Parents' Perspectives on Supporting Father Involvement in African American Families During Pregnancy and Early Infancy.

OBJECTIVE: To explore fathers' pregnancy and early infancy experiences in supporting his infant, partner, and himself, using information collected from fathers, mothers, and mother-father dyads in a low-income, urban community. BACKGROUND: Father involvement is associated with positive child health outcomes and parental well-being. However, little information exists about low-income parents' perceived needs for father involvement during pregnancy and infancy. METHODS: This was an exploratory qualitative study of parents in low-income communities of Baltimore, Maryland. Participants were conveniently sampled via partnerships with community organizations. Eighty percent of parents were African American. Four focus groups were conducted with fathers (n = 8), 4 with mothers (n = 9), and 4 interviews with father-mother dyads (n = 8). Sessions were audio-recorded, transcribed, and analyzed using iterative, inductive open coding performed independently by two team members (interrater agreement 86%). Frequency tables were generated for identified categories for content analysis and theme development. RESULTS: Five themes were identified: perspectives on the father role, supporting partners, negotiating co-parenting, parenting logistics, and learning parenting skills. Participants expressed the importance of fathers to "be there" and barriers to being involved (e.g., finances, lack of role models). Fathers discussed needing to learn how to manage partner conflicts, while mothers discussed fathers' need for greater empathy. Dyads discussed the importance of co-parenting strategies (e.g., effective communication, sharing responsibilities). Logistics included direct infant care, finances, and community resources. Fathers discussed learning by trial and error rather than informational resources and relying on healthcare professionals for pregnancy information and female relatives for infant care. CONCLUSION: Participants discussed various needs of fathers to be effective partners and parents, and lacking informational resources tailored specifically for fathers. Research is needed to explore the best ways to tailor and disseminate information to fathers, especially prenatally. IMPLICATIONS: Study findings have significant implications for improving the ways in which maternity care, community-based programs, and pediatric providers support father involvement.

The father's role in risk and resilience among Mexican-American adolescents.

Research suggests fathers are important to adolescent well-being, yet there is limited information regarding how fathering is associated with adolescent risk and resilience in Mexican American families. This cross-sectional study utilized a structural equation model to examine whether parent-child alienation mediated the relations between parental displays of warmth and hostility and the outcomes of adolescent resilience and delinquency in Mexican American families (N = 272). Results indicated that adolescent-perceived alienation from parents was a significant predictor of both resilience and delinquency. Additionally, alienation mediated the relations between father warmth and resilience and father warmth and delinquency, as well as the relations between mother hostility and adolescent outcomes. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Paternal involvement and support and risk of preterm birth: findings from the Boston birth cohort.

OBJECTIVE: To investigate to what extent paternal involvement and support during pregnancy were associated with preterm (PTB) and small-for-gestational age (SGA) births. METHODS: Using data from the Boston Birth Cohort (n = 7047), multiple logistic regression models were performed to estimate the log odds of either PTB or SGA birth, with paternal involvement, paternal social support, and family and friend social support variables as the primary independent variables. RESULTS: About 10% of participating mothers reported their husbands not being involved or supportive during their pregnancies. Lack of paternal involvement was associated with 21% higher risk of PTB (OR = 1.21, 95% CI: 1.01-1.45). Similarly, lack of paternal support was borderline associated with PTB (OR = 1.13, 95% CI: 0.94-1.35). Also marginally significant, lack of paternal involvement (OR = 1.18, 95% CI: 0.95-1.47) and father's support (OR = 1.19, 95% CI: 0.96-1.48) were associated with higher odds of SGA birth. No associations were found between familial and friend support during pregnancy and PTB or SGA. CONCLUSIONS: Among predominantly low-income African Americans, lack of paternal involvement and lack of paternal support during pregnancy were associated with an increased risk of PTB, and suggestive of SGA birth. These findings, if confirmed in future research, underscore the important role a father can play in reducing PTB and/or SGA.

Changing times? Gender roles and relationships in maternal, newborn and child health in Malawi.

BACKGROUND: For years, Malawi remained at the bottom of league tables on maternal, neonatal and child health. Although maternal mortality ratios have reduced and significant progress has been made in reducing neonatal morality, many challenges in achieving universal access to maternal, newborn and child health care still exist in Malawi. In Malawi, there is still minimal, though increasing, male involvement in ANC/PMTCT/MNCH services, but little understanding of why this is the case. The aim of this paper is to explore the role and involvement of men in MNCH services, as part of the broader understanding of those community system factors. METHODS: This paper draws on the qualitative data collected in two districts in Malawi to explore the role and involvement of men across the MNCH continuum of care, with a focus on understanding the community systems barriers and enablers to male involvement. A total of 85 IDIs and 20 FGDs were conducted from August 2014 to January 2015. Semi-structure interview guides were used to guide the discussion and a thematic analysis approach was used for data analysis. RESULTS: Policy changes and community and health care provider initiatives stimulated men to get involved in the health of their female partners and children. The informal bylaws, the health care provider strategies and NGO initiatives created an enabling environment to support ANC and delivery service utilisation in Malawi. However, traditional gender roles in the home and the male 'unfriendly' health facility environments still present challenges to male involvement. CONCLUSION: Traditional notions of men as decision makers and socio-cultural views on maternal health present challenges to male involvement in MNCH programs. Health care provider initiatives need to be sensitive and mindful of gender roles and relations by, for example, creating gender inclusive programs and spaces that aim at reducing perceptions of barriers to male involvement in MNCH services so that programs and spaces that are aimed at involving men are designed to welcome men as full partners in the overall goals for improving maternal, neonatal and child health outcomes.

Testosterone and Jamaican Fathers : Exploring Links to Relationship Dynamics and Paternal Care.

This paper investigates relationships between men's testosterone and family life in a sample of approximately 350 Jamaican fathers of children 18-24 months of age. The study recognizes the role of testosterone as a proximate mechanism coordinating and reflecting male life history allocations within specific family and cultural contexts. A sample of Jamaican fathers and/or father figures reported to an assessment center for an interview based on a standardized questionnaire and provided a saliva sample for measuring testosterone level. Outcomes measured include subject demographics such as age and relationship status as well as partnership quality and sexuality and paternal attitudes and behavior. The variation in these fathers' relationship status (e.g., married co-residential fathers, fathers in new non-residential relationships) was not associated with men's testosterone. Too few stepfathers participated to enable a direct test of the prediction that stepfathers would have higher testosterone than biological fathers, although fathers who reported living with partners' (but not his own) children did not have higher testosterone than fathers not reporting residing with a non-biological child. Fathers' relationship quality was negatively related to their testosterone. Measures of paternal attitudes and behavior were not related to fathers' testosterone. Consistent with previous ethnography, this sample of Jamaican fathers exhibited variable life history profiles, including residential status. We discuss why fathers' relationship quality was found to be negatively related to their testosterone level, but other predictions were not upheld.

Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda.

BACKGROUND: Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization's Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context. METHODS: This study employed ethnographic methods including participant observation, which took place in the process of everyday life activities of the respondents within the community; 12 focus group discussions, and 12 in-depth interviews with community members and key informants. Participants in this study were purposively selected to include TBAs, men, opinion leaders like village chairmen, and other key informants who had knowledge about the configuration of maternity services in the community. Data analysis was done inductively through an iterative process in which transcribed data was read to identify themes and codes were assigned to those themes. RESULTS: Contrary to the thinking that TBA services are utilized by women only, we found that men actively seek the services of TBAs and utilize them for their wives' healthcare within the community. TBAs in turn sensitize men using both cultural and biomedical health knowledge, and become allies with women in influencing men to provide resources needed for maternity care. CONCLUSION: In this study area, men trust and have confidence in TBAs; closer collaboration with TBAs may provide a suitable platform through which communities can be sensitized and men actively brought on board in promoting maternal health services for women in rural communities.

Transmission of Work Ethic in African-American Families and Its Links with Adolescent Adjustment.

A strong work ethic generally has positive implications for achievements in work and school settings, but we know little about how it develops. This study aimed to describe the intra-familial transmission of work ethic and the associations between work ethic and adjustment in African American youth. Mothers, fathers, and two adolescent siblings (M age = 14.1 years) in 158 families were interviewed on two occasions. Path models revealed that fathers' work ethic was positively linked with older siblings' work ethic, which in turn was linked with more positive youth adjustment in the domains of school functioning and externalizing and internalizing problems. Moreover, the results indicated that the work ethics of older siblings, but not parents, was linked to those of younger siblings. The discussion focuses on the importance of African American fathers and siblings in youth adjustment and how work ethic may promote positive development.

Associations between dietary intakes of first-time fathers and their 20-month-old children are moderated by fathers' BMI, education and age.

Children's learning about food is considerable during their formative years, with parental influence being pivotal. Research has focused predominantly on maternal influences, with little known about the relationships between fathers' and children's diets. Greater understanding of this relationship is necessary for the design of appropriate interventions. The aim of this study was to investigate the associations between the diets of fathers and their children and the moderating effects of fathers' BMI, education and age on these associations. The diets of fathers and their first-born children (n 317) in the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program were assessed using an FFQ and 3 × 24-h recalls, respectively. The InFANT Program is a cluster-randomised controlled trial in the setting of first-time parents groups in Victoria, Australia. Associations between father and child fruit, vegetable, non-core food and non-core drink intakes were assessed using linear regression. The extent to which these associations were mediated by maternal intake was tested. Moderation of associations by paternal BMI, education and age was assessed. Positive associations were found between fathers' and children's intake of fruit, sweet snacks and take-away foods. Paternal BMI, education and age moderated the relationships found for the intakes of fruit (BMI), vegetables (age), savoury snacks (BMI and education) and take-away foods (BMI and education). Our findings suggest that associations exist at a young age and are moderated by paternal BMI, education and age. This study highlights the importance of fathers in modelling healthy diets for their children.

The journey into fatherhood: A grounded theory study.

The objective of this study was to explore the process of transition into fatherhood for Thai men from childbirth to the postpartum period. Forty-one first-time Thai fathers were voluntarily recruited from two hospitals in Chiang Mai, Thailand, from December 2012 to June 2013. In-depth interviews were used to collect the data, which were analyzed based on grounded theory methodology. The basic social process that emerged as the core category was termed: "the journey into fatherhood." This process was divided into three phases: labor, delivery, and family beginning. Within this process, there were various situations, challenges, and pressures, which caused many changes of mood and feelings for the first-time fathers. Throughout this process, they applied various strategies to manage their concerns and needs, in order to develop into masterly fathers. Identifying the process of the journey into fatherhood provides nurses and midwives insight into the new fathers' experiences, which will enable them to be more sensitive, respectful, and effective caregivers.

Portion sizes for children are predicted by parental characteristics and the amounts parents serve themselves.

BACKGROUND: Children's energy intakes are influenced by the portions they are served. Factors influencing the amounts adults offer children are not well described. OBJECTIVE: We assessed whether the amounts that were served to and consumed by children at meals were related to amounts that parents served themselves. DESIGN: In this repeated-measures, cross-sectional observational study, 145 parents and their preschoolers (82 Hispanic, 57 African American, 6 unidentified) were recruited from Head Start settings in Houston, TX. The amounts served to and consumed by children and parents during 3 at-home evening meals were measured and analyzed. We assessed children's and parents' heights and weights, and body mass indexes (BMIs) were calculated. Associations between portions served for parents and children and between amounts served to and consumed by children were evaluated. Multiple linear regression was used to determine whether maternal characteristics (race-ethnicity, sociodemographic factors, and caregivers' BMIs) predicted the amounts caregivers served to children. RESULTS: The amounts that parents served themselves were significantly associated with the amounts that they served to their children (r = 0.51, P < 0.0001). Multiple regression analysis showed that African American parents (compared with Hispanics) served more food to themselves and to their children (P < 0.01, R² = 6.9%) and that employed (compared with unemployed) parents served more food to their children (P = 0.025, R² = 3.3%). The amounts served to children were strongly associated with the amounts children consumed (r = 0.88, P < 0.0001). When parents served more to themselves, they also served more to their children (P < 0.001). CONCLUSIONS: These findings underscore the strong relation between portions offered by caregivers and the amounts children consume at a meal and suggest that factors unrelated to the child (such as the amount a parent serves himself or herself) are important predictors of children's consumption. Efforts aimed at improving parents' recognition of developmentally appropriate portions for young children could be useful for future obesity-prevention efforts.

Even with the best of intentions: paternal involvement and the theory of planned behavior.

Implicit in much of the fatherhood discourse is the assumption that if fathers want to take an active role in their children's lives, they could and would do so. While research has highlighted the factors associated with fathers' involvement, very few, if any, of these studies have been guided by a theory that accounts for both fathers' involvement intentions and their ability to follow through on those intentions. The theory of planned behavior and its emphasis on attitudes, the beliefs of significant others, and whether one has control over engaging in behavior is a conceptual fit to respond to questions related to the complex nature of paternal involvement. Using data from the Fragile Families and Child Well-being Study, the purpose of this study was to test the utility of the theory of planned behavior in predicting fathers' involvement intentions and reports of involvement. The results revealed that the theory of planned behavior can be useful in examining paternal involvement and should be used in future research to enhance the fatherhood literature.

Female genital mutilation in Sierra Leone: who are the decision makers?

The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals' associations need to consider how to prevent further medicalization of the practice.

Inequalities in care-seeking for febrile illness of under-five children in urban Dhaka, Bangladesh.

Fever is an easily-recognizable primary sign for many serious childhood infections. In Bangladesh, 31% of children aged less than five years (under-five children) die from serious infections, excluding confirmed acute respiratory infections or diarrhoea. Understanding healthcare-seeking behaviour for children with fever could provide insights on how to reduce this high rate of mortality. Data from a cross-sectional survey in the catchment areas of two tertiary-level paediatric hospitals in Dhaka, Bangladesh, were analyzed to identify the factors associated with the uptake of services from trained healthcare providers for under-five children with reported febrile illness. Health and demographic data were collected in a larger study of 7,865 children using structured questionnaires. Data were selected from 1,290 of these under-five children who were taken to any healthcare provider for febrile illness within two months preceding the date of visit by the study team. Certified doctors were categorized as 'trained', and other healthcare providers were categorized as 'untrained'. Healthcare-seeking behaviours were analyzed in relation to these groups. A wealth index was constructed using principal component analysis to classify the households into socioeconomic groups. The odds ratios for factors associated with healthcare-seeking behaviours were estimated using logistic regression with adjustment for clustering. Forty-one percent of caregivers (n=529) did not seek healthcare from trained healthcare providers. Children from the highest wealth quintile were significantly more likely [odds ratio (OR)=5.6, 95% confidence interval (CI) 3.4-9.2] to be taken to trained healthcare providers compared to the poorest group. Young infants were more likely to be taken to trained healthcare providers compared to the age-group of 4-<5 years (OR=1.6, 95% CI 1.1-2.4). Male children were also more likely to be taken to trained healthcare providers (OR=1.5, 95% CI 1.2-1.9) as were children with decreased level of consciousness (OR=5.3, 95% CI 2.0-14.2). Disparities across socioeconomic groups and gender persisted in seeking quality healthcare for under-five children with febrile illness in urban Dhaka. Girls from poor families were less likely to access qualified medical care. To reduce child mortality in the short term, health education and behaviour-change communication interventions should target low-income caregivers to improve their recognition of danger-signs; reducing societal inequalities remains an important long-term goal.

Fathering an ADHD child: an examination of paternal well-being and social support.

The purpose of this study was to examine the influence of having a child diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) on the social and emotional well-being of fathers. While mothers have been carefully scrutinized in ADHD-related literature, fathers have been largely excluded from research designs developed to explore the effects of raising a child with ADHD. Prior research has been primarily based on small, clinically referred and homogenous samples, often without comparisons or controls. This research utilizes a nationally representative sample from the 2001 U.S. National Health Interview Survey to determine differences between fathers of children with ADHD and control fathers and to analyze how the ADHD status of the child, problematic behavior, use of medication, and paternal social support influences fathers' sense of well-being. This research is also designed to determine whether there are child and family contexts in which the effect of ADHD status on paternal well-being is moderated. Contrary to previous findings about the emotional and social burden associated with raising an ADHD child, few differences between fathers were found.

Tales from the "hood:" placing reproductive health communication between African American fathers and children in context.

OBJECTIVE: To evaluate reproductive health communication between African American fathers and their children. DESIGN: In this qualitative ethnographic study, data were collected through tape-recorded individual interviews about the content and timing of reproductive health communication, the reproductive health values fathers intended to impart to their children, and their comfort level in doing so. SAMPLE: A total sample of 19 African-American fathers participated. MEASUREMENTS: Data were coded according to the qualitative analytic principles established by Miles and Huberman (1994), and analyzed using manifest and latent content analysis approaches. RESULTS: Although 10 fathers reported feeling uncomfortable having these conversations, 18 reported having reproductive health communication with their children, and most encouraged their sons and daughters to delay sex until adulthood. These conversations were primarily driven by the fear of HIV/AIDS and the negative consequences of sex; however, some conversations were inappropriate for developmental age. CONCLUSIONS: African-American fathers may benefit from education to help them have age appropriate reproductive health communication with their children. Registered Nurses and Nurse Practitioners are well positioned to educate African American adolescents and their fathers on reproductive health. Future dyadic African American father-child studies are needed to explore more fully African-American children's perceptions of reproductive health communication and the effect on delaying sex.

Thai men becoming a first-time father.

The purpose of this study was to understand the process of Thai men becoming a first-time father. Twenty expectant fathers were voluntarily recruited from the antenatal clinics of three hospitals in Chiang Mai, northern Thailand. The data were collected by in-depth interviews and analyzed on the basis of grounded theory methodology. The findings demonstrated that "protecting the unborn baby" was the basic social process that emerged as the core category. This process was divided into three phases: confirming and accepting, perceiving the unborn baby as a human being, and ensuring the health of the mother and baby. Throughout this process, the Thai expectant fathers applied many strategies to manage their concerns, needs, and emotions and to develop themselves into fathers. The process of protecting the unborn baby provides insight into the expectant fathers' experiences, which will enable nurses and midwives to assist and care for men as they become fathers.

Prevalence and associated factors of passive smoking in Thai infants.

BACKGROUND: Passive smoking or exposure to environmental tobacco smoke (ETS) is associated with an increased risk of several respiratory illnesses for infants. OBJECTIVE: To assess the prevalence and the associated factors of ETS exposure in Thai infants. METHODS: A cross-sectional survey based on interviews with parents of infants aged 1 year old, conducted during October 2001-August 2003, under the Prospective Cohort study of Thai Children. RESULTS: A total of 3256 parents (76.7% of eligible subjects) provided the required information. The prevalences of father or mother smoking in the same room as the infants were 35.1 and 0.3% respectively. Smoking in the presence of an infant was significantly associated with paternal age of 25-34 or more than 44 years, education at or less than secondary school, and a Muslim father. CONCLUSIONS: The results suggest that ETS exposure is common in Thai infants and the main source of exposure is from a smoking father. This finding is different from other studies in Western countries where both the father and mother made substantial contributions to infant exposure to ETS. Interventions should be considered to reduce infant exposure to ETS.

"It's not just about MOMMAS": African-American non-resident fathers' views of paternal involvement.

Many social and economic policies have been developed to increase fathers' involvement with their children. Yet, we know little about the meaning of involvement for African-American non-resident fathers. The purpose of this study was to obtain African-American non-resident fathers' perspectives on involvement and perceptions of their involvement. Seven focus groups were conducted with 69 fathers. Fathers' views of involvement were grouped into four major areas of importance, including sharing and caring, providing guidance, providing support, and serving in culturally specific roles. Fathers described many impediments to, and expressed dissatisfaction with, their level of involvement. The findings support the need for father-focused interventions.