Recruiting first-time expectant fathers via social media for text4FATHER to improve father-infant interactions & family health across 11 months

Father engagement is associated with improved infant mother and father well-being. Yet this opportunity window has not been well leveraged to promote engaging first-time expectant fathers especially those with lower income who have limited clinical and public health touchpoints to learn about infant care. Past research indicates fathers feel left out of maternity care and have infant care skills and support gaps. The grantee developed text4FATHER a multi-modal texting intervention to increase infant care self-efficacy and behavioral engagement among expectant fathers with lower income in metro Baltimore with target population feedback expert consensus-building and an evidence-based review. Grantee's pilot trial showed significant increases in father infant care self-efficacy and behavioral engagement and reduced conflict between fathers and their partners� mothers from baseline to 7-month follow-up (2 months postnatally) in the intervention than control arm (R21HD097453). This study is aligned with MCHB Strategic Research Issue Goals #1�#6. Goal: By end of Year 3 and recruitment via national social media approach to provide first-time expectant fathers infant care partner support and father well-being knowledge and skills. Objectives: By end of Year 3 to: 1) examine whether text4FATHER improves father-infant and relational outcomes at 2- and 5-month postnatal follow-up; 2) evaluate equity in text4FATHER reach with social media approach by first-time fathers� characteristics and explore these factors as moderators of the intervention by study outcomes; and 3) assess text4FATHER acceptability satisfaction and use among intervention fathers and among intervention fathers explore relationship between these factors with study outcomes. Proposed dataset/target population: We will conduct a randomized trial to evaluate text4FATHER efficacy with a national audience of first-time expectant fathers including fathers with lower income recruited from social media. We will recruit father/mother dyads at 15-25 weeks of pregnancy and follow through 5 months postnatally (11 months duration) and we will recruit equal father samples in each arm by lower income (defined at or below 200% of federal poverty threshold) and middle/higher income. Products: We will produce peer-reviewed manuscripts: Papers #1 and #2 will summarize study objective #1 results Paper #3 objective #2 results and Paper #4 objective #3 results and disseminate findings to our key identified stakeholder target audiences: our father/mother participants social media platforms community-based fatherhood programs maternity care and pediatric providers researchers State Title V and other related programs serving MCH populations policymakers families and the general public and work with our partners who have local regional and national reach. Evaluation: We will apply separate random intercept coefficient regression models for each study outcome accounting for two levels of nesting (repeated measures and individuals) to estimate odds of an intervention participant experiencing change in a study outcome between baseline and follow-up relative to a control participant. This study builds upon our team�s collaborative work on text4FATHER over the past 7 years; we will use a continuous quality improvement model approach to be effective and efficient in attaining the study�s goals and objectives.