Wynter Karen, Mansour Kayla A, Forbes Faye, Macdonald Jacqui A
Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.
School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Health Promot J Austr. 2024 Oct;35(4):891-910. doi: 10.1002/hpja.846. Epub 2024 Mar 17.
Engagement with health supports benefits the whole family, yet few health services report successful engagement of fathers. Our aim was to describe available evidence on barriers and opportunities relevant to health system access for fathers.
Scoping reviews were conducted seeking empirical evidence from (1) Australian studies and (2) international literature reviews.
A total of 52 Australian studies and 44 international reviews were included. The most commonly reported barriers were at the health service level, related to an exclusionary health service focus on mothers. These included both 'surface' factors (e.g., appointment times limited to traditional employment hours) and 'deep' factors, in which health service policies perpetuate traditional gender norms of mothers as 'caregivers' and fathers as 'supporters' or 'providers'. Such barriers were reported consistently, including but not limited to fathers from First Nations or culturally diverse backgrounds, those at risk of poor mental health, experiencing perinatal loss or other adverse pregnancy and birth events, and caring for children with illness, neurodevelopmental or behavioural problems. Opportunities for father engagement include offering father-specific resources and support, facilitating health professionals' confidence and training in working with fathers, and 'gateway consultations', including engaging fathers via appointments for mothers or infants. Ideally, top-down policies should support fathers as infant caregivers in a family-based approach.
Although barriers and opportunities exist at individual and cultural levels, health services hold the key to improved engagement of fathers. SO WHAT?: Evidence-based, innovative strategies, informed by fathers' needs and healthy masculinities, are needed to engage fathers in health services.
与健康支持机构合作对整个家庭有益，但很少有医疗服务机构报告称成功让父亲参与进来。我们的目的是描述与父亲获得医疗服务相关的障碍和机会的现有证据。
进行了范围综述，以寻找来自（1）澳大利亚研究和（2）国际文献综述的实证证据。
共纳入了52项澳大利亚研究和44项国际综述。最常报告的障碍存在于医疗服务层面，与医疗服务以母亲为重点的排他性有关。这些障碍包括“表面”因素（如预约时间限于传统工作时间）和“深层”因素，即医疗服务政策使母亲作为“照顾者”、父亲作为“支持者”或“提供者”的传统性别规范长期存在。这些障碍在各类人群中均有一致报告，包括但不限于来自原住民或文化背景多样的父亲、有心理健康问题风险的父亲、经历围产期损失或其他不良妊娠及分娩事件的父亲，以及照顾患有疾病、神经发育或行为问题儿童的父亲。让父亲参与的机会包括提供针对父亲的资源和支持、增强医护人员与父亲合作的信心并提供相关培训，以及“入门咨询”，包括通过母亲或婴儿的预约让父亲参与进来。理想情况下，自上而下的政策应以家庭为基础支持父亲成为婴儿照顾者。
尽管在个人和文化层面存在障碍和机会，但医疗服务机构是提高父亲参与度的关键。那又如何？：需要基于证据、以父亲的需求和健康的男性气质为依据的创新策略，以使父亲参与到医疗服务中。
