Home Visitors Attitudes, Expectations, and Practice Following Training in Dads Matter: Results from a Qualitative Study

Background and Purpose:

Few home visitors report engaging fathers in services. One of the barriers identified in prior literature has been home visitors’ attitudes toward working with fathers. This paper describes a qualitative study embedded in a randomized controlled trial (RCT) of an intervention enhancement to home visitation services that addresses fathers and their roles in their young children’s lives, called “Dads Matter”. The aims of this paper are to describe home visitors’ approaches to assessing and engaging fathers in the context of home visiting by comparing workers who received training in Dads Matter to those that did not. Successful engagement of fathers in traditionally mother-focused home visiting services depends on workers’ ability to assess the needs of both mothers and fathers and purposefully seek to engage both parents in services.

Methods:

A multisite clustered RCT was conducted across five large organizations. Home visitors were randomized to deliver Dads Matter enhanced services or home visiting services as usual, and those within the intervention condition implemented the enhancement through a train-the-trainer model. In this paper we present findings from a qualitative study of 24 home visitors who participated in the RCT across both study conditions. Workers completed a brief survey and were interviewed using a semi-structured interview guide by telephone. Triangulation of data sources, multiple coders, and member checking were used to enhance rigor. Interviews were recorded and transcribed, and then data were analyzed using dedoose software. Major themes were produced a priori and implemented as tree nodes designed to focus on assessment and engagement strategies targeted by the training.

Results:

The sample was all female and primarily bachelor’s level, Latina and African American workers. Workers reported generally positive attitudes toward serving fathers, regardless of whether or not they received intervention training; but nearly all workers also described a lack of time, the perception that fathers don’t want to participate, a lack of training, and the concern that working with fathers would take away from services as common barriers to serving fathers. Workers in the intervention group who were trained in Dads Matter were more likely to report using specific strategies to assess and engage fathers, or to assess the family as a whole, as compared to workers who did not receive training in Dads Matter. Intervention group workers also reported that participation in the intervention changed their work. Data also suggest that workers need more support to implement the intervention with high level of fidelity. Findings point to needed improvements to the Dads Matter intervention and training to enhance father-inclusive assessment and engagement strategies among workers.

Conclusions and Implications:

Home visitors overall report being generally positively inclined toward working with fathers, however few fathers are included in visits, and specific barriers should be targeted in training or other interventions designed to increase fathers’ engagement in home visiting. Dads Matter appears to improve home visitors’ use of specific efforts to assess and engage fathers in services, but additional supports are needed to move services more fully toward father inclusiveness.