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