Working out dads (WOD): a study protocol for a randomised controlled trial of a group-based peer support intervention for men experiencing mental health difficulties in early fatherhood.

BACKGROUND: Approximately one in ten men experience mental health difficulties during the early years of fatherhood, and these can have negative impacts on children and families. However, few evidence-based interventions targeting fathers' mental health are available. The aim of the trial is to evaluate the effectiveness and cost-effectiveness of Working Out Dads (WOD) - a facilitated peer support group intervention for fathers of young children, in reducing psychological distress and other mental health symptoms. METHODS: This trial will employ a parallel-arm randomised controlled trial (RCT) to evaluate the effectiveness and cost effectiveness of WOD peer support group intervention compared to usual care (a 30-min mental health and service focused phone consultation with a health professional). A total of 280 fathers of young children (aged 0-4 years) who are experiencing mental health difficulties and/or are at risk of poor mental health will be recruited. Randomisation and analyses will be at the level of the individual participant. The primary outcome is psychological distress symptoms, measured by the Kessler Psychological Distress Scale (K10) from baseline to 24 weeks post randomisation. A range of secondary outcomes will be assessed including suicidal ideation; mental health disorders, specific symptoms of depression, anxiety, and stress; social support, quality of life, health service use, and health care costs. Data will be collected at baseline, 10- and 24 weeks post-randomisation. DISCUSSION: This trial will examine the effectiveness of a novel group-based peer support intervention in reducing the psychological distress and other mental health symptoms of fathers compared to usual care. The economic and process evaluation will guide policy decision making along with informing the future implementation of WOD on a larger scale if effectiveness is demonstrated. TRIAL REGISTRATION: The current trial has been registered with ClinicalTrials.gov (Registration ID - NCT04813042 ). Date of Registration: March 22nd, 2021.

The experience of the COVID-19 pandemic for families of infants involved with Child Protection Services for maltreatment concerns.

The COVID-19 pandemic and associated physical distancing restrictions have exacerbated social, economic and health disadvantage within our communities. With increases in mental health difficulties and family violence already being seen, there is concern that the risk of child maltreatment risk may also be increased. The current study aimed to explore the experience of the COVID-19 pandemic for families identified to be at risk of child maltreatment in Victoria, Australia. Understanding the experiences of the pandemic for families already at risk is essential in identifying how to best support vulnerable parents and young children during this challenging time. Interviews were conducted with 11 parents currently involved with Child Protection Services, and nine clinicians working within a child and family health services, supporting clients with child protection involvement. Parents and clinicians described a range of pandemic related stressors including employment and financial stress, worry about infection and changes to service access. In addition, parents with children in out of home care discussed decreased access to their children resulting from physical distancing restrictions. Parents and clinicians perceived the pandemic to be having a negative impact on parent mental health, parenting stress and isolation. Although parents raised minimal concerns about the impact of the pandemic on child well-being, clinicians expressed concerns about the rise in risk factors for child maltreatment. Parents discussed a range of coping strategies which they perceived to be helpful during the pandemic, and clinicians and parents described the need for additional mental health support and support to access basic needs. The study highlights the importance of ensuring at risk families have access to parenting and mental health support throughout the pandemic and the importance of ensuring children within at-risk families are sighted and their safety assessed.

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.

"We're in the background": Facilitators and barriers to fathers' engagement and participation in a health intervention during the early parenting period.

ISSUES ADDRESSED: Little is known about the barriers and facilitators associated with engaging fathers in interventions targeting their physical and mental health. The current research therefore aimed to explore fathers' perceived barriers and facilitators to engagement and participation in a health intervention delivered during the early parenting period. METHODS: Eleven fathers of young children (0-4 years) were interviewed about their perceptions and experiences of facilitators and barriers to engaging and participating in an intervention (Working Out Dads) to target their mental and physical health. Interviews were recorded and transcribed. Transcripts were analysed using thematic analysis. RESULTS: Fathers identified a number of program-related and father-related facilitators and barriers which impacted their engagement and participation. Program-related facilitators included: accessibility of the program; father advocacy of the program; group fitness/exercise component; and having a father-specific program. Facilitating factors related to fathers included: making social connections; learning how to be a better dad/partner; and partner support and encouragement to attend. Program-related barriers included: travel; lack of awareness; and gender roles. While father-related barriers included: being time poor; sacrifices to family; and apprehension. CONCLUSIONS: The current findings identified many areas that facilitate, encourage and motivate men to participate in interventions which support their mental and physical health during the early parenting period. RELEVANCE: Generating evidence on barriers and facilitators to health interventions is important to improving the current intervention along with informing the development of engaging and targeted health interventions for fathers in early parenthood.