wow-inequalities/02-data/intermediate/wos_sample/55acf321dd1c523690e1fd910105b427-garfield-cf-and-isa/info.yaml

abstract: 'OBJECTIVE. Societal and economic shifts have expanded the roles that

  fathers play in their families. Father involvement is associated with

  positive cognitive, developmental, and sociobehavioral child outcomes

  such as improved weight gain in preterm infants, improved breastfeeding

  rates, higher receptive language skills, and higher academic

  achievement. However, father involvement in health care has been studied

  little, especially among nonmarried, minority fathers. Fathers are a

  significant part of the child''s medical home, and comprehensive

  involvement of both parents is ideal for the child''s well-being and

  health. Well-child visits (WCVs) represent opportunities for fathers to

  increase their involvement in their child''s health care while learning

  valuable information about the health and development of their child.

  The objective of this study was to explore fathers'' involvement in,

  experience and satisfaction with, and barriers to WCVs using qualitative

  methods.

  METHODS. In-depth, semistructured, qualitative interviews were conducted

  in 2 cities with a subsample of fathers who were participating in the

  national Fragile Families and Child Wellbeing Study. The 32 fathers who

  participated in our study come from a nested qualitative study called

  Time, Love, and Cash in Couples with Children. Fathers in our study

  reside in Chicago or Milwaukee and were interviewed about health care

  issues for 1.5 hours when the focal child was 3 years of age. Questions

  focused on the father''s overall involvement in his child''s health care,

  the father''s attendance and experiences at the doctor, health care

  decision-making between mother and father, assessment of focal child''s

  health, gender/normative roles, and the father''s health. The open-ended

  questions were designed to allow detailed accounts and personal stories

  as told by the fathers. Coding and analysis were done using content

  analysis to identify themes. Particular themes that were used for this

  study focused on ideals of father involvement and dis/satisfaction,

  barriers to, and experiences in the health care system.

  RESULTS. Of the 50 fathers from the Time, Love, and Cash in Couples with

  Children study in the 2 cities, 3 had moved out of the state, 6 were in

  jail, 7 had been lost in earlier follow-up, and 1 had died, leaving 33

  eligible respondents. Of those, 1 refused to participate, resulting in a

  final sample of 32 fathers and an adjusted response rate of 97\%. The

  mean age was 31 years, and the sample was 56\% black, 28\% Hispanic, and

  15\% white; 53\% were nonmarried. Only 2 fathers had attained a college

  degree or higher, and 84\% of the fathers were employed at the time of

  the interview. The majority (53\%) had attended a WCV and 84\% had been

  to see a doctor with their child in the past year. Reasons for attending

  a WCV included (1) to gather information about their child, (2) to

  support their child, (3) to ask questions and express concerns, and (4)

  to gain firsthand experience of the doctor and the WCV. Fathers reported

  positive and negative experiences in their encounters with the health

  care system. The 3 main contributors to fathers'' satisfaction with

  health care professionals were (1) inclusive interactions with the

  physician, (2) the perception of receiving quality care, and (3)

  receiving clear explanations. The negative experiences were often

  specific instances and noted along with positive comments. The negative

  experiences that were mentioned by the fathers included feeling viewed

  suspiciously by health care staff, being perceived as having a lesser

  emotional bond with their child than the mother, and the perception that

  they were receiving a lower quality of service compared with the mother.

  Major barriers to attending WCVs include employment schedules as well as

  their relationship with the focal child''s mother. For example, some

  fathers stated that they did not attend WCVs because that was a

  responsibility that the mother assumed within the family. Other fathers

  lacked confidence in their parenting skills, which resulted in lower

  involvement levels. Also mentioned were health care system barriers such

  as inconvenient office hours and a lack of access to their child''s

  records. Despite the presence of several barriers that seem to prevent

  fathers from attending WCVs, many fathers (20 of 32; 63\%) mentioned

  ``situational flexibility,{''''} which enables them to overcome the stated

  barriers and attend doctor visits. For example, some fathers viewed the

  seriousness of the visit such as ``ear surgery{''''} as a reason to

  rearrange their schedules and attend a doctor visit with their child.

  CONCLUSION. The majority of fathers from our sample have attended a WCV,

  and most have been to their child''s doctor in the past year; WCVs and

  doctor appointments are ways in which fathers are involved in their

  child''s health care. Fathers detailed specific reasons for why they

  attend WCVs, such as to support their child, ask questions, express

  concerns, and gather information firsthand. The fathers reported more

  positive than negative experiences with the health care staff, and,

  overall, they are satisfied with their experiences with the health care

  system. Reasons for satisfaction include feeling as though their

  questions had been dealt with seriously and answered appropriately.

  However, the fathers in our study did report a variety of barriers to

  health care involvement, including conflicting work schedules, a lack of

  confidence in their parental role, and health care system barriers.

  Professionals who care for children and families need to explore

  creative ways to engage fathers in the structured health care of their

  children. For example, pediatricians can stress the benefits of both

  parents being involved in their child''s health care while reframing the

  importance of WCVs. Understanding that many fathers have situational

  flexibility when it comes to health care encounters may encourage

  physicians to suggest more actively that fathers attend WCVs.

  Pediatricians can also support existing public policies such as the

  national 2003 Responsible Fatherhood Act that provides grants and

  programs that promote the father''s role in the family and advocate for

  additional policies that would foster quality father involvement.

  Continued collaboration among families, physicians, and other health

  care professionals is essential to support father involvement and ensure

  positive health outcomes for children.'
affiliation: 'Garfield, CF (Corresponding Author), Evanston NW Healthcare Res Inst,
  1001 Univ Ave, Evanston, IL 60201 USA.

  Evanston NW Healthcare Res Inst, Evanston, IL 60201 USA.

  Northwestern Univ, Feinberg Sch Med, Dept Pediat, Chicago, IL 60611 USA.'
author: Garfield, CF and Isacco, A
author-email: c-garfield@northwestern.edu
author_list:
- family: Garfield
  given: CF
- family: Isacco
  given: A
da: '2023-09-28'
doi: 10.1542/peds.2005-1612
eissn: 1098-4275
files: []
issn: 0031-4005
journal: PEDIATRICS
keywords: fathers; medical home; parenting; pediatric; well-child visit
keywords-plus: 'AFRICAN-AMERICAN FATHERS; LOW-INCOME; INVOLVEMENT; PREDICTION;

  ATTITUDES; DECISION; OUTCOMES; DADS; MEN'
language: English
month: APR
number: '4'
number-of-cited-references: '48'
orcid-numbers: Garfield, Craig/0000-0002-6512-6005
pages: E637-E645
papis_id: 494824b9338f786c1bf1068ab0219766
ref: Garfield2006fatherswellchild
researcherid-numbers: 'Garfield, Craig/AAE-2525-2020

  '
times-cited: '83'
title: Fathers and the well-child visit
type: article
unique-id: WOS:000236540500005
usage-count-last-180-days: '1'
usage-count-since-2013: '41'
volume: '117'
web-of-science-categories: Pediatrics
year: '2006'