Developing an intervention for paternal perinatal depression: An international Delphi study

Abstract

• Key components of an intervention for paternal perinatal depression were explored. • A strengths-based approach is important when working with fathers. • Interventions should be framed around fatherhood rather than depressive symptoms. • Relationships and physical health are key components to be included. • System-wide barriers to help-seeking need to be overcome to support access to interventions. Around 10% of fathers suffer from depression during the perinatal period. There is a need to develop interventions which address the specific needs of fathers in order to reduce the burden on men and their families. This study aimed to achieve expert consensus about the components of a CBT-based intervention for paternal perinatal depression using the Delphi method. Ten international experts, recruited through purposive sampling, completed an online survey. This included an initial round of open-ended questions about the potential components and targets of an intervention, followed by a second round of scale questions to identify components with the greatest agreement across experts. Free-text responses from round 1 covered a range of social, psychological and behavioural factors which could be targeted in an intervention for paternal depression. These were analysed using thematic analysis, and the resulting 82 codes were presented to respondents in round 2 as summary statements. 42 (52%) items reached consensus to include in an intervention. Only two rounds were used, reducing opportunities to revise responses; one question produced very divergent types of responses which could not easily be summarised; some have argued there may be issues with representativeness of small samples of experts. Experts highlighted the importance of a strengths-based approach, with content framed around learning about fatherhood rather than overcoming symptoms of depression, including a focus on the partner relationship, understanding infant development, and social connections. These findings will contribute to the development of an intervention for paternal perinatal depression.