Support for Fathers Affected by Postpartum Depression
Objectives: This retrospective, multi-site (New Brunswick, Ontario, Alberta) multi-method (qualitative, quantitative) study seeks to understand fathers’ support needs when their partners are ill with postpartum depression (PPD). This study builds upon the team’s published research on support needs and interventions for mothers with PPD and funded pilot study of fathers’ support needs and intervention preferences in NB and AB. Further, the proposed research addresses an identified gap in examining PPD from fathers’ perspectives using gender and sex-based analytic approaches. This study will permit the development of an intervention to be tested in follow-up randomized controlled trial across Canada.
Background: Recent data suggest that 15% (1 in 7) mothers are affected by PPD. While much is known about the negative health consequences of PPD on mothers and their children, only recently have the implications of PPD for fathers come to light. As many as quarter to a half of depressed mothers’ partners are men who also experience depression. As such, maternal PPD is the most potent predictor of paternal depression. Maternal PPD and paternal depression in combination place children at dual risk for developmental problems. However, researchers have paid limited attention to supporting fathers as they cope with depression in themselves or their partner with PPD. While fathers are regarded as important sources of support for mothers with PPD, to date, no research has been found that explored fathers’ support needs for coping with their partners’ PPD alone or in combination with paternal depression. Preliminary analysis of data from the pilot of the proposed study (n=12) reveals that fathers are unsure of how to identify PPD, how to support their partners when they are experiencing PPD, and feel excluded from treatment.
Qualitative Questions include: (1) What are fathers’ experiences with coping with PPD in their partner? (2) What are fathers’ personal experiences with paternal depression? (3) What are fathers’ support needs when coping with PPD and/or paternal depression? (4) What are fathers’ support resources when coping with PPD and/or paternal depression? (5) What barriers do fathers encounter in finding support for themselves and/or in supporting their partners with PPD? (6) What support interventions do fathers prefer when coping with PPD or paternal depression? (7) Using gender and sex-based analysis, how do fathers and mothers differ with respect to the preceding questions?
Quantitative Questions include: (1) What are the psychometric properties of measures of depression for fathers? (2) What is the relationship among demographic and descriptive variables (i.e. life stress, marital quality, social support) and paternal depression?
Methods: Pilot research with 12 fathers (6 in NB and 6 in AB) established that methods are feasible and acceptable to participants. Thirty fathers will be recruited in each province and individually interviewed by telephone. Consistent with community-based/ participatory approaches, a National Advisory Committee (NAC) has been created to guide the research. Members include stakeholders from direct practice, fathers’ groups, and community agencies. Group (in-person) interviews will be used to validate individual interview findings and to develop family-centred support intervention(s) in close consultation with fathers and the NAC.
Measures: Collected by return electronic or regular mail, demographic data and standard measures of depression and PPD will be used to describe the sample including the EPDS and CES-D. Other measures will examine fathers’ perceived social support, life stress and marital quality.
Analysis: Individual and group interviews will be audio taped, transcribed and subjected to thematic content analysis using a key category system of themes. Trained research assistants will code the data using inductive analysis, meet pre-specified criteria, use explicit coding rules, and maintain inter-rated agreement of 80%. Quantitative data will be analyzed with descriptive and correlational statistics.
Dissemination: Findings will reveal needed data about fathers’ experiences with PPD, paternal depression and their support needs. In consultation with our NAC, results will be shared via traditional and non-traditional means including peer-reviewed publications, conferences, fact sheets, in-service workshops, research web sites, and hosted conference for service providers.
1 Fathers are defined as males who report a continuing relationship with a mother-child pair affected by PPD and may or may not reside with the mother with postpartum depression either during the data collection or PPD episode.