Research

The research behind SMS4dads

A number of studies have informed the development of SMS4dads. Here you’ll find abstracts from some key papers.

SMS4dads man on phone
Abstracts Include
  1. Supporting men through their transition to fatherhood with messages delivered to their smartphones: a feasibility study of SMS4dads.
  2. The development and application of a protocol for the writing, assessing, and validating of a corpus of relationship-focused text messages for new and expecting fathers.
  3. Stayin’ on Track: the feasibility of developing Internet and mobile phone-based resources to support young Aboriginal fathers.
  4. Supporting partners of mothers with severe mental illness through text–a feasibility study.
  5. Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact.

Abstract 1

Fletcher R, Kay-Lambkin F, May C, Oldmeadow J, Attia J, Leigh L. (2017) Supporting men through their transition to fatherhood with messages delivered to their smartphones: a feasibility study of SMS4dads BMC Public Health DOI: 10.1186/s12889-017-4978-0

Abstract 2

May, C. D., & Fletcher, R. (2019). The development and application of a protocol for the writing, assessing, and validating of a corpus of relationship-focused text messages for new and expecting fathers. Health informatics journal, 25(2), 240-246.. DOI: 10.1177/1460458217704249

Abstract 3

Fletcher, R., Hammond, C., Faulkner, D., Turner, N., Shipley, L., Read, D., & Gwynn, J. (2017). Stayin’on Track: the feasibility of developing Internet and mobile phone-based resources to support young Aboriginal fathers. Australian journal of primary health, 23(4), 329-334.

Abstract 4

Fletcher, R., StGeorge, J., Rawlinson, C., Baldwin, A., Lanning, P., & Hoehn, E. (2020). Supporting partners of mothers with severe mental illness through text–a feasibility study. Australasian Psychiatry, 1039856220917073.

Abstract 5

Fletcher, R., Knight, T., Macdonald, J. A., & StGeorge, J. (2019). Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact. BMC Psychology, 7(1), 1-11.

ABSTRACT

Fletcher R, Kay-Lambkin F, May C, Oldmeadow J, Attia J, Leigh L. (2017) Supporting men through their transition to fatherhood with messages delivered to their smartphones: a feasibility study of SMS4dads BMC Public Health DOI: 10.1186/s12889-017-4978-0

Objective

The project aimed to test of the quality and acceptability of researcher-developed Short Message Service (SMS) messages designed to support fathers of infants aged 12 months or less.

Background

The findings of previous studies suggest antenatal and postnatal depression among fathers’ impacts negatively on the health of family members.

Method

Draft messages were first modified based on expert review. In a second phase, parents (mothers n = 56; fathers n = 46; unknown n = 4) were recruited through two early childhood parenting services to rate the clarity, usefulness and relevance of the 70 SMS messages using a paper-based survey. In a third phase, 15 fathers were recruited to receive texts at different times over three weeks.

Results

Findings suggest that SMS items were easily understood by the majority of parents, with only 3% of responses indicating an item was ‘not easily understood’. Feedback from parents indicated that negatively rated SMS messages were considered as either poorly phrased, lacking enough information or as not offering sufficient support. The majority (88%) of the SMS items were also rated as ‘useful’ by the parents.

Conclusion

Fathers’ responses indicated that

Fathers’ responses indicated that

The study has produced a set of brief text messages suitable and acceptable to new fathers and their partners.

ABSTRACT

May, C. D., & Fletcher, R. (2019). The development and application of a protocol for the writing, assessing, and validating of a corpus of relationship-focused text messages for new and expecting fathers. Health informatics journal, 25(2), 240-246.. DOI: 10.1177/1460458217704249

In developed countries, antenatal education aims to reduce difficulties that mothers and fathers experience during transition to parenthood.

However, fathers are often distracted from preparing themselves by the attention given to preparing and supporting mothers.

Developments in digital communication present alternative means of supporting fathers at this time.

In developed countries, antenatal education aims to reduce difficulties that mothers and fathers experience during transition to parenthood.

However, fathers are often distracted from preparing themselves by the attention given to preparing and supporting mothers.

The process employed in message development was similar to that previously employed in developing messages for people who had experienced a cardiac event.

A corpus of messages and linked information focusing on fathers’ relationships with their children, partners, and themselves were initially developed by a core group.

The corpus was then culled, refined, and expanded by a larger, more diverse, group of experts (n=46), including parents, academics, and practitioners.

The iterative, consultative process used in this study proved to be a functional way of developing and refining a large corpus of timed messages, and linked information, which could be sent to new fathers during their transition to fatherhood.

ABSTRACT

Fletcher, R., Hammond, C., Faulkner, D., Turner, N., Shipley, L., Read, D., & Gwynn, J. (2017). Stayin’on Track: the feasibility of developing Internet and mobile phone-based resources to support young Aboriginal fathers. Australian journal of primary health, 23(4), 329-334.

Young Aboriginal fathers face social and emotional challenges in the transition to fatherhood, yet culturally appropriate support mechanisms are lacking.

Peer mentoring to develop online and mobile phone-based resources and support may be a viable approach to successfully engage these young men.

This feasibility study engaged two trusted Aboriginal mentors and researchers to partner with one regional and two rural Aboriginal communities in New South Wales, Australia.

Early in the research process, 20 young Aboriginal fathers were recruited as co-investigators. These fathers were integral in the development of web-based resources and testing of mobile phone-based text messaging and mood-tracking programs tailored to provide fathering and mental health support.

Overwhelmingly positive feedback from evaluations reinforced community pride in and ownership of the outcomes.

The young men’s involvement was instrumental in not only developing culturally appropriate support, but also in building their capacity as role models for other fathers in the community. The positive results from this feasibility study support the adoption of participatory approaches to the development of resources for Aboriginal communities

ABSTRACT

Fletcher, R., StGeorge, J., Rawlinson, C., Baldwin, A., Lanning, P., & Hoehn, E. (2020). Supporting partners of mothers with severe mental illness through text–a feasibility study. Australasian Psychiatry, 1039856220917073.

Objective

During the perinatal period, partners of mothers with severe mental illness (SMI) play an important role in managing the new baby and supporting the mothers’ wellbeing. Providing information via mobile phone on infant care, partner support and self-care may assist partners in their support role.

Method

Partners (n = 23) of mothers with SMI were enrolled in a partner- focused SMS service sending brief texts 14 times per month for a maximum of 10 months.

Partners (n = 16) were interviewed on exit and their responses analysed for acceptability and perceived usefulness of the texts.

Results

Partners remained with the programme and expressed high acceptability of the texts. Participants identified effects such as

increased knowledge of and interaction with their baby; effective support for their partner; and reassurance that ‘things were normal’.

Few partners sought support for their own mental health.

Conclusions

Texts supplied to mobile phones of partners of new mothers with SMI may increase partners’ support. The texts in this study were acceptable to partners and were reported to

enhance a partner’s focus on the mother’s needs, raise the partner’s awareness of the infant’s needs, and support the partner’s confidence and competence in infant care.

ABSTRACT

Fletcher, R., Knight, T., Macdonald, J. A., & StGeorge, J. (2019). Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact. BMC Psychology, 7(1), 1-11.

Background

There is growing evidence for the value of technology-based programs to support fathers to make positive transitions across the perinatal period. However, past research has focused on program outcomes with little attention to the mechanisms of impact.

Knowledge of why a program works increases potential for replication across contexts.

Methods
Participants were 40 Australian fathers enrolled in the SMS4dads text-based perinatal support program (Mean age 35.11 (5.87). From a starting point between 16 weeks gestation and 12 weeks postpartum, they were sent a maximum of 184 text messages. An inductive approach was used to analyse post-program semi- structured interviews. The aim was to identify mechanisms of impact aligned to previously identified program outcomes, which were that SMS4dads:

  1. Is helpful/useful;
  2. Lessens a sense of isolation;
  3. Promotes the father-infant relationship; and
  4. Supports the father-partner relationship.

Results

We identified two types of mechanisms: four were structural within the program messages and five were psychological within the participant.

The structural mechanisms included: syncing information to needs; normalisation; prompts to interact; and, the provision of a safety net.

The psychological mechanisms were: increase in knowledge; feelings of confidence; ability to cope; role orientation; and, the feeling of being connected.

These mechanisms interacted with each other to produce the pre-identified program outcomes.

 

Conclusions

If the current findings are generalisable then, future mobile health program design and evaluation would benefit from explicit consideration to how both program components and individual cognitive and behavioural processes combine to elicit targeted outcomes.

KEYWORDS Process evaluation, Fathers, Mechanisms, Text-based, Qualitative

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.

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.