Add wos sample results library
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abstract: 'OBJECTIVE. Societal and economic shifts have expanded the roles that
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fathers play in their families. Father involvement is associated with
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positive cognitive, developmental, and sociobehavioral child outcomes
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such as improved weight gain in preterm infants, improved breastfeeding
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rates, higher receptive language skills, and higher academic
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achievement. However, father involvement in health care has been studied
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little, especially among nonmarried, minority fathers. Fathers are a
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significant part of the child''s medical home, and comprehensive
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involvement of both parents is ideal for the child''s well-being and
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health. Well-child visits (WCVs) represent opportunities for fathers to
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increase their involvement in their child''s health care while learning
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valuable information about the health and development of their child.
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The objective of this study was to explore fathers'' involvement in,
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experience and satisfaction with, and barriers to WCVs using qualitative
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methods.
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METHODS. In-depth, semistructured, qualitative interviews were conducted
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in 2 cities with a subsample of fathers who were participating in the
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national Fragile Families and Child Wellbeing Study. The 32 fathers who
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participated in our study come from a nested qualitative study called
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Time, Love, and Cash in Couples with Children. Fathers in our study
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reside in Chicago or Milwaukee and were interviewed about health care
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issues for 1.5 hours when the focal child was 3 years of age. Questions
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focused on the father''s overall involvement in his child''s health care,
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the father''s attendance and experiences at the doctor, health care
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decision-making between mother and father, assessment of focal child''s
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health, gender/normative roles, and the father''s health. The open-ended
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questions were designed to allow detailed accounts and personal stories
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as told by the fathers. Coding and analysis were done using content
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analysis to identify themes. Particular themes that were used for this
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study focused on ideals of father involvement and dis/satisfaction,
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barriers to, and experiences in the health care system.
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RESULTS. Of the 50 fathers from the Time, Love, and Cash in Couples with
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Children study in the 2 cities, 3 had moved out of the state, 6 were in
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jail, 7 had been lost in earlier follow-up, and 1 had died, leaving 33
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eligible respondents. Of those, 1 refused to participate, resulting in a
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final sample of 32 fathers and an adjusted response rate of 97\%. The
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mean age was 31 years, and the sample was 56\% black, 28\% Hispanic, and
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15\% white; 53\% were nonmarried. Only 2 fathers had attained a college
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degree or higher, and 84\% of the fathers were employed at the time of
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the interview. The majority (53\%) had attended a WCV and 84\% had been
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to see a doctor with their child in the past year. Reasons for attending
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a WCV included (1) to gather information about their child, (2) to
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support their child, (3) to ask questions and express concerns, and (4)
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to gain firsthand experience of the doctor and the WCV. Fathers reported
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positive and negative experiences in their encounters with the health
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care system. The 3 main contributors to fathers'' satisfaction with
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health care professionals were (1) inclusive interactions with the
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physician, (2) the perception of receiving quality care, and (3)
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receiving clear explanations. The negative experiences were often
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specific instances and noted along with positive comments. The negative
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experiences that were mentioned by the fathers included feeling viewed
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suspiciously by health care staff, being perceived as having a lesser
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emotional bond with their child than the mother, and the perception that
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they were receiving a lower quality of service compared with the mother.
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Major barriers to attending WCVs include employment schedules as well as
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their relationship with the focal child''s mother. For example, some
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fathers stated that they did not attend WCVs because that was a
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responsibility that the mother assumed within the family. Other fathers
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lacked confidence in their parenting skills, which resulted in lower
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involvement levels. Also mentioned were health care system barriers such
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as inconvenient office hours and a lack of access to their child''s
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records. Despite the presence of several barriers that seem to prevent
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fathers from attending WCVs, many fathers (20 of 32; 63\%) mentioned
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``situational flexibility,{''''} which enables them to overcome the stated
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barriers and attend doctor visits. For example, some fathers viewed the
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seriousness of the visit such as ``ear surgery{''''} as a reason to
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rearrange their schedules and attend a doctor visit with their child.
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CONCLUSION. The majority of fathers from our sample have attended a WCV,
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and most have been to their child''s doctor in the past year; WCVs and
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doctor appointments are ways in which fathers are involved in their
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child''s health care. Fathers detailed specific reasons for why they
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attend WCVs, such as to support their child, ask questions, express
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concerns, and gather information firsthand. The fathers reported more
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positive than negative experiences with the health care staff, and,
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overall, they are satisfied with their experiences with the health care
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system. Reasons for satisfaction include feeling as though their
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questions had been dealt with seriously and answered appropriately.
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However, the fathers in our study did report a variety of barriers to
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health care involvement, including conflicting work schedules, a lack of
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confidence in their parental role, and health care system barriers.
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Professionals who care for children and families need to explore
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creative ways to engage fathers in the structured health care of their
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children. For example, pediatricians can stress the benefits of both
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parents being involved in their child''s health care while reframing the
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importance of WCVs. Understanding that many fathers have situational
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flexibility when it comes to health care encounters may encourage
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physicians to suggest more actively that fathers attend WCVs.
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Pediatricians can also support existing public policies such as the
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national 2003 Responsible Fatherhood Act that provides grants and
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programs that promote the father''s role in the family and advocate for
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additional policies that would foster quality father involvement.
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Continued collaboration among families, physicians, and other health
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care professionals is essential to support father involvement and ensure
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positive health outcomes for children.'
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affiliation: 'Garfield, CF (Corresponding Author), Evanston NW Healthcare Res Inst,
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1001 Univ Ave, Evanston, IL 60201 USA.
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Evanston NW Healthcare Res Inst, Evanston, IL 60201 USA.
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Northwestern Univ, Feinberg Sch Med, Dept Pediat, Chicago, IL 60611 USA.'
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author: Garfield, CF and Isacco, A
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author-email: c-garfield@northwestern.edu
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author_list:
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- family: Garfield
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given: CF
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- family: Isacco
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given: A
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da: '2023-09-28'
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doi: 10.1542/peds.2005-1612
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eissn: 1098-4275
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files: []
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issn: 0031-4005
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journal: PEDIATRICS
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keywords: fathers; medical home; parenting; pediatric; well-child visit
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keywords-plus: 'AFRICAN-AMERICAN FATHERS; LOW-INCOME; INVOLVEMENT; PREDICTION;
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ATTITUDES; DECISION; OUTCOMES; DADS; MEN'
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language: English
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month: APR
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number: '4'
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number-of-cited-references: '48'
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orcid-numbers: Garfield, Craig/0000-0002-6512-6005
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pages: E637-E645
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papis_id: 494824b9338f786c1bf1068ab0219766
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ref: Garfield2006fatherswellchild
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researcherid-numbers: 'Garfield, Craig/AAE-2525-2020
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'
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times-cited: '83'
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title: Fathers and the well-child visit
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type: Article
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unique-id: WOS:000236540500005
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usage-count-last-180-days: '1'
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usage-count-since-2013: '41'
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volume: '117'
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web-of-science-categories: Pediatrics
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year: '2006'
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