in Japan

This study aimed to ascertain whether paternal involvement in childrearing at 18 months was associated with developmental and caregiving outcomes at the age of 3 years. We used the health examination records of 52,921 children born in Kitakyushu City, Japan, between 2013 and 2019, whose caregivers were designated to answer a question about paternal involvement at the 18-month examination. Valid responses were given by 33,619 caregivers, of whom 21,956 (65.3%) reported consistent involvement. To adjust for confounding by child and family characteristics, 1:1 propensity score matching was applied, yielding 11,175 matched pairs of children with consistent versus inconsistent involvement. The primary outcome, physician-flagged developmental issues, was slightly less prevalent among children with consistent paternal involvement (11.1% vs. 12.3%; relative risk .91, 95% CI .83-.99). Fewer children in this group were unable to say their own name (11.8% vs. 13.4%) or had difficulty dressing (5.5% vs. 7.0%). A lower proportion of caregivers reported concerns about childcare (19.6% vs. 23.5%) and frustration with childcare (16.3% vs. 20.3%). These findings suggest that consistent paternal engagement during toddlerhood is associated with slightly better child development and caregiver well-being, highlighting its potential relevance to early childhood health promotion strategies.