Father Support Research Articles

Racial socialization and perceived social support for African American fathers in academia

AbstractObjectiveThe purpose of this study was to understand the role that racial socialization plays in African American fathers' abilities to balance the responsibilities of being productive scholars and active parents and understand how racial socialization affects the perceived social support in the home and work environments.BackgroundThough there is research on the microaggressions and implicit bias that African American faculty face, there is little research that specifically details the experiences of those balancing both the father and faculty member roles.MethodData were collected using semistructured interviews with 20 African American fathers who were employed as faculty members at various institutions in the United States. Additionally, I explored how the murders related to the #SayTheirName movement influenced conversations fathers had with their children related to racial socialization and anti‐Black racism in the United States.ResultsParticipants noted that they experienced microaggressions in their academic environments. They were perceived as intimidating or characterized as the Angry Black Man. These perceptions were sources of mundane extreme environmental stress for participants. An emergent finding related to social support and work–life balance was that most study participants were members of Black Greek Letter Organizations (BGLOs) and found instrumental, informational, and emotional social support from these relationships.ConclusionRacial socialization received in their upbringing was a source of self‐efficacy for some participants. Additionally, perceived social support from the home and work environment was important for the participants' individual development, yet it was not the primary factor that influenced their work–life balance.

Facilitators and Constraints: Toward an Understanding of Fathers’ Involvement in Their Children’s Youth Programs

A challenge for park and recreation youth programming is adequate adult support for programming facilitation. Many recreation programs, whether municipal or private organizations, struggle to attract and retain volunteer coaches, particularly fathers. In recognition of this challenge, we aimed to learn more about this challenge by comparing fathers’ and practitioners’ experiences with youth programming. In particular, we wanted to learn more about the constraints and facilitators to fathers’ engagement in youth programming leadership. Working and fathering both require time that can be in conflict with one another when it comes to father involvement. However, McGill (2014) suggests that work does not have a negative relationship with time for leisure even though at times work may be seen as a barrier to leisure. While fathers do not report diminished time for leisure, they do report a negative relationship between work and physical care for children (McGill, 2014). Fathers, whether employed or not, who feel that they play a significant role in their children’s development, are likely to preserve time in their day for engagement with their children. Those that feel they play a key role and have a responsibility to be involved in child development are likely to reduce their personal leisure time to be more engaged in their children’s leisure time (McGill, 2014). The concepts of constraints (Jackson, 1991) and facilitators (Raymore, 2002) were employed in this project. As a result, the purpose of this study was to better understand what facilitators and constraints are experienced by fathers when it comes to their engagement in youth programs of their children. More specifically, the objectives of the study were to explore: a) what facilitates fathers' involvement in their children’s youth programs, as perceived by fathers and youth program professionals; b) what constrains fathers’ involvement in youth programs, as perceived by fathers and youth program professionals. Our results suggest that a more concerted effort to recruit, train, and support fathers as volunteer program leaders is needed to address the concern about limited participation among fathers in their children’s leisure and recreation programs.

The Effect of Parenting and the Parent-Child Relationship on a Child's Cognitive Development: A Literature Review.

Various studies have been done on subjects such as parenting, parent-child relationships, parenting style, effortful parenting, the concept of parenting, the cognitive development of children, and the cognition of parents. This research is mainly based on parenting practice, child development, and maturation. Children's cognitive development starts in the first year of life and then progresses gradually. Children require positive parenting in painful and different situations. Parenting gives a child the confidence to face crucial, challenging problems. Sensitive parenting and caregiving are required for the child's maturity and cognitive development. Media has been observed to be essential in improving parenting practices. Children exhibit internalizing and externalizing symptoms as a result of harsh, aggressive, and intrusive parenting. According to the data, it is seen that the risk of depression increases in adolescence. The main reason for the rise in depression in children is the non-cooperation and support of mothers and fathers. The risk of depression decreases in children whose mothers and fathers are cooperative and supportive. While family and social stress increase the chances of depression in children, a negative parenting style means children face family and social anxiety. Due to the high level of hostile parenting and low level of positive parenting, they experience stress, peer pressure, and social and family relationship problems. Another excellent term for effortful control parenting is required for children's cognitive development. Parenting is necessary for the regulation of emotions and behavior. There are many problems seen in infancy, early childhood, and late childhood. There are four types of parenting styles seen: authoritative parenting, authoritarian parenting/controlling parenting, permissive parenting/indulgent parenting, and uninvolved parenting/neglecting to parent. Good parenting requires one to know the concept of good parenting, the idea of parenting, the importance of parenting and children's needs, the components of parenting, and the consequences of parenting.

P5 - Expectant and new fathers’ health literacy and engagement in maternity and early infant health services

Fathers’ participation in antenatal and postnatal (perinatal) health services is widely recommended, yet rarely achieved at desired levels. One barrier may be health services’ poor understanding of fathers’ health literacy. This study aimed to investigate (a) health literacy strengths and barriers, and (b) associations between health literacy and health service engagement, among expectant and new fathers, to inform the development of more father-inclusive health services. Cross-sectional study. Expectant and new fathers (infants born since 2020) were recruited in August 2021 through Prolific, an international paid online survey platform. The survey included the Health Literacy Questionnaire (HLQ) which encompasses nine conceptually distinct dimensions of health literacy, and questions about fathers’ engagement with perinatal health visits. Surveys were completed by 889 men (46.8% with pregnant partners, 53.2% with infants up to 18mnths). Respondents resided in the USA (30.9%), UK (27%), South Africa (17.5%) and other countries (24.7%). Highest HLQ scores among respondents were in Scale 9: ‘Understanding health information enough to know what to do’ (Mean 4.13, scale range 1-5) and Scale 8 ‘Ability to find good health information’ (Mean 4.05, scale range 1-5). Lowest HLQ scores were seen for Scale 3 ‘Actively managing my health’ (Mean 2.94, scale range 1-4), and Scale 1: ‘Feeling understood and supported by health care providers’ (Mean 2.96, scale range 1-4). Most fathers (81.8%) attended at least half of health visits with their partners/infants; regular attendance was associated (p<0.01) with higher scores on seven HLQ subscales. Expectant and new fathers report good basic, functional health literacy skills but face barriers to engaging actively in their healthcare. Health services should consider ways to improve their support for fathers. These data can inform tailored health information and engagement strategies for fathers, with potential long-term benefits for fathers, partners and infants.

Fathers' experience of depression during the perinatal period: a qualitative systematic review.

The objective of this review was to understand fathers' experiences of depression in the perinatal period, including how they recognize their depression, the emotions they experience, the impact of depression on their relationships, and their help-seeking behaviors and support. Whilst the prevalence of perinatal depression in men is now estimated to be just below that in women, no current care pathways exclusively for affected men exist in the United Kingdom. However, evidence demonstrates that paternal depression has severe consequences, affecting men's relationships with their partners and infants, their parenting behaviors, and the well-being of their children. This demonstrates a need to focus on the paternal experience of depression during this stage of life. This review included qualitative studies that included biological fathers over the age of 18 years. The phenomenon of interest was depression or mental distress in fathers within the context of the perinatal period. All qualitative designs were included in the study with a focus on lived experiences of fathers. Searches for existing systematic reviews were carried out in March 2021 and no similar protocols or completed reviews were identified. Seven databases were searched in August 2021: MEDLINE, CINAHL, PsycINFO, Scopus, ProQuest Sociology, ProQuest Dissertations and Thesis Global, and OpenGrey. Search limits included English language and Organisation for Economic Co-operation and Development (OECD) countries. Two reviewers assessed methodological quality. A standardized data extraction tool was used to extract and synthesize data. Confidence in the findings was subsequently assessed. Nine studies were included after full-text review that were considered relevant to the research questions and that focused on fathers' experiences (n = 138), although only two focused specifically on depression. The overall quality of the studies was moderate. Overall, 109 findings were collated into 22 categories producing six synthesized findings. These were mental health literacy around paternal perinatal depression is poor among men; relationships are experienced as both comforting and distressing in the perinatal period; fathers in the perinatal period do experience depression, but this is avoided, normalized, or hidden; fathers feel judged about mental health difficulties and so are reluctant to disclose them; help-seeking in fathers is prevented by non-targeted support for fathers; and all men have the potential to struggle because fatherhood is challenging. The review found that fathers may experience depression and negative emotions around the time their child is born, including anger, irritability, and resentment of the child. Men found their relationship changes difficult, feeling that fatherhood did not seem real until the baby was born. There was a significant lack of father-focused support for men, who were aware of stigma and social expectations of them. Men were not eager to seek help for their feelings, in part due to prioritizing the needs of the mother (and child) as more important. There is a need for greater attention on paternal perinatal depression through research and practice. PROSPERO CRD42021245894.

Supporting Fathers to Prevent Child Maltreatment: How Paid Family Leave and Child Care Subsidies are Part of a Public Health Approach.

There are multiple components of a public health approach for preventing child maltreatment. One of these components is the question of who to intervene with. Fathers are an under-targeted and under-studied group for child maltreatment prevention. In this conceptual article, we describe a public health approach for intervening with fathers. Acknowledging financial stress as a key risk factor for child maltreatment among fathers, we explore two policy interventions that aim to increase economic support for families during the early years of a child's life: paid family leave and child care subsidies. During the weeks following the child's birth, paid family leave can promote child-father bonding and enable fathers to engage in more caregiving during a critical family transition. After paid family leave ends, child care subsidies can make child care affordable for families with low income, thereby promoting parents' employment and earnings. We conclude by highlighting ways in which fathers can take an active role in preventing child maltreatment.

Depressive Symptoms in Fathers during the First Postpartum Year: The Influence of Severity of Preterm Birth, Parenting Stress and Partners' Depression.

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants’ birth weight categories, fathers’ EPDS scores at 3 and 9 months, Parent–Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth.

Gravens By Design: Supporting Fathers in the NICU

Gravens By Design: Supporting Fathers in the NICU

Support for Mothers, Fathers, or Guardians of Transgender Children and Adolescents: A Systematic Review on the Dynamics of Secondary Social Networks.

Mothers’, fathers’, or guardians’ support for disclosures of diverse gender identity has significant relationships with decreased suicidality for transgender children and adolescents. They play an essential role in facing transphobia, protecting trans children, and strengthening the expression of their identity. These guardians need structural, emotional, and informative support; they need to be prepared to recognize and manage of their own feelings, as well as deal with the challenges that come with new social contexts of transphobia in schools, health institutions, and other community spaces. This study aimed to analyze the scientific evidence on the dynamics of secondary social networks to support mothers, fathers, or guardians of transgender children and adolescents. This is a systematic review of qualitative studies, guided by PRISMA guidelines. Controlled and free vocabularies were used to survey the primary studies in the following databases: EMBASE; Scopus; MEDLINE; Cumulative Index to Nursing and Allied Health Literature (CINAHL); PsycInfo; Latin American and Caribbean Literature in Health Sciences (LILACS); and Web of Science. A total of 28 articles made up the final sample of this review. Secondary social networks were described as fragile, characterized by conflicting and broken ties with healthcare services and professionals, isolation and unpreparedness from schools, and emotional and informational support from peer groups and some qualified healthcare professionals. The literature shows the potential of the dynamics of secondary social support networks; however, it presented the unpreparedness of professionals and institutional policies for welcoming transgender children and adolescents and their families, with the peer group being the main emotional and informative support network.

The Effect of a Father's Support on Breastfeeding: A Systematic Review.

Aim: Including fathers in breastfeeding education programs may raise infant breastfeeding rates and durations. The aim of the study was to assess the effect on breastfeeding of breastfeeding education and/or psychosocial interventions in which fathers are included. Method: The study is based on the PRISMA method, the technique that is used in systematic reviews. A search was conducted in the literature over the period November 1, 2021-December 1, 2021 using keywords and without imposing any time restrictions. The databases "PubMed," "Web of Science," Scopus," "Medline," and "CINAHL" were scanned. Results: A total of 462 publications were reached. However, only 7 studies were considered for review on the basis of the inclusion criteria. Six of these 7 studies indicated that the support of the father increased the breastfeeding rate. Conclusions: This review shows that a father's support of breastfeeding improves breastfeeding outcomes. Including fathers in the breastfeeding process and ensuring their active participation increase breastfeeding rates.

Stakeholder engagement in developing a father-inclusive early life obesity prevention intervention: First Heroes

BackgroundAlthough paternal involvement in the perinatal period is associated with benefits for maternal-child health and reduced obesity risk, fathers are seldom included in perinatal or obesity prevention efforts. Engaging community leaders and fathers as stakeholders in intervention development is a critical step in designing a father-inclusive intervention that is efficacious and responsive to their needs.MethodsWe conducted a structured engagement study, including community stakeholder engagement and qualitative interviews with new fathers, to inform the development of a prospective randomized controlled trial that includes mothers and fathers as equal partners in infant obesity prevention. We interpreted stakeholder feedback through the Consolidated Framework for Implementation Research (CFIR) framework.ResultsBetween September 2019 and April 2020, we held a Community Engagement meeting, formed a Community Advisory Board, and conducted 16 qualitative interviews with new fathers. Stakeholder engagement revealed insights across CFIR domains including intervention characteristics (relative advantage, complexity, design quality & packaging), outer setting factors (cosmopolitanism and culture), individual characteristics (including self-efficacy, state of change, identification with the organization) and process (engagement and adaptation). Stakeholders discussed the diverse challenges and rewards of fatherhood, as well as the intrinsic paternal motivation to be a loving, supportive father and partner. Both community leaders and fathers emphasized the importance of tailoring program delivery and content to meet specific parental needs, including a focus on the social-emotional needs of new parents.ConclusionsA structured process of multidimensional stakeholder engagement was successful in improving the design of a father-inclusive perinatal obesity prevention interventions. Father engagement was instrumental in both reinforcing community ties and increasing our understanding of fathers’ needs, resulting in improvements to program values, delivery strategies, personnel, and content. This study provides a practical approach for investigators looking to involve key stakeholders in the pre-implementation phase of intervention development.Trial registrationClinicalTrials.gov, NCT04477577. Registered 20 July 2020.

Residency training experiences of residents with children: A phenomenological study

ABSTRACT Parenthood during postgraduate medical training has become an increasingly relevant topic in recent years. While previous research has attempted to explore the experiences of residents in a parenting role through surveys and limited qualitative studies, an in depth understanding of the postgraduate training experience of these parent residents has not been clearly described. The optimal means of supporting trainees completing residency while parenting remains unclear. The study aim was to develop a rich understanding of the residency training experience of residents in a parenting role. We conducted 15 semi-structured telephone interviews. Our study population included postgraduate trainees from 9 different programs from a large research-intensive university who were parents upon entry to residency or who became parents during residency training. Transcendental phenomenology was used as a qualitative research methodology, guided by life course theory. Thematic analysis of residents’ training experiences revealed the following themes: 1) challenges of being a parent with residency responsibilities; 2) work-life balance; 3) support systems; 4) impact on patient interactions; 5) impact on other interactions; and 6) unspoken expectations. Participants suggested actionable solutions to improve the training experience for residents in a parenting role, which included: 1) family-inclusive events; 2) scheduling flexibility; 3) support for fathers; and 4) optimizing support for breastfeeding mothers. Residents in a parenting role represent a unique postgraduate trainee population. Despite focus on resident wellness, challenges remain for individuals trying to navigate parenthood and residency. This data may be utilized to inform support and strategies to optimize the training experiences of these residents.

Postpartum depression and social support: A longitudinal study of the first six months as parents.

The study aimed to (1) investigate the changes in maternal and paternal depression, along with social support, across the 6-month postpartum period; (2) explore the relationships between maternal and paternal depression and social support during the 6-month postpartum period; and(3) compare the differences in postpartum depression and social support between mothers and fathers at 2-3 days, 6 weeks, 3 months and 6 months postpartum. An increasing body of evidence now shows that postpartum depression affects both mothers and fathers. The notable increase in postpartum depression in China is particularly concerning. A longitudinal study was conducted, guided by the STROBE checklist. 122 pairs of parents were recruited from September 2020 to October 2021 at a teaching hospital in Guangzhou, China. Data were collected from each parent at 2-3days, 6weeks, 3months and 6months postpartum, using the Edinburgh Postnatal Depression Scale and the Social Support Rating Scale. We also acquired socio-demographic and obstetric data at 2-3days postpartum. Maternal depression was lowest at 2-3days postpartum compared with that measured at 6weeks, 3months and 6months postpartum. Maternal and paternal social support was highest at 2-3days postpartum compared with that measured at 6weeks, 3months and 6months postpartum. Maternal depression was significantly correlated with paternal depression while maternal social support was significantly correlated with paternal social support at different time points. Postpartum depression in mothers and social support in both mothers and fathers, showed significant changes during the 6-month postpartum period. Healthcare providers should pay attention to the mental health of both parents, view them as a team and provide both family-based and women-cantered interventions.

Protective and risk factors associated with involved fatherhood in a traditional culture

AbstractObjectiveConsistent with ecological systems theory and the heuristic model of parental behavior dynamics, the current study is focused on both individual and contextual factors that determine fatherhood involvement in the context of a traditional patriarchal culture.BackgroundFather–child interaction during the early childhood period is a salient factor in predicting later child outcomes. However, studies on antecedents of involved fatherhood are scarce, mostly concentrated on one aspect of fathering behavior, and limited to few cultural contexts.MethodData were collected from a representative urban sample of fathers of preschoolers in Turkey (N = 1,070). Different components of fatherhood involvement were assessed to project three distinct paternal behavior dimensions as care, affection, and control.ResultsFather role satisfaction, psychological value attributed to the child, and perceived family support were positively associated with involved fatherhood and higher parental warmth. Working hours per day was negatively associated with involved fatherhood, as expected. Higher life satisfaction was associated with higher positive parenting. Patriarchal views of masculinity were found to be the main predictor of parental physical punishment, controlling for all other predictors in the model.ConclusionStudy findings emphasized the importance of factors other than parenting skills that contribute to fathers' parental effectiveness.ImplicationsOur study's findings have implications for family practices and policies. For example, besides parenting skills, father support programs should also focus on other factors such as developing awareness of traditional masculinity norms and gender role prescriptions that can harm democratic family environments and childcare practices.

The correlation between spousal support and postpartum depression in fathers.

This study was conducted using a descriptive design to examine the correlation between spousal support and postpartum depression (PPD) in fathers. The participants of the study were the fathers of infants born in the obstetrics and gynecology clinic of a state hospital affiliated with the Ministry of Health in a province in Turkey. It was determined that while the possibility of paternal PPD was lower in the early postpartum period (p < 0.001), it increased in the late postpartum period (p < 0.001). A negative statistically significant correlation was identified between the Edinburgh Postnatal Depression Scale (EPDS) scores and the Spouse Support Scale (SSS) scores of the participants in the early postpartum period (p = 0.031). There was a highly negative significant correlation between late postpartum EPDS scores and the early (p < 0.001) and late period (p < 0.001) SSS scores. A highly negative significant correlation was observed between the mean score of the early spousal support period and the mean score of the late spousal support period (p < 0.001). In this study, spousal support decreased PPD in fathers. This study indicated the necessity of routinely screening men for PPD symptoms. Early diagnosis and spousal support would contribute to reducing early and late paternal PPD, thus protecting the family's integrity.

“She is Always Doing the Work"

Marianismo is a term that refers to the prioritization of Latina mothers in regard to their children and families. In defining as such, this term acknowledges how selfless Latina mothers are. This study utilized an adapted version of Narrative Analysis to explore the insights of Latino adolescent mentees when it comes to their experiences living with a single mother. Specifically, the participants’ narratives included their highly positive relationships with their mothers who exhibit many admirable qualities, they spoke about their varying relationships with their biological fathers, and they also discussed helpful, supportive father figures (i.e., natural mentors) in their lives. The Discussion section relates the study’s findings to Attachment Theory and Social LeMarianismo refers to the prioritization of Latina mothers concerning their children and families. This term acknowledges the selflessness of Latina mothers. This study explored the perceptions of thirteen Latino adolescent participants following their experiences of being raised by a single mother. To study this relationship, an adapted version of Narrative Analysis was used. While the analysis focused on participants’ relationships with their mothers, relationships with their biological fathers and other father figures (i.e., natural mentors) in their lives were explored. The study’s findings are contextualized through the lens of attachment theory, social learning theory, and the relevant literature. This study shines light on the important impact of mothers and natural mentors on the lives of Latino male adolescents. Social workers from varying professional domains who are working with Latino families can take the marianismo cultural value into account in their own interactions and services with their clients. Additionally, just as the Latino adolescents in this study were keenly aware of their mothers’ many positive values, strengths, and contributions to their lives, it is vital for social workers to do the same. arning theory, as well as relevant literature. This study shines light on the great impacts that mothers and natural mentors can have on Latino male adolescents.

How Can Support From Fathers Increase Breastfeeding in Children?

A father who provides full support to his wife in the breastfeeding process, from the phase of pregnancy onwards, can improve breastfeeding. The purpose of this research was to determine the correlation between the breastfeeding support of fathers and the provision of breastfeeding in children aged 6-24 months. This research used a descriptive correlation approach with a cross-sectional design. The sample included 117 respondents, recruited through purposive sampling. Data collection was through a questionnaire and checklist. Analysis of these data was through the Chi-square test. The results of the study showed that 76 respondents (65.0%) had implemented breastfeeding support by the fathers, and 50 respondents (42.7%) carried out partial breastfeeding. The results of the Chi-square test were significant (p = 0.001), indicating that there was a correlation between breastfeeding support from fathers and the administration of breastfeeding in children aged 6-24 months. It is therefore suggested that parents who have children aged 6-24 months ensure that the father provides support for breastfeeding for more than 6 months.&#x0D; Keywords: breastfeeding, father, administering breastfeeding, children

Relational impacts of capitalization in early parenthood.

Relationship difficulties are common during the transition to parenthood and may persist for years. Strategies that enhance couples' daily relational experiences early in the parenting years may serve a protective role. In general, engaging in a capitalization attempt (i.e., sharing personal good news) with one's romantic partner and perceiving the partner to be responsive are associated with better relationship outcomes among committed couples. However, it is unknown whether these relational benefits extend to the early parenting years or to other relational domains such as coparenting, which plays a central role in family functioning. The current study examined same-day associations between couples' capitalization process and relationship closeness and perceived coparenting support in a dyadic context during the first year of parenthood. A subsample of primarily non-Hispanic White coresident mixed-gender couples who participated in a randomized controlled trial of a transition to parenthood program (N = 141) completed daily diaries at 10 months postpartum for 8 consecutive days. On days when mothers shared, both partners reported greater closeness. On days when fathers shared, mothers reported greater closeness and perceived coparenting support. Furthermore, perceived partner responsiveness was associated with greater closeness for both partners and greater coparenting support for fathers. Fathers also perceived greater closeness and coparenting support on days when mothers shared about the child. Findings highlight the potential benefits of capitalization in early parenthood for both closeness and perceived coparenting support and suggest that capitalization may be a low cost, high yield strategy for enhancing new parents' daily relational experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Support Father Engagement: What Can We Learn From Fathers?

Fathers play a unique and important role in children’s lives. However, gendered attitudes and practices with families have precluded their full engagement in children’s education and development. Based on the collective effort of a local fatherhood coalition, the purpose of this community-based study was to explore how fathers view themselves as involved in children’s lives and their perceived barriers to involvement in order to initiate change in local schools and community. Twenty-three fathers from ethnically and socioeconomically diverse backgrounds participated in interviews and focus groups to describe their definitions of father involvement, strengths as fathers, and needs. A collaborative, qualitative analysis of data led to the identification of four themes that framed the experiences of fathers and their needs. Mothers played a powerful role in promoting and prohibiting fathers’ involvement; technology provided opportunities to connect but also interfered with attachment efforts; fathers in more privileged positions were able to focus on attachment rather than merely providing; and school engagement was rarely mentioned with a focus on extra-curricular involvement. We discuss the influence of paternal characteristics and situational factors in how these themes inform the lives of fathers and the complex nature of fatherhood. Implications for schools and communities are offered in hopes to disrupt current practices and design more inclusive and equitable approaches to including fathers in family engagement efforts.

Association of a Family Integrated Care Model With Paternal Mental Health Outcomes During Neonatal Hospitalization

During newborn hospitalization in the neonatal unit, fathers often feel anxious and excluded from their child's caregiving and decision-making. Few studies and interventions have focused on fathers' mental health and their participation in neonatal care. To study the association of a family integrated care (FICare) model (in single family rooms with complete couplet-care for the mother-newborn dyad) vs standard neonatal care (SNC) in open bay units with separate maternity care with mental health outcomes in fathers at hospital discharge of their preterm newborn and to study whether parent participation was a mediator of the association of the FICare model on outcomes. This prospective, multicenter cohort study was conducted from May 2017 to January 2020 as part of the fAMily Integrated Care in the Neonatal Ward Study, at level-2 neonatal units in the Netherlands (1 using the FICare model and 2 control sites using SNC). Participants included fathers of preterm newborns admitted to participating units. Data analysis was performed from January to April 2021. FICare model in single family rooms with complete couplet-care for the mother-newborn dyad during maternity and/or neonatal care. Paternal mental health was measured using the Parental Stress Scale: NICU, Hospital Anxiety and Depression Scale, Post-partum Bonding Questionnaire, Perceived (Maternal) Parenting Self-efficacy Scale, and satisfaction with care (EMpowerment of PArents in THe Intensive Care-Neonatology). Parent participation (CO-PARTNER tool) was assessed as a potential mediator of the association of the FICare model with outcomes with mediation analyses (prespecified). Of 309 families included in the fAMily Integrated Care in the Neonatal Ward Study, 263 fathers (85%) agreed to participate; 126 fathers were enrolled in FICare and 137 were enrolled in SNC. In FICare, 89 fathers (71%; mean [SD] age, 35.1 [4.8] years) responded to questionnaires and were analyzed. In SNC, 93 fathers (68%; mean [SD] age, 36.4 [5.5] years) responded to questionnaires and were analyzed. Fathers in FICare experienced less stress (adjusted β, -10.02; 95% CI, -15.91 to -4.13; P = .001) and had higher participation scores (adjusted odds ratio, 3.424; 95% CI, 0.860 to 5.988; P = .009) compared with those in SNC. Participation mediated the beneficial association of the FICare model with fathers' depressive symptoms (indirect effect, -0.051; 95% CI, -0.133 to -0.003) and bonding with their newborns (indirect effect, -0.082; 95% CI, -0.177 to -0.015). These findings suggest that the FICare model is associated with decreased paternal stress at discharge and enables fathers to be present and participate more than SNC, thus improving paternal mental health. Supporting fathers to actively participate in all aspects of newborn care should be encouraged regardless of architectural design of the neonatal unit.