Research and History

The SMS4dads team joins with researchers and clinicians across Australia and internationally to build the knowledge base for expanding and deepening the support that we can offer to new fathers, their partners and babies

RESEARCH PROJECTS

SMS4dads continues to carry out research fine-tuning and tailor-making the message service for various groups. Below is a showcase of some of our research projects.

Mental Health Screening and Risk Identification

Screening for depression in new fathers beyond the clinic: An observational study.
Fletcher, R., So, J. T. H., Leigh, L., & StGeorge, J. (2026).

This is an observational study that investigated the screening for depression specifically targeting new fathers outside of traditional clinical settings. The research investigates several avenues for mental health screening relevant to fathers during the perinatal period. 

Online mental health screening for rural fathers over the perinatal period.
Fletcher, R., Regan, C., Leigh, L., Dizon, J., & Deering, A. (2023).

This article describes research on rural fathers enrolled in SMS4dads during the perinatal period. It describes risk factors and compares to the urban population. 

Screening Aboriginal and Torres Strait Islander fathers’ mental health through a digital parenting programme.
Hammond, C., Adams, M., So, J., StGeorge, J., & Fletcher, R. (2025).

This work reports on the screening of the mental health of Aboriginal and Torres Strait Islander fathers by use of the MoodChecker. 

Intervention Development and SMS4dads Program Design

Developing a text message intervention for fathers with partners experiencing perinatal depression or anxiety.
Fletcher, R., Regan, C., May, C., White, S., & St George, J. (2025).

This research focuses on the development process for specific text messages to support fathers whose partners are dealing with perinatal depression or anxiety. Parents with lived experience and clinicians participated in the co-design of the messages. 

Developing text-messaging support for fathers after perinatal loss.
Fletcher, R., Regan, C., May, C., Rennie, A., Ludski, K., & George, J. S. (2024).

This article details the steps taken to develop text-messaging support for fathers who have experienced perinatal loss. Co-designed text messages were developed in collaboration with a perinatal bereavement organisationmothers and fathers with lived experience of perinatal loss, and clinicians working with bereaved parents. 

Testing the acceptability of stillbirth awareness messages in an SMS program for fathers.
Fletcher, R., Symonds, I., StGeorge, J., Warland, J., & Stark, M. (2023).

Information on risk factors can be provided to fathers via a father-focused text messaging service such as SMS4dads. Fathers’ awareness of the risk factors for stillbirth can assist mothers to take appropriate actions for a healthy birth.

Co-Creation and Cultural Adaptation

Facilitating family centred care: the co-design development of text messages for fathers with an infant in NICU.
Fletcher, R., May, C., Liackman, R., StGeorge, J., Regan, C., & Stark, M. (2025).

This research details the co-design process, with clinicians and parents, used to develop text messages intended for fathers whose infants are in the Neonatal Intensive Care Unit (NICU).

Consulting With First Nations Communities to Develop Text-Based Support for Grieving Fathers.
Hammond, C., Adams, M., & Fletcher, R. (2025).

This work describes the process of consulting directly with First Nations communities to develop culturally appropriate text-based support resources specifically for fathers experiencing grief. Co-design participants included Red Nose and community representatives.

SMS4dads Program Engagement and Usage

Characterizing Engagement Measures and Profiles in a Mobile Health Intervention, SMS4dads.
St George, J., Dizon, J., Leigh, L., Macdonald, J. A., & Fletcher, R. (2025).

In this study, the authors characterized engagement through analysing a range of usage metrics within the SMS4dads program.   

Understanding Attrition in Text-Based Health Promotion for Fathers: Survival Analysis.
Fletcher, R., Regan, C., Dizon, J., & Leigh, L. (2023).

This study utilized survival analysis to understand the issue of attrition in text-based health promotion programs. The research specifically examined sociodemographic factors related to fathers dropping out of the program.    

Implementation and Knowledge Translation

Providing clinicians with ‘how to’ knowledge for technology-based innovation: Introducing the SMS4dads texts.
Fletcher, R., Regan, C., & StGeorge, J. (2024).

This study assessed the impact of disseminating a ‘taster’ set of SMS messages to increase clinicians’ engagement with SMS4dads. 

Supporting Father's to Support Families

Equipping fathers to support distressed mothers: What do mothers want fathers to know and do?
Fletcher, R., Regan, C., May, C., White, S., & St George, J. (2023).

This research investigated the expectations of mothers regarding their partners’ support when the mothers are distressed. Mothers experiencing perinatal depression and anxiety require a range of supportive actions by their partners, including household tasks and baby-care, encouragement, listening and managing relationships with family and friends. 

SMS4DADS GLOBAL REACH

SMS4dads has extended its reach globally. Find out how SMS4dads translates to dads world-wide.

Below are projects showcasing the work of SMS4dads in Kenya, Ethiopia, Belgium, Colombia and Kenya. Get in touch to find out more about international developments and opportunities to support new fathers via digital methods.

Richard’s research revealed possible long-term negative impacts on the children of dads with mental health issues. Fathers’ depressive symptoms in the first year after the birth predicted behaviour problems in their children years later.

“If dads’ mental health has such a dramatic impact then we need to be screening dads for depression, not just mums,” Richard explains.

In response to these limitations, Richard and his team have designed a smart-phone based program that allows mobile connection for new and expectant dads.

Participants receive texts containing information and links, and self-report their mood. If the mood tracker identifies dads as needing extra support, they will be offered a phone call from a counsellor trained in this area.

Following the success of the pilot of the SMS4dads program, Funding was received to enable a National roll-out.

“When dad’s miss antenatal classes or activities, they also miss out on contact and links to other people.  They may never get the chance to say to anyone, look I’m really stressed,” he points out.

“SMS4dads is a way of bringing dads into the health system and keeping them linked in with services and support,” explains Richard.

SMS4dads

Richard Fletcher

Associate Professor, PhD

Richard credits a varied career, a talented and innovative team, and much life experience for affording him the insight needed to address the challenges related to actively engaging dads.

After completing his masters in Medical Science, studying epidemiology, Richard earned his PhD focusing on fathers and attachment.

“Fathers are invisible in many places, and that is endemic. Not because people dislike fathers, but because the system is set up to be focused on mothers.”

Some services and organisations are aware of the need to engage dads, but have been unsuccessful in their attempts.

“When people are challenged about this, they generally want dads involved,” Richard affirms.

“Often, however, they just don’t know how to do it.”

Richard works with health professionals on issues related to fathers, and has delivered many antenatal programs for expectant dads.

He credits his own family with giving him an understanding of the role of fathers needed to make his work relevant.

“I have three daughters and two stepdaughters,”

“My kids would say they taught me just about everything I know and they’d be right. They’ve taught me a lot, and still do.”

Richard’s research revealed possible long-term negative impacts on the children of dads with mental health issues. Fathers’ depressive symptoms in the first year after the birth predicted behaviour problems in their children years later.

“If dads’ mental health has such a dramatic impact then we need to be screening dads for depression, not just mums,” Richard explains.

In response to these limitations, Richard and his team have designed a smart-phone based program that allows mobile connection for new and expectant dads.

Participants receive texts containing information and links, and self-report their mood. If the mood tracker identifies dads as needing extra support, they will be offered a phone call from a counsellor trained in this area.

Following the success of the pilot of the SMS4dads program, Funding was received to enable a National roll-out.

“When dad’s miss antenatal classes or activities, they also miss out on contact and links to other people.  They may never get the chance to say to anyone, look I’m really stressed,” he points out.

“SMS4dads is a way of bringing dads into the health system and keeping them linked in with services and support,” explains Richard.