Perinatal Mental Health: Father Inclusion At The Local, State, And National Levels.

Fathers occupy a dual role in the realm of perinatal mental health: partner and parent. In fathers' role as partners, their support for mothers during pregnancy and postpartum is associated with improved maternal mental health. In their role as parents, fathers themselves are vulnerable to perinatal mood and anxiety disorder. This article aims to advance awareness of paternal perinatal mental health issues and impacts on families. We first review the evidence on paternal perinatal mental health. This evidence includes the critical role played by fathers in maternal perinatal mental health, the prevalence of paternal perinatal mood and anxiety disorder, the impact of paternal mental health on child and family well-being, and screening and treatment approaches. Next, we offer recommendations for more inclusive approaches at the local, state, and national levels aimed at improving parental mental health and health outcomes for fathers, mothers, and babies.

Black fathers' contributions to maternal mental health.

This mixed-methods research study aimed to assess the contribution of interparental relationship quality and paternal support for mothers to maternal mental health among Black parents in a metro area characterized by severe racial disparities. We also explored Black parents' understanding of meaningful paternal support for mothers. Using survey data collected from Black mothers (N = 75), we examined correlations among the study variables, then conducted mediation and moderation analyses to examine whether relationship quality would mediate the association between paternal support and maternal mental health and to test whether relationship quality would moderate the association between paternal support and maternal self-reported overall health. We used inductive thematic analysis to analyze data from focus groups with Black parents (N = 15). We found that mothers' mental health was positively correlated with relationship quality, mothers' subjective health was positively correlated with paternal support, and relationship quality significantly mediates the relationship between paternal support and maternal mental health while controlling for relationship status. Our thematic analysis yielded four themes to characterize meaningful paternal support for mothers and a high quality interparental relationship: (1) Teammates; (2) Multidimensional, everyday support; (3) Communication is key; and (4) Challenge racism and disrupt intergenerational trauma. Findings suggest that paternal support and interparental relationship quality can play a protective role, promoting maternal mental health and wellbeing. Providers of perinatal services should support Black parents to support one another, including as advocates in confronting racism.

New Parent Support Needs and Experiences with Pediatric Care During the COVID-19 Pandemic.

OBJECTIVES: Despite evidence for heightened psychiatric risk and unique parenting challenges during the COVID-19 pandemic, no research exists on the specific needs of parents of infants and responsiveness of pediatric care to their needs. We aimed to describe the support needs of new parents and explore their experiences with pediatric care. METHODS: In late 2020 we conducted semi-structured interviews with 30 mothers of babies born or due that year. Interviews addressed perinatal experiences during the pandemic, with an emphasis on experiences related to social support. In an iterative, inductive process, thematic analysis was used to analyze the data. RESULTS: This study identifies a set of support needs specific to the context of parenting an infant during the COVID-19 crisis: coping with the compound psychological impacts of the postpartum period and a pandemic; parenting in the absence of expected social support; risk assessment to keep infant and family safe. This study finds that policies implemented by health care providers to reduce risk of COVID-19 transmission came at a cost to new parents and parent-provider relationships. Participants reported mixed experiences with in-person and telehealth pediatric care, including inadequate and/or uncomfortable postpartum mental health screening and breastfeeding support, and identified specific features that constituted responsive care during the pandemic. CONCLUSIONS: Normative changes associated with the postpartum period combined with complex adaptations necessitated by the COVID-19 pandemic presented substantial challenges for families with infants, even relatively privileged families. Providers can incorporate these findings to enhance support for families and promote maternal and child health.

Technology-Facilitated Abuse Prevalence and Associations Among a Nationally Representative Sample of Young Men.

PURPOSE: We undertook a study to determine the prevalence and associations of technology-facilitated abuse (TFA)-insults, harassment, coercion, or threats carried out using digital tools such as smartphones and computers-among a US nationally representative sample of young men. METHODS: Analyses were based on 1,079 men aged 18 to 35 years who completed questionnaires during August and September of 2014 and reported ever having been in a romantic relationship. We used validated measures to assess demographics, health service use, mental health and substance use, and TFA delivered to and received from partners in the past year. We calculated survey-weighted descriptive statistics and conducted multinomial logistic regression analysis. RESULTS: Overall, 4.1% of men reported delivering TFA only, 8.0% receiving TFA only, and 25.6% both delivering and receiving TFA. Men were more likely to report only delivering TFA if they identified as Hispanic (adjusted odds ratio [AOR] = 2.72; 95% CI, 1.13 to 6.57), used marijuana (AOR = 1.31; 95% CI, 1.02 to 1.68), and used prescription opioids for nonmedical reasons (AOR 2.86; 95% CI, 1.48 to 5.54). Men were more likely to report only receiving TFA if they identified as Hispanic (AOR = 2.55; 95% CI, 1.01 to 6.43) and used prescription opioids for nonmedical reasons (AOR = 2.43; 95% CI, 1.34 to 4.39), whereas a primary care connection appeared protective (AOR = 0.43; 95% CI, 0.22 to 0.86). Men were more likely to report both delivering and receiving TFA if they identified as non-Hispanic Black (AOR = 2.83; 95% CI, 1.44 to 5.58), owned a smartphone (AOR = 1.80; 95% CI, 1.05 to 3.09), had ever had mental health care visits (AOR = 1.86; 95% CI, 1.16 to 2.98), misused alcohol (AOR = 1.10; 95% CI, 1.04 to 1.17), and used prescription opioids for nonmedical reasons (AOR = 1.79; 95% CI, 1.04 to 3.08). CONCLUSIONS: We found that TFA was prevalent among young men, with 1 in 25 reporting delivery only, 1 in 12 reporting receipt only, and 1 in 4 reporting both. Primary care physicians can consider assessing TFA among male patients and developing interventions to mitigate this behavior.VISUAL ABSTRACT.

Locating Infant and Early Childhood Mental Health at the Heart of Social Work.

Infant and early childhood mental health (IECMH)-an interdisciplinary field dedicated to advancing understanding of early relationships, socioemotional development, and cultural and contextual influences on caregiving-offers essential tools for social workers to support the well-being of infants, toddlers, preschoolers, and their families. Even though social worker Selma Fraiberg was a founder of the field, and social workers are central to the work of assessment and intervention with young children and their caregivers in many settings, few schools of social work offer training in IECMH, and few social workers are familiar with its core principles, scholarship, and intervention approaches. In this article, faculty members from four U.S. social work programs address the vital role of IECMH in social work training, research, and practice as well as issue a call to the field to recover and renew commitment to a practice perspective and knowledge base with roots in social work. Twenty-five years ago, Social Work published a similar call, but the request has gone largely unheeded. The authors examine the changing landscape and argue that it is more important and timelier than ever for social workers to learn and integrate the relationship-based approach to promotion, prevention, intervention, and treatment offered by IECMH.

Present as a partner and a parent: Mothers' and fathers' perspectives on father participation in prenatal care.

Supportive father involvement during pregnancy can positively impact maternal and child outcomes. Father participation in prenatal care is increasing, yet little research exists to understand how mothers and fathers experience father participation in prenatal care and their preferences for father participation. We interviewed expectant first-time mothers (N = 22) and fathers (N = 20) to learn about fathers' participation in prenatal care, perceptions of providers' treatment of fathers, and preferences for father participation. Interviews were coded using principles of grounded theory. Father participation ranged from attendance at visits considered "important" (e.g., ultrasounds) to attendance at every appointment. Experiences of father participation varied, with many describing it as both an important act of support for the mother and part of assuming the role of father. Most participants saw great value in father participation in prenatal care as an opportunity for fathers to learn how to support a healthy pregnancy, bond with their developing baby, and share joy and/or worries with mothers. Participants generally felt that fathers were made to feel welcome and wanted providers to be inclusive of fathers during appointments. Results of this study suggest that father participation presents an opportunity for prenatal care providers to foster fathers' positive involvement in pregnancy, support for mothers, and preparation to parent.

El apoyo participativo del papá durante el embarazo puede tener un impacto positivo en el resultado materno y del niño. La participación del papá en el cuidado prenatal está aumentando, sin embargo, existe poca investigación para comprender cómo las mamás y los papás experimentan la participación del papá en el cuidado prenatal, y sus preferencias en cuanto a la participación del papá. Entrevistamos a madres primerizas embarazadas (N = 22) y papás (N = 20) para conocer acerca de la participación de los papás en el cuidado prenatal, las percepciones que acerca de los papás tenían quienes ofrecen el tratamiento, así como las preferencias en cuanto a la participación del papá. Se codificaron las entrevistas usando principios de teoría fundamentada. La participación del papá osciló desde el asistir a visitas consideradas "importantes" (v.g. el ultrasonido) hasta el asistir a cada cita. Las experiencias de la participación del papá variaron, y muchos las describieron como un acto importante de apoyo para la mamá y parte de asumir el papel de papá. La mayoría de los participantes vio un gran valor en la participación del papá en el cuidado prenatal, así como una oportunidad para los papás de aprender cómo prestar apoyo a un embarazo sano, establecer una relación con su bebé en desarrollo y compartir las alegrías y/o las preocupaciones con las mamás. Los participantes generalmente sintieron que a los papás se les hizo sentir bienvenidos y querían que quienes prestaban el cuidado incluyeran a los papás durante la cita. Los resultados de este estudio sugieren que la participación del papá presenta una oportunidad para quienes prestan el cuidado prenatal de fomentar una participación positiva en el embarazo, el apoyo a las mamás y la preparación para ser padre.

La participation d'appui du père durant la grossesse peut affecter de manière positive les résultats maternels et l'enfant. La participation du père au soin prénatal augmente et cependant il existe peu de recherches permettant de comprendre comment les mères et les pères font l'expérience de la participation du père au soin prénatal et leurs préférences pour la participation du père. Nous avons interviewé des mères attendant leur premier enfant (N = 22) et des pères (N = 20) afin de découvrir la participation des pères au soin prénatal, les perceptions de manière dont les prestataires traitent les pères, et les préférences pour ce qui concerne la participation des pères. Les entretiens ont été codés en utilisant les principes de théorie ancrée. La participation du père est allée de la présence aux visites considérées comme étant "importantes" (comme par exemple les ultrasons) à la présence à chaque rendez-vous. Les expériences de la participation des pères ont varié, la plupart des participants la décrivant comme étant à la fois un acte de soutien important pour la mère et une partie du fait d'assumer le rôle de père. La plupart des participants ont ressenti une grande valeur en la participation du père dans le soin prénatal, en la considérant comme une chance pour les pères d'apprendre comment soutenir une grossesse saine, de se lier avec leur bébé se développant et de partager la joie et/ou les inquiétudes avec les mères. Les participants ont généralement ressenti que les pères étaient bien accueillis et souhaitaient que les prestataires incluent les pères durant les rendez-vous. Les résultats de cette étude suggèrent que la participation du père présente une opportunité pour les prestataires de soin prénatal de cultiver une participation positive des pères à la grossesse, au soin des mères et à la préparation au parentage.

Men's Knowledge of Anticipatory Guidance Topics: Results From a Nationally Representative Survey.

OBJECTIVE: 1) To describe young men's knowledge of infant routines, discipline, development, safety, sleep, and nutrition, using items assessing the American Academy of Pediatrics Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 2) To report differences in knowledge between fathers and non-fathers. 3) To examine factors associated with men's greater knowledge. METHODS: Participants were men (N = 1303) aged 18 to 35 years responding to a cross-sectional survey that was administered to a national panel established through probability sampling of the civilian, non-institutionalized US population. Survey weights allow reporting of nationally representative analyses. RESULTS: Participants (mean age = 27; 58% white, 36% fathers) correctly answered 52% of the infant knowledge questions. Fathers and non-fathers answered 64% and 46% of the items correctly, respectively. The difference in knowledge between fathers and non-fathers was statistically significant (B = 0.16, P< .001). The subscale with the highest number of correct responses was routines (80% accuracy), followed by discipline (59% accuracy), safety (52% accuracy), sleep (51% accuracy), development (50% accuracy), and nutrition (40% accuracy). Multivariate analyses showed that depressive symptoms (B = -0.07, P < .05) were associated with lower infant knowledge, while higher education (B = 0.06, P < .05) and current employment (B = 0.06, P < .01) were associated with higher infant knowledge. CONCLUSIONS: Significant gaps exist in men's knowledge of infant development. Pediatric health care providers can address gaps in parenting knowledge by providing anticipatory guidance to fathers.

Prescription Opioid Misuse and Intimate Partner Violence Perpetration among a Nationally Representative Sample of Young Men.

BACKGROUND: Drug use is associated with intimate partner violence (IPV) perpetration among men, but few studies have examined the relation between prescription opioid misuse and IPV perpetration. Objectives: The purpose of this study is to examine the relation between prescription opioid misuse and IPV perpetration while controlling for demographic, depression, alcohol, and illicit drug use risk factors among a non-clinical, nationally representative sample of young men aged 18-35. Methods: Cross-sectional survey in August 2014 of 1,053 partnered men aged 18-35 in a nationally representative sample of the adult U.S. population. The survey assessed physical IPV perpetration, depressive symptoms, alcohol misuse, marijuana use, illegal drug use, prescription opioid misuse, and demographic characteristics. We calculated descriptive statistics and conducted weighted bivariate and multivariate logistic regression to assess associations of IPV perpetration with prescription opioid misuse and other known IPV risk factors. Results: Weighted analyses show 19.4% of men reported IPV perpetration in the current or most recent relationship, and 7.3% reported prescription opioid misuse in the past year. After controlling for marijuana use, illegal drug use, depressive symptoms, and demographic characteristics, prescription opioid misuse in the past year (A.O.R. = 1.94, 95% CI = 1.33-2.84) was associated with increased odds of young men's physical IPV perpetration in the current or most recent relationship. Conclusions/importance: Prescription opioid misuse is associated with IPV perpetration at a population-level among young men and is not unique to clinical samples. Prevention and intervention strategies should be developed to simultaneously target prescription opioid misuse and IPV perpetration.

Prevalence of Intimate Partner Violence and Beliefs About Partner Violence Screening Among Young Men.

PURPOSE: Few clinical guidelines focus on how physicians can identify intimate partner violence (IPV) perpetration or victimization among male patients, and little is known of men's experiences and beliefs regarding screening in health care settings. Our objective was to determine prevalence of men's experiences with IPV screening in health care settings and associations with men's beliefs regarding health care clinician identification of IPV. METHODS: Using a cross-sectional online survey of a nationally representative sample of 916 men aged 18-35 years, we conducted survey-weighted descriptive analyses to determine IPV prevalence, screening experiences and beliefs, and multivariate logistic regression to examine associations of demographics, IPV perpetration, and IPV victimization with men's screening experiences and beliefs. RESULTS: Of 916 men surveyed, 19% reported perpetration and 27% reported victimization in relationship with current or previous spouse/partner, 90% believed health care clinicians should ask about perpetration, 92% believed health care clinicians should ask about victimization, but only 11% had been asked about perpetration and 13% about victimization. Beliefs regarding IPV were associated with African American non-Hispanic race, IPV perpetration, and IPV victimization. Experiences being asked about IPV were associated with educational attainment and IPV perpetration. CONCLUSIONS: Among young US men, 9 in 10 support IPV identification by health care clinicians, nearly 1 in 5 report using IPV, but only about 1 in 10 report health care clinicians asking about IPV. These represent missed opportunities for health care IPV identification. Beliefs and experiences regarding health care IPV identification vary by race, education, and men's IPV perpetration and victimization. These disparities can inform tailored health care identification approaches.

Your baby is so happy, active, uncooperative: How prenatal care providers contribute to parents' mental representations of the baby.

BACKGROUND: Parents' prenatal mental representations (i.e., thoughts and expectations) of their future child and relationship to that child have been associated with parenting and parent-child relationships after birth. OBJECTIVE: To explore how prenatal care providers contribute to parents' mental representations of the baby they are expecting. METHODS: Routine prenatal ultrasounds of 22 pregnant women recruited through prenatal care were observed. Detailed notes were taken using an adaptation of the "Observation of Routine Screen Form" (Boukydis, 2006). Data collection included interaction among parents and providers relevant to the relational, rather than medical, aspect of the exam (e.g., comments on the "personality" of the fetus, speculation about how the future baby will be like and unlike parents). Principles of grounded theory informed thematic analysis of the data. FINDINGS: Providers varied widely in their recognition of the relational aspect of prenatal ultrasound and their interactive style. Through informal interactions during ultrasounds, providers alternately inhibited, amplified, and shaped parents' mental representations of their baby. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The manner in which providers narrate and interpret images has implications for parents' prenatal mental representations of the baby. Given the importance of prenatal representations for future parenting and parent-child relationships, providers should attend to and facilitate parents' efforts to develop their own mental representations and establish feelings of connection to the baby.

Strategies to Engage Men and Boys in Violence Prevention: A Global Organizational Perspective.

This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic, and contextual concerns of the local community, with nuanced messages and appropriate messengers. In addition, respondents reported key principles informing their organizational strategies to deepen men and boys' engagement. Attention is also paid to respondents' caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves.

Hush now baby: mothers' and fathers' strategies for soothing their infants and associated parenting outcomes.

OBJECTIVES: The purpose of this study was to examine the types of soothing behaviors used by mothers and fathers of infants, differences in use trajectories over time, and associated parenting outcomes. METHODS: A longitudinal study of 241 families expecting their second child was performed. Data were collected at 1, 4, and 8 postnatal months and included measures of parental soothing techniques, involvement in soothing, distress in response to infant crying, and parenting self-efficacy. RESULTS: The average number of soothing techniques used was 7.7 for mothers and 5.9 for fathers. Soothing frequency decreased over time, and change patterns of soothing differed over time by gender. In couples who shared responsibility for soothing, fathers felt more efficacious in parenting and mothers were less upset by infant crying. DISCUSSION: Clinicians are encouraged to support fathers' engagement in infant soothing, facilitate the development of fathers' parenting confidence, and promote fathers' involvement in children's health and health care.

Fathering after military deployment: parenting challenges and goals of fathers of young children.

Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They described a need for support in expressing emotions, nurturing, and managing their tempers. Results affirm the need for support to military families during reintegration and demonstrate that military fathers are receptive to opportunities to engage in parenting interventions. Helping fathers understand their children's behavior in the context of age-typical responses to separation and reunion may help them to renew parent-child relationships and reengage in optimal parenting of their young children.

Strong, safe, and secure: negotiating early fathering and military service across the deployment cycle.

Military fathers of young children often endure repeated separations from their children, and these may disrupt the early parent-child relationship. Postdeployment reunification also poses challenges; disruptions that have occurred must often be repaired in the context of heightened emotions on the part of each family member at a time when fathers are themselves readjusting to the routines and responsibilities of family life. The current study employed qualitative research with the central aim of informing a richer understanding of these experiences. Interviews were conducted with 14 military fathers of young children who had experienced separation from their families during deployment. Narratives were coded using principles of grounded theory, and common parenting themes were extracted. Fathers shared their hopes that their young children would develop qualities of strength, confidence, and self-sufficiency. They also discussed difficulty in supporting the development of these qualities in their young children due to problems dealing with the negative emotions and difficult behaviors that their children exhibited. Reliance on their parenting partner was commonly cited as an effective strategy as fathers transitioned back to family life. Implications for intervention programs include the provision of parenting and self-care skills and inclusion of the father's parenting partner in the intervention.