Fathers online: learning about fatherhood through the internet

The transition to fatherhood - evaluation of an online intervention for new fathers

This mixed-methods study explores an innovative online group intervention for new fathers. The specific aims were to investigate attendance rates, fathers' participation experiences, and the effects on their psychological well-being and marital quality. The research design included a randomized controlled trial with 122 participants split into intervention (n = 62) and comparison groups (n = 60). The study measured post-partum depression symptoms (PPD) using the Edinburgh Post-Natal Depression Scale (EPDS) and spousal relationship quality using the Israeli Marital Quality Scale (IMQS). Qualitative data were collected through session transcripts and feedback questionnaires that were completed two years post- intervention. Results reveal an 86.47% average attendance rate in the intervention groups and positive outcomes at both individual and spousal levels. Participants reported feeling a sense of normalcy, decreased loneliness, increased awareness of fatherhood transition, and becoming active co-parents. Marital quality also showed better results for the intervention group. Further research is recommended to explore online group interventions among additional groups of post-partum fathers.

Becoming a father: a qualitative study on the journey to fatherhood

BACKGROUND

The transition to fatherhood represents one of the most significant changes in a man's life and brings many challenges. Despite the great importance of this period, empirical data on it are not abundant, with only a small amount of psychological research on fatherhood available in the Czech Republic; this topic is also rather marginalized abroad. This qualitative study aims to explore men's unique experiences with the process of becoming a father and to understand how paternal identity is shaped.

PARTICIPANTS AND PROCEDURE

Four men who had recently become fathers participated in the research. A semi-structured interview was conducted with each of them.

RESULTS

Using the interpretative phenomenological analysis (IPA) approach, an in-depth analysis of the data identified five significant categories that emerge during the transition to fatherhood: responsibility and commitment to the child, father identity formation, fatherhood and motherhood, changes in the partner relationship and coping with the father role.

CONCLUSIONS

The research suggests that the process of becoming a father is a long-term dynamic process, in which father identity is shaped and consolidated through a variety of situations and experiences. Within this process, paternal identity is also shaped through repeated comparisons and definitions of the role of the mother. Process of becoming a father involves developmental, identity, personality, partnership and family aspects.

Examining online information-seeking behaviours and antenatal anxiety of expectant fathers

This study was designed to examine online information-seeking behaviours of expectant fathers regarding pregnancy and birth and their antenatal anxiety. The present study was conducted using 120 expectant fathers who accompanied their wives to the maternity outpatient clinic in western Turkey, İzmir Province. The fathers' anxiety levels were assessed using a trait anxiety subscale of the State-Trait Anxiety Inventory (STAI), which is a validated test for scoring trait anxiety (basal anxiety, STAI-T). The results showed that 92.5% of the expectant fathers searched for information online during pregnancy. They most frequently searched for the following topics: foetal development, complications to pregnancy and nutrition. The mean total trait anxiety scale score of the expectant fathers was 47.35 ± 6.98 (range = 31-62). The anxiety scores of the expectant fathers who searched for information on topics related to vaccination during pregnancy, exercise, antenatal tests, labour pain and childbirth signs were high. Health professionals should consider the information needs and concerns of expectant fathers during pregnancy while providing family-centred care.

Fathers' perceptions and experiences of support to be a parenting partner during the perinatal period: A scoping review

AIMS AND OBJECTIVES

The aim of this study was to explore fathers' perceptions and experiences of support in the perinatal period. Change in society has seen the increased visibility of fathers being involved during pregnancy and engaging in their infants' lives and the expectation and benefits of men playing an equal and direct role in caring for their children. However, less is known about the nature of support that fathers require to facilitate this role transition.

DESIGN

A scoping review was conducted in accordance with Arksey and O'Malley's six-step scoping review framework and the PRISMA-ScR guidelines.

METHODS

A systematic search of CINAHL Plus, MEDLINE, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology, Soc INDEX and Behavioural Sciences Collections databases for qualitative or mixed methods studies with qualitative data was undertaken. Qualitative data were extracted from original studies for coding and theme generation. Thematic synthesis was employed for the final stages of analysis.

RESULTS

Overall, 23 papers were included. Men desired to fulfil their rite of passage to be an involved father to their child. This transitional process commenced with men articulating their commitment to creating a role as an involved father and to be a role model for their children. Becoming a father is seen as having a significant status in society which contributes to their self-efficacy as fathers.

CONCLUSION

Fathers require support from all levels of the 'ecosystem' including policy, socio-cultural and workplace changes as well as recognition and support from partners, family, peers and in particular from health service providers. Developing the parenting partnership requires a co-production approach and commitment at macro, meso and micro levels.

RELEVANCE TO CLINICAL PRACTICE

Supporting men to be engaged fathers requires policy, socio-cultural and workplace changes; however, maternity services and particularly midwives have an important role in this change.

Does Antenatal Education Affect Level Of Empathy And Attachment Of Fathers?

OBJECTIVE

The study aimed to determine the effects of antenatal education on the paternal bonding and empathic tendency levels of men who would become fathers for the first time.

BACKGROUND

There are a limited number of studies in the literature that have investigated the effects of antenatal education programmes on fathers.

METHODS

This prospective, controlled quasi-experimental study was conducted in a hospital in Istanbul. The men in the antenatal educational group (EG) and their wives participated in training in antenatal classes. The men in the control group (CG) came for routine prenatal follow-up examinations with their wives. The Empathic Tendency and Paternal Postnatal Attachment Scales were used to collect the data.

RESULTS

The Empathic Tendency Scale was applied before the education (1) - after the education (2) and at the 6th postpartum week (3), whilst the Paternal Postnatal Attachment Scale was used at the 6th postpartum month (4). EG had higher emphatic tendency levels in the 2nd and 3rd measurements and higher paternal bonding levels in the 4th measurement in comparison to CG (p < 0.05).

CONCLUSION

Antenatal education increased the emphatic tendency of the fathers and the effects of this education continued in the postpartum period and affected paternal bonding positively.

Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact

BACKGROUND

There is growing evidence for the value of technology-based programs to support fathers to make positive transitions across the perinatal period. However, past research has focused on program outcomes with little attention to the mechanisms of impact. Knowledge of why a program works increases potential for replication across contexts.

METHODS

Participants were 40 Australian fathers enrolled in the SMS4dads text-based perinatal support program (Mean age 35.11 (5.87). From a starting point between 16 weeks gestation and 12 weeks postpartum, they were sent a maximum of 184 text messages. An inductive approach was used to analyse post-program semi-structured interviews. The aim was to identify mechanisms of impact aligned to previously identified program outcomes, which were that SMS4dads: 1) is helpful/useful; 2) lessens a sense of isolation; 3) promotes the father-infant relationship; and 4) supports the father-partner relationship.

RESULTS

We identified two types of mechanisms: four were structural within the program messages and five were psychological within the participant. The structural mechanisms included: syncing information to needs; normalisation; prompts to interact; and, the provision of a safety net. The psychological mechanisms were: increase in knowledge; feelings of confidence; ability to cope; role orientation; and, the feeling of being connected. These mechanisms interacted with each other to produce the pre-identified program outcomes.

CONCLUSIONS

If the current findings are generalisable then, future mobile health program design and evaluation would benefit from explicit consideration to how both program components and individual cognitive and behavioural processes combine to elicit targeted outcomes.

Exploring the Transition to Fatherhood: Feasibility Study Using Social Media and Machine Learning

BACKGROUND

Fathers' experiences across the transition to parenthood are underreported in the literature. Social media offers the potential to capture fathers' experiences in real time and at scale while also removing the barriers that fathers typically face in participating in research and clinical care.

OBJECTIVE

This study aimed to assess the feasibility of using social media data to map the discussion topics of fathers across the fatherhood transition.

METHODS

Discussion threads from two Web-based parenting communities, r/Daddit and r/PreDaddit from the social media platform Reddit, were collected over a 2-week period, resulting in 1980 discussion threads contributed to by 5853 unique users. An unsupervised machine learning algorithm was then implemented to group discussion threads into topics within each community and across a combined collection of all discussion threads.

RESULTS

Results demonstrated that men use Web-based communities to share the joys and challenges of the fatherhood experience. Minimal overlap in discussions was found between the 2 communities, indicating that distinct conversations are held on each forum. A range of social support techniques was demonstrated, with conversations characterized by encouragement, humor, and experience-based advice.

CONCLUSIONS

This study demonstrates that rich data on fathers' experiences can be sourced from social media and analyzed rapidly using automated techniques, providing an additional tool for researchers exploring fatherhood.

Fathers' experiences of care when their partners suffer from peripartum cardiomyopathy: a qualitative interview study

Background

Peripartum cardiomyopathy (PPCM), a potentially life-threatening condition in women, can have a profound impact on the family. Although structured support systems are developed, these systems tend to be based on the healthcare providers’ perceptions and focus mainly on mothers’ care. Fathers’ vital role in supporting their partners has been advocated in previous research. However, the impact of PPCM on the male partners of women is less understood. The aim of this study was to explore the experiences of healthcare in fathers whose partner was suffering from peripartum cardiomyopathy.

Methods

The data from interviews with fourteen fathers were analysed using inductive content analysis.

Results

An overarching category “The professionals could have made a difference” was identified from the data, characterised by the sub-categories: ‘To be informed/not informed,’ ‘To feel secure/insecure,’ ‘To feel visible/invisible’ and ‘Wish that it had been different’. Lack of timely information did not allow fathers to understand their partner´s distress, and plan for the future. The birth of the child was an exciting experience, but a feeling of helplessness was central, related to seeing their partner suffering. A desire for follow-up regarding the effect of PPCM on themselves was expressed.

Conclusions

When men, as partners of women with PPCM, get adequate information of their partner´s condition, they gain a sense of security and control that gives them strength to handle their personal and emotional life-situation during the transition of becoming a father, along with taking care of an ill partner with PPCM. Hence, maternity professionals should also focus on fathers’ particular needs to help them fulfil their roles. Further research is urgently required in this area.

Impacts of online and group perinatal education: a mixed methods study protocol for the optimization of perinatal health services

Background

Prenatal education is a core component of perinatal care and services provided by health institutions. Whereas group prenatal education is the most common educational model, some health institutions have opted to implement online prenatal education to address accessibility issues as well as the evolving needs of future parents. Various studies have shown that prenatal education can be effective in acquisition of knowledge on labour and delivery, reducing psychological distress and maximising father’s involvement. However, these results may depend on educational material, organization, format and content. Furthermore, the effectiveness of online prenatal education compared to group prenatal education remains unclear in the literature. This project aims to evaluate the impacts of group prenatal education and online prenatal education on health determinants and users’ health status, as well as on networks of perinatal educational services maintained with community-based partners.

Methods

This multipronged mixed methods study uses a collaborative research approach to integrate and mobilize knowledge throughout the process. It consists of: 1) a prospective cohort study with quantitative data collection and qualitative interviews with future and new parents; and 2) a multiple case study integrating documentary sources and interviews with stakeholders involved in the implementation of perinatal information service networks and collaborations with community partners. Perinatal health indicators and determinants will be compared between prenatal education groups (group prenatal education and online prenatal education) and standard care without these prenatal education services (control group).

Discussion

This study will provide knowledge about the impact of online prenatal education as a new technological service delivery model compared to traditional group prenatal education. Indicators related to the complementarity of these interventions and those available in community settings will refine our understanding of regional perinatal services networks. Results will assist decision-making regarding service organization and delivery models of prenatal education services.

Protocol version

Version 1 (February 9 2018).

Fathers' Worries During Pregnancy: A Qualitative Content Analysis of Reddit

Qualitative investigations into the emotional needs of expectant fathers have been limited by difficulties with recruitment. This study aimed to unobtrusively obtain insights into fathers' worries during pregnancy by analyzing the content of posts on the Internet forum Reddit. The majority of worries related to infant well-being (50.8%), particularly the potential for perinatal loss (23.0%). Concerns relating to partner well-being and the couple relationship were also common, comprising 17.0% of posts. Several posts related to individual factors, such as apprehension about the father role (16.3%). Finally, situational factors such as work-family conflict accounted for 15.9% of posts. These findings contribute to the growing literature on fathers' experiences of pregnancy and can inform the development of father-inclusive perinatal education.

[Translation and validation in French of the First-Time Father Questionnaire]

OBJECTIVES

For fathers, being present at a birth for the first time is not an insignificant event. Witnessing suffering can cause feelings of loneliness and powerlessness, which may be associated with postnatal problems such as depression. However, without a confirmed French-language tool concerning the experience of childbirth for fathers, we are limited in our ability to develop our understanding of their experiences and establish links between these experiences and their distress (anxiety, depression, etc.), or to develop appropriate methods of support. Our objective has been to translate and validate the Swedish "First-Time Father Questionnaire" with a French-speaking sample.

METHODS

The tool was translated using a translation/backtranslation process (using two independent agencies, with a pre-test on 30 new fathers as well as exchanges with the Swedish authors). The French version was then tested with 154 new fathers at 1 month post-partum. Factorial analysis followed by multi-trait analysis and variance analyses were conducted, with subgroups contrasted according to the mode of delivery.

RESULTS

The factorial structure is satisfactory, retaining 19 items and reproducing 54.12% of variance. Professional support, worry, and prenatal preparation constitute the 3 dimensions of this. Internal consistency, homogeneity, and the discriminating capacity of the questionnaire are good.

CONCLUSION

Validation of the questionnaire shows good metrological qualities. It can therefore be used in the perinatal field to evaluate the childbirth experience for first-time fathers.

The Ebb and Flow of Filipino First-Time Fatherhood Transition Space

Fatherhood, as a developmental process, is both a human experience and a text that needs to be read. For developing nations like the Philippines, little is known about the process undergone by first-time fathers on their transition to fatherhood, and how nurses can play a significant role in assisting them. This grounded theory study purported to conceptualize the multifaceted process of transition from the lens of Filipino first-time fathers’ lived experiences. A total of 20 first-time fathers from Metro Manila, Philippines, were purposively selected to take part in an individual, semistructured, and in-depth interview. The Glaserian (classical) method of analysis was specifically used, and field texts were inductively analyzed using a repertory grid. Member checking and correspondence were done to validate the findings of the study. Six surfacing stages emerged relative to the process of transition. Interestingly, The B.R.I.D.G.E. Theory of First-Time Fatherhood Transition Space describes how these fathers progress from the beholding, reorganizing, inhibiting, delivering, grasping, and embracing phases toward successful transition. This emerged theoretical model can be used in framing health care programs where the needs of fathers during this period are met and addressed. Finally, it can also be used in guiding nurses in their provision of a more empathetic care for first-time fathers.

A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD

Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies.

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.

Fathers' experiences of supporting breastfeeding: challenges for breastfeeding promotion and education

Increasing breastfeeding rates is a strategic priority in the UK and understanding the factors that promote and encourage breastfeeding is critical to achieving this. It is established that women who have strong social support from their partner are more likely to initiate and continue breastfeeding. However, little research has explored the fathers' role in breastfeeding support and more importantly, the information and guidance he may need. In the current study, 117 men whose partner had given birth in the previous 2 years and initiated breastfeeding at birth completed an open-ended questionnaire exploring their experiences of breastfeeding, the information and support they received and their ideas for future breastfeeding education and promotion aimed at fathers and families. Overall, the findings showed that fathers were encouraging of breastfeeding and wanted to be able to support their partner. However, they often felt left out of the breastfeeding relationships and helpless to support their partner at this time. Many reported being excluded from antenatal breastfeeding education or being considered unimportant in post-natal support. Men wanted more information about breastfeeding to be directed towards them alongside ideas about how they could practically support their partner. The importance of support mechanisms for themselves during this time was also raised. The results highlight the need for health professionals to direct support and information towards fathers as well as the mother-infant dyad and to recognise their importance in promoting and enabling breastfeeding.

[Effects of newborn care education for first-time fathers on their knowledge and confidence in newborn care at postpartum one month]

PURPOSE

This study was conducted to identify the effects of newborn care education for fathers on their knowledge and confidence in newborn care at postpartum one month.

METHODS

A nonequivalent control group pretest posttest design was used. The participants were 53 first-time fathers of newborns, 27 in experimental group, and 26 in control group. They were recruited at the nursery of one municipal hospital in Seoul. For the experimental group, a 50-minute education on newborn care using video, verbal education, demonstration and practice were provided prior to discharge. Fathers' knowledge and confidence in newborn care and their satisfaction with the education program were measured at postpartum one month.

RESULTS

The fathers in the experimental group showed significantly higher knowledge (t=-4.51, p<.001), and confidence in newborn care (t=-2.29, p=.026) compared to the control group at postpartum one month. Fathers in the experimental group had a satisfaction score of 27.37±2.73 immediately after the education, and 25.30±3.40 at postpartum one month.

CONCLUSION

Results indicate that newborn care education for first-time fathers is an effective method in enhancing the level of knowledge and confidence in newborn care. It can be used in the nursery department before discharge as a useful nursing intervention.

Men's Experiences of Grandfatherhood: A Welcome Surprise

The present-day involvement of men in many facets of childrearing stands in contrast to previous eras when men accepted that the major task of fathering was to provide a secure income to support the family. This imperative often required long hours away from the family. However, when men whose contact with children has been limited due to work and cultural constraints retire, their newly acquired lifestyle may bring fresh opportunities for involvement with grandchildren. An important question therefore concerns the impact of caring for young children on men's perceptions of their role as grandfathers. This interview study explores the experiences of 19 Australian grandfathers. The analysis found themes that relate to relationships and change, as well as themes concerning core beliefs and existential questions. The findings demonstrate the potential for insight into family relationships and personal growth in older age when studying the topic of grandparenting and caring from the male perspective.

Internet-based peer support for parents: a systematic integrative review

OBJECTIVES

The Internet and social media provide various possibilities for online peer support. The aim of this review was to explore Internet-based peer-support interventions and their outcomes for parents.

DESIGN

A systematic integrative review.

DATA SOURCES

The systematic search was carried out in March 2014 in PubMed, Cinahl, PsycINFO and Cochrane databases.

REVIEW METHODS

Two reviewers independently screened the titles (n=1793), abstracts and full texts to decide which articles should be chosen. The inclusion criteria were: (1) an Internet-based community as an intervention, or at least as a component of an intervention; (2) the participants in the Internet-based community had to be mothers and/or fathers or pregnant women; (3) the parents had to interact and communicate with each other through the Internet-based community. The data was analysed using content analysis. When analysing peer-support interventions only interventions developed by researchers were included and when analysing the outcomes for the parents, studies that focused on mothers, fathers or both parents were separated.

RESULTS

In total, 38 publications met the inclusion criteria. Most of the studies focused on Internet-based peer support between mothers (n=16) or both parents (n=15) and seven focused on fathers. In 16 studies, the Internet-based interventions had been developed by researchers and 22 studies used already existing Internet peer-support groups, in which any person using the Internet could participate. For mothers, Internet-based peer support provided emotional support, information and membership in a social community. For fathers, it provided support for the transition to fatherhood, information and humorous communication. Mothers were more active users of Internet-based peer-support groups than fathers. In general, parents were satisfied with Internet-based peer support. The evidence of the effectiveness of Internet-based peer support was inconclusive but no harmful effects were reported in these reviewed studies.

CONCLUSIONS

Internet-based peer support provided informational support for parents and was accessible despite geographical distance or time constraints. Internet-based peer support is a unique form of parental support, not replacing but supplementing support offered by professionals. Experimental studies in this area are needed.