The Father Friendly Initiative within Families: Using a logic model to develop program theory for a father support program

Experiences in the application of logic models in the context of workplace health promotion - A focus group discussion

Gathering evidence on complex workplace health promotion interventions faces methodological challenges. Therefore, the application of logic models as a theory of change is recommended to support outcome and process evaluations. The present study explores challenges and opportunities of applying logic models in application-oriented intervention research on workplace health promotion. A focus group (n = 6), consisting of scientists and workplace health promotion practitioners, was conducted using a semi-structured interview guide. The recorded qualitative data were transcribed and analysed using the structuring content analysis method. According to the focus group, logic models provide several opportunities for planning and evaluating complex workplace health promotion interventions. Logic models support the communication between science and practice, and have benefits for the provider of workplace health promotion interventions. The main challenges in working with logic models were dealing with the complex and constantly developing intervention and with the derivation and implementation of reasonable evaluation methods. The focus group exposed repeated application and a shared understanding between stakeholders as facilitators for working with logic models. In conclusion, at the science-practice interface, logic models could enhance the integrative understanding and the further development of evidence-based workplace health promotion.

A Low-Cost Method for Understanding How Nature-Based Early Learning and Childcare Impacts Children's Health and Wellbeing

Nature-based play and learning provision is becoming increasingly popular across the early learning and childcare (ELC) sector in Scotland. However, there remains a lack of understanding of how the program is expected to function. This has implications for program learning and may affect wider rollout of the program. Secondary data analysis of parent interviews (n = 22) and observations (n = 7) in Scottish ELC settings, and review of internationally published studies (n = 33) were triangulated to develop a program theory using the Theory of Change approach. This approach makes a program's underlying assumptions explicit by systematically demonstrating the relationship between each component: inputs, activities, outcomes, impact, and the contexts of the program. Findings suggested that location of outdoor nature space, affordances, availability of trained practitioners, and transport to location lead to activities such as free play, educator-led activities, and interactions with nature, resulting in longer durations of physical activity, interactions with peers and educators, and increased engagement with the natural environment. These activities are vital for supporting children's physical, cognitive, social, and emotional development. Our results demonstrate the value of using secondary data analysis to improve our understanding of the underlying theory of nature-based ELC which can support future evaluation designs. These findings will be of interest to program evaluators, researchers, practitioners, and funders, who find themselves with limited resources and want to better understand their program before investing in an evaluation. We encourage researchers and evaluators in the field of early years and outdoor play in other countries to refine this logic model in their own context-specific setting.

Using a logic model to develop an intervention for improving miscarriage care in the emergency department

Miscarriage is the most common pregnancy-related complication and is frequently treated at the emergency department (ED). Parents have expressed dissatisfaction with the care they received at the ED and few interventions have been developed for improving miscarriage care. When planning an intervention, it is crucial to develop a program theory specifying what must be done for an intervention to achieve its objectives. The purpose of this paper is to describe the logic model process for developing an intervention intended to improve parents' miscarriage experience at the ED. The six steps of W. K. Kellogg Foundation (2004) theory logic model were used to 1) describe the problem; 2) conduct a needs assessment; and to identify 3) expected results, 4) influential factors, 5) intervention strategies, and 6) assumptions related to change strategies. A community-based participatory approach was used. It included two planning groups: parents who had visited the ED for a miscarriage (N = 9) and health professionals (N = 8). The theory logic model provided a rigorous framework for intervention development based on theories, scientific evidence, and the experiences of parents and health professionals. Detailed description of the intervention should facilitate its implementation, evaluation, and replication for other health problems.

Influence of gender norms in relation to child's quality of care: follow-up of families of children with SCD identified through NBS in Tanzania

Introducing newborn screening (NBS) services for sickle cell disease (SCD) in Africa has been proven to be one of the most cost-effective approach to reducing morbidity and mortality associated with this condition. In view of this evidence, efforts have been made by countries in Africa where SCD prevalence is high to pilot NBS programmes and to strengthen comprehensive care services for SCD. While it is important to reap the benefits of NBS for SCD in Africa in terms of overall quantitative measures, it is also important to understand how certain social and cultural conditions may disproportionately influence the outcomes of screening for some groups. The aim of this study was to analyse the role of gender norms before and after NBS for SCD in Tanzania, and to assess how they influence the quality of care of diagnosed children. Using qualitative methods, we did in-depth interviews with families of children with SCD identified through the NBS services and focus group sessions with nurses working in neonatal and postnatal sections of regional referral hospitals in Dar es Salaam. By analysing the experiences of both the families and nurses, we were able to provide evidence on, firstly, the gendered relations that undergird childcare and, secondly, how those relations influence the quality of care the child may potentially receive. The results emphasize the importance of studying the social implications of SCD in Africa, especially with regard to improving the quality of care for patients with SCD in the region. We propose simple interventions, including gender-conscious health education and genetic counselling, which can help to improve the community understanding of genetic diseases while also reducing gender-related inequalities related to SCD care in Africa.

Assessing the impacts of an interdisciplinary programme supporting father involvement on professionals' practices with fathers: A qualitative study

AIMS AND OBJECTIVES

The study aimed to assess the impacts of the Father-Friendly Initiative within Families (FFIF) programme, an interdisciplinary programme supporting father involvement, on health professionals' practices with fathers.

BACKGROUND

It is increasingly recognised that father involvement benefits children's cognitive and social development and contributes to both parents' well-being. Recent research has shown health professionals' support to be a protective factor in father involvement. Research results were translated into practice through the implementation of a programme, the FFIF, aimed at empowering health professionals to support father involvement.

DESIGN

The study employed a qualitative impact assessment approach based on semi-structured interviews with 36 health professionals to assess the impacts of the FFIF on professionals' practices with fathers.

METHODS

A total of 36 health professionals were interviewed (13 nurses, 10 social workers, six community workers, three educators, two psychoeducators, one health manager, and one special education teacher). Interviews were transcribed, and a qualitative thematic analysis was carried out. This study is presented in line with COREQ's checklist.

RESULTS

Impacts of the FFIF on health professionals were seen in changes on three fronts: (a1) their beliefs; (b) their conception of their role; and (c) their interventions. These changes related to three themes: (a) difficulties experienced by fathers; (b) importance of father involvement; and (c) differences between fathers and mothers. The professionals, having realised the importance of their own role in improving the services offered to fathers, made concrete changes in their interventions, such as reaching out to fathers more effectively, encouraging their participation and treating them fairly and equitably.

CONCLUSIONS

After attending this interdisciplinary programme supporting father involvement, participating professionals adopted father-friendly beliefs, redefined their conception of their role and modified their interventions.

RELEVANCE TO CLINICAL PRACTICE

To provide family-centred care, nurses and other health professionals need to adopt father-inclusive practices.

Perceived Paternal Involvement, Relationship Satisfaction, Mothers' Mental Health and Parenting Stress: A Multi-Sample Path Analysis

Research has demonstrated the short- and long-term impacts of maternal mental health and well-being on children's emotional and behavioral outcomes. It is thus important to better understand the antecedents of maternal depression and stress. The aim of this study was to determine whether the contribution of perceived paternal involvement to account for mothers' depression and parental stress was mediated by relationship factors such as parenting alliance and dyadic adjustment. A second aim was to determine whether these relationships hold equally true in mothers of infants and young toddlers (0-24 months) and mothers of older children (25 months and older). Cross-sectional data were collected from 447 mothers. Mothers reported on their perceptions of paternal involvement with childcare responsibilities, dyadic adjustment, parenting alliance, parenting stress, and depression. Multi-sample path modeling analyses were conducted. Results revealed that perceived paternal involvement was positively related to both dyadic adjustment and parental alliance, that parenting alliance was negatively related to all three subscales of parenting stress and mothers' depression but that dyadic adjustment was negatively related to parenting distress (one subscale of parenting stress) and mothers' depression. Results from the multi-sample analyses indicated that the pattern of relationships was the same in the two groups, but that the model was not invariant. The most notable difference was that parenting alliance did not significantly account for depression in the mothers of younger children. Correlates of maternal mental health and well-being identified in this study could be useful when designing psychological interventions for mothers and fathers.

Peyakohewamak-Needs of Involved Nehiyaw (Cree) Fathers Supporting Their Partners During Pregnancy: Findings From the ENRICH Study

We sought to understand the needs of involved Nehiyaw (Cree) fathers who supported their partners during pregnancy. We used qualitative description and a community-based participatory research approach. We carried out in-depth semi-structured interviews with six Nehiyaw fathers. Four also participated in photovoice and follow-up interviews. All data were content analyzed qualitatively. Fathers felt they had to support their partners and overcome challenges resulting from intergenerational colonial impacts (residential schools particularly) by reclaiming their roles and acknowledging the pregnancy as a positive change. Providing support was possible through their own strong support system stemming from family, faith, culture, and a stable upbringing with positive male role models and intact Nehiyaw kinships. Perinatal programming did little to include fathers. Attempts to improve perinatal care and outcomes should allow more inclusion of and support for Indigenous fathers through genuinely incorporating into care traditional culture and Elders, families, flexibility, cultural understanding, and reconciliation.

Professionals' positive perceptions of fathers are associated with more favourable attitudes towards including them in family interventions

AIM

This Université du Québec en Outaouais study examined professionals' attitudes towards fathers, their perceived self-efficacy when working with them and their perceptions of the importance of including fathers in family interventions.

METHODS

Professionals in Québec, Canada, working in childcare fields such as education, social services, health, community services and management answered a self-report questionnaire between 2013 and 2015. The 296 respondents (90% females) had a mean age of 39 (20-65), were from urban, semi-urban and rural settings and provided services to families with children up to five years of age.

RESULTS

Social service professionals perceived fathers more negatively than did other professionals. Even though male professionals perceived fathers more negatively, they felt more confident working with them than did their female counterparts. Positive perceptions of fathers were associated with more favourable attitudes towards including them in family interventions, and this association was mediated by the professionals' perceptions of their own self-efficacy.

CONCLUSION

The most negative attitudes were reported by social service professionals. Male professionals viewed fathers more negatively but were more confident working with them than were female colleagues. Improving professionals' perceptions of fathers could help to promote their inclusion in family interventions.

[Health promotion and logic models]

The first phase of interventional research in the health of populations is the development of its conceptual basis. Programme logic models are used to describe the way in which the results should be generated. The programme theory is used to develop intermediary objectives and to increase the chances of success of public health actions. This approach requires the coproduction of knowledge between researchers and partners. The teams can benefit from the application of evaluation to the theory in order to clarify the results obtained.