Preservation and reunification for families of young children: case file review of a home-visiting program.

OBJECTIVE: The Home Parenting Education and Support (HoPES) programme is a new intensive 8-week home-visiting intervention supporting the preservation and reunification of families with young children (aged 0-4 years) receiving child protection services following child abuse and/or neglect in Australia. The aims of the study were to (a) describe families who had participated in HoPES, (b) describe the key education content and support activities of the programme, and (c) identify the enablers and challenges in implementing HoPES. BACKGROUND: Intensive home-based family preservation programs are designed to improve parenting skills, reduce specific abusive behaviours, and address child, parent and contextual risk factors for child maltreatment and its recurrence. METHODS: A casefile review and document analysis of 34 families who enrolled in HoPES was conducted. RESULTS: Families enrolled in HoPES were experiencing significant parent and child risk factors for child maltreatment and recurrence. Despite challenges in supporting families experiencing many complex social health issues and stressful life circumstances, there was evidence of intervention tailoring and use of strengths-based approaches to meet the needs of families. CONCLUSION: This casefile review gathered rich evidence to inform further development of a trauma informed and culturally sensitive intervention to support family preservation and reunification, and to guide the next stage of evaluation research to generate a more robust level of evidence.

A mixed-methods feasibility study of the Home Parenting Education and Support Program for families at risk of child maltreatment and recurrence in Australia.

BACKGROUND: Efforts to prevent child maltreatment and its recurrence in infancy and early childhood are critical to disrupting pathways to poor physical and mental health and interpersonal relationships across the life course. The Home Parenting Education and Support (HoPES) program is an intensive 8-week home-visiting intervention for families of infants and young children (0-4 years) receiving child protection services or welfare services. OBJECTIVE: The aims of this feasibility study were to: (a) explore parents' and clinicians' perceptions of the outcomes related to participation in HoPES, and (b) obtain preliminary data about potential intervention outcomes related to parent-child interactions, parent mental health, and parenting self-efficacy. PARTICIPANTS AND SETTING: HoPES was delivered to 30 families by a child and family health service. Seven mothers and eight HoPES clinicians also participated in qualitative interviews. METHODS: A mixed-methods evaluation was conducted incorporating qualitative interviews and self-report pre-post intervention data was conducted. RESULTS: Interviews with mothers identified perceived benefits for parent mental health and wellbeing, parenting, and relationships with children. This was further supported by clinician interviews and by the analysis of pre-post assessment data which revealed moderate to large decreases in maternal stress (d = 0.35) and increases in parental self-efficacy (0.76). CONCLUSIONS: The findings of this study have important implications for further development of HoPES, and the design of a rigorous evaluation in next stage of evaluation research.

Systematic review of the impact of coparenting interventions on paternal coparenting behaviour.

AIMS: The aim of this study was to evaluate the efficacy of interventions to support coparenting, how partners relate to and support one another as parents, on paternal outcomes. BACKGROUND: Despite societal shifts in gender roles leading to fathers' increasing involvement in parenting and growing recognition of the need for couples-based parenting interventions, fathers have been underrepresented in parenting research. DESIGN: Systematic review. DATA SOURCES: Medline, Embase, Healthstar, and PsycInfo. REVIEW METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify peer-reviewed articles published up to 2016 that evaluated the effectiveness of coparenting interventions for expectant fathers or fathers of children <18 years. Study quality was assessed using Cochrane risk of bias criteria for Effective Practice and Organisation of Care reviews; Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were used to summarize quality of the evidence. The primary outcome was coparenting behaviour among men. RESULTS: We identified 16 randomized controlled trials that evaluated 14 coparenting interventions. Nine interventions targeted partners in the perinatal period; five targeted parents of children. All but one involved face-to-face contact, but this varied in duration and intensity. Of the 12 trials that examined coparenting outcomes, eight reported an effect on at least one measure of paternal coparenting behaviour. The quality of the evidence was at a low level. CONCLUSION: Success was moderate, supporting the need for future research to explore the use of additional approaches to increase efficacy, including technology-based interventions, to improve uptake among men.

Midwives' perceptions and experiences of engaging fathers in perinatal services.

BACKGROUND: The active engagement of fathers in maternity care is associated with long-term benefits for the father, their partner, and their child. Midwives are ideally placed to engage fathers, but few studies have explored midwives' experiences of working with men. Therefore, the aim of this study was to describe midwives' perceptions and experiences of engaging fathers in perinatal services. METHOD: A multi-method approach was utilised. Registered midwives (N=106) providing perinatal services to families in Australia participated in an online survey. Of these, 13 also participated in semi-structured telephone interviews. Descriptive analyses summarised the online survey data. The interview data were coded using semantic thematic analysis. RESULTS: Survey results indicated that midwives unanimously agreed that engaging fathers is part of their role and acknowledged the importance of receiving education to develop knowledge and skills about fathers. Analysis of the telephone interviews led to the identification of a range of strategies, facilitators and barriers to engaging fathers in midwifery services. Some of these were related to characteristics of midwives, factors related specifically to fathers, and several external factors relating to organisational policies. CONCLUSIONS: Findings from this study could inform maternity health care policies, as well the development of resources, education and ongoing professional training for midwives to promote father-inclusive practice.

Fathers' Worries During Pregnancy: A Qualitative Content Analysis of Reddit.

Qualitative investigations into the emotional needs of expectant fathers have been limited by difficulties with recruitment. This study aimed to unobtrusively obtain insights into fathers' worries during pregnancy by analyzing the content of posts on the Internet forum Reddit. The majority of worries related to infant well-being (50.8%), particularly the potential for perinatal loss (23.0%). Concerns relating to partner well-being and the couple relationship were also common, comprising 17.0% of posts. Several posts related to individual factors, such as apprehension about the father role (16.3%). Finally, situational factors such as work-family conflict accounted for 15.9% of posts. These findings contribute to the growing literature on fathers' experiences of pregnancy and can inform the development of father-inclusive perinatal education.

Fathers' postnatal distress, parenting self-efficacy, later parenting behavior, and children's emotional-behavioral functioning: A longitudinal study.

Fathers' postnatal distress has been associated with subsequent emotional and behavioral problems for children; however, the mechanisms by which this occurs have received less attention. One potential pathway could be via the negative effects that father mental health problems and parenting self-efficacy (PSE) in the postnatal period have on later parenting behaviors. Using a nationally representative cohort of Australian father-child dyads (N = 3,741), the long-term relationships between fathers' psychological distress and PSE in the postnatal period, parenting behavior when children were aged 4-5 years, and emotional-behavioral outcomes for children aged 8-9 years were explored. Path analysis indicated that high distress and low PSE in the postnatal period was associated with higher levels of hostile parenting and lower parenting consistency when children were aged 4-5 years; in turn, these were associated with poorer child outcomes at 8-9 years. These results remained significant after controlling for socioeconomic position, couple relationship quality, mothers' and fathers' mental health, and fathers' concurrent parenting behavior. The pathways among PSE, parenting hostility, parenting consistency, and children's outcomes at age 8-9 years differed for fathers of boys compared with fathers of girls. Results highlight the importance of father-inclusive assessments of postnatal mental health. Support programs targeting new fathers' perceptions of parenting competence may be particularly important for fathers experiencing postnatal distress. For fathers, building a stronger sense of parenting competence in the postnatal period is important for later parenting behavior, which relates to children's emotional and behavioral outcomes during middle childhood. (PsycINFO Database Record

A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies.