Fathers and Babies (FAB) Research Study

FAB was adapted from Mothers and Babies (MB), an evidence-based perinatal depression prevention intervention. Like MB, FAB was designed using principles from cognitive behavioral therapy (CBT) to help parents manage negative moods and emotions through pleasant activities, helpful ways of thinking and contact with others. MB and FAB can be delivered concurrently or as stand-alone interventions. MB and FAB are both delivered in nine sessions, with each session lasting 20-25 minutes. FAB can be implemented in-person, virtually, or via text message. MB has been found effective to prevent the onset of postpartum depression and reduce depressive symptoms through multiple randomized controlled trials (RCT). Home Visiting (HV) services target expectant parents and parents of young children to provide support in the home using evidence-based models that focus on children's development. Though HV programs tend to focus on mothers, there have been increasing efforts to engage fathers in HV services. Evidence-based models vary in their approach to reaching fathers, though most models place an emphasis on the promotion of responsible fatherhood. Efforts to include fathers in these programs stem from the increasing knowledge that father involvement is associated with positive child development outcomes, like peer relationships, increased self-esteem, and fewer externalizing and internalizing behaviors. Furthermore, fathers involved in HV services with their partners show increased knowledge of child development and more responsive parenting practices. More attention has been recently directed toward fathers' perinatal mental health, with epidemiological evidence indicating an unmet need for the treatment of paternal depression and anxiety. Paternal depression in the United States has a reported prevalence of 8.4% during pregnancy and the postpartum period, though the prevalence between three and six months postpartum can be as high as 13%. Postpartum depression disproportionately affects low-income men across racial and ethnic groups. However, men across racial and ethnic groups are less likely to seek mental health services compared to women. Fathers with worse mental health outcomes during the perinatal period are less likely to have nurturing relationships with their children, which can negatively affect child outcomes from infancy through adolescence. Despite the prevalence of paternal depression, few interventions have targeted fathers during the perinatal period to address their mental health. To address this gap, FAB was developed to address the mental health of fathers during the perinatal period. FAB was developed in collaboration with infant mental health consultants, academics, home visitors, fatherhood experts, and fathers. In the pilot study, FAB was concurrently delivered with MB, and tested among 30 mother-father dyads. Data from the pilot study showed that FAB led to reductions in anxiety and depressive symptoms, and perceived stress among fathers receiving the intervention. Additionally, 88% of fathers indicated that FAB gave them skills to help manage their mood and stress and 82% indicated that FAB helped them and their partner talk about stress and parenting. All pilot participants indicated that they would recommend FAB to other fathers. In this longitudinal RCT, the investigators will examine the effectiveness and implementation of the FAB intervention. To do this, the investigators will partner with HV programs in the state of Illinois (IL) and Texas (TX). Home visitors will be randomized to receive (intervention) or not to receive (controls) the FAB training. Home visitors that are randomized to receive FAB training will be trained and implement the FAB or FAB with MB. Home visitors randomized to serve as controls will continue to deliver their normal home visiting services during the study and refer fathers or fathers and their partners (mother of the child).