Father Involvement in Healthcare

1
Father Involvement in Healthcare Craig F.
Garfield, M.D.¹ ² Anthony Isacco, M.A.¹
1Evanston Northwestern Healthcare, Evanston, IL
2Feinberg School of Medicine, Northwestern
University, Chicago, IL
Methods
Results
Background
Discussion

• Our understanding of how fathers in the United
  States are involved in
• their childrens lives continues to grow.
  From 1965 to 2000, for
• example, time-diary studies report fathers
  time spent on child care
• duties rose from 2.5 hours/week to 7
  hours/week.
• Father involvement has been associated with
  positive outcomes for
• children of various ages, ranging from infants
  to adolescents.
• Yet father involvement is more than counting
  hours. Involvement
• includes understanding the various roles
  fathers assume, the quality
• of time spent with their children, and
  investigating emerging
• childcare domains. The healthcare domain may
  represent a novel
• point of childcare involvement for fathers.
• In order to better conceptualize father
  involvement in healthcare, we
• use the following traditional 3-part framework
  (Lamb, 1987) to
• examine father involvement in the healthcare
  domain
• accessibility (i.e., as in the fathers
  availability to his child)
• engagement (i.e., direct interactions) and

Table 3 Engagement and Responsibility in
Healthcare Setting

• This study adds to the body of knowledge in the
  father involvement
• literature by describing in fathers own
  words how they are involved in the
• health and healthcare of their children
  within the prevailing framework of
• father involvement (i.e., accessibility,
  engagement, and responsibility).
• Most fathers were accessible to be involved in
  their childs healthcare (e.g.,
• maintaining residence with the child and
  interacting with their child on a
• daily basis). Fathers described being
  involved in two settings the
• healthcare setting and home. In each
  setting, fathers described ways in
• which they are engaged and responsible in
  their involvement. Fathers also
• reported an additional component of their
  involvement, i.e., cognitive
• involvement, which represents a fathers
  awareness of their childs needs
• and how those needs are being met.
• Our findings confirm previous research
  concerning father involvement in
• their childs health and healthcare, such as
  attendance at birth and
• healthcare encounters (e.g., well-child
  visits). Beyond these encounters,
• fathers reported additional involvement
  through asking the childs doctor
• specific questions, preparing healthy foods,
  and administering medications

• Fathers in our sample are a sub-sample of the
  national Fragile Families and Child Wellbeing
  Study of 3,600 randomly sampled hospital births
  in large U.S. cities and participants in the
  nested qualitative study Time Love and Cash in
  Couples with Children (TLC3).
• We interviewed fathers in Milwaukee and Chicago
  for 1.5 hours when their child was approximately
  3 years old using in-depth, semi-structured
  interviews focusing on father involvement in the
  family, health, and healthcare of the child and
  changes and experiences around the birth of the
  child.
• Qualitative Methodology
• Open Coding interprets interview narratives
  using little inference, which leads to the
  establishment of new codes, distinct themes, and
  an evolving codebook through team discussions and
  investigator triangulation.
• Content and Narrative Analysis We examined all
  codes and themes related to how fathers are
  involved in their childs healthcare, using the
  three paternal involvement components (i.e.,
  Accessibility, Engagement, and Responsibility) as
  our measurement conceptualization.

Objectives
Results
Table 4 Engagement and Responsibility at Home

• To qualitatively describe father involvement in
  their childs health
• and healthcare using the traditional
  conceptualization of father
• involvement.
• To explore how fathers may extend the
  traditional conceptualization
• of father involvement in the healthcare
  domain.

Of the 33 available fathers from the TLC3 study
in Chicago and Milwaukee, 31fathers agreed to
participate (adjusted response rate94). Of the
31 fathers, 84 were non-White, 48 had an income
of 34,999 or less, and 61 did not educationally
advance beyond high school (Table 1).
.
Table 1 Sample Demographics
Conceptual Model of Father Involvement


Table 2 Accessibility to Healthcare Involvement
Table 5 Cognitive Involvement