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参与与改善婴儿结局有关（例如， 身体、社会和情感健康和发展），以及母亲和父亲的福祉。然而，这把钥匙 没有充分利用机会之窗来促进父亲的参与，特别是第一次 准爸爸虽然参与父亲被广泛提倡，但准父亲的临床和 公共卫生接触点，让他们在围产期了解婴儿护理。没有参与的父亲 危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 父亲感到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 text4FATHER，一种多模式短信移动的健康（mHealth）干预，以提高婴儿护理自我效能 巴尔的摩市受教育程度较低的准父亲的行为参与与反馈 从目标人群，专家共识的建立，并以证据为基础的审查。text4FATHER发送 每周两次向父亲发送文本，内容包括支持婴儿、伴侣和父亲的福祉，包括 资源链接，以支持从怀孕中期到产后2个月的行为改变。文本， 在五年级阅读水平上书写，被编程为根据以下因素定制推送/接收：胎龄/婴儿 出生后的年龄和父亲的居民身份。我们的试点试验表明，首次 父亲的婴儿护理自我效能和行为参与以及减少父亲之间的冲突， 从基线到7个月随访（出生后2个月），他们的伴侣的母亲在干预中比平时 护理（R21HD 097453）。 由于这一流行病以及父亲陪同伴侣接受产妇护理的能力受到限制，我们 在巴尔的摩地铁试用社交媒体直接接触准爸爸;更感兴趣的准爸爸 巴尔的摩的父亲直接联系我们的人数比我们之前研究的纳入标准要多。使用社交媒体 直接招募第一次怀孕的父亲从来没有在全国范围内进行过审查， 目前还没有类似的战略。在这个R21提案中，我们建议调整text4FATHER， 在全国范围内使用社交媒体招募的第一次怀孕的准爸爸。我们将评估其 父亲参加三个组之一的有效性：text4FATHER，注意力控制或常规护理控制; 评估干预组的可接受性和满意度，以及父亲特征的影响范围;我们将 还招募准妈妈对结果数据以及父亲与母亲和其他人的互动进行三角分析。 照顾者目前的提案将是第一个检查移动健康干预措施有效性的提案， 使用社交媒体吸引美国各地首次准爸爸的参与。结果将有助于确定是否使用 与社交媒体的全国短信方法可以作为一个桥梁，招募不同的样本，第一次 更多的准爸爸需要和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.