Systematic review of the impact of coparenting interventions on paternal coparenting behaviour

Thoughts and experiences of well-educated fathers about their role when breastfeeding difficulties arose

OBJECTIVE

To investigate how fathers or partners perceive their roles as new parents when confronted with early breastfeeding challenges, how they navigate these difficulties, and the specific type of support they seek from the Child Health Care Centre (CHCC).

METHOD

In-depth, individual interviews conducted with 12 partners of women for whom breastfeeding was difficult. Reflexive thematic analysis was applied on the interview data.

RESULTS

Interviews resulted in three themes: 1) 'It is a revolutionary time to be a new father' represented a tumultuous time when fathers wanted to be involved in all decisions and part of a strong team with their partners. 2) 'When a breastfeeding problem arose'; fathers questioned the sovereignty of breast milk and began to seek more knowledge. They experienced a strong social norm about breastfeeding that led to feelings of guilt for their partners. They felt helpless when their partners suffered and lacked support. 3) 'Child Health Care Centre's duty'; was instrumental, as knowledge and competence were found to be important for trust. The fathers wanted concrete solutions to breastfeeding problems and more conversations of support with the CHCC nurse.

CONCLUSION

Well-educated fathers desire to protect their partners as they experience suffering due to a robust social norm telling them that breastfeeding is best. This can result in them starting to question the sovereignty of breast milk. Fathers need support to help their partners successfully during breastfeeding. They want counselling to strengthen their role as parents and help them build trusting teams with their partners.

Adaptation of the Coparenting Relationship Scale Questionnaire to Spanish Parents with Offspring

The scientific literature supports that practicing positive coparenting leads to the healthy development of children. Consequently, professional interest in parenting and coparenting has experienced significant growth, and evaluating coparenting is crucial in family psychology for establishing action protocols in clinical practice. An instrument highly regarded within the scientific community for evaluating coparenting dynamics is The Coparenting Relationship Scale (CRS). This research aims to achieve two objectives: first, to adapt the CRS for the Spanish population of both engaged and separated/divorced parents and to ascertain its reliability, validity, and factorial invariance psychometric properties; second, to assess the effectiveness of the total coparenting measure in categorizing sample participants. A cross-sectional non-experimental investigation was conducted to address these objectives. The first objective was answered by conducting an instrumental study, and the second by an exploratory study using classification techniques and a causal-comparative study using multivariate inferential methods. It was concluded that the model comprising 20 items across two factors, Positive Coparenting and Negative Perception of Coparenting, is the simplest and best fit for the Spanish parent sample; it is invariant regarding gender and marital status, and the measures derived from each factor demonstrate reliability and convergent and discriminant validity. The resulting questionnaire for Spanish parents is named CRS-SEg-S&D. The Coparental Vitality measure calculated using the total weighted measure of CRS-SEg-S&D allows the sample of participants to be divided into three differentiated clusters called Coparental Robustness, Moderate Coparenting, and Coparenting Rickets.

Fatherhood, Behavioral Health, and Criminal Legal System Contact over the Life Course

Life course theories suggest that fathers' lifetime criminal legal system contact could contribute to poor parent-child outcomes via deterioration in couple relationship quality and fathers' behavioral health. Using paired, longitudinal data from the Multi-site Family Study (N = 1,112 couples), the current study examines the influence of three dimensions of fathers' life course legal system contact on individual and parent-child outcomes. In fitted models, accumulated system contact in adulthood predicts fathers' later depressive symptoms and drug misuse, which in turn predict diminished father-child relationship quality (as reported by both co-parents). Fathers who were older at the time of their first arrest had poorer relationships with their children's mothers and, in turn, poorer behavioral health and parent-child outcomes. Conditions of confinement during fathers' most recent prison stay do not significantly predict later parent-child outcomes, net of the influence of age at first arrest and accumulated criminal legal system contact in adulthood.

Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies

BACKGROUND

Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers.

OBJECTIVE

This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum.

METHODS

A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool.

RESULTS

A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall.

CONCLUSIONS

New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.

Midwives and child health nurses' support is associated with positive coparenting for fathers of infants: A cross-sectional analysis

AIMS AND OBJECTIVES

To examine if the professional support that fathers received from midwives and child health nurses was associated with improvements in fathers' coparenting. A secondary aim was to investigate if there were any support differences between fathers based on parity.

BACKGROUND

Stronger coparenting is associated with improved maternal, paternal and child health. It is unclear if routine prenatal and postnatal professional support is associated with improved coparenting in fathers of infants.

DESIGN

Cross-sectional online survey.

METHODS

In total, 612 fathers of infants (aged 0-24 months) completed baseline data between November 2018 and March 2020. Socio-demographics, pregnancy control variables, social support, professional support, being invited to attend and attending three specific visits for fathers, respectively, and the fathers' coparenting relationship, using the Brief Coparenting Relationship Scale, were assessed. The STROBE checklist was used as the reporting guideline for this study.

RESULTS

Fathers' attendance at child health visits, support from the prenatal and postnatal midwife, respectively, and total support from the child health nurse, are associated with more positive coparenting. Primiparous fathers reported more received social and professional support, as well as a more positive coparenting relationship than multiparous fathers.

CONCLUSIONS

Receiving clinical support from both midwives and child health nurses is associated with fathers' positive coparenting. All fathers should be invited and encouraged to attend prenatal, postnatal and child health visits to further support their coparenting relationship. Relative to primiparous fathers, multiparous fathers may require targeted and additional clinical support regarding their coparenting relationship.

RELEVANCE TO CLINICAL PRACTICE

With fathers becoming more involved in childrearing, having stronger coparenting skills can help them better adapt to their parental roles. Our findings help understand how routine professional support from midwives and child health nurses are experienced among new fathers and that multiparous fathers are in further need of coparenting support.

Paternal postpartum depression, coparenting, and father-infant bonding: Testing two mediated models using structural equation modeling

BACKGROUND

Impaired father-infant bonding is a mental health issue that has been understudied. The current study aimed to examine the extent to which fathers' depression symptoms and coparenting relationship, respectively, are associated with infant bonding, as well as how these two variables mediate in the association with infant bonding.

METHODS

Cross-sectional data from 612 fathers of infants (0-24 months) were used in this study. Path analyses on two competing mediation models were used to examine the direct and indirect associations between fathers' depression symptoms, coparenting relationship, and infant bonding, after controlling for several known covariates.

RESULTS

Whether fathers reported depression symptoms (Model 1) or reported lower levels of coparenting relationships (Model 2), they also reported higher levels of impaired infant bonding, rejection and anger, and anxiety about care after controlling for the covariates. The analysis further found significant indirect associations between father depression symptoms and father-infant bonding via the coparenting relationship (Model 1) as well as significant indirect associations between the coparenting relationship and father-infant bonding via father depression symptoms (Model 2).

LIMITATIONS

The cross-sectional data cannot show causal links. Specific efforts were made to recruit fathers with depression symptoms, and therefore prevalence rates may appear skewed.

CONCLUSIONS

Decreasing depression symptoms and improving coparenting quality can potentially improve father-infant bonding. Fathers' depression symptoms and coparenting quality can be bi-directionally related in the association with father-infant bonding. Early detection and preventive treatments for paternal depression symptoms and coparenting are warranted.

Bidirectional associations between paternal postpartum depression symptoms and coparenting: A cross-lagged panel model of fathers of infants and toddlers

BACKGROUND

Finding modifiable predictors of paternal depression symptoms is helpful for developing interventions. The aim is to assess the unidirectional and/or bidirectional associations between paternal postpartum depression symptoms and coparenting among fathers of infants and toddlers.

METHODS

Longitudinal data were collected prospectively from 429 fathers of infants aged 0-24 months (median = 8 months) in Sweden, with 6- and 18-month follow-ups. All fathers participated in at least two of three waves of data collection, and multiple imputation was used for missing values. The Edinburgh Postnatal Depression Scale was used to detect depression symptoms (≥10 points), while the Brief Coparenting Relationship Scale measured the coparenting relationship. A cross-lagged panel model was used to estimate the associations between paternal depression symptoms and coparenting relationship quality over time, controlling for several known covariates and COVID-19 exposure.

RESULTS

Fathers with higher coparenting scores at Time 1 and 2 had less depression symptoms at Time 3, and fathers with more depression symptoms at Time 2 had lower coparenting scores at Time 3. Plotted probabilities of having at least mild depression symptoms revealed a multifold increase in the probability of depression symptoms at Time 3 for fathers with minimal coparenting scores at Times 1 and 2, respectively, compared to fathers with mean coparenting scores at Times 1 and 2, respectively.

LIMITATIONS

Causal links cannot be determined using the current non-experimental study design. Using the EPDS alone may have missed some fathers with depression symptoms.

CONCLUSIONS

Clinicians seeking to reduce paternal depression symptoms should help strengthen the coparenting relationship.

Coparenting as a mediator between physical custody arrangements and children's mental health

The detrimental effects of parental break-up on children's mental health are well-documented. However, research has also shown that children living in joint physical custody (JPC) arrangements often fare better than children living in sole physical custody (SPC) arrangements. Thus, the question arises: What are the differences between JPC and SPC that account for those results? Drawing on data from the Family Models in Germany (FAMOD) study conducted in 2019, structural equation models (SEM) were estimated to deduct the mediating role of coparenting support in children's mental health in 465 JPC and 652 SPC families with children aged 2-14. The findings suggest that the better mental health observed among children in JPC families than among children in SPC families was fully mediated by coparenting support. However, this held true only for internalizing and externalizing behavior, but not for prosocial behavior as no differences between JPC and SPC were found for this dimension. The findings affirm the importance of supportive coparenting for children's well-being after family dissolution in both SPC and JPC arrangements. After breaking up, parents should be supported in their parental engagement through coparenting counseling or psychoeducation classes.

Ecological factors influencing parenting self-efficacy among working mothers with a child under 36 month old in South Korea: a cross-sectional and correlational study

BACKGROUND

Parenting self-efficacy is an essential component for parents to successfully perform their role and is important for mother and child well-being. To support parenting self-efficacy amongst working mothers, it is necessary to understand the factors influencing parenting self-efficacy amongst this group. However, the majority of previous studies regarding factors influencing parenting self-efficacy did not focus on working mothers. Therefore, this study aimed to identify the factors influencing parenting self-efficacy of working mothers using an ecological framework.

METHODS

The research design was a cross-sectional, correlational study. The participants were 298 working mothers with a child under 3 years of age, who were recruited from ten nurseries. Data were collected from August 8 to September 22, 2017 using structured questionnaires, including the Parenting Sense of Competency scale, a one-item Short Form Health Survey scale, the Maternal Role Satisfaction scale, the Parenting Stress Inventory, the Work and Parent Role Conflict scale, the Parenting Alliance Inventory, the Social Support scale, and the Childbirth and Parenting Friendly System scale. The study process of this study was approved by the Institutional Review Board. Collected data were analyzed by SPSS 23.0 Win program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression.

RESULTS

Working mothers who were the primary caregiver had higher parenting self-efficacy compared to those who were not the primary caregiver (β = .13, p = .022). At the individual level, the higher maternal role satisfaction, the higher parenting self-efficacy of working mothers (β = .27, p < .001). In the micro-system level, higher parenting support by a spouse was associated with higher parenting self-efficacy of working mothers (β = .19, p = .002).

CONCLUSIONS

Educational interventions for increasing the awareness and satisfaction of maternal role and various strategies for fathers' active participation in parenting should be developed. In addition, practical interventions that reduce the burden of parenting while supporting parenting self-efficacy of working mothers who are the primary caregiver should also be considered.

Paternal prevalence and risk factors for comorbid depression and anxiety across the first 2 years postpartum: A nationwide Canadian cohort study

OBJECTIVE

To determine the prevalence of comorbid depression and anxiety symptoms in fathers and investigate the predictors for comorbidity during the first- and second-year following birth.

METHODS

In a longitudinal Canadian study, couples were recruited within 3 weeks of childbirth. Fathers completed a survey after the birth of their child followed by questionnaires at 3, 6, 9, 12, 18, and 24 months postpartum on paternal depression and anxiety symptoms and potential risk factors. Sequential logistic regression was used for analysis.

RESULTS

Of the 3217 enrolled fathers, 2544 (79.08%) provided data for at least one time point during the first year postpartum and 2442 (75.29%) in the second year. Overall, 569 fathers (22.4%) had comorbid depression and anxiety symptoms at some point during the first year postpartum (2.2% at baseline to 8.9% at 6 months), and 323 fathers (13.2%) had comorbidity at some point during their second year postpartum (8.1% at 18 months and 8.6% at 24 months). Strongest risk factors associated with paternal comorbidity were poor or fair perceived health at 4 weeks postpartum, depression before pregnancy, anxiety in the current pregnancy, significant adverse childhood experiences, positive ADHD screen, and victim of intimate partner violence.

CONCLUSION

High rates of comorbidity among fathers in the first 2 years postpartum demonstrate the importance of perinatal mental health management at a family level. The identification of important modifiable comorbidity risk factors highlights areas for further research and the development of interventions to support paternal mental health to optimize child and family outcomes.

The effects of co-parenting/intergenerational co-parenting interventions during the postpartum period: A systematic review

BACKGROUND

Co-parenting interventions have been offered, particularly to enhance paternal involvement in infant care. However, little is known about whether such co-parenting interventions can be effective in improving the psychological health of families and co-parenting outcomes during the postpartum period.

OBJECTIVES

The aim of this review was to examine the effects of interventions on the co-parenting relationship of families, the psychological health of members involved, and on co-parenting outcomes during the postpartum period.

METHODS

This was a systematic review with a meta-analysis. Randomized controlled trials of co-parenting intervention studies were selected following the standardized methods recommended by the Cochrane Handbook for Systematic Reviews of Interventions Version 6. The Cochrane Risk of Bias Assessment tool was used to assess the risk of bias in the included studies.

RESULTS

Twelve co-parenting randomized controlled trials were included in this review. Most studies reported positive effects in promoting at least one domain of co-parenting in mothers and/or fathers, especially in co-parenting support, couple communication, parent-child interactions and reducing co-parenting undermining. Meta-analysis showed that mothers in the intervention group showed significantly lower depressive symptoms compared to those in the control group. The only online co-parenting intervention identified produced similar effects to that of face-to-face interventions on improving co-parenting support, and reducing co-parenting undermining. Only one study focused on parent-grandparent co-parenting, which reported positive effects on 'family management' and 'cooperation in childcare between mothers with depressive symptoms and their 'mother-in-law'. Another study found that significantly more mothers continue to breastfeed in the intervention group compared to the control group at 12 weeks postpartum as a positive outcome in co-parenting.

CONCLUSION

Co-parenting interventions have demonstrated some positive effects on co-parenting support, co-parenting undermining, couple communication, parent-child interactions of parents and the depressive symptoms of mothers. Limited evidence was found on the overall effects on co-parenting, division of labor, childrearing agreement, the psychological health of fathers, parenting self-efficacy and baby feeding practices. Further studies are recommended to examine the effects of interventions for intergenerational (parent-grandparent) families on co-parenting, the psychological health in parenting, parenting self-efficacy and baby feeding practices during the postpartum period by adopting online approaches.

Meta approaches in knowledge synthesis in nursing: A bibliometric analysis

OBJECTIVE

To analyze the bibliometric patterns of meta-approaches use in nursing research literature.

METHODS

Descriptive, exploratory and historical bibliometrics analyses were used. The papers were harvested from the Web of Science Core Collection.

FINDINGS

The search resulted in 2065 publications. The trends in using most individual meta approaches show that the use of meta-analysis is increasing exponentially, the use of meta-synthesis is increasing linearly, while the use of meta-ethnography is constant in last 6 years. Most productive countries were United States of America, United Kingdom and Peoples Republic of China. Most publications were published in the Journal of Advanced Nursing, International Journal of Nursing Studies, and Journal of Clinical Nursing. Twenty-seven percent of all publications were funded. Thirty-four meta approaches were identified.

DISCUSSION

The study revealed that the trend in the literature production is positive. Research community use of meta-approaches in nursing exhibit considerable growth. Regional concentration of literature production was observed.

A Experiência da Coparentalidade na Guarda Compartilhada

Resumo Com o intuito de preservar o exercício da parentalidade por ambos os pais após a separação conjugal, a lei da guarda compartilhada busca favorecer o equilíbrio dos papéis parentais. Contudo, a dinâmica conflituosa do divórcio pode dificultar o exercício da responsabilização parental de forma conjunta. A partir disso, este estudo objetivou compreender a experiência da coparentalidade de pais separados que possuíam a guarda compartilhada do(s) filho(s), por meio de um estudo de casos coletivos com três duplas parentais residentes no interior do Rio Grande do Sul. Os dados obtidos por meio de um questionário sociodemográfico e de uma entrevista semiestruturada foram submetidos à Análise de Conteúdo. Mesmo no caso em que a coparentalidade foi exercida satisfatoriamente no casamento, quando a relação do casal começou a apresent ar conflitos, isso se perpetuou no pós-divórcio e influenciou a relação coparental. Entende-se que aspectos que permeiam a relação conjugal e a coparental são influenciados mutuamente e que a forma como os pais exercem a coparentalidade relaciona-se com o conhecimento e a informação que possuem sobre o assunto. Considera-se que o investimento em programas de intervenções, mediação familiar e psicoterapia podem auxiliar na melhoria do exercício coparental no pós-divórcio.

Improved Child Mental Health Following Brief Relationship Enhancement and Co-Parenting Interventions During the Transition to Parenthood

The transition to parenthood has been identified as a significant relationship stressor. Many couples report declines in relationship satisfaction and difficulty with individual stress and co-parenting-problems that have been associated with both child temperament as well as emotional and behavioral problems. Several parenting and relationship interventions have been developed to buffer against these difficulties. In the current study, we report secondary analyses of a randomized controlled trial of brief (6-hr) interventions that focused on improving either relationship satisfaction or co-parenting, delivered during pregnancy and the early postpartum period. In this trial, 90 opposite-sex couples (180 participants), who were pregnant with their first child, and were assessed as being at high risk for declines in relationship satisfaction, were randomized to receive either (1) a relationship intervention, (2) a co-parenting intervention, or (3) an information control. At 12 months postpartum, couples who received either the relationship or co-parenting intervention rated their infants as having lower negative emotionality and as having fewer externalizing symptoms compared to the information-only control. Lower externalizing symptoms at 12 months were, in turn, associated with reduced externalizing symptoms at 24 months postpartum. Whereas, lower ratings of child negative emotionality at 12 months were associated with reduced internalizing symptoms at 24 months postpartum. These results indicate that brief relationship or co-parenting interventions delivered during the transition to parenthood have secondary benefits for child mental health.

Differential Patterns of the Division of Parenthood in Chinese Family: Association With Coparenting Behavior

The current study explored the division of parenthood in Chinese families with adolescents by identifying the parental involvement patterns in the data obtained from 786 pairs of parents. Division-of-parenthood patterns were created via factor mixture modeling using self-reported three dimensions of father and mother involvement. Three differential division-of-parenthood patterns were identified: (a) parent-cooperation pattern, where moderate and equivalent involvement existed between mothers and fathers; (b) mother-dominated pattern, where mother involvement was particularly greater than father involvement; and (c) father-dominated pattern, where father involvement was particularly greater than mother involvement. Families were more likely to be in the mother- or the father-dominated pattern as their levels of positive coparenting behaviors increased. By contrast, as the levels of paternal conflict behavior increased, families were likely to be in the mother-dominated pattern. This study highlighted parents' individual parenting role, the diverse division-of-parenthood patterns in the family, and the important role of coparenting behavior.