Part 2: exploring views from fathers and perinatal practitioners on the inclusion of fathers by perinatal services

Background This is the second of a two-part series exploring father's inclusion in the perinatal years. The first paper was published in volume 29, issue 4 of the British Journal of Midwifery. This paper explores the results of the study and discussion in relation to previous literature and to professional practice. Positive father involvement during the perinatal period has important implications for families. However, previous research suggests that fathers experience marginalisation, while staff report a lack of training and time for engaging fathers. Aims This study explored fathers' and perinatal professionals' experiences of fathers' involvement during the perinatal period, and ideas for paternal support. Method A Delphi method was employed. Thematic analysis from focus groups informed an online survey which was completed by 24 fathers and 22 professionals. A third-round survey finalised group consensus. Results Both groups agreed on the importance of fathers. Participants suggested improvement ideas, such as supporting fathers with psychological change. Groups disagreed on some ideas, such as fathers receiving a session alone to discuss concerns. Discussion The findings support the inclusion of fathers in perinatal services and a focus on the whole family system. Limitations of this study include low participant diversity and possible selection bias. Implications for further research are discussed.

Peer Influence during Adolescence: The Moderating Role of Parental Support

Although many studies show that peers influence the development of adolescent internalizing and externalizing difficulties, few have considered both internalizing and externalizing difficulties in the same study, and fewer have considered the contributions of parents. Using a longitudinal sample of 385 adolescents, the contributions of best friends’ internalizing and externalizing difficulties (as assessed in Grade 6; G6: Mage = 13.64 years; 53% female; 40% ethnic or racial minority) were examined as they predicted subsequent adolescent internalizing and externalizing difficulties (at G8); in addition, the moderating role of both maternal and paternal support (at G6) was explored. Structural equation modelling revealed that best friend internalizing difficulties predicted decreases, but that best friend externalizing difficulties predicted increases in adolescents’ externalizing difficulties over time. Significant interactions involving both maternal and paternal support revealed that the negative impact of a G6 best friend having internalizing problems on later G8 adolescent externalizing problems was stronger at low levels of maternal and paternal support. The findings highlight the complex, and interactive, influences of friends and parents on the development of internalizing and externalizing symptomatology during adolescence, and underscore the importance of targeting both sources of social influence in research and clinical work.

Part 1: exploring views from fathers and perinatal practitioners on the inclusion of fathers by perinatal services

Background This is the first of a two-part series exploring father's inclusion in the perinatal years. Part 2 will explore the results of the study and discuss in relation to previous literature and to professional practice. Positive father involvement during the perinatal period has important implications for families. However, previous research suggests that fathers experience marginalisation, while staff report a lack of training and time for engaging fathers. Aims This study explored fathers' and perinatal professionals' experiences of fathers' involvement during the perinatal period, and ideas for paternal support. Method A Delphi method was employed. Thematic analysis from focus groups informed an online survey which was completed by 24 fathers and 22 professionals. A third-round survey finalised group consensus. Results Both groups agreed on the importance of fathers. Participants suggested improvement ideas, such as supporting fathers with psychological change. Groups disagreed on some ideas, such as fathers receiving a session alone to discuss concerns. Discussion The findings support the inclusion of fathers in perinatal services, and a focus on the whole family system. Limitations of this study include low participant diversity and possible selection bias. Implications for further research are discussed.

Virtual and reality: risk and protective factors of cyber and offline relational victimization

Background Cyber victimization (CV) and offline relational victimization (ORV) both impede adolescent development and might pose self-harm or suicide. The aim of this work is to examine the risk and protective factors of the two experiences across gender. Methods A total of 1,712 junior and senior high school students who came from 34 schools randomly sampled from northern Taiwan. The study included multi-facet supports (i.e. maternal, paternal, grandparent, peer, and teacher supports), positive and negative peer connections, smartphone addiction and family characteristics (i.e. parental marital status and self-perceived financial status) as predictors. Results 10.3% of the participants reported CV more than once (56.8% girls) and 35.2% of them reported ORV more than once (52.4% girls) in the last three months. Results of logistic regression models showed that smartphone addiction positively related to CV (boys: OR = 1.3, 95% CI = 1.1-1.6; girls: OR = 1.6, 95% CI = 1.3-2.0) and ORV (boys: OR = 1.2, 95% CI = 1.1-1.4; girls: OR = 1.2, 95% CI = 1.1-1.3) regardless gender. Negative peer connection related to ORV only among boys (OR = 1.4, 95% CI = 1.7-1.7). Low-level self-perceived financial status related to having CV (OR = 2.8, 95% CI = 1.4-5.5) and ORV (OR = 2.0, 95% CI = 1.2-3.4) only among girls. Interestingly, paternal support is the only significant protective factor among three family supports. Paternal support negatively associated with CV (OR = 0.8, 95% CI = 0.6-0.9) and ORV of boys (OR = 0.8, 95% CI = 0.7-0.9) as well as ORV of girls (OR = 0.8, 95% CI = 0.6-0.9). Furthermore, teacher support negatively associated with girls' CV (OR = 0.8, 95% CI = 0.6-0.9) and boys' ORV (OR = 0.8, 95% CI = 0.7-0.9). Conclusions The study identified a few gender-specific risk factors. For both gender, to prevent CV and ORV, supporting adolescents to avoid smartphone addiction is critical. Enhancing paternal support and teacher support can be effective in preventing adolescents' cyber and offline relational victimization. Key messages Paternal and teacher supports, rather than other sources of supports, are protective factors of cyber victimization and offline relational victimization among adolescents. Smartphone addiction, regardless of gender, not only positively associated with cyber victimization but also positively related to offline relational victimization.

Individual, relational, and cultural correlates of U.S. Latino/a college students' prosocial behaviors

Prosocial behaviors, or actions intended to benefit others, are important social behaviors that people conduct towards others. These behaviors can be motivated by a host of variables, including individual-level characteristics, relational-level considerations, and culture-specific values. Socioemotive, sociocognitive, and cultural variables have all been studied as important correlates of prosocial behaviors. In addition, maternal and paternal support may play a role in the internalization of these moral motivations. The goal of this study was to test a series of models using both variable-centered and person-centered statistical approaches to investigate how individual-level characteristics, relational-level variables, and culture-specific values both interrelate and simultaneously affect prosocial behaviors. The study used questionnaire measures completed by 250 U.S. Latino/a college students (M age = 21.0 years; 62.0% women). Latent profile analysis and path analysis were used to examine relations among empathic concern, perspective taking, familism, maternal and paternal support, and prosocial behaviors. This research can lend support for culture-specific models of prosocial development that simultaneously account for individual-level, relational-level, and culture-specific characteristics.

Mothers’ Healthcare Autonomy, Maternal-Health Utilization and Healthcare for Children under-3 Years: Analysis of the Nigeria DHS Data (2008–2018)

This study was designed to simultaneously examine if mothers’ personal healthcare autonomy within the household, and the level of their maternal-healthcare utilization, translates into better preventive (complete immunization) and curative (treatments for diarrhoea, fever and acute respiratory infection) efforts on morbidities in child healthcare. We analysed data pooled from three consecutive waves of the Nigeria Demographic and Health Survey: the surveys of 2008, 2013 and 2018. Using a multilevel logistic regression, we estimated the odds ratio for each of the outcome variables while adjusting for covariates. Findings revealed that mothers’ health autonomy is positively associated with child immunization and treatment of morbidities (except diarrhoea), a relationship moderated by the frequency of mothers’ exposure to media. Additionally, mothers’ healthcare utilization is positively associated with complete immunization, and all forms of morbidity treatment (except diarrhoea). Although the relationship between mothers’ healthcare-utilization and child immunization is not dependent on family wealth, however, the relationship between mothers’ healthcare utilization and treatment of morbidity is dependent. Policy effort should be geared towards stimulating mothers to seek appropriate and timely child healthcare and future studies could consider looking into the mediating role of paternal support in this relationship.

Paternal Involvement and Adverse Birth Outcomes in South Gujarat, India

Background and Objectives: While the impact of maternal factors on birth outcomes are widely reported, the extent to which paternal involvement and varying cultural family dynamics influence birth outcomes particularly in an international context, remain understudied. The purpose of this study was to assess the relationship between paternal involvement and adverse birth outcomes in South Gujarat, India. Methods: An in-person questionnaire was administered to adult women at delivery or during the one-month postpartum visit at New Civil Hospital, in South Gujarat, India between May and June 2016 to assess level of paternal support and attendance at prenatal appointments and household structure. Pregnancy variables including birthweight and gestational age at delivery were collected from maternal and newborn record/chart review. Chi-square and t-test were used to assess demographics, as appropriate. Logistic regression was used to examine the association between paternal involvement and pregnancy birth outcomes. Results: Of the 404 infants born during the study period, 26.7% were premature (<37 weeks gestation) and 29% were of low birth weight (<2500g). More than 40% of the women surveyed reported their in-laws were the primary household decision-makers; however, those who reported high paternal attendance were less likely to report in-laws as the primary decision-maker (p=0.03). Adjusted logistic regression analysis indicated the odds of delivering a low birth weight infant were greater among mothers who reported low paternal support and low paternal attendance at prenatal visits (OR=2.99 (95% Confidence Interval (CI): 1.84-4.86) and OR=2.16 (95% CI: 1.35-3.47), respectively). Conclusion And Global Health Implications: Low paternal support during pregnancy may be a missed opportunity to increase healthy practices during pregnancy as well as decrease the risks associated with limited social support during pregnancy. It is important to consider varying socio-cultural family dynamics in different populations and how they may influence paternal involvement during pregnancy. Key words: • Paternal involvement • Paternal support • Pregnancy complications • Low birth weight • Preterm birth Copyright © 2020 Godbole et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.