Date of Paper/Work

5-2021

Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Kathleen Bell

Department/School

Doctor of Nursing Practice

Abstract

Background: Family home visiting programs provide antepartum and parenting support to families identified as "high-risk" to promote healthy parenting habits and behaviors that result in positive health outcomes for the child and the family as a whole. However, home visiting programs rarely include fathers as integral participants in services despite fathers' critical role in the family.

Purpose: This project aims to support public health nurses in serving fathers in family home visiting services by developing and implementing an infrastructure for working with fathers.

Theoretical Framework: The theoretical framework used to guide this project was the FamilyCentered Care Theory.

Methods: Six family home visiting public health nurses from Dakota County Public Health in Minnesota were trained in and implemented standards and guidelines for working with fathers that included engagement strategies, enrollment procedures, periodic visit requirements, documentation practices, and billing processes.

Results: Five fathers enrolled in family home visiting services, documentation on home visits with a father increased from 0% to 45%, health insurance reimbursement for home visits with a father increased from 0% to 20%, fathers who received education materials explicitly geared toward them increased from 30% to 40%, fathers who received mental health and substance use screenings increased from 20% to 30%, and 100% of families with a father enrolled in services were retained at the end of the project implementation period.

Conclusion: Implementing father-inclusive home visiting guidelines resulted in positive outcomes for family home visiting clients. When father-inclusive procedures are in place, fathers are enrolled in services, have individualized care plans, receive education materials geared toward them, and are screened for mental health concerns and substance abuse at evidence-based intervals. Family retention rates are also positively impacted by the intentional inclusion of fathers in home visiting services.

Implications: Home visiting programs must implement father-inclusive home visiting guidelines, including engagement strategies, enrollment procedures, periodic visit requirements, documentation practices, and billing processes. Recommendations include that home visitors should involve fathers at the initiation of services, highlight how the father can add value to visits, schedule visits with both the mother and father, provide appointments outside of business hours, and offer a broad selection of educational materials and resources explicitly geared toward fathers. Further investigation of father-inclusive visits is needed with a larger sample size and over an extended time frame.

Available for download on Monday, September 11, 2023

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