背景:数字干预有助于解决传统医疗保健服务的障碍。父亲在家庭中扮演着重要的育儿角色,他们的参与有利于家庭幸福。尽管数字干预是促进围产期父亲参与的有希望的途径,大多数是面向母亲的需求,而不是解决父亲的独特需求。
目的:本系统综述描述了从受孕到产后12个月的婴儿父亲存在或正在开发的数字干预措施。
方法:对MEDLINE的系统搜索,PsycINFO,Cochrane中央控制试验登记册,Embase(使用Ovid),我们进行了CINAHL(使用EBSCO)数据库,以确定从数据库开始到2022年6月的文章,其中39篇符合纳入标准.如果对文章进行了同行评审,并描述了针对胎儿父亲或≤12个月婴儿的数字干预措施,则包括这些文章。系统审查,荟萃分析,意见被排除在外。这些研究的数据是使用叙事综合方法提取和主题化的。使用混合方法评估工具对文章进行质量评估。
结果:共检索到2816篇,其中39人(1.38%)在删除重复项和筛查后符合入选标准。符合条件的文章包括13个国家的29种不同的干预措施。大多数文章(22/29,76%)描述了完全数字化的干预措施。有各种各样的数字模式,但干预措施最常见的设计是通过网站或基于网络的门户(14/29,48%).超过一半(21/39,54%)的文章描述了旨在从怀孕到产后分娩的干预措施。只有26%(10/39)的研究专门针对父亲。包括了广泛的结果,54%(21/39)的研究包括与干预可行性相关的主要结局。定性和混合方法研究报告了数字干预措施的总体积极经验和向合作伙伴提供支持的重要性的定性主题,提高育儿信心,并确定了应激的正常化。在18项主要检查疗效结果的研究中,13例(72%)报告了统计学上显著的干预效果。这些研究总体上表现出中等质量水平。
结论:新的和期待的父亲使用数字技术,这可以用来帮助解决传统医疗保健服务中父亲特有的障碍。然而,与目前对母亲的数字干预相比,以父亲为中心的干预措施缺乏评估和证据。在现有的关于父亲数字干预的研究中,关于它们的可行性似乎有不同的发现,可接受性,和功效。有必要对针对父亲确定的优先事项的干预措施进行更多的发展和标准化评估。这项审查受到不评估以公平为导向的结果的限制(例如,种族和社会经济地位),这也应该在未来的干预发展中加以考虑。
Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate
father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers.
This systematic
review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum.
A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool.
A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall.
New and expecting fathers use digital technologies, which could be used to help address
father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers,
father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This
review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.