TABLE 3

Study Characteristics and Results for Father’s Parenting and Health Outcomes (N = 21)

Author, ProgramStudy DesignStudy AimStudy PopulationResults Related to Father Outcomes
Beal52; NBAS; Brazelton56RCTTo investigate the effects of NBAS on father-infant interaction and other outcomesTarget population: working class, whiteOutcomes assessed at 2 mo postpartum
N = 44 fathersFather-infant interaction: higher father-infant interaction quality (P < .01). No difference in father-infant interaction amount between groups
All first-time fathers; mean age 28 y; 14 y of education; working class; majority white
Father involvement in caregiving: no significant differences between groups
Father’s attitude and parenting self-efficacy: no significant differences between groups
Feinberg and Kan,47 Feinberg et al48; FFRCTTo assess whether the FF had positive effects on the short-term outcomes, including coparenting, parental depression and anxiety, and distress in the parent-infant relationship at posttestTarget population: middle class, whiteOutcomes assessed at 6 mo and 1 y postpartum
N = 169 couplesFather-infant interaction: less parent-child dysfunctional interactions compared with control at 6 mo postpartum (P < .05)
All primiparous and cohabiting couples; mean age 29.76 y; 14.5 y of education; median family income $65 000; 90% whiteFather involvement: higher levels of positive parenting (eg, sensitivity) and lower levels of negative parenting (eg, irritability) compared with control at 1 y (P < .05)
Coparenting relationship: higher coparenting support and parenting-based closeness with their partner compared with control at 6 mo postpartum (P < .05). Lower coparental competition and triangulation compared with control at 1 y (P < .05). No significant difference between groups for coparenting undermining at 6 mo or 1 y
Father’s mental health: no significant differences between groups for depressive symptoms and anxiety at 6 mo
Other (ie, partner relationship): more partner warmth compared with control at 1 y (P < .05)
Field et al53; pregnancy massage therapy delivered to mothers by fathersRCTTo examine whether pregnancy massage therapy delivered by fathers twice a wk for 16 wk could reduce fathers’ mental health issues and improve perceptions of relationship with motherTarget population: low- to middle-income, ethnic and racial minoritiesOutcomes assessed at 32-wk gestation
N = 47 womenFather’s mental health: decreased levels of depression and anxiety compared with control (P < .01)
Prenatally depressed women and their partner in second trimester of pregnancy; mean age 27.9 y; 46% of women with high school degree or less; predominantly low to middle income; 59% of the women Hispanic, 32% African American, 9% whiteOther (ie, partner relationship quality): improved perceptions of relationship with their partner compared with control (P < .01)
Pfannenstiel and Honig35,36; Information and Insights About Infants (III)RCTTo determine the effectiveness of a prenatal information support program on father’s knowledge of child care and development, sensitivity, and empathy with infants among first-time, low-income fathers-to-be in both low- and high-risk pregnancy situationsTarget population: low-income, majority whiteOutcomes assessed at intrapartum (birth through hospital discharge of infant) and 1 mo postpartum
N = 67 fathersFather-infant interaction: more sensitive during feeding interactions on the day of hospital discharge than control (P < .01). Fade out of program effect by 1 mo postpartum (P = .06)
All first-time fathers; age range 19–32 y; mean 11 y of education; 70% white; 54%; unmarriedFather’s parenting knowledge: more knowledge of infant care and development than control (P < .001)
Westney et al39; prenatal education programRCT, nonrandom sampleTo examine (1) the effects of a prenatal education program for unwed adolescent fathers on their knowledge of prenatal care, labor, delivery, and infant development and care; and (2) the relation between knowledge and supportive behaviors toward motherTarget population: adolescent, African AmericanOutcomes assessed immediately after the program
N = 28 couplesFather’s parenting knowledge: intervention fathers significantly increased mean total parenting knowledge scores (P < .05), as well as scores on pregnancy and prenatal (P < .05) and infant development and care (P < .01) subscales, compared with control
All unmarried couples; mean age 16.9 y for intervention group fathers; mean age 17 y for control group fathers; African American
Other (ie, father’s supportive behaviors): significant correlations (P < .05) between father’s parenting knowledge and supportive behaviors for both intervention and control group fathers
Fagan50; Minnesota Early Learning Design57 for Young Dads (Minnesota Early Learning Design, 1997)Quasi-RCT; rather than follow an intent-to-treat model, the authors created a no-intervention control group from the postrandomization attrition groupTo examine the effects of a prebirth coparenting intervention on fathers’ support of the mother, parental alliance, coparenting communication, father prenatal involvement, father engagement with the infant, and parenting self-efficacyTarget population: adolescent, ethnic and racial minoritiesOutcomes assessed immediately after program (during pregnancy) with a follow-up at 3 mo postpartum
N = 154 fathersFather involvement: no significant differences between groups in prenatal involvement immediately after program. There was significantly higher father involvement with infant caregiving compared with control at 3 mo postpartum (P < .05). Effect size, Embedded Image = 0.07 for fathers’ reports
Age range 14–25 y; 55% completed <12th grade; 47.3% African American, 38.8% Hispanic; 85.5% primiparousFather’s attitude and parenting self-efficacy: no significant differences in parenting competence at follow-up
Coparenting relationship: significant increases in parenting alliance (P < .001) and communication (P < .01) compared with controls immediately after program. Effect sizes, Embedded Image = 0.09 and Embedded Image = 0.10, respectively. Significant increases in parenting alliance (P < .001) at follow-up (Embedded Image = 0.19) compared with controls
Other (ie, father’s supportive behaviors): significant increases in father’s support of the mother (P < .05) compared with control immediately after program. Effect size, Embedded Image = 0.05. Significant increases in father’s support of the mother (P < .05) compared with controls at follow-up (Embedded Image = 0.07)
Bryan37; GCFQuasi-experimental (ie, pretest-posttest control group)To determine the effects of GCF, a prenatal couple group intervention, on parent-infant interaction postbirthTarget population: low- to middle-income, whiteOutcomes assessed at on average 10.5 mo postpartum
N = 77 couplesFather-infant interaction: intervention group fathers scored higher in socioemotional growth fostering (P < .05) compared with control group fathers. Intervention group fathers also scored higher on the contingency scores for mutual socioemotional interaction between father and child compared with control group fathers (P < .05)
All married or unmarried couples; mean age 28 y; 44% of participants had some college education and 39% had completed college or beyond; median annual income $20 000–$29 999; majority white; primiparous
Diemer38; father-focused discussion perinatal classesQuasi-experimental (ie, pretest-posttest control group)To compare the effects of father-focused discussion perinatal classes with traditional childbirth classes on expectant fathers’ stress or psychological symptom status, coping strategies, social support, and spousal relations at posttestTarget population: middle-income, whiteOutcomes assessed during third trimester
N = 83 couplesFather’s mental health: higher levels of seeking social support as a coping mechanism compared with control (P < .05). No significant group differences in other coping strategies
Mean age 28 y; average education 14.3 y; average family income $35 250; majority white and married; 71% first pregnancyOther (ie, father’s supportive behaviors): more housework support compared with control (P < .05). There were no significant group differences in other spousal supportive behaviors (eg, infant and/or pregnancy support)
Other (ie, partner relationship quality): more reasoning as a conflict tactic compared with control (P < .05). No significant group differences in the use of verbal aggression as a conflict tactic
Smith et al55; Rising,58 group-based prenatal care program and case managementQuasi-experimental (ie, pretest-posttest control group)To examine the effects of the prenatal intervention on partner relationship and perceived male partner supportTarget population: adolescent, ethnic and racial minoritiesOutcomes assessed at 1 mo postpartum
N = 173 adolescentsOther (ie, father’s supportive behaviors): no differences between groups
Mean age 18.7 (range: 15–29); majority of mothers in school; 42.2% did not have enough money to live on; majority African American and Hispanic
Other (ie, partner relationship quality): no differences between groups
Barth et al54; TAPPQuasi-experimental, (ie, no pretest; posttest only with nonequivalent groups)To describe TAPP and analyze its effects on infants’ birth weightsTarget population: adolescent, ethnic and racial minoritiesOutcomes assessed at various time points during pregnancy and at birth
N = 121 fathersFather involvement: TAPP fathers were more likely to attend birth (P < .01), participate in prenatal health visit (P < .05), attend fatherhood groups (P < .001), attend birthing classes (P < .001) compared with non-TAPP fathers
Mean age 19; 33% enrolled in school and 34% graduated from high school; 50% African American, 30% Hispanic, 10% white
Hart and Foster40; child birth education classes that included sessions on signs of labor, stages of labor, pain management, etcQuasi-experimental (ie, no control group; 1 group pretest-posttest)To examine couples’ prenatal attitudes toward childbirth before and after childbirth education classesTarget population: middle-income, majority whiteOutcomes assessed immediately after the program
N = 73 couplesFather’s attitude and parenting self-efficacy: increase in father’s levels of anticipated control during labor and delivery after participating in the childbirth classes (P < .01)
Mean age 31 y (range: 15–54); all had high school degree and 42% had college degree; majority white; 82% of mothers primiparous
Salman-Engin et al49; FIOCQuasi-experimental (ie, no control group; 1 group pretest-posttest)To examine whether parents derived material benefits from participation in the prenatal FIOC coparenting interventionTarget population: low-income, African AmericanOutcomes assessed at 3 mo postpartum
N = 14 couplesFather’s mental health: fathers’ self-reported depression scores did not significantly decline
All primiparous couples; mean age 24 y for fathers (range: 14–40); all families had income 200% below poverty level; African American; unmarried
Smith and Smith41; parent education projectQuasi-experimental (ie, no control group; 1 group pretest-posttest)To educate parents about the physical and psychological aspects of pregnancy, childbirth, infant care, parenting, and child development, and to establish and strengthen parents’ systems of supportTarget population: middle- income, marriedOutcomes assessed at last session
N = 41 couplesFather’s parenting knowledge: no improvement in father knowledge of when a child begins to see or hear, but there was improvement in father knowledge of child development (P < .05)
Mean age 29.1 y; 70% of fathers and 47% of mothers completed greater than high school; 73% were primiparous; married
Van de Carr and Lehrer42; Prenatal University (Van de Carr, 1979) program during pregnancyNonexperimental (3 groups, posttest only)To examine the effects of the Prenatal University program on father-infant relationships as perceived by the motherTarget population: middle-incomeOutcomes assessed on 6 mo to 3-y-old children
N = 150 parentsFather-infant interaction: full- and partial-participant groups reported more enhanced father-child relationship compared with the nonparticipants group (P < .05)
Multiparous (no other demographic information)
Fawcett and Burritt43; educational pamphlet on cesarean delivery and follow-up via home visit or telephone call to reinforce pamphlet contentMixed methodsTo develop and test an antenatal education program of cesarean birth informationTarget population: upper-middle incomeOutcome assessed shortly after birth
N = 15 couplesOther (ie, father’s evaluation of the intervention): 13 of 15 fathers indicated that the pamphlet was informative. All fathers stated that the follow-up home visit or phone call was beneficial in that it provided opportunity for clarification of pamphlet content and provision of additional information about pregnancy in general and cesarean birth
Primiparous who had a cesarean birth; mean age 31.3 y for fathers; upper-middle to upper class
Mackert et al46; pregnancy-related e-health application on a tablet computer developed by authorsMixed methodsTo investigate the value of an e-health application to educate men about pregnancy-related healthTarget population: majority whiteOutcome assessed during and immediately after the e-health application was used
N = 23 adult menOther (ie, father’s evaluation of the intervention): most men reported enjoying the graphics and stated that they were easy to understand. They also liked the overall “feel” of the application. Men expressed mixed opinions about whether they would use an application such as this one in the future
Mean age 26 y; all men had at least some level of postsecondary education; 52% white, 26% Hispanic, 9% Asian, 9% multiracial or other, 4% African American
Fawcett and Henklin44; educational pamphlet on cesarean delivery and follow-up via home visit or telephone call to reinforce pamphlet contentMixed methodsTo compare responses of vaginally delivered and cesarean-delivered parents to an antenatal educational program of cesarean birth information and to determine the feasibility of incorporating the educational program into Lamaze childbirth preparation classesTarget population: upper-middle to upper classOutcome assessed at 1–3 wk postpartum
N = 42 couplesOther (ie, father’s evaluation of the intervention): no significant differences in men’s reactions to the pamphlet were found between the fathers from the cesarean delivery group and those from the vaginal delivery group. Most men indicated that the pamphlet provided the information they needed to prepare for the possibility of a cesarean birth. All but 1 man in each delivery group stated that the pamphlet and class discussion provided desired information
Pregnant women and their male partner; mean age 31.5 y for men; majority upper-middle to upper class
Mackert et al45; My Pregnancy Today (BabyCenter, no date), a pregnancy-related e-health application on a tablet computerMixed methodsTo investigate the value of an e-health application to educate men about pregnancy-related health information regardless of the men’s level of health literacyTarget population: ethnic and racial minoritiesOutcome assessed during and immediately after using the tool, during pregnancy
N = 32 adult menOther (ie, father’s evaluation of the intervention): men generally stated that the application was easy to use and that it contained useful information; in general, participants felt there was ‘‘just the right amount of information’’ presented, and they did not need to click on the videos for more information
Mean age 33.2 y; 75% reported having at least high school diploma or GED; 38% Hispanic, 28% African American; 28% white; 6% multiracial; majority had at least 1 child or a partner who was pregnant
Gambrel and Piercy51; Mindful Transition to Parenthood Program adapted from the Mindfulness-Based Stress Reduction program59Phenomenological qualitative studyTo assess the effects of the parenting program on internal and interpersonal attunementTarget population: middle-income, majority whiteOutcome assessed 1 wk after last session
N = 13 couplesFather involvement: mothers in the program reporting stronger commitment from their male partners as well as more willingness from male partners to discuss preparations for childbirth and future involvement
Couples expecting their first child; parents age 24–41 y old; median range of income was $30 000–$39 000; 73% were whiteFather’s attitude and parenting self-efficacy: fathers reported preparedness for parenthood; they felt more confident about becoming parents
Father’s mental health: fathers reported increases in regulation of negative emotions and feelings of joy, relaxation, peace, enjoyment, and energy level as a result of the intervention
Other (ie, partner relationship quality): fathers reported that they felt the intervention helped them to be more present with their partner and led to deeper connections in their relationships. They felt more love and appreciation for and from partners. Fathers also experienced an increased ability to relate to partner’s point of view and resolve conflict more effectively
  • e-health, electronic health; FF, Family Foundations; FIOC, Figuring It Out for the Child; GCF, Growing as a Couple and Family; GED, General Education Development; NBAS, Neonatal Behavioral Assessment Scale; TAPP, Teenage Pregnancy and Parenting Project.