Who Benefits from a Brief Educational Program for First-Time Fathers of Healthy Infants?

1. Who Benefits from a Brief Educational Program for First-Time Fathers of Healthy Infants? Father Involvement Research Conference 2008Toronto, Ontario

2. Funding Alberta Heritage Foundation for Medical Research (AHFMR)

3. Research Team • University of Calgary • Karen Benzies, RN, PhD • University of Alberta • Joyce Magill-Evans OT(C), PhD • Margaret J. Harrison, PhD • Mark Gierl, PhD • Sandra MacPhail, RN, MN • Health Regions • Maureen Best, RN, MN • Laurie Blahitka, RN, MN • Cathy Kimak, BScN

4. Canadian families are changing • Increased labour force participation by mothers • Increased father involvement in parenting • Fathers prioritized “father-specific” parenting classes as one of their top 5 supports to increase skills and confidence

5. Why are Fathers Important? • Social interactions (play) between parents and their infants promote language acquisition • Father-child interactions during infancy predicted child language development at 18 months and 4 years

6. Few Father-Specific Programs • Most programs for fathers are based on programs for mothers • There is some evidence that programs may be effective in enhancing the father’s interactions with his child if: • interventions involve active participation with the father’s own child • interventions involve observations of the father’s own child

7. New Father-Specific Program • We designed and tested a father-specific program for first-time fathers of infants • Self-modeled video-taping and feedback • Delivered during home visits • The new program improved fathers’ skills in interaction with his infant • Increased cognitive growth fostering • Maintained sensitivity to his infants’ cues

8. What is the Problem? • We do not know if the fathers found the program useful • We do not know whether some fathers experienced greater benefits from the new program • Could these fathers be targeted to receive the program?

9. Father Involvement Theory • Includes three components: • Paternal engagement/direct interaction • Accessibility or availability to the child • Responsibility or efforts to ensure child is cared for and has necessary resources • The new program focused on paternal engagement (Lamb, Pleck, Charnov, & Levine, 1985)

10. Conceptual Framework • Generative fathering • Assumes fathers want to be involved with their children • Emphasizes fathers’ strengths and potential for growth (Hawkins & Dollahite, 1997)

11. Research Questions • Is the new program useful to fathers? • What are the characteristics of fathers who benefited from the program?

12. Sample • 81 first-time biological fathers of healthy, singleton infants • Lived with the infant’s mother • Range of education levels from partial high school to graduate degrees • 85% European Canadian • Spoke primarily English to the infant

13. The New Program

14. Measurement • Video tape made during home visits was scored using the 72-item Nursing Child Assessment Teaching Scale (NCATS) • Parent Domain Total = 50 items (scored yes/no)

15. Nursing Child Assessment Teaching Scale (NCATS) (Sumner & Speitz, 1994)

16. Handouts with Feedback • Reinforced verbal feedback • Topics: • Infant Cues - Things your baby might do when….. • Teaching Loop – Teaching Your Baby

17. Is ready to learn Look at your face Reach out to you Turn towards you Smile Babble Coo Stop moving Needs a break or change Turn head or eyes away Cry/fuss Squirm/kick Pull away Yawn or frown Arch back Pushing away Put hands to mouth or behind ear Things your baby might do when he/she:

18. Teaching Your Baby Babies learn when dads follow this sequence: Alert Baby Praise & Suggestions Show & Explain Give Baby Time to Try • Use words that describe how to play with the toy. • Praise your baby’s attempts. • Give your baby a break if she or he is restless or fusses. • Smile, laugh or talk when your baby smiles or makes sounds.

19. Pre-Program Interaction

20. Was the Program Useful? • Structured interviews with fathers following the outcome home visit at 8 months • What was useful? • What would you change? • Responses transcribed • Content analysis

21. Results Fathers enjoyed the focus on fathering The program was feasible • Fathers liked: • the brief home visits • that the visits were scheduled to accommodate the family

22. Results • Fathers said their needs were different from mothers (who like group programs) • Fathers wanted home visits earlier and to last longer • Fathers wanted websites with discussion boards • Fathers suggested father-infant play groups and workshops when their child was older (at least 12 months)

23. Results • Self-modeled video taping and feedback increased awareness of specific behaviours to enhance play interactions • Handouts were useful reminders • Fathers liked to show the video tape to mothers • Fathers consistently viewed the play activity as a test and worked hard to help their infant succeed

24. Results • Demographic characteristics did not identify fathers (n = 4) who achieved the greatest increases in interaction scores • Sub-sample (n = 34) divided into marked (±1SD; ~4 points) positive and negative change groups • Demographic characteristics did not identify change in either group

25. Results • Fathers with positive change started with less skill in interaction than fathers with negative change • After controlling for baseline (5 month) interaction scores, demographic characteristics did not predict outcome (8 month) scores

26. Post-Program Interaction

27. Conclusion • Fathers want educational programs designed specifically to meet their needs • A new brief educational program with demonstrated efficacy in a community sample of fathers is feasible and useful to fathers

28. Future research • What is the impact of the program on later child language development? • Will the intervention work with fathers of vulnerable infants, such as those born preterm?

29. Implication for Practice • The program may be useful in public health settings where programs for fathers are a priority • Caution is needed when generalizing these results to fathers with complex risk factors

30. Your questions and comments… Contact us: benzies@ucalgary.ca 1-403-220-2294 Joyce.Magill-Evans@ualberta.ca 1-780-492-0402 Reference: Benzies, K., Magill-Evans, J., Harrison, M. J., MacPhail, S., & Kimak, K. (2008) Strengthening new fathers’ skills in interaction with their 5-month-old infants: Who benefits from a brief intervention? Public Health Nursing, 25(5), 431-439.