A randomized feasibility and acceptability study comparing modes of parenting education delivery for young fathers

Abstract

Limited research and reliance on maternal reports of father involvement in caregiving provides an inadequate understanding of adolescent fatherhood. Despite improved outcomes for infants and adolescent mothers when adolescent fathers remain positively engaged in their lives, parenting education programs have not included young fathers. This lack of inclusion and absence of randomized studies of instructional methods has resulted in a dearth of interventions to improve parenting skills and outcomes for these young men, their children, and their partners. The purpose of this randomized study was to examine the feasibility and acceptability of instructor-led parenting education compared to online parenting education on parenting self-efficacy and parenting activities of adolescent fathers. Using consecutive sampling and recruitment flyers, 15 to 22-year-old fathers were recruited over 12 months from a large urban area of Alaska. This study used a randomized alternative treatments design with repeated measures, and recruited from two primary care clinics, a support group for pregnant and parenting adolescents, and a regional medical center. The 2-week instructor-led parenting education was led by an experienced parent educator in the learning center of a local hospital. Learning objectives included knowledge of infant growth and development, and confidence in parenting skills. The online parenting education had similar learning objectives, but learning was initiated by participants. Measures included feasibility of protocol adherence, recruitment, and retention, and acceptability of the intervention to participants. Exploratory measures included the Parenting Sense of Competence (PSOC) scale to measure parenting self-efficacy, and the Child Care Activities Scale (CCAS) to measure participation in parenting activities of adolescent fathers. One hundred fifty-seven potential participants were screened and (n=41, 26%) met inclusion criteria. Twenty-six (63%) declined participation and (n=15, 37% enrolled in the study. Eight (58%) participants completed the study. Feasibility findings included: Randomization into groups, as planned, from the block randomization list, 100% adherence to intervention fidelity, and zero missing data. Acceptability results included a median response for all items of “strongly agree”. Participants found the content, location of the intervention, learning method randomized into, and gift cards acceptable; the intervention and survey completion were not burdensome. Randomization, intervention delivery, and data collection were feasible, while recruitment and retention require protocol refinement. Interventions were highly acceptable to participants.