Father Inclusive Prenatal Care Study

Study Overview
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Brief Summary
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Young families need additional institutional support to help them meet the challenges of parenthood. Prenatal clinics are well situated to address some of their needs by expanding services to include fathers. The Father Inclusive Prenatal Care (FIPC) model is designed to prepare young men for the challenges of parenting by supporting the development of their relationship skills as part of routine prenatal healthcare. This approach involves assessing expectant fathers and mothers with a parent prep-check (PPC) to identify their needs and then offer services to address those needs and prepare them for parenthood. Services include: (1) parent education about how to understand and care for infants, and how to build secure parent-child bonds; (2) an evidence-based co-parenting program to strengthen and stabilize their family; and (3) educational and employment support designed to help young parents find and keep living wage jobs. The project will be implemented through several community based healthcare sites that are well positioned to engage young fathers through their prenatal clinics. To extend the reach and accessibility of the model, trainings and most services will be available online. As a result of participating in this project it is expected that young couples will have better co-parenting relationships and be better prepared to take care of their infants.

Detailed Description
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Recruitment: This project will recruit/engage young expectant fathers using a multi-stage process. First, primary care providers (PCP) will ask their patients (17-25-year-old pregnant women) about the degree to which the father of her child will be participating in parenting and supporting their baby. If the mother anticipates the fathers' involvement, the provider will tell her about the Parent Prep-Checks (PPC), give her a brochure about describing that process (including incentives), and ask about connecting her with members of the research team in order to receive additional information. The research team members will establish father eligibility based upon age (18-29 years) and schedule time to meet with both parents. The intake process - the Parent Prep Check - is a strategy for engaging young fathers and mothers in research and intervention activities. In addition to collecting useful baseline data, the PPC is designed to build a strong alliance between project staff and participants. For example, FIPC intake staff are trained to administer a semi-structured interview designed to help participants articulate their feelings about becoming parents, which most find to be an interesting and rewarding experience. Then to facilitate recruitment into the intervention, a motivational interviewing approach is used that (a) gives feedback to participants based on their self-reported data and (b) engages them in thinking about what services will help them get ready for parenthood. When fathers are given the chance to say what concerns them, they are more likely to be receptive to participating in programs that can address those concerns. Intake staff will then introduce expectant parents to a FIPC provider, who discusses the goals and benefits of the FIPC program. Emphasizing how FIPC programs address a parent's self-identified goals has been an effective way to engage and retain participants. The most critical element in this process is the quality of communication between FIPC staff and the expectant mother and father. If done well, both parents will feel appreciated, supported, and respected. Another key factor is flexibility. FIPC staff are trained to be as accommodating as possible about scheduling appointments. Related to this, almost all FIPC services and research activities are available online to increase participant reach and accessibly. Finally, fathers and mothers are told they will be reimbursed for their time. Incentivizing patients is not sustainable over the long run; however, it is deemed necessary to get a representative sample for this project. In years 4 and 5, incentives for services will be reduced as part of the sustainability plan. In past projects, this strategy has been effective in recruiting between 60 and 75% of eligible expectant fathers. Staff at partner clinics and Rush program coordinators who will be trained on the FIPC program and research/evaluation data protocol will be responsible for recruiting the sample. The clinic staff will be asking eligible mothers if they think their partner (father of the baby) would be interested in participating. The FIPC program coordinators will be responsible for contacting fathers and recruiting them to participate after mothers share their contact information. Barrier reduction strategies will be used to support participant engagement. Due to the length of the Parent Prep check (3 hours), expectant parents will be offered a snack during the interview.

Official Title
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Preparing for Parenthood: A Father Inclusive Model of Prenatal Care

Conditions
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Antenatal Care, Pregnancy Related, Parent-Child Relations, Parenting, Education, Counseling

Intervention / Treatment
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* Behavioral: Father Inclusive Prenatal Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women: Nulliparous pregnant woman Men & women have to be willing to participate at baseline interview together Exclusion Criteria: Men & Women: Language other than Spanish or English and cognitive disability interfering with ability to understand the informed consent process.

Ages Eligible for Study
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Minimum Age: 17 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Quasi-Experimental using a Stepped-Wedge design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Father Inclusive Prenatal Care<br>Co parenting, parenting education, employment and educational readiness training and support. | Behavioral: Father Inclusive Prenatal Care<br>* Pregnant and parenting couples participate in co-parenting and parenting education, and job skills and education readiness<br>|
| No Intervention: Standard Care<br>Participants will receive usual prenatal care services and information about community resources. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in conflict in Adolescent Dating Relationship Inventory- Short Form | Used to measure couple relationships and potential conflict. | Change from Baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 
| Change in Coparenting Relationship Questionnaire | Used to examine father-mother relationship status | Change from baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 
| Change in Parenting Stress Index - Short Form | Evaluates parents' perception of parenting-related stress | Change from baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 
| Perceived Maternal Parenting Self-Efficacy Tool | Evaluates how confident parents feel taking care of their infant | Time 2 - six months post birth | 
| Self-efficacy for Parenting Task Index - Toddler-Short | Evaluates how capable parents feel of addressing their child's needs. | Time 3 - eighteen months post birth | 
| Change in Julion Index of Paternal Involvement | Measures how often fathers are involved with their children in a variety of activities | Change from baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 
| Brief Infant Toddler Social & Emotional Assessment (BITSEA) | This form is used to measure infant social-emotional development | Time 3- eighteen months post birth | 
| Change in Quality of Relationship Inventory | Examines the quality of the relationship between co-parenting couples | Change from baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maternal Health Outcome Assessment | Instrument used to report infant birth and mother delivery data. | Six months post birth | 
| Change in Trait Emotional Intelligence Questionnaire | Measure of emotional intelligence | Change from baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 
| Change in Parent Health Questionnaire (PHQ9) | Screening for symptoms of depression | Change from baseline (2nd trimester of pregnancy) at 6 months and 18 months post birth | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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fatherhood, prenatal care, coparenting, parenting education