Engaging Fathers In Doula Services: Engaging Doulas In the Adaptation of a Home Visiting Intervention for Dads

Background/Purpose: Fathers’ contributions to perinatal outcomes for families and children is increasingly documented. Dads Matter-Home Visitors (DM-HV) is a manualized, module-based, intervention (Bellamy et al., 2021) that increases perinatal involvement of fathers, reduces child maltreatment risk, improves the father-child relationship, and supports positive co-parenting dynamics. DM-HV is currently the only father engagement intervention recognized as “Supported by Research Evidence” by the California Evidence Based Clearinghouse. Doula services have many similarities to home visiting programs and face some similar challenges to father engagement (Steel et al., 2015). However, no evidence-supported father engagement interventions have been identified for doula services. The aim of this project is to inform the adaptation of DM-HV for doula services.

Methods: This project engaged a group of (n=9) doulas in DM-HV training and qualitative data collection to seek their input on possible intervention adaptations. The DM-HV training was provided to participating doulas in four sessions, and following each session participating doulas were engaged in focus group and individual interview sessions to identify: 1) which elements of the standard DM-HV intervention fit with doula services, 2) which elements of the standard DM-HV intervention may require adaptation, and 3) any new content that would be needed for a father engagement intervention for doulas. Qualitative data was analyzed using an interpretive description approach (Thorne, Kirkham & MacDonald-Emes, 1997) using NVivo software.

Results: Preliminary findings indicated that many of the elements of DM-HV could work well for doula services, including strategies to improve father inclusion in intake, assessment, and other organizational practices. Adaptations to the DM-HV intervention recommended by doulas included more flexibility for addressing diverse family structures and relationships and new content such as engaging fathers in “comfort measures” during birth. Doulas described active strategies for engaging fathers in hands-on practice and engagement. Participating doulas also identified more nuanced adaptations that could be used to tailor specific modules to the shorter time horizon and specific activities of doula services.

Conclusion/Implications: DM-HV is a promising general approach to engaging fathers in doula services, with many elements of assessment, engagement, and substantive content that translate well from home visiting. Although DM-HV is a promising intervention for doulas, important adaptations are needed to optimize the fit of the intervention within doula services, including content targeted to doula services and programs, as well as new content aimed specifically at doulas. Findings from this study will inform the development and future testing of the DM-Doula intervention.