Health Risk Behavior of Rural Low-Income Expectant Fathers

Using a citizens' jury approach to determine a good nutrition resource for pregnant women

OBJECTIVE

The development of user-friendly nutrition resources for pregnant women seldom involves end-users. This qualitative study used a citizens' jury approach to determine if our modification of a longstanding, frequently used dietitian-informed diet and diabetes booklet was deemed to be a good healthy eating resource for pregnant women.

DESIGN

Midwives recruited thirteen first-time pregnant women not requiring specialist obstetric care or specialist dietetic advice for any reason. Participants were sent a copy of the modified healthy eating in pregnancy booklet prior to 'jury day'. Five women were unable to attend the citizens' jury citing reasons such as early labour. At the jury, five experts presented evidence. Participants adjourned, with an independent facilitator, to 'deliberate' as to whether the resource was suitable or not. The verdict was presented, and subsequent discussion was audio-recorded, transcribed and inductively content analysed.

SETTING

Southland, New Zealand.

PARTICIPANTS

Pregnant women aged 19-35 years (n 8), of whom half had a household income <$NZ30 000.

RESULTS

The verdict was 'Yes'; the resource was good. Three themes were derived: communication of health information, resource content and harm reduction in pregnancy. Based on these data, ways to enhance the quality and usability of the booklet were evident.

CONCLUSIONS

Citizens' juries can be used to obtain an independent assessment by end-users of health resources. Our modified diet and diabetes booklet was considered suitable for providing healthy eating advice to pregnant women. Inclusion of end-users' perspectives is critical for end-user relevant content, comprehension and resource credibility.

Psychosocial risk screening of expectant fathers in an urban home visiting service population

OBJECTIVE

To examine the occurrence of psychosocial risk factors among expectant fathers whose female partners were enrolled in prenatal home visiting services.

DESIGN

Cross-sectional, exploratory, quantitative design.

SAMPLE

Expectant father-mother pairs were recruited from two urban home visiting programs to participate in a randomized controlled trial of a father advocate intervention. The study sample consisted of 66 father-mother pairs who completed structured interviews at baseline, before randomization.

MEASUREMENTS

Participants were interviewed using a structured questionnaire. This study focused on their responses related to 11 psychosocial risk factors, as measured by the Brief Risk Overview (BRO) for men and the Prenatal Risk Overview (PRO) for pregnant women.

RESULTS

Moderate- or high-risk classification of psychosocial risk factors was prevalent among expectant fathers. The risk factors that fathers reported were diverse, related to their basic needs, social support, mental health, and substance use; risk factors frequently co-occurred. Fathers' and mothers' total risk scores, calculated as a composite of all 11 risk factors, were significantly correlated.

CONCLUSIONS

Expectant fathers who have a partner enrolled in home visiting would benefit from psychosocial risk screening. Addressing fathers' risk factors may improve paternal health, their involvement in parenting, and the well-being of their partners and children.

Evaluation of a brief intervention to assist health visitors and community practitioners to engage with fathers as part of the healthy child initiative

Aims

To improve engagement of Health Visitors and Community Practitioners delivering the Healthy Child Programme with fathers. To evaluate a one-day, father-focused workshop with a supporting handbook for Practitioners. To identify institutional and organisational barriers to engagement with fathers.

Background

The UK government policy encourages health professionals to engage with fathers. This derives from robust evidence that fathers’ early involvement with their children impacts positively on emotional, behavioural and educational development. Yet, there is little evidence that the importance of engaging fathers is reflected in Health Visitor training or that primary-care services are wholly embracing father-inclusive practice. The Fatherhood Institute (FI), a UK charity, has developed a workshop for Practitioners delivering the Healthy Child Programme.

Method

A ‘before and after’ evaluation study, comprising a survey followed by telephone interviews, evaluated the impact of the FI workshop on Health Visitors’ and Community Practitioners’ knowledge, attitudes and behaviour in practice. A total of 134 Health Visitors and Community Practitioners from eight NHS Trusts in England attended the workshop from November 2011 to January 2014 at 12 sites. A specially constructed survey, incorporating a validated questionnaire, was administered before the workshop, immediately afterwards and three months later. Telephone interviews further explored participants’ responses.

Findings

Analysis of the questionnaire data showed that the workshop and handbook improved participants’ knowledge, attitudes and behaviour in practice. This was sustained over a three-month period. In telephone interviews, most participants said that the workshop had raised their awareness of engaging fathers and offered them helpful strategies. However, they also spoke of barriers to engagement with fathers. NHS Trusts need to review the training and education of Health Visitors and Community Practitioners and take a more strategic approach towards father-inclusive practice and extend services to meet the needs of fathers.

Experiences of health and well-being among Finnish low-income fathers

This article describes the everyday experiences of health and well-being among Finnish low-income fathers. The aim of study is to understand the health experiences of low-income fathers and the factors influencing the health experience and to develop nursing care in order to provide support for them. The approach is phenomenological and method is based on hermeneutical and descriptive phenomenology. The informants in this study were seven low-income Finnish fathers with children under 16 years old. Well-being of the fathers appeared as personal, realistic and bound to everyday life: income sufficient for meeting basic needs, everyday health, the pleasure and priviledge of life and the meaningfulness of the relationships in family and in community. Fathers used individual methods for maintaining the experience of well-being and they experienced the support from official sources as positive or negative. The findings of this study suggest that well-being of low-income fathers living under threat of marginalisation will be supported by care providers taking into account individual, social and economic factors, and that this support will have to be gender-sensitive, realistic and based on their everyday life.

Contribuições da literatura para a enfermagem de família no contexto rural

Trata-se de um estudo de revisão da literatura de enfermagem que objetivou identificar aspectos do ciclo vital e da saúde da família no contexto rural. Foram analisados 22 artigos, entre 2003 e 2010, obtidos nas bases Medline, Lilacs, BDEnf e Cinahl, selecionados sob critérios de inclusão e de exclusão. Os resultados mostram aspectos da saúde da unidade familiar nas transições típicas das fases do ciclo vital, a relação com os profissionais de enfermagem e implicações da informação/conhecimento de saúde nos comportamentos de cuidado e promoção da saúde familiar. Conclui-se que o cuidado da enfermagem promove a saúde das famílias rurais, ao considerar a cultura, a educação em saúde e o meio ambiente. Reforça a importância da informação e do conhecimento em saúde para a promoção de comportamentos saudáveis nas famílias, aliado ao papel da enfermagem no cuidado centrado na família, com ênfase na educação em saúde.

Men's tobacco and alcohol use during and after pregnancy

Men's health risk behaviors are rarely considered as a component of their partners' prenatal care. Men living with a pregnant partner completed telephone surveys at two time points, during pregnancy and postpartum, answering questions about tobacco and alcohol use behaviors and other sociodemographic variables. Men's smoking did not change significantly from pregnancy (46.9%) to postpartum (45.8%). Hazardous drinking (five or more drinks/day in a month) changed from 27.1% to 22.9%. Nonsmoking status of men was significantly related to a pregnant partner's quitting smoking during pregnancy and remaining quit at postpartum (p = .019). Household prohibitions from indoor smoking increased from 62.5% at pregnancy to 76% postpartum (p = .009). Pregnancy alone does not appear sufficient for men to quit smoking or change hazardous drinking. Continued exclusion of young men during prenatal care is a missed opportunity to address health risk behaviors and improve paternal, maternal, and family health.