In a recently released issue of Pediatrics, Joyce Lee and colleagues (10.1542/peds.2018-0437) report on a systematic review of father-inclusive perinatal parenting programs in the United States (US) that include father outcomes. The past decade has seen increasing recognition of the vital role that fathers involvement in parenting has to the well-being of their children, their partners and their own physical and mental health. The authors took a broad approach, and included all peer-reviewed studies that were not just experimental or quasi-experimental (no control group) but also those that were non-experimental, provided the study included or targeted fathers and had a father-focused outcome in the first year of life. Savvy readers will not be very surprised to learn that a total of just 21 studies met inclusion criteria and could be reviewed. Indeed the authors’ systematic review is timely, particularly since most parent education programs target mothers, and most that focus on fathers gain access via the mother.
The broad range of programs and participants is impressive: in 21 studies, 19 separate programs were evaluated, and these enrolled a broad range and number of participants, whose age, racial, ethnic, income and marital status descriptors varied widely. The authors’ narrative synthesis leads the reader through the many interesting and diverse program styles, curricula and outcomes.
I was mildly surprised to learn that our own “go to” perinatal father-focused community-based parenting program was not the subject of any of the studies. Bootcamp for New Dads is a licensed business franchise based in California that has been adopted across the US. (I do not have any financial interest in or relationship to the business). Following training, Coaches who are dads themselves spend 3 hours with new fathers with their infants “inspiring and equipping” them to “become confidently engaged” with their babies. In a non-peer reviewed report including father-partner paired responses, 143 (57.2%) of 250 participants responded and self-reported participation, engagement and bonding with their children 1-2 years following their Bootcamp experience. More than 130 fathers (my best read of a histogram) thought Boot Camp had “a lot” or “some” positive impact on their bonding with their baby. Internally conducted positive satisfaction surveys are separately reported on the website. The great challenge here is that although identified as a best practice and “top fatherhood resource” by national organizations, and an intuitive and popular “winner” as a parenting program, the supporting research lacks rigor. This is not a criticism of the program, or to diminish its great value to our and other communities, but rather the realistic acknowledgement that conducting objective and peer-reviewable outcomes research is challenging and expensive. For any community based organization, funding is scarce, and it is difficult to identify appropriately trained individuals who do not have a conflict of interest to do the work.
Where to from here? Keeping the focus on fathers is well supported by the literature. The next step may be to plan for and expect assessment to be built into grants and sustainable funding for these and other community-based parenting programs. Passionate program leaders will likely use every dollar for outreach and engagement, so forward-thinking grantors may need to consider building in systematic evaluation as organizations grow and thrive and seek to serve their communities. Hopefully all partners will benefit from this approach.
