LTP Plus Dads-Partner Inclusive Intervention for Depressed Fathers in Pakistan

The SCID is a semi-structured diagnostic interview which has been widely used in cross-national epidemiological and treatment studies (Weissman et al., 1996). The interview consists of standardized diagnostic questions arranged in modules corresponding to each DSM-V disorder. This interview will be conducted by trained psychologists.

The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. Higher score indicates more severe depression. Scores ranging from 1-4 Minimal depression, 5-9 Mild depression,10-14 Moderate depression,15-19 Moderately severe depression, 20-27 Severe depression.

A 7-item scale measuring generalised anxiety. GAD-7 total score for the seven items ranges from 0 to 21. Higher score indicates more severe anxiety.

A 36-item perceived stress measure in 3 subscales, parenting distress, difficult child characteristics, and dysfunctional parent-child interaction. A Total score is calculated by summing the three subscales scores, ranging from 36 to 180. Scores of 90 or above may indicate a clinical level of stress. Higher score indicates more severe parenting stress.

This picture booklet can help the early detection of mood disturbance in pregnancy and/or following childbirth. The booklet can be used by a verity of health workers or support workers. It is designed to assess the feelings today and in the past few days and to talk about moods, emotions and general health." Higher score indicates more severe depression

A 25 -item questionnaire of paternal knowledge and expectations for child development in the first three years. Higher score indicate (ranging from 0 to 25) better knowledge about child development.

A 4-item intimate partner violence screener producing a score of 4-20. Higher score indicates more severe level of violence

Health-related quality of life as measured for mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The maximum score of 1 indicates the best health state, by contrast with the scores of individual questions, where higher scores indicate more severe or frequent problems. In addition, there is a visual analogue scale (VAS) to indicate the general health status with 100 indicating the best health status.

It is used to collect information on the whole range of services and supports study participants may use. This data can be used for a wide range of applications, including estimating the costs of service receipt.

DAS is a 32 items self-report questionnaire, to measure couple satisfaction and to assess how each partner perceives his/her relationship. The scale has good psychometric properties (Graham, Liu, \& Jeziorski, 2006) and has also been used with depressed mothers (Wolman, Chalmers, Hofmeyr, \& Nikodem, 1993). The resultant score ranges from 0 to 151, with higher scores indicating a more positive dyadic adjustment and a lower level of distress.

A brief self-report screening questionnaire that assesses the presence of attenuated psychotic symptoms, the PQ-16 is a reliable measure and correlates well with the CAARMS. The scale has been used in a previous study in Pakistan (Qurashi et al., 2017). Higher score (range 0-16) indicates more probability of having psychosis.

The adult self-administered version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a 36-item measure that assesses disability in adults age 18 years and older. It assesses disability across six domains, including understanding and communicating, getting around, self-care, getting along with people, life activities (i.e., household, work, and/or school activities), and participation in society. Translated version of scale has been used in previous trials in Pakistan(Naeem et al., 2015) . Higher score indicates more disability, ranging from 0 to 100, where 0 = no disability; 100 = full disability.

The PSI is one of the most widely used self-report inventories in problem solving. The PSI assesses an individual's awareness and evaluation of his or her problem-solving abilities or style, and this provides a global appraisal of that individual as a problem solver. Higher score indicates better problem solving that ranges from 32 to 192.

The GSES is a simple 10 item self-administered scale. The scale is developed to assess a general sense of perceived self-efficacy with the aim to predict coping with daily hassles as well as adaptation after experiencing all kinds of stressful life events. A total score ranges from 10 to 40. Higher scores indicate higher perceived general self-efficacy, lower scores indicate lower perceived general self-efficacy.

The PBQ is designed to detect disturbance in the mother-child relationship. The scale has25 items, each followed by six alternative responses ranging from 'always' to 'never'. Positive responses, such as ''I enjoy playing with my baby'', are scored from zero ('always') to 5 ('never'). Negative responses, such as ''I am afraid of my baby'', are scored from 5 ('always') to zero ('never'). A high score indicates pathology in mother-child relationship. Higher score indicates more strong bonding

Data on child growth: Anthropometric measures of child growth will be collected through measuring children's weight in kilogram

Data on child growth: Anthropometric measures of child growth will be collected through measuring children's height in meters at baseline, and 6 months after baseline.

Data on child growth: Anthropometric measures of child growth will be collected through measuring children's head circumference in centimeters at baseline, and 6 months after baseline.

parent-reported screening instrument comprising of 25/29 items on social and emotional difficulties recommended for evaluating early interventions.

This validated global rating measure evaluates qualities of observed parent-child interaction from 6-minute video clips of unstructured play interaction. It comprises of seven seven-point rating scales that covers key characteristics of interaction, such as caregiver sensitive responsiveness, child attentiveness to caregiver, and level of mutuality, which are understood to reflect the quality of the parent-child relationship and the child's social and emotional environment. Due to the resource requirements of an observational measure, 5% from each intervention arm will be selected randomly for MACI assessment.

It is a standard series of measurements to assess the development of infants and toddlers, ages 1-42 months. This measure consists of a series of developmental play tasks and takes between 45 - 60 minutes to administer. The Bayley is an early childhood, norm-referenced assessment instrument that evaluates the current level of functioning for young children. The instrument, which is individually administered by qualified professionals, assesses developmental domains such as language, cognitive, personal/social, fine motor, and gross motor skills. The assessment of these skills in conjunction with other forms. Other specific purposes of the Bayley are to identify possible developmental delays and inform professionals about specific areas of strength or weakness when planning a comprehensive intervention and provide a method of monitoring a child's developmental progress.

HOME is a descriptive profile which yields a systematic assessment of the caring environment in which the child is reared. The primary goal of the scale is to measure, with in a naturalistic context, the quality and quantity of stimulation and support available to a child in home environment. It contains 45 items under 6 subscales which are; 1. Emotional and verbal responsively of the primary caregiver (item 1-11); 2. Avoidance of restriction and punishment (item 12-19); 3. Organization of the physical and temporal environment (item 20-25); 4. Provision of appropriate play materials (item 26-34); 5. Parental involvement with the child (item 35-40), 6. Opportunity for variety in daily stimulation (item 40-45).

The WHOQOL-BREF is a self-administered questionnaire comprising 26 questions on the individual's perceptions of their health and well-being over the previous two weeks. Responses to questions are on a 1-5 Likert scale where 1 represents "disagree" or "not at all" and 5 represents "completely agree" or "extremely.