Fathers as Allies in Optimizing Postpartum Mental Health in Neonatal Intensive Care Settings

• In Event: What Is the Black Maternal Health Crisis and What Is It Doing in a Nice Field Like Education?

Abstract

Objectives/Purpose
The postpartum period is often devoid formal and informal support networks and families caring for babies in neonatal intensive care units (NICUs) face exacerbated needs (Okereafor et al., 2021). Studies report NICU parents experience long-standing mental health challenges such as anxiety-related disorders, depression, and posttraumatic stress disorder (PTSD) (Spence et al., 2023). Practice models to support the mental health of NICU parents broadly engage mothers in the singular navigation of infant care with limited attention directed to fathers (Merritt et al., 2022) despite growing evidence suggesting paternal involvement is positively associated with reduced negative maternal health behaviors and improved infant health outcomes (Alio et al., 2010; Alio et al., 2011). The purpose of this paper is to describe the development of the Fathers First Initiative (FFI), which is a parenting education model designed to foster paternal involvement for NICU families.

Perspective/Theoretical Framework

The health belief model posits two components of health behavior: (1) the desire to avoid illness (or get well if ill) and (2) the belief that a specific health action will prevent (or cure) an illness (Glanz et al., 2015). These beliefs are rooted in six constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy. The FFI model is designed to increase fathers’ beliefs that their involvement in social support and parenting education will fortify their own mental health and advance their capacity to respond to NICU mothers and babies. Research on paternal involvement, as supported by the health belief model, underscores the prediction that the collective engagement of fathers within a group environment that has been curated to center their own health and well-being will provide the catalyst for sustained engagement and improved secondary and tertiary postpartum health outcomes for mothers and babies.

Methods/Modes of Inquiry/Data Sources

A mixed methods approach using an embedded design to determine the feasibility and acceptability of the intervention will be employed for two stages of behavioral health intervention development (Gitlin & Czaja, 2016). Stage 0 includes formative pre-pilot development while Stage 1 involves preliminary pilot testing. Model specifications will focus on six objectives: identifying barriers to father involvement, redefining stereotypical narratives of father engagement in newborn care, reducing the stigma associated with the care of critically ill newborns, educating fathers on quality newborn care, promoting positive mental health for fathers, and fostering peer to peer social support for NICU fathers. Parents of NICU graduates and NICU healthcare providers will be recruited to inform intervention development.

Arguments/Conclusions/Significance

The existing system of pediatric healthcare for NICU families inadvertently puts the onus of decision-making for critically ill newborns on mothers during a particularly high stress and psychologically vulnerable time with limited initial engagement directed to proactively involve fathers. I explain how the Fathers First Initiative intentionally engages, educates, and supports fathers to improve postpartum mental health outcomes for NICU parents. Describing this intervening approach is significant for advancing health promotion and creating educational models developed by helping professionals to address health disparities.

Author

• Tyriesa Howard, Washington University in St. Louis