Adapting text4FATHER to directly link to first-time expectant fathers using social media to improve infant and family health

摘要 父亲在产前和婴儿期的投入与改善婴儿结局有关(例如， 身体、社会和情感的健康和发展)以及父母的幸福。但是，这个密钥 机会之窗没有足够的杠杆作用来促进父亲的订婚，特别是第一次 准爸爸。虽然广泛提倡聘用父亲，但准父亲的临床和临床经验有限 公共卫生接触点，让他们在围产期了解婴儿护理。不吸引人的父亲 损害母亲和孩子的健康，让父亲失望。过去的研究，包括我们自己的研究表明， 父亲感觉自己被排除在产妇护理之外，在婴儿护理技能和支持方面存在差距。我们开发了 Text4FATHER，多模式短信移动健康(MHealth)干预，提高婴儿护理自我效能 在巴尔的摩大都市低教育程度的准爸爸中的行为投入和反馈 从目标人群、专家建立共识和基于证据的审查。文本4发送者发送 每周给父亲发两次短信，内容包括支持婴儿、伴侣和父亲的幸福 支持从怀孕中期到出生后2个月的行为改变的资源网络链接。短信， 五年级阅读水平，根据胎龄/婴儿量身定做推送/接收 出生后年龄和父亲的居民身份。我们的试点试验表明，在第一次试验中， 父亲照顾婴儿的自我效能感和行为投入以及减少父亲和母亲之间的冲突 其配偶的母亲从基线到7个月(产后2个月)的随访比平时要好 CARE(R21HD097453)。 由于大流行和父亲陪伴伴侣照顾产妇的能力受到限制，我们 在巴尔的摩地铁试行使用社交媒体直接接触准爸爸；更感兴趣的是准爸爸 巴尔的摩大都会的父亲们直接伸出援手，比我们之前研究的纳入标准要好。使用社交媒体 直接招募第一个准爸爸从来没有在全国范围内为了所有人的利益而进行过审查 目前没有类似策略的父亲。在此R21提案中，我们建议将文本4FATHER调整为 与通过社交媒体招募的首次怀孕父亲的全国受众一起使用。我们将评估其 父亲在以下三个方面中的一种情况下的有效性：文本4、注意力控制或日常护理控制； 评估其在干预臂中的可接受性和满意度，并根据父亲的特征评估其伸展范围；我们将 还招募孕妇来三角测量结果数据和父亲与母亲和其他人的互动 照顾者。目前的提案将是第一个检查mHealth干预措施有效性的方案 通过社交媒体在全美范围内与第一次怀孕的父亲进行互动。结果将有助于确定是否使用 全国性的社交媒体短信方式可以作为一座桥梁，招募不同的首次见面样本 更需要的怀孕父亲，并通知一个更大的随机试验。

ABSTRACT Father engagement in the prenatal and infant periods is associated with improved infant outcomes (e.g., physical, social and emotional health and development), and mother and father well-being. However, this key window of opportunity has been insufficiently leveraged to promote father engagement, especially, first-time expectant fathers. While engaging fathers is widely advocated, expectant fathers have limited clinical and public health touchpoints that engage them perinatally to learn about infant care. Not engaging fathers compromises the health of mothers and children and fails fathers. Past research, including our own, indicates fathers feel left out of maternity care and have gaps in their infant care skills and support. We developed text4FATHER, a multi-modal texting mobile health (mHealth) intervention, to increase infant care self-efficacy and behavioral engagement among expectant fathers with lower education in metro Baltimore with feedback from the target population, expert consensus-building, and an evidence-based review. text4FATHER sends texts twice-weekly to fathers with threaded content to support infant, partner, and father well-being including resource weblinks to support behavior change from mid-pregnancy through 2 months postnatally. Texts, written at a 5th grade reading level, are programmed to push/receive tailored based on: gestational age/infant age after birth and father’s resident status. Our pilot trial demonstrated significant improvements in first-time fathers’ infant care self-efficacy and behavioral engagement as well as reduced conflict between fathers and their partners’ mothers from baseline to 7-month follow-up (2 months postnatally) in the intervention than usual care (R21HD097453). Due to the pandemic and limits placed on fathers’ ability to accompany partners to maternity care, we piloted using social media in metro Baltimore to directly reach expectant fathers; more interested expectant fathers in metro Baltimore directly reached out than met our prior study’s inclusion criteria. Use of social media to directly recruit first-time expectant fathers has never been examined on a national scale for the benefit of all fathers where no similar strategy currently exists. In this R21 proposal, we propose adapting text4FATHER for use with a national audience of first-time expectant fathers recruited using social media. We will evaluate its efficacy with fathers enrolled in one of three arms: text4FATHER, attention control, or usual care control; assess its acceptability and satisfaction in the intervention arm, and its reach by father characteristics; we will also recruit expectant mothers to triangulate outcome data and fathers’ interactions with mothers and other caregivers. The current proposal would be the first to examine the efficacy of an mHealth intervention designed to engage first-time expectant fathers across the U.S. using social media. Results will help determine if using a national texting approach with social media can serve as a bridge to recruit a diverse sample of first-time expectant fathers in greater need and inform a larger randomized trial.