A Prenatal Coparenting Intervention With Unmarried Father–Mother Dyads: Fidelity of Intervention Delivery by Male–Female Community Mentor Teams

Abstract

Background: Most prenatal preventive interventions for unmarried mothers do not integrate fathers or help the parents plan for the development of a functional coparenting alliance after the baby’s arrival. Furthermore, properly trained professionals have only rarely examined the fidelity of these interventions. Purpose: This report examines whether experienced community interventionists (home visitors, health educators, fatherhood service personnel) with no formal couples’ therapy training are capable of pairing together to deliver with adequate fidelity a manualized dyadic intervention designed for expectant unmarried mothers and fathers. Methods: Three male and four female mentors (home visitors, health educators, fatherhood personnel) working in paired male–female co-mentor teams delivered a seven-session “Figuring It Out for the Child” curriculum (six prenatal sessions, one booster) to 14 multirisk, unmarried African American families (parent age ranging from 14 to 40). Parental well-being and views of fatherhood were assessed before the intervention and again 3 months after the baby’s birth. Quality assurance analysts evaluated mentor fidelity (adherence to the curriculum, competence in engaging couples with specified curricular content) through a review of the transcripts and audiotapes from the sessions. Mentors also rated their own adherence. Results: Although the mentors overestimated adherence, quality assurance analyst ratings found acceptable levels of adherence and competence, with no significant male–female differences in fidelity. Adherence and competence were marginally higher in sessions that required fewer direct couples’ interventions. Parents reported satisfaction with the interventions and showed statistically significant improvement in the family dimensions of interest at 3–4 months posttreatment. Conclusions/Implications for Practice: Findings support the wisdom of engaging men both as interventionists and as recipients of prenatal coparenting interventions—even in families where the parents are uncoupled and non-co-residential.

Starting the Conversation: Common Themes Typifying Expectant Unmarried Black Parents’ Discussions About Coparenting a First Child Together

“…As was the FIOC program itself, the manual was vetted for content by Black lay and pastoral counselors, seasoned activists, community organizers, and community leaders, all residents of a southern U.S. city where the program was delivered, in collaboration with the second and fifth authors of this report. Adherence to the program manual has been formally investigated in prior research and has been shown to be uniformly strong for both male and female users (see Salman-Engin et al, 2016).…”

Father-Inclusive Perinatal Parent Education Programs: A Systematic Review

“…48 In the majority of the studies, researchers implemented programs in hospital settings, with outcomes based on parents' selfreports. Some researchers delivered the intervention at the group level, 35 -40, 48, 55 couple level, 43,49,52 or individual level. 10,42,45,46 Studies also differed in whether researchers used a manualized curriculum, who delivered the sessions (eg, nurse versus social worker), when the sessions were delivered (eg, before birth versus after birth), and mode of intervention delivery (eg, in-person versus mobile application) (for details see Table 2).…”

“…Researchers for 4 quantitative (2 RCTs and 2 quasi-experimental) and 1 qualitative studies examined fathers' mental health outcomes. 38,47,49,53 The results of a low RoB quasi-experimental study of a general education program 38 revealed significant increases in fathers' social support seeking related to pregnancy-related stressors measured during the third trimester. It was reported in a qualitative study of a relationship program intervention that occurred during pregnancy 51 that fathers felt improved emotion regulation and greater relaxation, peace, and enjoyment after the intervention.…”

Examining the Effectiveness of the Fathers and Babies Intervention: A Pilot Study

“…A systematic review conducted by Lee et al (2018) found 19 interventions for fathers-delivered in the United States-during the perinatal period that had been tested using experimental or quasiexperimental designs. These interventions focused on general childbirth education and infant care, co-parenting skills, or case management with only four examining mental health outcomes (Diemer, 1997;Feinberg and Kan, 2008;Field et al, 2008;Salman-Engin et al, 2017). Of the four interventions that assessed paternal mental health, improvements in mental health were found only by Field et al (2008) who generated reductions in paternal depressive symptoms via an intervention that taught fathers how to provide massages for their partner aimed at reducing pain and improving dyadic relationship quality.…”