Development and initial acceptability of tailored text messaging to increase father engagement in home visitation

• In Event: 2-047 - Making an App for That: Initial program creation and evaluation of technology-based parent guidance programs

Integrative Statement

Healthy Start is a home visitation program that serves low-income mothers and children from the prenatal period through the child’s first two years of life (U.S. Department of Health and Human Services, 2010). Even though home visitation programs are considered an evidence-based model (Eckenrode et al., 2017), they target primarily mothers and their infants, with few resources and services for fathers. Indeed, there are few programs for fathers in general during the perinatal period and the first year of the child’s life (Lee et al., 2018).

Our research team developed a peer support text messaging-based program aimed primarily at improving father engagement in Healthy Start home visitation programs designed for low-income fathers. Text4Dad allows mentors—Fatherhood Community Healthy Workers (F-CHWs) in this this case—to send tailored text messages to fathers. The text messages are developmentally appropriate and pertain to different parenting topics, such as father-infant attachment, infant care, infant development, father-infant play, coparenting, and self-care. We developed the text messages by referencing reputable parent education sources, such as WebMD, BabyCenter, and the American Academy of Pediatrics’ Bright Future anticipatory guidance.

This presentation will focus on the development of the text messages and pilot test data examining the acceptability, applicability, and relevance of the program’s text messages. First, we organized focus groups with fathers enrolled in the Healthy Start home visitation programs to assess the domains of parenting topics and content of text messages. Fathers generally provided positive feedback on the text messages. Analysis indicated that the text messages were appealing and appropriate for low-income fathers in the Healthy Start home visitation programs.

Second, we conducted an online survey on Amazon Mechanical Turk (MTurk) in August 2017. Fifty men participated. The mean age for participants was 32.15 year (range: 23-40 years, SD = 4.4). Majority of the participants were White, middle-income, and married. Participants were asked to rate the acceptability of the messages (e.g., “As a father, I would find the text messages helpful”). The text messages had overall high acceptability. Participants generally responded positively to the content: “Great advice... I love all the resources and information provided.” Participants expressed preference for standard English over text language (e.g., “you” vs. “u”). When asked about additional topics, participants reported that they would like to learn more about caregiving, stress management, and ways to support the mother’s health. Although the MTurk survey participants were majority White and well educated, and thus not highly representative of low-income fathers, the survey results paired with the qualitative focus groups conducted with Healthy Start fathers suggest that the text messages are acceptable to fathers in a variety of contexts.

This presentation has implications for how to effectively engage at-risk, low-income fathers in home visitation programs. First, results demonstrate the importance of pilot testing content of messages to ensure that they are father friendly and appropriate for the target audience of fathers. Second, implementation of the interactive Text4dad program suggests that text messaging can be used to keep fathers engaged in a community-based, father-inclusive home visitation program.

Authors

• Joyce Y Lee, University of Michigan
  Presenting Author

• Shawna J Lee, University of Michigan
  Non-Presenting Author