A mixed-methods feasibility study of an intervention to improve men’s mental health and wellbeing during their transition to fatherhood

Background Many health visiting services in England use the Promotional Guide system with mothers and fathers, an intervention to support their transition to parenthood, but there is little known about its use and effectiveness, especially with fathers. The aim of this study was to test the feasibility and acceptability of the Promotional Guide system with first-time fathers and pilot potential outcome measures to assess their mental health and wellbeing. Methods A mixed methods prospective observational cohort study. Expectant first-time fathers were recruited from four London (UK) local authority boroughs. Data were collected through online pre and post intervention questionnaires, and semi-structured telephone interviews. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using framework analysis. Results Eighty-six fathers were interested in participating; 7 did not meet inclusion criteria and 79 were invited to complete the baseline questionnaire. Questionnaires completed by 45 men at both timepoints were included in the final analysis. Mean and standard deviations were calculated for all outcomes, showing a slight deterioration in the scores across all measures in the postnatal period compared to the antenatal. Ten of these men were also interviewed. Six major categories were identified: 1) Experience of health visitor contact, 2) Experience of Promotional Guides, 3) Experience of perinatal health services, 4) Experience of fatherhood, 5) Fathers’ mental health and wellbeing, and 6) Experience of the research process. While antenatal and postnatal outcomes were collected from 45 first-time fathers, none had received the intervention in its entirety. This study identified major gaps in the implementation of the Promotional Guide system with fathers. Conclusion This study assessed recruitment of first-time fathers, time to complete recruitment, and retention rates and identified outcome measures that could be used in a future definitive study. While it wasn’t possible to examine the potential changes following the use of the Promotional Guide system, the study reported on the changes in the fathers’ ‘states’ in the antenatal and postnatal period. It provided a narrative on whether first-time fathers found it acceptable to be asked about their mental health and wellbeing, highlighted their specific needs during their transition to fatherhood, and how they wanted to be supported. It also identified barriers to implementation of the Promotional Guide system by health visitors, which need to be addressed prior to any future research into this intervention. These findings have a number of implications for researchers, health professionals, health service managers, commissioners, policy makers and parents.

The New Dad: The Career-Caregiving Conundrum

This chapter draws mainly from “The New Dad” studies, a decade long research series done by the Boston College Center for Work & Family which studied the changing role of primarily college-educated, white-collar fathers working in large US-based corporate settings. The series explored the experiences of these fathers on a wide range of issues including their transition to fatherhood, work roles, definitions of success, attitudes on paternity leave and caregiving, and work-family issues.

Steps in Developing a Public Health Surveillance System for Fathers

Including the voice of the father in research related to fathering is essential. This chapter describes efforts to establish a new public health surveillance for fathers in the United States. The ultimate goal of this research is to study fatherhood to support healthy child development by collecting valuable information on father health and experiences in the perinatal period. Understanding fathers is key to learning about and improving family health, since fathers impact mothers and babies’ health. Studying the health of fathers during the transition to fatherhood can also provide a window into the overall health status of men, expanding the field of public health to include more specifics on the health of fathers and their impact on families. Currently surveillance systems are lacking in including the fathers’ perspective in measurement of paternal health and the transition to fatherhood. To address these issues we utilized a multi-pronged approach to inform development of a public health surveillance system for fathers: (1) review of the current literature to identify gaps in knowledge on the role of fatherhood in male and family health and identify current national-level surveillance data on fathers; (2) assessed feasibility of identifying participants to implement a surveillance system for fathers; (3) conducted formative research to develop methodology; and (4) piloted a public health surveillance system called the Pregnancy Risk Assessment Monitoring System for Dads or “PRAMS for Dads.”

Canadian Fathers’ Preferences for Support During the Transition to Fatherhood

While there is growing recognition that fathers lack social support during the transition to fatherhood, little is known about the types of services fathers would access. An online survey was conducted with Canadian fathers asking about the type and helpfulness of support they sought. Participants also rated their interest in, convenience of, and the likelihood of using alternative options. All fathers sought support and the majority relied on partners, friends, and family. Fathers were equally likely to have accessed online support versus support from professionals. While fathers rated face-to-face interactions as potentially helpful, they rated online sources as most convenient.

NEW DAD STUDY (NEST): A mixed-methods feasibility study of an intervention to improve men’s mental health and wellbeing during their transition to fatherhood

Background: Many health visiting services in England use the Promotional Guide system with mothers and fathers, an intervention to support their transition to parenthood, but there is little known about its use and effectiveness, especially with fathers. The aim of this study was to test the feasibility and acceptability of the Promotional Guide system with first-time fathers and pilot potential outcome measures to assess their mental health and wellbeing. Methods: A mixed methods prospective observational cohort study. Expectant first-time fathers were recruited from four London (UK) local authority boroughs. Data were collected through online pre and post intervention questionnaires, and semi-structured telephone interviews. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using framework analysis. Results: Eighty-six fathers were interested in participating; 7 men did not meet inclusion criteria and 79 were invited to complete the baseline questionnaire. Questionnaires completed by 45 men at both timepoints were included in the final analysis. Ten of these men were also interviewed. Six major categories were identified: 1) Experience of health visitor contact, 2) Experience of Promotional Guides, 3) Experience of perinatal health services, 4) Experience of fatherhood, 5) Fathers’ mental health and wellbeing, and 6) Experience of the research process. While antenatal and postnatal outcomes were collected from 45 first-time fathers, none had received the intervention in its entirety. This study identified major gaps in the implementation of the Promotional Guide system with fathers. Conclusion: This study highlighted first-time fathers’ mental health and wellbeing needs during their transition to fatherhood, and how they wanted to be supported. It also identified barriers to implementation of the Promotional Guide system by health visitors, which need to be addressed prior to any future research into this intervention. These findings have a number of implications for researchers, health professionals, health service managers, commissioners, policy makers and parents.

“My emotions on the backseat”. Heterosexually partnered men’s experiences of becoming fathers through surrogacy

Surrogacy is a family building option for people unable to conceive or carry a pregnancy. In heterosexual couples seeking surrogacy, a woman who is not the intended father’s partner, facilitates this pregnancy. Whilst normative discourses reinforced by contemporary healthcare policies highlight the importance of involving fathers throughout pregnancy, little is known about heterosexually partnered men’s experiences of surrogacy. This qualitative study explores how surrogacy shapes men’s construction of their father identity and parenting expectations. Drawing on interviews with ten men (nine self-identifying as white and one as white-Asian; all employed in professional occupations) during or after their surrogacy arrangement, we explore their transition to fatherhood, interactions in the pregnancy, and relationship with the surrogate and their intimate partner. This is the first study explicitly focusing on heterosexually-partnered men’s experiences of surrogacy. The findings provide new insights into this unique form of family building, expanding understanding of men’s role preference and level of involvement in a triad surrogacy relationship.

What are the experiences of black African and African Caribbean men during the transition to fatherhood?

This study aimed to explore the experiences of men from African and African Caribbean heritage on transition to fatherhood and support received. Semi-structured interviews were undertaken with eight black fathers living in the south east of England. Four themes were identified: preparation for fatherhood; experiences post birth; influences on ideas about fatherhood; and reflections on transition and suggestions for support for future fathers. While some fathers benefited from formal support, others did not attend antenatal classes and there was uncertainty around healthcare roles identified during the men's experiences post birth. Findings highlight the importance of extended family and friends in providing advice and the importance of culture in forming the identity of African fathers.

Building Trust: A Cross-Cultural Narrative Process

The transition to fatherhood is a complex journey scarcely researched in Australian First Nations populations. Historical and political legacy, along with cultural traditions must be taken into consideration before exploring the experiences of Australia’s First Nations expectant fathers, especially when the experience is related to the millennia honored “women’s business.” This article shares the challenges, opportunities, and rewards the authors experienced while researching with Australia’s First Nations men who supported their partners during childbirth in a hospital setting. Ethical insights and input from all members of the research team ensured that culturally safe strategies were used to address all encountered difficulties. Building a trusting relationship with the local community was fundamental to the legitimacy, richness, and success of this research project. Lessons learned from this experience can provide an insight to Non-Indigenous researchers choosing to conduct or support research with Australia’s First Nations people in a respectful and meaningful manner.