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Mestermann S, Kleinöder JM, Arndt M, Krämer J, Eichler A, Kratz O. The Father's Part: A Pilot Evaluation of a Father-Centered Family Intervention Group in Child and Adolescent Psychiatry. Behav Sci (Basel) 2023; 14:13. [PMID: 38247664 PMCID: PMC10812738 DOI: 10.3390/bs14010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Changes in parental roles have renewed the focus on a father's involvement in an offspring's psychological development. However, fathers are still under-represented in family research. There are only a few structured father-centered intervention programs in child and adolescent psychiatry. In a German population sample, a pilot father-centered family intervention program with n = 16 participants, conducted in person (n = 8) and online (n = 8), in a child and adolescent psychiatry inpatient/day clinic setting was evaluated by comparing paternal stress, PSE, and child-rated paternal competence in a pre-post design. Participating fathers showed significant decreases in child-related parenting stress (presence: p = 0.042, online: p = 0.047) and significant increases in PSE (p = 0.006/0.012). Parent-related stress and child-rated paternal competence were unaffected (p = 0.108/0.171; p = 0.167/0.101), while small-to-medium effect size measures pointed in the direction of our hypothesis (d = 0.48/0.36; d = 0.37/0.50). Participant satisfaction was higher in person than online (p = 0.008). As social and biological fathers have important influences on child and adolescent well-being and development, they should be included more frequently in prevention and intervention programs. Fathers seem to benefit from gender-specific intervention programs with regard to stress reduction, as well as experiencing competence- and PSE-increasing effects.
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Gonzalez JC, Klein CC, Barnett ML, Schatz NK, Garoosi T, Chacko A, Fabiano GA. Intervention and Implementation Characteristics to Enhance Father Engagement: A Systematic Review of Parenting Interventions. Clin Child Fam Psychol Rev 2023; 26:445-458. [PMID: 36947287 PMCID: PMC10031187 DOI: 10.1007/s10567-023-00430-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
In recent years, the prevalence rates of children's mental health disorders have increased with current estimates identifying that as many as 15-20% of children meet criteria for a mental health disorder. Unfortunately, the same robust parenting interventions which have long targeted some of the most common and the most treatable child concerns (e.g., externalizing, disruptive behavior, and aggression) have also shown consistently low rates of father engagement. This persistent issue of engagement comes in the wake of an increasingly large body of literature which highlights the unique positive contributions fathers make to children and families when they are engaged in parenting interventions. As the role fathers play in families shifts to become more inclusive of childcare responsibilities and less narrowly defined by financial contributions, it becomes increasingly important to understand how best to engage fathers in interventions that aim to enhance parenting efficacy and family outcomes such as coparenting. The current review examined intervention (e.g., format and setting) and implementation characteristics (e.g., training and agency-level changes) associated with father engagement. Particular attention is paid to studies which described father-specific engagement strategies (e.g., inviting fathers directly, father-only groups, and adapting intervention to incorporate father preferences). A total of 26 articles met inclusion criteria after screening and full-text review. Results indicate that father engagement (i.e., initiating treatment) remains low with 58% of studies either not reporting father engagement or having engagement rates below 50%. More than two-thirds of studies did not include specific father engagement strategies. Those that did focused on changes to treatment format (e.g., including recreational activities), physical treatment setting (e.g., in-home and school), and reducing the number of sessions required for father participation as the most common father-specific engagement strategies. Some studies reported efforts to target racially and ethnically diverse fathers, but review results indicated most participants identified as Non-Hispanic White. Interventions were largely standard behavioral parent training programs (e.g., PCIT and PMT) with few exceptions (e.g., COACHES and cultural adaptations), and very few agencies or programs are systematically making adjustments (e.g., extended clinic hours and changes to treatment format) to engage fathers. Recommendations for future directions of research are discussed including the impact of differential motivation on initial father engagement in treatment, the importance of continuing to support diverse groups of fathers, and the potential for telehealth to address barriers to father engagement.
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Affiliation(s)
| | | | - Miya L Barnett
- University of California, Santa Barbara, Santa Barbara, USA
| | | | - Tina Garoosi
- University of California, Santa Barbara, Santa Barbara, USA
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Jenkin T, Anderson VA, D'Cruz K, Scheinberg A, Knight S. Family-centred service in paediatric acquired brain injury rehabilitation: Bridging the gaps. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1085967. [PMID: 36619530 PMCID: PMC9816340 DOI: 10.3389/fresc.2022.1085967] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Background Children and adolescents who sustain an acquired brain injury (ABI) can experience acute and ongoing difficulties in a range of cognitive and functional domains, and their families often experience significant life changes and challenges. Family-centred service is therefore considered best practice in paediatric ABI rehabilitation. Despite widespread acceptance of family-centred service in this context, recent literature indicates that family needs are often unrecognised and unmet following paediatric ABI. Although family-centred service was introduced in the field of developmental disability over five decades ago, there remains a lack of clarity about how this approach is implemented in practice. Additionally, limited literature has discussed the implementation of family-centred service in paediatric ABI rehabilitation despite key differences between ABI and developmental disability, including nature and timing of onset, rehabilitation foci, and impacts on families. Aims In this review, we aim to: (i) outline common sequelae of paediatric ABI with a focus on family outcomes; (ii) summarise paediatric rehabilitation and highlight opportunities for family support and involvement; (iii) discuss and synthesise literature across paediatric ABI rehabilitation and family-centred service to highlight gaps in knowledge and practice; and (v) identify clinical implications and future research directions. Conclusions There is a clear need for greater clarity and consensus regarding the implementation of family-centred service in paediatric ABI rehabilitation. This review highlights the importance of providing professional development opportunities for clinicians to increase competency in practising in a family-centred manner, and opportunities to actively involve, empower and support families within rehabilitation. This review also emphasises the importance of services implementing relevant supports to address family needs where possible and developing clear referral pathways so that families can access further support elsewhere when needed.
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Affiliation(s)
- Taylor Jenkin
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Vicki A. Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Brain and Mind, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Kate D'Cruz
- Summer Foundation, Melbourne, VIC, Australia
| | - Adam Scheinberg
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Knight
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
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Strategic Priorities for Implementation of Father-Inclusive Practice in Mental Health Services for Children and Families: A Delphi Expert Consensus Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022:10.1007/s10488-022-01222-1. [DOI: 10.1007/s10488-022-01222-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 12/24/2022]
Abstract
AbstractThe aim of this study was to investigate expert consensus on barriers and facilitators to the organizational implementation of Father-Inclusive Practice (FIP) in child and family services to establish strategic priorities for implementation. An international panel of 56 experts in child and family service provision and father inclusion were surveyed using the Delphi technique. Three online questionnaires were used to gather opinions and measure experts’ levels of agreement in regard to factors that enable or hinder the organizational implementation of FIP. Survey design, analysis and interpretation was guided by the Consolidated Framework for Implementation Research (CFIR). Consensus was achieved for 46.4% (n = 13) statements. Eight barriers and five facilitators were identified as strategic priorities to organizational implementation of FIP. The key factors were related to the following CFIR themes: leadership engagement, access to information and knowledge, implementation climate, structural characteristics, networks and communication, client needs and resources, external policies and incentives, and reflecting and evaluating. The study findings suggest that issues related to central prioritization, top-down organizational processes and external policy context should represent priority areas for implementation. Our results prioritise methods for improving FIP by highlighting the key areas of organizational practice to be addressed by tailored implementation strategies.
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Westrupp EM, Greenwood CJ, Fuller-Tyszkiewicz M, Berkowitz TS, Hagg L, Youssef G. Text mining of Reddit posts: Using latent Dirichlet allocation to identify common parenting issues. PLoS One 2022; 17:e0262529. [PMID: 35108299 PMCID: PMC8809584 DOI: 10.1371/journal.pone.0262529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 12/28/2021] [Indexed: 11/19/2022] Open
Abstract
Parenting interventions offer an evidence-based method for the prevention and early intervention of child mental health problems, but to-date their population-level effectiveness has been limited by poor reach and engagement, particularly for fathers, working mothers, and disadvantaged families. Tailoring intervention content to parents' context offers the potential to enhance parent engagement and learning by increasing relevance of content to parents' daily experiences. However, this approach requires a detailed understanding of the common parenting situations and issues that parents face day-to-day, which is currently lacking. We sought to identify the most common parenting situations discussed by parents on parenting-specific forums of the free online discussion forum, Reddit. We aimed to understand perspectives from both mothers and fathers, and thus retrieved publicly available data from r/Daddit and r/Mommit. We used latent Dirichlet allocation to identify the 10 most common topics discussed in the Reddit posts, and completed a manual text analysis to summarize the parenting situations (defined as involving a parent and their child aged 0-18 years, and describing a potential/actual issue). We retrieved 340 (r/Daddit) and 578 (r/Mommit) original posts. A model with 31 latent Dirichlet allocation topics was best fitting, and 24 topics included posts that met our inclusion criteria for manual review. We identified 45 unique but broadly defined parenting situations. The majority of parenting situations were focused on basic childcare situations relating to eating, sleeping, routines, sickness, and toilet training; or related to how to respond to child negative emotions or difficult behavior. Most situations were discussed in relation to infant or toddler aged children, and there was high consistency in the themes raised in r/Daddit and r/Mommit. Our results offer potential to tailor parenting interventions in a meaningful way, creating opportunities to develop content and resources that are directly relevant to parents' lived experiences.
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Affiliation(s)
- Elizabeth M. Westrupp
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Centre for Social and Early Emotional Development, Melbourne, Victoria, Australia
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Christopher J. Greenwood
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Centre for Social and Early Emotional Development, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Centre for Social and Early Emotional Development, Melbourne, Victoria, Australia
| | - Tomer S. Berkowitz
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Centre for Social and Early Emotional Development, Melbourne, Victoria, Australia
| | - Lauryn Hagg
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - George Youssef
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Centre for Social and Early Emotional Development, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
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Whittaker A, Elliott L, Taylor J, Dawe S, Harnett P, Stoddart A, Littlewood P, Robertson R, Farquharson B, Strachan H. The Parents under Pressure parenting programme for families with fathers receiving treatment for opioid dependence: the PuP4Dads feasibility study. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/yowk7214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background
The impact of parental drug use on children is a major public health problem. However, opioid-dependent fathers have been largely ignored in parenting research.
Objective
To implement and test the feasibility and acceptability of the Parents under Pressure programme (PuP4Dads) for opioid-dependent fathers and their families, and to determine whether or not a full-scale evaluation could be conducted.
Design
A mixed-methods feasibility study.
Setting
Two non-NHS family support services for parents who use drugs in Scotland.
Participants
Fathers prescribed opioid substitution therapy (n = 25), their partners (n = 17) and children, as well as practitioners, supervisors, service managers and referrers.
Intervention
A home-visiting programme, including an integrated theoretical framework, case formulation, collaborative goal-setting and modules designed to improve parenting, the caregiving environment and child welfare. The programme was delivered flexibly over 6 months by accredited practitioners.
Main outcome measures
Feasibility progression criteria included the recruitment target (n = 24 fathers), acceptability of PuP4Dads, father engagement in the study (including a minimum of 66% of fathers completing PuP and a minimum of 10 fathers completing baseline and post-treatment research interviews), engagement in qualitative interviews (including a minimum of 10 fathers and 90% practitioner uptake and 80% manager uptake), focus groups (with a minimum of 80% referrer uptake), adequate fidelity and no adverse events.
Data sources
The following researcher-administered validated questionnaires were used: the Brief Child Abuse Potential Inventory, the Parenting Sense of Competence Scale, the Difficulties in Emotion Regulation Scale, the Paternal Antenatal Attachment Scale, the Maternal Antenatal Attachment Scale, the Emotional Availability Scale, the Brief Infant Toddler Social and Emotional Assessment, the Strengths and Difficulties Questionnaire, the Conflict Tactics Scale, Treatment Outcome Profile and the EuroQol-5 Dimensions, five-level version. Other sources included parent-completed service use (an economic measure), social work child protection data, NHS opioid substitution therapy prescription data and practitioner-reported attendance data. We also conducted interviews with fathers (n = 23), mothers (n = 14), practitioners (n = 8), supervisors (n = 2) and service managers (n = 7); conducted focus groups with referrers (n = 28); and held an ‘expert event’ with stakeholders (n = 39).
Results
The PuP4Dads was successfully delivered within non-NHS settings and was considered acceptable and suitable for the study population. Referrals (n = 44) resulted in 38 (86%) eligible fathers, of whom 25 (66%) fathers and 17 partners/mothers consented to participate. Most fathers reported no previous parenting support. A total of 248 sessions was delivered to the 20 fathers and 14 mothers who started the intervention. Fourteen fathers (and 10 mothers) completed ≥ 6 sessions and six fathers (and four mothers) completed ≤ 5 sessions. Father and mother attendance rates were equal (mean 71%). Median length of engagement for fathers was 26 weeks and for mothers it was 30 weeks. Twenty-three fathers completed interviews at baseline, 16 fathers completed interviews at follow-up 1 and 13 fathers completed interviews at follow-up 2. Outcome measures were well tolerated; however, the suitability of some measures was dependent on family circumstances. The researcher-administered questionnaires had few missing data. The perceived benefits of PuP4Dads reported by parents, practitioners and managers included the following: the therapeutic focus on fathers improved parental emotion regulation, there was improved understanding and responding to child’s needs, there was better multiagency working and the programme was a good fit with practice ‘ethos’ and policy agenda. Learning highlighted the importance of service-wide adoption and implementation support, strategies to improve recruitment and retention of fathers, managing complex needs of both parents concurrently, understanding contextual factors affecting programme delivery and variables affecting intervention engagement and outcomes.
Limitations
Lack of emotional availability and economic (service use) data.
Conclusions
A larger evaluation of PuP4Dads is feasible.
Future work
Further work is required to demonstrate the effectiveness of PuP4Dads and the cost implications. A better understanding is needed of how the intervention works, for whom, under what circumstances and why.
Trial registration
Current Controlled Trials ISRCTN43209618.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Anne Whittaker
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Lawrie Elliott
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Julie Taylor
- School of Nursing, University of Birmingham, Birmingham Women’s and Children’s NHS Trust, Birmingham, UK
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Paul Harnett
- School of Criminology and Criminal Justice, Griffith University, QLD, Australia
| | - Andrew Stoddart
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Peter Littlewood
- Substance Use Psychology Service, Astley Ainslie Hospital, NHS Lothian, Edinburgh, Scotland, UK
| | - Roy Robertson
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Barbara Farquharson
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Sawrikar V, Plant AL, Andrade B, Woolgar M, Scott S, Gardner E, Dean C, Tully LA, Hawes DJ, Dadds MR. Global Workforce Development in Father Engagement Competencies for Family-Based Interventions Using an Online Training Program: A Mixed-Method Feasibility Study. Child Psychiatry Hum Dev 2021; 54:758-769. [PMID: 34800248 PMCID: PMC10140122 DOI: 10.1007/s10578-021-01282-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Global access to practitioner training in the clinical engagement of fathers in family-based interventions is limited. The current study evaluated the feasibility of training practitioners in Canada and UK using online training developed in Australia by examining improvements in practitioner confidence and competence in father engagement, training satisfaction, qualitative feedback, and benchmarking results to those from an Australian sample. Practitioners were recruited to participate in a 2-h online training program through health services and charity organisations. The online program required practitioners to watch a video and complete self-reflection exercises in a digital workbook. Pre- and post-training measures were collected immediately before and after the online training program. The results indicated significantly large improvements in self-reported confidence and competence in engaging fathers following training, with levels of improvement similar to those found in Australia. Training satisfaction was high and qualitative feedback suggested providing local resources and increasing representation of social diversity could improve training relevance in local contexts. The findings suggest online training in father engagement can contribute to global workforce development in improving practitioners' skills in engaging fathers in family-based interventions.
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Affiliation(s)
- Vilas Sawrikar
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
| | - Alexandra L Plant
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Brendan Andrade
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Matt Woolgar
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Stephen Scott
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | | | | | - Lucy A Tully
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - David J Hawes
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Mark R Dadds
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
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Hawes DJ, Dadds MR. Practitioner Review: Parenting interventions for child conduct problems: reconceptualising resistance to change. J Child Psychol Psychiatry 2021; 62:1166-1174. [PMID: 33543502 DOI: 10.1111/jcpp.13378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Abstract
Parenting interventions based on social learning theory have received extensive empirical support in the treatment of child conduct problems; yet, they fail to produce lasting gains in as many as a third of cases. Perspectives on these poor outcomes have been informed by numerous lines of research, and practitioner recommendations for improving such outcomes have often emphasized processes related to clinical engagement. In this Practitioner Review, we examine recent theory and evidence pertaining to these processes, including emerging research into the therapeutic relationship across face-to-face and eHealth treatment modalities, and the clinical engagement of both mothers and fathers. The concept of resistance to change is examined in light of these developments, and it is argued that the process of overcoming such resistance can be characterized as one of reflective practice. A novel process model based on this perspective is presented, comprising practical clinical strategies that are designed to be initiated from the earliest contacts with a family and build on one another across treatment.
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Affiliation(s)
- David J Hawes
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Mark R Dadds
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
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McCoy A, Lachman JM, Ward CL, Tapanya S, Poomchaichote T, Kelly J, Mukaka M, Cheah PY, Gardner F. Feasibility pilot of an adapted parenting program embedded within the Thai public health system. BMC Public Health 2021; 21:1009. [PMID: 34051772 PMCID: PMC8164235 DOI: 10.1186/s12889-021-11081-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/17/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This feasibility pilot of the Parenting for Lifelong Health for Young Children program in Thailand aimed to: 1) explore the feasibility of study evaluation approaches; 2) assess the feasibility of delivering an adapted program; 3) report indicative effects on child maltreatment and related outcomes; and 4) examine intervention content associated with key mechanisms of change perceived by caregivers and facilitators. METHOD Sixty primary caregivers of children aged 2-9 years were recruited for an 8-week parenting program embedded within the local health system. Mixed-methods approaches included quantitative caregiver-report and observational data from standardized instruments, and qualitative data from individual and group interviews with caregivers and program facilitators. Analyses involved Wilcoxon signed-rank tests, paired t-tests, Friedman's ANOVA, and thematic analysis. RESULTS Participants reported that most (65%) were grandparents or great-grandparents. Study retention and response rates were high, and enrolled caregivers attended an average of 93% of sessions. Primary outcomes showed caregiver-reported pre-post reductions in overall child maltreatment (d = - 0.58, p < 0.001), as well as reductions in physical (d = - 0.58, p < 0.001) and emotional abuse (d = - 0.40, p < 0.001). Combined caregiver report and observational assessments using the HOME Inventory showed reductions in abusive and harsh parenting (d = - 0.52, p < 0.001). Secondary outcomes demonstrated decreases in child neglect; dysfunctional parenting; poor child monitoring and supervision; parental sense of inefficacy; child behavior problems; daily report on child problem behavior; parent overall depression, anxiety, and stress; and attitudes supporting physical punishment and harsh discipline. There were increases in overall positive parenting, daily positive parenting behavior, as well as HOME Inventory assessments on parent-child relationships. Thematic analyses from interviews and focus group data identified six key program themes associated with strengthened parent-child relationships, reduced child behavior problems, improved attitudes and strategies toward discipline, and improved management of parental stress. CONCLUSIONS This study represents one of few evaluations to test the feasibility of an evidence-based parenting program embedded within routine public health service delivery in a low- or middle-income country. Findings show preliminary effectiveness in reducing child maltreatment, improvements on 22 of 24 secondary outcomes, and perceived mechanisms of change that support quantitative findings. Prospects are promising for program scalability, pending randomized controlled trial results. TRIAL REGISTRATION 11/01/2019, ClinicalTrials.gov, ID# NCT03539341 .
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Affiliation(s)
- Amalee McCoy
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Sombat Tapanya
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Tassawan Poomchaichote
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jane Kelly
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Mavuto Mukaka
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK
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Wynter K, Di Manno L, Watkins V, Rasmussen B, Macdonald JA. Midwives' experiences of father participation in maternity care at a large metropolitan health service in Australia. Midwifery 2021; 101:103046. [PMID: 34098224 DOI: 10.1016/j.midw.2021.103046] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/31/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Engagement of fathers to participate in pregnancy, birth and early postnatal care has significant advantages for women and infants as well as fathers. In Australia, guidelines for midwifery practice do not include specific recommendations about father-inclusive care, and models for publicly funded maternity care do not extend to the provision of care tailored specifically towards the needs of fathers. This study investigated the perceptions of midwives regarding their role in fathers' wellbeing, the extent of fathers' attendance at and participation in their services, advantages and disadvantages of father participation and barriers and enablers to father engagement. DESIGN Convergent mixed methods, cross-sectional. SETTING A large metropolitan public maternity hospital that provides care to some of the most socio-economically disadvantaged suburbs and multi-cultural communities in Melbourne, Australia. PARTICIPANTS All midwives employed at the hospital (n=196) were invited to participate. METHODS Anonymous online survey and semi-structured interviews. Descriptive statistics were calculated for quantitative survey responses. Interview data and qualitative survey responses were analysed thematically. FINDINGS Forty midwives working in all areas of maternity services across the hospital completed surveys, and six participated in interviews. The data illustrate the dilemma faced by midwives in their specific role of supporting women and babies. On the one hand, participants indicated that fathers' wellbeing should be part of their role and named many advantages of father participation in maternity services, including support and advocacy for mothers and bonding with infants. Participants estimated that most fathers attend births and visit their partner and infant on the postnatal ward, 52% attend antenatal appointments and 76% are present at postnatal home visits. Participants reported several midwife strategies and health service factors which facilitate father attendance and active engagement. On the other hand, participants reported several barriers to father engagement, including antenatal appointment schedules which are at odds with fathers' work commitments and the lack of on-site group antenatal education. Some of the barriers they reported are specific to the vulnerable communities for which they provide maternity care. Extraordinary circumstances were reported, including fathers working overseas, fathers in prison, new immigrant status that is often accompanied by a lack of family support to care for other children even during labour and birth, and poor socio-economic status. In addition, in many cultures, pregnancy and birth are seen as "women's work"; fathers would not traditionally be involved. Participants also reported that midwives lack training and confidence in engaging fathers, particularly in responding to fathers with mental health concerns. When providing care for families at risk of family violence, father attendance was perceived a significant disadvantage. KEY CONCLUSIONS Midwife-provided health services represent a significant opportunity to include and address fathers, and midwives recognise the significant advantages of engaging fathers, unless there is a risk of family violence. However, midwives currently report lack of training and confidence in addressing fathers' needs, and several individual, social, cultural, and health service factors can present barriers to engaging fathers. IMPLICATIONS FOR PRACTICE Given the substantial benefits of engaging fathers for women and infants, we argue that maternity services should promote father engagement, for example by offering after hours appointment schedules, free antenatal and parenting education, and workshops to upskill midwifery staff. Education regarding the importance of father participation and skills for working with fathers should be included in the undergraduate preparation of midwives and other key maternity care professionals. Addressing the challenges of providing care to a multicultural community requires sensitive discussion with families from each of those cultures.
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Affiliation(s)
- Karen Wynter
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Australia; Nursing and Midwifery, Sunshine Hospital, Western Health, Australia.
| | - Laura Di Manno
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Australia
| | - Vanessa Watkins
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Australia; Nursing and Midwifery, Sunshine Hospital, Western Health, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Australia; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Denmark
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Australia; Department of Paediatrics, University of Melbourne, Australia; Murdoch Children’s Research Institute, Melbourne, Australia
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Orte Socias C, Sánchez-Prieto L, Pascual Barrio B, Montaño Moreno JJ. The Association between Trainer Expertise and Changes in Adolescent Symptomatology in an Evidence-Based Family Prevention Programme. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:353-368. [PMID: 33413040 DOI: 10.1080/26408066.2020.1867280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE The aim of this study is to assess whether the outcomes of implementations of the Universal Strengthening Families Program (SFP 11-14) are linked to the competences or specific skills of the trainers of social field who gave them. METHOD The analyzed data was based on ratings awarded by the 174 mothers participating in the SFP 11-14. By conducting a K-means cluster analysis, significant groups were identified, based on the ratings awarded to the trainers. RESULTS/DISCUSSION A comparison of the clusters led to the identification of significant differences between cluster 2 (trainers with limited skills) and the other clusters in terms of changes in the children's symptoms after participating in the SFP 11-14. Trainers with limited skills were associated with fewer changes in the symptomatology. It highlights the importance of proficient trainers in programme outcomes, and it could serve as a guide for the public social work in the design of EBP.
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Affiliation(s)
- Carmen Orte Socias
- Department of Education and Didactics, University of the Balearic Islands, Palma, Spain
| | - Lidia Sánchez-Prieto
- Department of Education and Didactics, University of the Balearic Islands, Palma, Spain
| | - Belén Pascual Barrio
- Department of Education and Didactics, University of the Balearic Islands, Palma, Spain
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12
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Macdonald JA, Graeme LG, Wynter K, Cooke D, Hutchinson D, Kendall G, StGeorge J, Dowse E, Francis LM, McBride N, Fairweather AK, Manno LD, Olsson CA, Allsop S, Leach L, Youssef GJ. How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years. J Affect Disord 2021; 281:727-737. [PMID: 33234285 DOI: 10.1016/j.jad.2020.11.081] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/18/2020] [Accepted: 11/08/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. METHODS Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. RESULTS Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LIMITATIONS This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. CONCLUSIONS A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.
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Affiliation(s)
- Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Liam G Graeme
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Karen Wynter
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia; Deakin University, Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Australia
| | - Dawson Cooke
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia; University of New South Wales, National Drug and Alcohol Research Centre, Sydney, Australia
| | - Garth Kendall
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | | | - Eileen Dowse
- University of Newcastle, School of Nursing and Midwifery, Newcastle, Australia
| | - Lauren M Francis
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Nyanda McBride
- Curtin University, National Drug Research Institute, Perth, Australia
| | - A Kate Fairweather
- Flinders University, Discipline of Behavioural Health, College of Medicine and Public Health, Adelaide, Australia
| | - Laura Di Manno
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Perth, Australia
| | - Liana Leach
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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13
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Macdonald JA, Greenwood CJ, Francis LM, Harrison TR, Graeme LG, Youssef GJ, Di Manno L, Skouteris H, Fletcher R, Knight T, Williams J, Milgrom J, Olsson CA. Profiles of Depressive Symptoms and Anger in Men: Associations With Postpartum Family Functioning. Front Psychiatry 2020; 11:578114. [PMID: 33329118 PMCID: PMC7719778 DOI: 10.3389/fpsyt.2020.578114] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Evidence suggests that men commonly experience depression as feelings of anger; yet, research has not investigated what this means for the manifestation of depressive symptoms in the early years of fatherhood and for key indicators of family functioning. Methods: Using data from a longitudinal cohort study of men at the normative age for entering fatherhood (28-32 years), we conducted latent class analyses to identify patterns of depressive symptoms and 3 sub-types of state anger (feeling; verbal; physical). We then assessed whether class membership was associated with paternity status (n = 535). In a subsample of fathers of infants aged up to 18 months (n = 162), we prospectively assessed associations with paternal-infant bonding, co-parenting, perceived social support, paternal involvement in childcare and alcohol use up to 2 years later. Results: Five classes emerged that differentiated men by anger and depressive symptom severity and by the degree to which men endorsed the feeling of wanting to express anger physically. Compared to the reference class with minimal symptoms, fathers had a higher probability of being in either the mild or most severe symptom classes. Men in symptomatic classes were at higher risk of lower levels of social support, co-parenting problems, and paternal-infant bonds. Class membership was not associated with alcohol use or paternal involvement in childcare. Conclusions: Our results reveal patterns of co-existing symptoms of depression and anger in fathers of infants that will be relevant to men's own need for support, their family safety, partner mental health and child developmental outcomes.
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Affiliation(s)
- Jacqui A. Macdonald
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Lauren M. Francis
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Tessa R. Harrison
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Liam G. Graeme
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - George J. Youssef
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Laura Di Manno
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Richard Fletcher
- Faculty of Health and Medicine, Family Action Centre, University of Newcastle, Callaghan, NSW, Australia
| | - Tess Knight
- Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Craig A. Olsson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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14
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Hansen A, Broomfield G, Yap MBH. A systematic review of technology‐assisted parenting programs for mental health problems in youth aged 0–18 years: Applicability to underserved Australian communities. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12250] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ashlyn Hansen
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia,
| | - Grace Broomfield
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia,
| | - Marie B. H. Yap
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia,
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia,
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15
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Lechowicz ME, Jiang Y, Tully LA, Burn MT, Collins DAJ, Hawes DJ, Lenroot RK, Anderson V, Doyle FL, Piotrowska PJ, Frick PJ, Moul C, Kimonis ER, Dadds MR. Enhancing Father Engagement in Parenting Programs: Translating Research into Practice Recommendations. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12361] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | | | - Rhoshel K. Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales,
| | - Vicki Anderson
- Murdoch Children's Research Institute, Royal Children's Hospital,
- Department of Psychology, University of Melbourne,
- Department of Paediatrics, University of Melbourne,
| | | | | | - Paul J. Frick
- Learning Sciences Institute of Australia, Australian Catholic University,
- Department of Psychology, Louisiana State University, and
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16
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Kang AW, Gans KM, Minkel J, Risica PM. Effects of Coparenting Quality, Stress, and Sleep Parenting on Sleep and Obesity Among Latinx Children: A Path Analysis. J Pediatr Health Care 2020; 34:e77-e90. [PMID: 32891498 DOI: 10.1016/j.pedhc.2020.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION We sought to examine the associations among parent-level constructs, sleep-related parenting practices, and child sleep in Latinx families. METHOD A quantitative study was conducted with 101 Latinx parents of children aged 2-5 years. Key variables that were examined included parental stress, coparenting quality, bedtime routine consistency, parent-child sleep interactions, and child's sleep duration. RESULTS Path analysis results indicated that (1) parent stress had a direct effect on child sleep duration (p =.005) and was mediated by parent-child sleep interactions (p =.021); (2) coparenting quality had a direct effect on child sleep duration (p =.001) and was mediated by bedtime routine consistency (p =.010); and (3) bedtime routine consistency had an indirect effect on child body mass index percentile and was mediated by sleep duration (p =.049). DISCUSSION Coparenting quality and parental stress may be important constructs to consider when designing interventions to improve Latinx child sleep duration.
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17
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Seymour M, Peace R, Wood CE, Jillard C, Evans K, O'Brien J, Williams LA, Brown S, Giallo R. "We're in the background": Facilitators and barriers to fathers' engagement and participation in a health intervention during the early parenting period. Health Promot J Austr 2020; 32 Suppl 2:78-86. [PMID: 33051918 DOI: 10.1002/hpja.432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 11/09/2022] Open
Abstract
ISSUES ADDRESSED Little is known about the barriers and facilitators associated with engaging fathers in interventions targeting their physical and mental health. The current research therefore aimed to explore fathers' perceived barriers and facilitators to engagement and participation in a health intervention delivered during the early parenting period. METHODS Eleven fathers of young children (0-4 years) were interviewed about their perceptions and experiences of facilitators and barriers to engaging and participating in an intervention (Working Out Dads) to target their mental and physical health. Interviews were recorded and transcribed. Transcripts were analysed using thematic analysis. RESULTS Fathers identified a number of program-related and father-related facilitators and barriers which impacted their engagement and participation. Program-related facilitators included: accessibility of the program; father advocacy of the program; group fitness/exercise component; and having a father-specific program. Facilitating factors related to fathers included: making social connections; learning how to be a better dad/partner; and partner support and encouragement to attend. Program-related barriers included: travel; lack of awareness; and gender roles. While father-related barriers included: being time poor; sacrifices to family; and apprehension. CONCLUSIONS The current findings identified many areas that facilitate, encourage and motivate men to participate in interventions which support their mental and physical health during the early parenting period. RELEVANCE Generating evidence on barriers and facilitators to health interventions is important to improving the current intervention along with informing the development of engaging and targeted health interventions for fathers in early parenthood.
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Affiliation(s)
- Monique Seymour
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Ryan Peace
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Catherine E Wood
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Chris Jillard
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Kirsty Evans
- Tweddle Child and Family Health Services, Footscray, VIC, Australia
| | - Jacquie O'Brien
- Tweddle Child and Family Health Services, Footscray, VIC, Australia
| | - Le Ann Williams
- Tweddle Child and Family Health Services, Footscray, VIC, Australia
| | - Stephanie Brown
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia.,Department of General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, VIC, Australia.,South Australia Health and Medical Research Institute, Adelaide, SA, Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia
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18
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Keys EM, Norris JM, Cameron EE, Bright KS, Tomfohr-Madsen LM, Benzies KM. Recruitment and retention of fathers with young children in early childhood health intervention research: a systematic review and meta-analysis protocol. Syst Rev 2019; 8:300. [PMID: 31787109 PMCID: PMC6886200 DOI: 10.1186/s13643-019-1215-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fathers are under-represented in research and programs addressing early childhood health and development. Recruiting fathers into these interventions can be hampered for multiple reasons, including recruitment and retention strategies that are not tailored for fathers. The primary aim of this systematic review and meta-analysis is to determine the effectiveness of recruitment and retention strategies used to include fathers of children (from conception to age 36 months) in intervention studies. The secondary aim is to investigate study-level factors that may influence recruitment and retention. METHODS We will conduct searches for scholarly peer-reviewed randomized controlled trials, quasi-experimental studies, and pre-post studies that recruited fathers using the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), and CINAHL. English-language articles will be eligible if they recruited self-identified fathers of children from conception to age 36 months for health-promoting interventions that target healthy parents and children. Two reviewers will independently screen titles/abstracts and full texts for inclusion, as well as grading methodological quality. Recruitment and retention proportions will be calculated for each study. Where possible, we will calculate pooled proportional effects with 95% confidence intervals using random-effects models and conduct a meta-regression to examine the impact of potential modifiers of recruitment and retention. DISCUSSION Findings from this review will help inform future intervention research with fathers to optimally recruit and retain participants. Identifying key factors should enable health researchers and program managers design and adapt interventions to increase the likelihood of increasing father engagement in early childhood health interventions. Researchers will be able to use this review to inform future research that addresses current evidence gaps for the recruitment and retention of fathers. This review will make recommendations for addressing key target areas to improve recruitment and retention of fathers in early childhood health research, ultimately leading to a body of evidence that captures the full potential of fathers for maximizing the health and wellbeing of their children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018081332.
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Affiliation(s)
- Elizabeth M. Keys
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Jill M. Norris
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Emily E. Cameron
- Department of Psychology, University of Calgary, Calgary, Alberta Canada
| | - Katherine S. Bright
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
| | - Lianne M. Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Karen M. Benzies
- Faculty of Nursing, University of Calgary, PF2278, 2500 University Drive NW, Calgary, Alberta T2N 1 N4 Canada
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
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19
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Barnett M, Miranda J, Kia-Keating M, Saldana L, Landsverk J, Lau AS. Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol. BMJ Open 2019; 9:e028988. [PMID: 31324682 PMCID: PMC6661633 DOI: 10.1136/bmjopen-2019-028988] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Behavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successful implementation of evidence-based practices (EBPs) in community settings that serve low-income, ethnic minority families. Lay health workers (LHWs)-individuals without formal mental health training-represent an important workforce to increase engagement, as they are members of the communities they serve. However, the mobilisation of LHWs has not been well studied as an implementation strategy to extend the reach or effectiveness of EBPs in the USA. LHW-delivered implementation interventions that specifically support the engagement of Latinx parents in evidence-based BPT programmes have the potential to improve clinical and implementation outcomes. METHODS AND ANALYSIS A community-partnered approach will use the Quality Implementation Framework (QIF) to tailor and implement an LHW-delivered implementation intervention that aims to promote Latinx parent engagement in BPT programmes. Steps from the QIF will guide study activities to (1) conduct a mixed methods needs assessment to fit the implementation intervention to the local context, (2) adapt LHW-delivered implementation strategies to promote parent access to and engagement in Parent-Child Interaction Therapy and (3) conduct a hybrid effectiveness-implementation pilot trial to examine the feasibility, acceptability and preliminary effectiveness of the LHW implementation intervention at increasing engagement. ETHICS AND DISSEMINATION Study procedures have been approved by the Institutional Review Board at the University of California, Santa Barbara. Results will be shared with the community-advisory group, at community-based meetings for other stakeholders involved in the pilot project, and submitted for publication in peer-reviewed journals.
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Affiliation(s)
- Miya Barnett
- Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California, USA
| | - Jeanne Miranda
- Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Center for Health Services and Society, University of California Los Angeles, Los Angeles, California, USA
| | - Maryam Kia-Keating
- Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California, USA
| | - Lisa Saldana
- Oregon Social Learning Center, Eugene, Oregon, USA
| | | | - Anna S Lau
- Psychology, University of California Los Angeles, Los Angeles, California, USA
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20
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Schuppan KM, Roberts R, Powrie R. Paternal Perinatal Mental Health: At-Risk Fathers’ Perceptions of Help-Seeking and Screening. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/1060826519829908] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Given the prevalence of paternal perinatal mental health concerns, researchers have suggested introducing routine screening. However, little is known about the acceptability of perinatal screening measures in male populations. Furthermore, the need for screening is influenced by men’s perinatal help-seeking behaviors. A thematic analysis of interview data from nine men at risk of paternal perinatal depression and/or anxiety investigated both acceptability of screening and help-seeking behaviors. Themes indicate that routine screening is desired, but acceptability is influenced by perceptions of its intention and possible outcomes. Findings also suggest that barriers to men’s perinatal help-seeking are likely to be minimized by increased awareness and normalization. Future research and clinical practice should account for complexities raised by men’s perceptions of health care services.
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Affiliation(s)
| | | | - Rosalind Powrie
- Women’s and Children’s Health Network, North Adelaide, South Australia, Australia
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21
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Burn M, Tully LA, Jiang Y, Piotrowska PJ, Collins DAJ, Sargeant K, Hawes D, Moul C, Lenroot RK, Frick PJ, Anderson V, Kimonis ER, Dadds MR. Evaluating Practitioner Training to Improve Competencies and Organizational Practices for Engaging Fathers in Parenting Interventions. Child Psychiatry Hum Dev 2019; 50:230-244. [PMID: 30078112 PMCID: PMC6428790 DOI: 10.1007/s10578-018-0836-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Fathers are consistently underrepresented in parenting interventions and practitioners are an important target for change in interventions to enhance father engagement. This research examined the effects of two practitioner training programs in improving practitioner rated competencies and organizational father-inclusive practices. Two studies were conducted, each with a single group, repeated measures (pre, post and 2-month follow-up) design. Study 1 (N = 233) examined the outcomes of face-to-face training in improving practitioner ratings of competencies in engaging fathers, perceived effectiveness and use of father engagement strategies, organizational practices and rates of father engagement. Study 2 (N = 356) examined online training using the same outcome measures. Practitioners in both training formats improved in their competencies, organizational practices and rates of father engagement over time, yet those in the online format deteriorated in three competencies from post-training to follow-up. The implications for delivering practitioner training programs to enhance competencies and rates of father engagement are discussed.
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Affiliation(s)
- M. Burn
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - L. A. Tully
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - Y. Jiang
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - P. J. Piotrowska
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - D. A. J. Collins
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - K. Sargeant
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - D. Hawes
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - C. Moul
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
| | - R. K. Lenroot
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052 Australia
| | - P. J. Frick
- 0000 0001 0662 7451grid.64337.35Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803 USA ,0000 0001 2194 1270grid.411958.0Learning Sciences Institute of Australia, Australian Catholic University, Brisbane, QLD 4000 Australia
| | - V. Anderson
- 0000 0000 9442 535Xgrid.1058.cRoyal Children’s Hospital, Murdoch Children’s Research Institute, Parkville, VIC 3052 Australia ,0000 0001 2179 088Xgrid.1008.9Department of Psychology, University of Melbourne, Parkville Campus, Melbourne, VIC 3010 Australia ,0000 0001 2179 088Xgrid.1008.9Department of Paediatrics, University of Melbourne, Parkville Campus, Melbourne, VIC 3010 Australia
| | - E. R. Kimonis
- 0000 0004 4902 0432grid.1005.4School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - M. R. Dadds
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Camperdown, NSW 2006 Australia
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22
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A benchmarking study of father involvement in Australian child mental health services. PLoS One 2018; 13:e0203113. [PMID: 30153291 PMCID: PMC6112673 DOI: 10.1371/journal.pone.0203113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 08/15/2018] [Indexed: 11/19/2022] Open
Abstract
Fathers are underrepresented in interventions focussing on child well-being, yet research suggests their involvement may be critical to enhancing intervention effectiveness. This study aimed to provide the first Australian benchmark of rates of father attendance across several child mental health services. Retrospective casefile reviews were conducted to obtain data on father and mother attendance at 10 Australian child mental health services. A total of 2128 casefile records were retrospectively examined to extract family-level data. The main outcome measures were rates of father and mother attendance at sessions involving parents, and rates of father- and mother-instigated referral to services. Across services, fathers attended on average 48.2% (range 39.7% to 72.0%) of total parent sessions, with an average of 68.4% (range 53.1% to 88.1%) of fathers attending at least one session. Mothers attended sessions at significantly higher rates; an average of 92.8% of total parent sessions and 96.9% attendance for at least one session. For self-referred families, on average 12.6% of referrals were from fathers, and 87.4% were from mothers. These results indicate that rates of father attendance at Australian child mental health services vary, but are significantly lower than attendance rates for mothers. This may compromise the quality and outcomes of child mental health services in Australia. Routine monitoring of rates of father attendance is needed, as are strategies to enhance father engagement.
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Caserta A, Fabiano GA, Hulme K, Pyle K, Isaacs L, Jerome S. A Waitlist-Controlled Trial of Behavioral Parent Training for Fathers of Preschool Children. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23794925.2018.1446768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Abigail Caserta
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Gregory A. Fabiano
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Karen Hulme
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Kellina Pyle
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Lesthia Isaacs
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Stephanie Jerome
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, New York, USA
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24
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Jiang Y, Tully LA, Burn MT, Piotrowska P, Collins DAJ, Moul C, Frick PJ, Hawes DJ, Kimonis ER, Lenroot RK, Anderson V, Dadds MR. Development and Psychometric Evaluation of the Father Engagement Questionnaire. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:3457-3467. [PMID: 30369777 PMCID: PMC6182713 DOI: 10.1007/s10826-018-1195-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
While there has been increasing interest in promoting father engagement in parenting interventions for child wellbeing, both research and practice endeavors have been hindered by a lack of a measure of father engagement practices. This paper reports the development and evaluation of a comprehensive, practitioner-report measure of father engagement practices--the Father Engagement Questionnaire (FEQ). Practitioners (N = 589; 84.5% females; mean age = 38.56) involved in delivering parenting interventions in Australia completed the FEQ, along with background demographics and questions regarding their own and organization's practice. A separate sample of 28 practitioners completed the FEQ twice, with a two-week interim, to assess test-retest stability of the measure. Exploratory factor analysis revealed five factors corresponding to the measure's five intended content areas: Confidence in Working with Fathers, Competence in Using Engagement Strategies, Perceived Effectiveness of Engagement Strategies, Frequency of Strategy Use, and Organizational Practices for Father Engagement. Each of these scales demonstrated adequate internal consistency reliability and test-retest stability. As the five scales appear to be related but distinct, it is recommended that the FEQ is used as a multidimensional measure of father engagement. In terms of predictive validity, higher scores on the Confidence in Working with Fathers, Frequency of Strategy Use, and Organizational Practices for Father Engagement scales were associated with a higher likelihood of practitioner-reported father attendance. The results provide support for adequate psychometric properties of the FEQ as a research and clinical tool for assessing and monitoring father engagement practices.
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Affiliation(s)
- Yixin Jiang
- School of Psychology, University of Sydney, Sydney, Australia
| | - Lucy A. Tully
- School of Psychology, University of Sydney, Sydney, Australia
| | - Matthew T. Burn
- School of Psychology, University of Sydney, Sydney, Australia
| | | | | | - Caroline Moul
- School of Psychology, University of Sydney, Sydney, Australia
| | - Paul J. Frick
- Learning Sciences Institute of Australia, Australian Catholic University, Brisbane City, QLD 4000 Australia
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803 USA
| | - David J. Hawes
- School of Psychology, University of Sydney, Sydney, Australia
| | - Eva R. Kimonis
- School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Rhoshel K. Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052 Australia
| | - Vicki Anderson
- Royal Children’s Hospital, Murdoch Children’s Research Institute, Parkville, VIC 3052 Australia
- Departments of Psychology & Pediatrics, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Mark R. Dadds
- School of Psychology, University of Sydney, Sydney, Australia
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25
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Tully LA, Piotrowska PJ, Collins DAJ, Mairet KS, Black N, Kimonis ER, Hawes DJ, Moul C, Lenroot RK, Frick PJ, Anderson V, Dadds MR. Optimising child outcomes from parenting interventions: fathers' experiences, preferences and barriers to participation. BMC Public Health 2017; 17:550. [PMID: 28592244 PMCID: PMC5463495 DOI: 10.1186/s12889-017-4426-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/15/2017] [Indexed: 11/24/2022] Open
Abstract
Background Early childhood interventions can have both immediate and long-term positive effects on cognitive, behavioural, health and education outcomes. Fathers are underrepresented in interventions focusing on the well-being of children. However, father participation may be critical for intervention effectiveness, especially for parenting interventions for child externalising problems. To date, there has been very little research conducted to understand the low rates of father participation and to facilitate the development of interventions to meet the needs of fathers. This study examined fathers’ experiences of, and preferences for, parenting interventions as well as perceptions of barriers to participation. It also examined how these factors were associated with child externalising behaviour problems, and explored the predictors of participation in parenting interventions. Methods A community sample of 1001 fathers of children aged 2–16 years completed an online survey about experiences with parenting interventions, perceived barriers to participation, the importance of different factors in their decision to attend, and preferred content and delivery methods. They also completed ratings of their child’s behaviour using the Strengths and Difficulties Questionnaire. Results Overall, 15% of fathers had participated in a parenting intervention or treatment for child behaviour, with significantly higher rates of participation for fathers of children with high versus low levels of externalising problems. Fathers rated understanding what is involved in the program and knowing that the facilitator is trained as the two most important factors in their decision to participate. There were several barriers to participation that fathers of children with high-level externalising problems were more likely to endorse, across practical barriers and help-seeking attitudes, compared to fathers of children with low-level externalising problems. Almost two-thirds of fathers of children with high-level externalising behaviour had not participated in a parenting intervention or treatment. The only significant predictors of intervention participation were severity of child externalising behaviour problems and child age. Conclusions The findings have important implications for services seeking to increase father engagement and highlight a number of strategies to enhance the promotion and delivery of parenting interventions to fathers. These strategies include more public health messaging about parenting programs and the importance of father participation.
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Affiliation(s)
- Lucy A Tully
- School of Psychology, University of Sydney, Sydney, Australia.
| | | | | | | | - Nicola Black
- School of Psychology, University of Sydney, Sydney, Australia
| | - Eva R Kimonis
- School of Psychology, University of New South Wales, Sydney, Australia
| | - David J Hawes
- School of Psychology, University of Sydney, Sydney, Australia
| | - Caroline Moul
- School of Psychology, University of Sydney, Sydney, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Paul J Frick
- Learning Sciences Institute of Australia, Australian Catholic University, Brisbane, Australia, & Department of Psychology, Louisiana State University, Baton Rouge, USA
| | - Vicki Anderson
- Royal Children's Hospital, Murdoch Children's Research Institute, Departments of Psychology & Paediatrics, University of Melbourne, Melbourne, Australia
| | - Mark R Dadds
- School of Psychology, University of Sydney, Sydney, Australia
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