What Do We Truly Mean By Father-friendly and

How Do We Achieve It?

Leybis Pena

Sarah Oo

Maria Yolanda Wigozki

Who we are

What brings you to this session today?

What we will cover in this session

• Background - Setting

• How we are implementing Father-friendly practices in MGH Chelsea

• Lessons learned

• Open discussion – what have others been doing around Fatherhood?

2 miles north of Boston – 2 square miles

37,000 + - population

62% Latino

23% living in poverty (48% of children)

Gateway city: Central America, Nepal, Bosnia, Somalia, Afghanistan, Iraq, Syria,

Northern, & Western Africa

Chelsea, Massachusetts

MGH Mission Statement

Guided by the needs of our patients and their families, we aim to deliver the

very best health care in a safe, compassionate environment; to advance that

care through innovative research and education; and to improved the health and

well-being of the diverse communities we serve.

Community Health Improvement 45 community health workers

25 countries / 21 languages

•Access to hospital services

•Managing chronic diseases

•Medication adherence

•Navigate patients to appointments (specialty, cancer, etc.)

•Community resources

Patients with:

History of trauma

Extreme poverty

Isolation

Low literacy

Language barriers

Social determinants of health

Healthy Families America

6 HFA Home Visitors (English, Spanish, Portuguese, Somali, Nepalese, Arabic)

1 Fatherhood Coordinator

Services to first time parents or first time parents in this country with 2 or more

significant risk factors

• Extreme poverty

• Isolation

• Cognitive challenges

• Medically complicated baby

• Trauma history

• Domestic violence

• Depression

How did we create our Fatherhood Program?

.- Compassion and Empathy

.- Multigenerational effects of ACEs

.- Trauma Informed Care

.- Integrating other provider’s insight

A bit about me

• Dominican Republic

• Adapting to a new city

• Becoming adult at young age

• Work & experience as a mentor and paving the way

• Partners in Parenting-BPHCI. Helping families reunite with imprisoned dads

II. Having children color postcards and vise versa

III. Welcome home dad signs when dad came home by the children

IV. Eventually helping dads with resources in the community

“You are going to be a dad”

• Becoming a dad/stepdad – feelings

• Feeling invisible - our OB/Prenatal visits

• Experiences as a new father of 3

• Online apps

• Online community- father related sites

• Poster on the wall- developmental stages goals, misses and fears

• What I understood was my role as a dad

• Had not known the importance of attachment, affection and physical contact

• Promotion of positive parent-child interaction

• Promotion of healthy growth and development

• Enhancement of family functioning

Fatherhood Program Goals

As Fatherhood Coordinator…

•Work on improving the healthcare center to be welcoming

to fathers

•Guide healthcare center staff to be responsive to fathers and

their needs

•Created services and collaborated with the ones in place:Home visiting

Family Development

Gatherings

Staff trainings

FatherhoodCoordinator

Interpreter/CHWHealthy Families

America - Chelsea

Fathers & Family MembersLarger

Community

MGH Chelsea

Providers

How do we do this?

Support culture change within MGH Chelsea:

- Training, environment –welcoming and support dads

Create special programs for dads -Play groups, outings, home visits, cultural events/gatherings

Data Collection -ETO

Physical and Emotional Health

A study of 1,977 children age 3 and older living with a residential father or father figure

found that children living with married biological parents had significantly fewer

externalizing and internalizing behavioral problems than children living with at least one

non-biological parent

Drug and Alcohol Abuse

The U.S. Department of Health and Human Services states, “Fatherless children are at a

dramatically greater risk of drug and alcohol abuse.”

The Consequences of Fatherlessness

Fatherlessness According to Research

•Research shows having dads around makes a difference in their children life - The Effects of

Fatherfullness

•Total dads 70,100,000 - Trends in Fathering

•Studies have consistently found that the most common way for fathers to interact with their

children is in the context of play. Mothers, on the other hand, tend to take on more of the

planning and organization that go into caregiving. Father-Child Relationship

Research…

Just the Facts

Barriers to Father Involvement

Communicate Knowledge

• Empathy– What is your baby

thinking?

• Reading baby’s cues

• Soothing

• Interacting– Singing

– Playing

– Laughing

– Praying

• Responding to cues

– “serve and return”

– Building Brain

connection

• Model

-“Growing Great Kids”

-Brain building activities

- Reading, playing,

singing

Photo in the health

center hallway

OB Waiting Area Before

OB Waiting Area AFTER

Created posters in

different languages

Cultural Change

Family Visits

Service DevelopmentBhutanese

Gatherings & Home Visits• Cultural broker

• Their desires

SomaliGatherings

• Ceased with no broker

Home Visits• Trying yet working

with moms

• Technology use

ArabicGatherings

• Little interest

Home Visits• Strong familial norms

Latino or Spanish SpeakingHome Visits

• Tandem using GKK

• Train and supervise HV

Gatherings• Diverse populations

• Interest level unknown

• Language capacity

• Family event

Cultural Sensitivity

Program details The Day to Day

Fatherhood Coordinator

Email Office Phone Walk Ins/ In person

OB, Pediatrics, Mental Health, Adult Med.

Provider Office Visit

Dads themselves HFA HV program Local High School Local Court and DCF

Referral Process - Snapshot

Data collection:

After the Referral

•Outreach- call or text

•Parent survey questions

•Set up an individualize plan where dad feels the need to improve.

•I am also able to make recommendations if I see an area where we can improve

• We set a GOAL

•Weekly meetings depending on dads availability

Example of Goal

Understanding Basic Care –GGK

Week 1: Discuss CryingCrying and why do they think their baby is crying, letting them know all babies cry. Assess for understanding and or

any frustrating behavior.

Week 2: Discuss strategies used to calm the baby

Listen to how they reacted when their son/daughter was crying, and how they manage the situation. Week 2

introducing new material- Lifting and hold, and how this is important to promote attachment

.

Week 3: Diapering

We discuss diapering, and the importance to help mom when she is overwhelm

Week 4: Reassess goal, set up a new one or keep working on the current one

We come back to the original goal and think of the process

Play Groups

•As part of the Fatherhood Program I encourage dads to attend biweekly group

meetings.

-There they can interact with other dads

- Discuss stages and developmental milestones of their child

-Share concerns

-Share happy moments

-Share resources

• Provide educational materials on a specific subject

Fatherhood Coordinator –Home Visiting

•Having the unique opportunity to do family home visits

•Engaging both parents in the conversation how to raise a child

•Benefits:

- I observe their parenting styles

- I get to see them in action playing with the child

- I get to ask questions related to plans for the future

EX. -What school or daycare do they want their child to go to?

- What type of student they want them to become?

•Most important is that I am able to follow up with them!

Peter’s Story

How Can We Help?

Questions or Comments?

Contact Information

Leybis Pena - lpena@partners.org

Sarah Oo - soo@partners.org

Maria Yolanda Wigozki - mwigozki@partners.org