Preliminary Findings from a Randomized Study of an Intervention to Increase Father Engagement in Home Visitation

Background and Purpose:

Research on the engagement of fathers in child and family interventions, suggests that fathers’ participation in services can both boost mothers’ engagement in the intervention and extend outcomes. To date, however, the field of home visitation has largely overlooked the significant role that fathers play in young children’s developmental outcomes, and ways to configure home visiting services to address fathers’ roles in the family.  As a result, scant evidence is available to guide home visiting programs in best addressing fathers’ roles in promoting positive child and family outcomes. In this context, the present study describes the preliminary results of a multisite cluster randomized control trial of an intervention enhancement to home visitation services that addresses fathers and their roles in their young children’s lives, called “Dads Matter”. Dads Matter is a manualized intervention designed to incorporate full consideration of fathers in the context of standard home visiting services.

Methods:

Twenty-one home visiting program supervisors, over 100 home visitors, and approximately 200 families served in five large organizations were included in the study. Supervisors were randomized to deliver Dads Matter enhanced services or home visiting services as usual, and those within the enhancement (intervention) condition implemented the enhancement through a train-the-trainer model. Participating mothers and fathers completed baseline, 4-month, and 1- year follow-up interviews, and audio recorded a day of the child’s language environment using the Language Environment Analysis (LENA) devices. Data was also collected at the worker, supervisor, and organizational levels, including fidelity data to gauge implementation of the intervention, and worker level factors such as attitudes and behaviors surrounding father involvement.

Results:

The study, to date, has enrolled about two-thirds of the participants (just over 120 families), and been able to retain a high proportion of those families for 4-month follow-up interviews. Of those reaching the 4-month interview, 85 families have completed it, and more are in process. Nearly 80 home visiting workers and supervisors have been trained and implemented the Dads Matter enhancement within their existing services, supervisors receiving the majority of training through the train-the-trainer model. Preliminary fidelity data is positive, showing that home visitors in the intervention condition reported providing more than twice the services to fathers relative to workers in the control group. Cohen’s d-scores will be used to judge change across condition, and across measures of parenting, parent relationships, father involvement, child maltreatment, and parent-child verbalizations. Preliminary evidence indicates measures are in the positive and hypothesized direction, for example mothers indicated increased support from fathers relative to the control group (d=.30), and fathers indicated a less abusive mother-father relationship relative to the control group (d=-.36).

Conclusions and Implications:

The Dads Matter enhancement to standard home visiting services is a potentially feasible, acceptable, and effective approach to increasing fathers’ engagement and promoting family and child wellbeing. Preliminary intervention outcomes are suggestive of improvements for families who receive home visiting enhanced with Dads Matter as compared to families who receive home visiting alone.