The research behind SMS4dads

There have been a number of studies that have informed the development of SMS4dads. Here you’ll find abstracts from some key papers

ABSTRACTS INCLUDE

Supporting men through their transition to fatherhood with messages delivered to their smartphones: a feasibility study of SMS4dads.

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.

Stayin’ on Track: the feasibility of developing Internet and mobile phone-based resources to support young Aboriginal fathers. 

Supporting partners of mothers with severe mental illness through text–a feasibility study. 

Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact. 

Just wanted to say thanks for this project. The text messages have been invaluable and i couldn’t have known just how important and how much I needed to receive these short and helpful messages.

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

receiving the texts at different times was acceptable and that message content was relevant to their fathering.

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

Relevant information popped up at the right time, just as things were starting to change I’d get a new message with relevant information.

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.

Studies, across a range of health concerns, have reported successful outcomes from text-based interventions. Text messaging, focusing on the issues that cause paternal distress at this time, could provide timely, targeted, and effective support to fathers in their transition to parenthood. This study aimed to develop a corpus of messages that could be sent to new fathers during pregnancy and in the months after birth. Messages were intended to support new dads in caring for their own physical and mental health, nurturing strong relationships with their child, and developing strong parenting partnerships.

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.

The messages I liked the most, and this is probably more relevant with the returning to work thing, were the messages that were written from the point of view of the child.

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.

Relevant information popped up at the right time, just as things are starting to change I’d get a new message with relevant information.

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

ONGOING RESEARCH

Australian Fatherhood Research Bulletin publishes regular articles and research on fatherhood

Checkout the Fatherhood Research Bulletin for latest research articles on fatherhood along with the AFRC Fatherhood Bulletin which includes an SMS4dads Article “New Dads to be Screened for Depression” in the Spring Edition.

For the first time in Australia, new fathers will be screened for depression through a state health service. With a $2.4 million grant from the Health Innovation Fund, NSW Health has launched a Focus on New Fathers (FONF) pilot program targeting 30,000 fathers in four Local Health Districts.

The FONF pilot will use SMS4dads, an innovative digital platform to reach men expecting a baby/with a newborn to provide information and a screening tool throughout the transition to fatherhood