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Doctoral Candidate, Harvard University

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The early childhood development literature has underscored important contributions of fathers. An increasingly robust body of evidence has demonstrated positive benefits of fathers' parenting behaviors on a variety of early child development outcomes, across various racial and ethnic groups, sociodemographic factors, and family composition structures in the U.S. and other high-income countries. However, very little empirical evidence has considered fathers in parenting or early childhood development research in low- and middle-income countries (LMICs). My dissertation research aims to advance our understanding of the role of fathers in their young children’s early care, health, and development in LMICs by utilizing three unique data sources, applying diverse methodologies (both rigorous quantitative and in-depth qualitative analyses), and tackling interrelated but distinct empirical research questions by which fathers influence their children’s early development.

My first chapter uses international household survey data from UNICEF’s Multiple Indicator Cluster Surveys to examine the relationship between fathers’ involvement in play and learning activities and children’s physical growth and early developmental outcomes in a sample of nearly 100,000 three- and four-year-old children across 38 LMICs.

My second chapter utilizes longitudinal data on 1,302 children and their caregivers who were involved in an early parenting intervention study in rural Pakistan. Using structural equation modeling, I examine both the maternal and paternal parenting process mechanisms that underlie the intervention’s positive effects on children’s cognitive and socioemotional development outcomes at age 4.

My third chapter is based on primary data from a qualitative study that I recently launched this year in rural Pakistan. Through in-depth interviews and direct parent-child observations in the home, this paper aims to better understand similarities and differences in the roles, expectations, manners of interactions between fathers and mothers in this community. These findings will not only provide a more holistic understanding of how fathers influence children’s development, but also undoubtedly inform promising intervention points for engaging both mothers and fathers in their young children’s lives in this community in Pakistan.

19 ITEMS PINNED

Fathers' involvement and children's developmental outcomes: a systematic review of longitudinal studies.

Abstract: This systematic review aims to describe longitudinal evidence on the effects of father involvement on children's developmental outcomes.Father involvement was conceptualized as accessibility (cohabitation), engagement, responsibility or other complex measures of involvement. Both biological fathers and father figures were included. We searched all major databases from the first dates. Data on father involvement had to be generated at least 1 year before measuring offspring outcomes.N = 24 publications were included in the overview: 22 of these described positive effects of father involvement, whereof 16 studies had controlled for SES and 11 concerned the study population as a whole [five socio-economic status (SES)-controlled]. There is certain evidence that cohabitation with the mother and her male partner is associated with less externalising behavioural problems. Active and regular engagement with the child predicts a range of positive outcomes, although no specific form of engagement has been shown to yield better outcomes than another. Father engagement seems to have differential effects on desirable outcomes by reducing the frequency of behavioural problems in boys and psychological problems in young women, and enhancing cognitive development, while decreasing delinquency and economic disadvantage in low SES families.There is evidence to support the positive influence of father engagement on offspring social, behavioural and psychological outcomes. Although the literature only provides sufficient basis for engagement (direct interaction with the child) as the specific form of 'effective' father involvement, there is enough support to urge both professionals and policy makers to improve circumstances for involved fathering.

Pub.: 07 Dec '07, Pinned: 26 Aug '17

Paternal depression in the postnatal period and child development: mediators and moderators.

Abstract: To explore potential mediating and moderating factors that influence the association between paternal depression in the postnatal period and subsequent child behavioral and emotional problems.A population-based cohort (N = 13,822) from the Avon Longitudinal Study of Parents and Children (ALSPAC) was recruited during pregnancy. Paternal and maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale at 8 weeks after the birth of the child. Child outcomes were assessed at 3.5 years by using the Rutter revised preschool scales and at 7 years by using the Strengths and Difficulties Questionnaire. Path analysis was used to assess hypothesized mediators (ie, depression in the other parent, couple conflict, and paternal noninvolvement) of the associations between both paternal and maternal depression and child outcomes. We also tested for hypothesized moderators (ie, paternal education and antisocial traits).Family factors (maternal depression and couple conflict) mediated two-thirds of the overall association between paternal depression and child outcomes at 3.5 years. Similar findings were seen when children were 7 years old. In contrast, family factors mediated less than one-quarter of the association between maternal depression and child outcomes. There was no evidence of moderating effects of either parental education or antisocial traits.The majority of the association between depression in fathers postnatally and subsequent child behavior is explained by the mediating role of family environment, whereas the association between depression in mothers and child outcomes appears to be better explained by other factors, perhaps including direct mother-infant interaction.

Pub.: 07 Jan '15, Pinned: 26 Aug '17

Paternal mental health and socioemotional and behavioral development in their children.

Abstract: To examine the association between symptoms of psychological distress in expectant fathers and socioemotional and behavioral outcomes in their children at age 36 months.The current study is based on data from the Norwegian Mother and Child Cohort Study on 31 663 children. Information about fathers' mental health was obtained by self-report (Hopkins Symptom Checklist) in week 17 or 18 of gestation. Information about mothers' pre- and postnatal mental health and children's socioemotional and behavioral development at 36 months of age was obtained from parent-report questionnaires. Linear multiple regression and logistic regression models were performed while controlling for demographics, lifestyle variables, and mothers' mental health.Three percent of the fathers had high levels of psychological distress. Using linear regression models, we found a small positive association between fathers' psychological distress and children's behavioral difficulties, B = 0.19 (95% confidence interval [CI] = 0.15-0.23); emotional difficulties, B = 0.22 (95% CI = 0.18-0.26); and social functioning, B = 0.12 (95% CI = 0.07-0.16). The associations did not change when adjusted for relevant confounders. Children whose fathers had high levels of psychological distress had higher levels of emotional and behavioral problems.This study suggests that some risk of future child emotional, behavioral, and social problems can be identified during pregnancy. The findings are of importance for clinicians and policy makers in their planning of health care in the perinatal period because this represents a significant opportunity for preventive intervention.

Pub.: 09 Jan '13, Pinned: 26 Aug '17

A Mixed-methods Study of Paternal Involvement in Hong Kong

Abstract: The research reported here examined Chinese fathers’ direct interaction or engagement in children's education both at home and in preschool during the early childhood years using a Hong Kong sample in two studies. In Study 1, comparisons between father and mother involvement practices and examination of the associations between family background variables and father involvement as well as between father involvement and school readiness were conducted. In Study 2, father and teacher focus-group interviews were conducted to explore fathers’ and teachers’ beliefs and practices concerning father involvement. Consistent with previous studies, the findings showed that teachers and fathers acknowledged the importance of fathering for children's positive development as well as supportive marital relationships. While fathers were found to be involved in various educational activities both at home and in preschool, the findings showed that the influence of family background may depend on the context of fathers’ involvement. In particular, family income, parental education background, parental work status, and fathers’ perception of child and teacher invitations were found to affect fathers’ preschool-based involvement, but not fathers’ home-based involvement. Finally, father involvement, however, was not found to associate with children's school readiness. These findings are likely to contribute to the literature on father involvement regarding its determinants and influence on child outcomes during the early years in Chinese culture, drawing important implications for father education, teacher education and family policy.

Pub.: 03 Oct '16, Pinned: 26 Aug '17

Gatekeeping and its impact on father involvement among Black South Africans in rural KwaZulu-Natal.

Abstract: Involved and caring fatherhood contributes to the health and wellbeing of children, women and men. The corollary is also true - men, women and children are affected when fathers are not involved or supportive of their children. Many factors affect fathers' involvement, including women's attitudes, the history and nature of the relationship between mother and father, and the cultural context. This study explores gatekeeping and its impact on father involvement among Black South Africans in rural KwaZulu-Natal. Among married couples, gatekeeping occurs with respect to childcare and housework through women's attempts to validate their maternal identity according to socially and culturally constructed gender roles. Among unmarried, non-resident parents, women control father-child contact and involvement, with mothers and/or their families either facilitating or inhibiting father involvement. In this context, we found that cultural gatekeeping had a huge impact on father involvement, with the non-payment of inhlawulo or lobola regulating father-child involvement. In a country like South Africa, where there is high non-marital fertility and father-child non-residence, future research, parenting and family programmes should focus on strategies that encourage positive paternal involvement as well as maternal and cultural support for father involvement, regardless of parental relationship and residence status.

Pub.: 27 Oct '15, Pinned: 26 Aug '17

Parenting Skills and Emotional Availability: An RCT.

Abstract: To investigate whether a responsive stimulation intervention delivered to caregivers of young children either alone or integrated with nutrition interventions would benefit parenting skills and emotional availability to promote children's development and growth compared with either a nutrition intervention alone or the usual standard of care.A cluster randomized factorial effectiveness trial was implemented in an impoverished community in Pakistan. The 4 trial arms were control (usual standard of care), responsive stimulation (responsive care and stimulation), enhanced nutrition (education and multiple micronutrients), and a combination of both enriched interventions. The 4 intervention packages were delivered by community health workers to 1489 mother-infant dyads in the first 2 years of life. Parenting skills and emotional availability indexed by mother-child interaction, caregiving environment, knowledge and practices pertaining to early childhood care and feeding, and maternal depressive symptoms were assessed at multiple intervals. An intention-to-treat factorial analysis was conducted.Intervention groups were comparable at baseline. Responsive stimulation significantly benefitted parenting skills with large effect sizes on mother-child interaction (Cohen's d 0.8), caregiving environment (Cohen's d 0.9-1.0), and knowledge and practices (Cohen's d 0.7-1.1) compared with small-modest significant effects as a result of nutrition intervention on mother-child interaction and caregiving environment only (Cohen's d 0.4 and 0.2, respectively). The combined intervention had a small significant effect on decreasing maternal depressive symptoms over time (Cohen's d 0-0.2).A responsive stimulation intervention can promote positive caregiving behaviors among impoverished families. Additional research is needed on interventions to reduce maternal depressive symptoms.

Pub.: 15 Apr '15, Pinned: 26 Aug '17

Effects of a parenting intervention to address maternal psychological wellbeing and child development and growth in rural Uganda: a community-based, cluster randomised trial.

Abstract: Parenting interventions have been implemented to improve the compromised developmental potential among 39% of children younger than 5 years living in low-income and middle-income countries. Maternal wellbeing is important for child development, especially in children younger than 3 years who are vulnerable and dependent on their mothers for nutrition and stimulation. We assessed an integrated, community-based parenting intervention that targeted both child development and maternal wellbeing in rural Uganda.In this community-based, cluster randomised trial, we assessed the effectiveness of a manualised, parenting intervention in Lira, Uganda. We selected and randomly assigned 12 parishes (1:1) to either parenting intervention or control (inclusion on a waitlist with a brief message on nutrition) groups using a computer-generated list of random numbers. Within each parish, we selected two to three eligible communities that had a parish office or a primary school in which a preschool could be established, more than 75 households with children younger than 6 years, and at least 15 socially disadvantaged families (ie, maternal education of primary school level or lower) with at least one child younger than 36 months. Participants within communities were mother-child dyads, where the child was 12-36 months of age at enrollment, and the mother had low maternal education. In the parenting intervention group, participants attended 12 fortnightly peer-led group sessions focusing on child care and maternal wellbeing. The primary outcomes were cognitive and receptive language development, as measured with the Bayley Scales of Infant Development, 3rd edn. Secondary outcomes included self-reported maternal depressive symptoms, using the Center for Epidemiologic Studies Depression Scale, and child growth. Theoretically-relevant parenting practices, including the Home Observation for Measurement of the Environment inventory, and mother-care variables, such as perceived spousal support, were also assessed as potential mediators. Baseline assessments were done in January, 2013, and endline assessments were done in November, 2013, 3 months after completion of the programme. Ethics approval was received from Mbarara and McGill universities. This trial is registered with ClinicalTrials.gov, NCT01906606.Between December, 2012, and January, 2013, 13 communities (194 dyads) were randomly assigned to receive intervention, and 12 communities (154 dyads) were assigned to a waitlist control. 319 dyads completed baseline measures (171 in the intervention group and 148 in the control group), and 291 dyads completed endline measures (160 in the intervention group and 131 in the control group). At endline, children in the intervention group had significantly higher cognitive scores (58·90 vs 55·65, effect size 0·36, 95% CI 0·12-0·59) and receptive language scores (23·86 vs 22·40, 0·27, 0·03-0·50) than did children in the control group. Mothers in the intervention group reported significantly fewer depressive symptoms (15·36 vs 18·61, -0·391, 95% CI -0·62 to -0·16) than did mothers in the control group. However, no differences were found in child growth between groups.The 12 session integrated parenting intervention delivered by non-professional community members improved child development and maternal wellbeing in rural Uganda. Because this intervention was largely managed and implemented by a local organisation, using local community members and minimal resources, such a programme has the potential to be replicated and scaled up in other low-resource, village-based settings.Plan Uganda via Plan Finland (Ministry of Foreign Affairs) and Plan Australia (Australian Aid).

Pub.: 07 Jul '15, Pinned: 26 Aug '17

Paternal Stimulation and Early Child Development in Low- and Middle-Income Countries.

Abstract: Few studies have examined the relationship between paternal stimulation and children's growth and development, particularly in low- and middle-income countries (LMICs). This study aimed to estimate the prevalence of paternal stimulation and to assess whether paternal stimulation was associated with early child growth and development.Data from the Multiple Indicator Cluster Surveys rounds 4 and 5 were combined across 38 LMICs. The sample comprised 87 286 children aged 3 and 4 years. Paternal stimulation was measured by the number of play and learning activities (up to 6) a father engaged in with his child over the past 3 days. Linear regression models were used to estimate standardized mean differences in height-for-age z-scores and Early Childhood Development Index (ECDI) z-scores across 3 levels of paternal stimulation, after controlling for other caregivers' stimulation and demographic covariates.A total of 47.8% of fathers did not engage in any stimulation activities, whereas 6.4% of fathers engaged in 5 or 6 stimulation activities. Children whose fathers were moderately engaged in stimulation (1-4 activities) showed ECDI scores that were 0.09 SD (95% confidence interval [CI]: -0.12 to -0.06) lower than children whose fathers were highly engaged; children whose fathers were unengaged showed ECDI scores that were 0.14 SD lower (95% CI: -0.17 to -0.12). Neither moderate paternal stimulation nor lack of paternal stimulation was associated with height-for-age z-scores, relative to high stimulation.Increasing paternal engagement in stimulation is likely to improve early child development in LMICs.

Pub.: 08 Sep '16, Pinned: 26 Aug '17