Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

Strengthening resilience through an extended postnatal home visiting program in a multicultural suburb in Sweden: fathers striving for stability

Authors: Kirsi Tiitinen Mekhail, Lene Lindberg, Bo Burström, Anneli Marttila

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

To improve prerequisites for better health development among children growing up in multicultural suburbs in Stockholm County, where poorer health is displayed in several aspects including child health, early support was initiated for first-time parents in one of the suburbs. An extended postnatal home visiting program during the child’s first 15 months was offered to families with first-time mothers during 2013–2014 and consisted of six home visits by a child health care nurse and a parental advisor from social services. Almost all invited families (94%) participated in the program and the program evaluation. Fathers’ participation in two or more home visits within the program was 53%.
The aim of this study was to explore the experiences of fathers participating in the program, with respect to their role as a first-time parent from a resilience perspective.

Methods

In-depth interviews were conducted with nine fathers. Constructivist grounded theory (GT) was applied in the analysis.

Results

The fathers’ experiences formed the core category of the study, ‘striving for stability in living conditions’, as well as three categories: ‘everyday life conditions’, ‘adjustment to fatherhood in Sweden’ and ‘channels of support’. The fathers perceived that the home visiting program strengthened their parental confidence and increased their knowledge of societal services and local resources for their family.

Conclusions

In terms of resilience, the extended postnatal home visiting program benefitted the interviewed migrant fathers on an individual level by meeting part of their need for support regarding knowledge and parental confidence; on a structural level the program helped fathers gain information about available societal services and resources in their local area.

Trial registration

The study was retrospectively registered (11 August 2016) in the ISRCTN registry (ISRCTN11832097 DOI: https://​doi.​org/​10.​1186/​ISRCTN11832097).
Appendix
Available only for authorised users
Literature
1.
go back to reference Chapter 2. The public health objective bill (Govt. bill 2002/03:35) - extended summary. Scand J Public Health. 2016;32(64_suppl):18–59. Chapter 2. The public health objective bill (Govt. bill 2002/03:35) - extended summary. Scand J Public Health. 2016;32(64_suppl):18–59.
4.
go back to reference Burström B, Burström K, Corman D: Livsvillkor, levnadsvanor och hälsa i Stockholms län öppna jämförelser 2014 [Living conditions, health-related behaviors and health in Stockholm County – open comparisons 2014]. Stockholm: Stockholms läns landsting; 2014. Rapport 2014:4. Burström B, Burström K, Corman D: Livsvillkor, levnadsvanor och hälsa i Stockholms län öppna jämförelser 2014 [Living conditions, health-related behaviors and health in Stockholm County – open comparisons 2014]. Stockholm: Stockholms läns landsting; 2014. Rapport 2014:4.
6.
go back to reference Burström B, Marttila A, Kulane A, Lindberg L, Burström K. Practising proportionate universalism - a study protocol of an extended postnatal home visiting programme in a disadvantaged area in Stockholm. Sweden BMC Health Serv Res. 2017;17(1):91.CrossRef Burström B, Marttila A, Kulane A, Lindberg L, Burström K. Practising proportionate universalism - a study protocol of an extended postnatal home visiting programme in a disadvantaged area in Stockholm. Sweden BMC Health Serv Res. 2017;17(1):91.CrossRef
7.
go back to reference Marttila A, Burström K, Lindberg L, Burström B: Utökat barnhälsovårdsprogram för förstagångsföräldrar – samverkan mellan Rinkeby BVC och föräldrarådgivare inom Kista-Rinkeby socialtjänst. Utvärderingsrapport 2015. [An extended child health care program for first-time parents – collaporation between Rinkeby Child Health Care Center and parental advisors within Kista-Rinkeby social services. Report of evaluation 2015]. Stockholm: Karolinska Institutet; 2015. http://dok.slso.sll.se/CES/FHG/Rapport-FHM-utokat-barnhalsovardsprogram.pdf. Accessed Oct 20 2015. In Swedish. Marttila A, Burström K, Lindberg L, Burström B: Utökat barnhälsovårdsprogram för förstagångsföräldrar – samverkan mellan Rinkeby BVC och föräldrarådgivare inom Kista-Rinkeby socialtjänst. Utvärderingsrapport 2015. [An extended child health care program for first-time parents – collaporation between Rinkeby Child Health Care Center and parental advisors within Kista-Rinkeby social services. Report of evaluation 2015]. Stockholm: Karolinska Institutet; 2015. http://​dok.​slso.​sll.​se/​CES/​FHG/​Rapport-FHM-utokat-barnhalsovardspr​ogram.​pdf. Accessed Oct 20 2015. In Swedish.
8.
go back to reference Barboza M, Kulane A, Burström B, Marttila A. A better start for health equity? Qualitative content analysis of implementation of extended postnatal home visiting in a disadvantaged area in Sweden. Int J Equity Health. 2018;17(1):42.CrossRef Barboza M, Kulane A, Burström B, Marttila A. A better start for health equity? Qualitative content analysis of implementation of extended postnatal home visiting in a disadvantaged area in Sweden. Int J Equity Health. 2018;17(1):42.CrossRef
9.
go back to reference McGinnis S, Lee E, Kirkland K, Smith C, Miranda-Julian C, Greene R. Engaging at-risk fathers in home visiting services: effects on program retention and father involvement. Child Adolesc Social Work J. 2018:1–12. McGinnis S, Lee E, Kirkland K, Smith C, Miranda-Julian C, Greene R. Engaging at-risk fathers in home visiting services: effects on program retention and father involvement. Child Adolesc Social Work J. 2018:1–12.
11.
go back to reference Marttila A, Lindberg L, Burström K, Kulane A, Burström B.: Utökat hembesöksprogram för förstagångsföräldrar − samverkan mellan Rinkeby BVC och föräldrarådgivare inom Rinkeby-Kista socialtjänst. Slutrapport utvärdering 2017. [An extended child health care program for first-time parents – collaporation between Rinkeby Child Health Care Center and parental advisors within Kista-Rinkeby social services. Final report of evaluation 2017]. Stockholm: Karolinska Institutet; 2017. http://dok.slso.sll.se/CES/FHG/Jamlik_halsa/Rapporter/BVC-rapport-2017.pdf. Accessed 10 May 2018. In Swedish. Marttila A, Lindberg L, Burström K, Kulane A, Burström B.: Utökat hembesöksprogram för förstagångsföräldrar − samverkan mellan Rinkeby BVC och föräldrarådgivare inom Rinkeby-Kista socialtjänst. Slutrapport utvärdering 2017. [An extended child health care program for first-time parents – collaporation between Rinkeby Child Health Care Center and parental advisors within Kista-Rinkeby social services. Final report of evaluation 2017]. Stockholm: Karolinska Institutet; 2017. http://​dok.​slso.​sll.​se/​CES/​FHG/​Jamlik_​halsa/​Rapporter/​BVC-rapport-2017.​pdf. Accessed 10 May 2018. In Swedish.
12.
go back to reference Rohner RP, Veneziano RA. The importance of father love: history and contemporary evidence. Rev Gen Psychol. 2001;5(4):382–405.CrossRef Rohner RP, Veneziano RA. The importance of father love: history and contemporary evidence. Rev Gen Psychol. 2001;5(4):382–405.CrossRef
13.
go back to reference Roer-Strier D, Strier R, Este D, Shimoni R, Clark D. Fatherhood and immigration: challenging the deficit theory. Child Family Social Work. 2005;10(4):315–29.CrossRef Roer-Strier D, Strier R, Este D, Shimoni R, Clark D. Fatherhood and immigration: challenging the deficit theory. Child Family Social Work. 2005;10(4):315–29.CrossRef
14.
go back to reference Ny P, Plantin L, Dejin-Karlsson E, Dykes AK. The experience of middle eastern men living in Sweden of maternal and child health care and fatherhood: focus-group discussions and content analysis. Midwifery. 2008;24(3):281–90.CrossRef Ny P, Plantin L, Dejin-Karlsson E, Dykes AK. The experience of middle eastern men living in Sweden of maternal and child health care and fatherhood: focus-group discussions and content analysis. Midwifery. 2008;24(3):281–90.CrossRef
15.
go back to reference Behnke A, Taylor B, Parra-Cardona J. “I hardly understand English, but…”: Mexican origin fathers describe their commitment as fathers despite the challenges of immigration. J Comp Fam Stud. 2008;39(2):187–205. Behnke A, Taylor B, Parra-Cardona J. “I hardly understand English, but…”: Mexican origin fathers describe their commitment as fathers despite the challenges of immigration. J Comp Fam Stud. 2008;39(2):187–205.
16.
go back to reference Este DC, Tachble A. Fatherhood in the Canadian context: perceptions and experiences of Sudanese refugee men. Sex Roles. 2008;60(7–8):456–66. Este DC, Tachble A. Fatherhood in the Canadian context: perceptions and experiences of Sudanese refugee men. Sex Roles. 2008;60(7–8):456–66.
17.
go back to reference Kilkey M, Plomien A, Perrons D. Migrant Men's fathering narratives, practices and projects in national and transnational spaces: recent polish male migrants to London. Int Migr. 2014;52(1):178–91.CrossRef Kilkey M, Plomien A, Perrons D. Migrant Men's fathering narratives, practices and projects in national and transnational spaces: recent polish male migrants to London. Int Migr. 2014;52(1):178–91.CrossRef
18.
go back to reference Riggs E, Yelland J, Szwarc J, Wahidi S, Casey S, Chesters D, Fouladi F, Duell-Piening P, Giallo R, Brown S. Fatherhood in a new country: a qualitative study exploring the experiences of afghan men and implications for health services. Birth. 2016;43(1):86–92.CrossRef Riggs E, Yelland J, Szwarc J, Wahidi S, Casey S, Chesters D, Fouladi F, Duell-Piening P, Giallo R, Brown S. Fatherhood in a new country: a qualitative study exploring the experiences of afghan men and implications for health services. Birth. 2016;43(1):86–92.CrossRef
19.
go back to reference Williams R, Hewison A, Wildman S, Roskell C. Changing fatherhood: an exploratory qualitative study with African and African Caribbean men in England. Child Soc. 2013;27(2):92–103.CrossRef Williams R, Hewison A, Wildman S, Roskell C. Changing fatherhood: an exploratory qualitative study with African and African Caribbean men in England. Child Soc. 2013;27(2):92–103.CrossRef
20.
go back to reference Osman F, Klingberg-Allvin M, Flacking R, Schon UK. Parenthood in transition - Somali-born parents' experiences of and needs for parenting support programmes. BMC Int Health Hum Rights. 2016;16(7):7.CrossRef Osman F, Klingberg-Allvin M, Flacking R, Schon UK. Parenthood in transition - Somali-born parents' experiences of and needs for parenting support programmes. BMC Int Health Hum Rights. 2016;16(7):7.CrossRef
21.
go back to reference Deng SA, Marlowe JM. Refugee resettlement and parenting in a different context. J Immigr Refug Stud. 2013;11(4):416–30.CrossRef Deng SA, Marlowe JM. Refugee resettlement and parenting in a different context. J Immigr Refug Stud. 2013;11(4):416–30.CrossRef
22.
go back to reference Ferguson H, Gates P. Early intervention and holistic, relationship-based practice with fathers: evidence from the work of the family nurse partnership. Child & Family Social Work. 2015;20(1):96–105.CrossRef Ferguson H, Gates P. Early intervention and holistic, relationship-based practice with fathers: evidence from the work of the family nurse partnership. Child & Family Social Work. 2015;20(1):96–105.CrossRef
23.
go back to reference Haggman-Laitila A. Early support needs of Finnish families with small children. J Adv Nurs. 2003;41(6):595–606.CrossRef Haggman-Laitila A. Early support needs of Finnish families with small children. J Adv Nurs. 2003;41(6):595–606.CrossRef
24.
go back to reference Rautio S. Parents' experiences of early support. Scand J Caring Sci. 2013;27(4):927–34.CrossRef Rautio S. Parents' experiences of early support. Scand J Caring Sci. 2013;27(4):927–34.CrossRef
25.
go back to reference Ny P, Plantin L, D Karlsson E, Dykes A-K: Middle eastern mothers in Sweden, their experiences of the maternal health service and their partner's involvement. Reprod Health 2007;4:9. Ny P, Plantin L, D Karlsson E, Dykes A-K: Middle eastern mothers in Sweden, their experiences of the maternal health service and their partner's involvement. Reprod Health 2007;4:9.
26.
go back to reference Berlin A, Tornkvist L, Hylander I. Watchfully checking rapport with the primary child health care nurses - a theoretical model from the perspective of parents of foreign origin. BMC Nurs. 2010;9:14.CrossRef Berlin A, Tornkvist L, Hylander I. Watchfully checking rapport with the primary child health care nurses - a theoretical model from the perspective of parents of foreign origin. BMC Nurs. 2010;9:14.CrossRef
27.
go back to reference Mangrio E, Persson K. Immigrant parents' experience with the Swedish child health care system: a qualitative study. BMC Fam Pract. 2017;18(1):32.CrossRef Mangrio E, Persson K. Immigrant parents' experience with the Swedish child health care system: a qualitative study. BMC Fam Pract. 2017;18(1):32.CrossRef
28.
go back to reference Sar BK, Antle BF, Bledsoe LK, Barbee AP, Van Zyl MA. The importance of expanding home visitation services to include strengthening family relationships for the benefit of children. Child Youth Serv Rev. 2010;32(2):198–205.CrossRef Sar BK, Antle BF, Bledsoe LK, Barbee AP, Van Zyl MA. The importance of expanding home visitation services to include strengthening family relationships for the benefit of children. Child Youth Serv Rev. 2010;32(2):198–205.CrossRef
29.
go back to reference Smith TK, Duggan A, Bair-Merritt MH, Cox G. Systematic review of Fathers' involvement in Programmes for the primary prevention of child maltreatment. Child Abuse Rev. 2012;21(4):237–54.CrossRef Smith TK, Duggan A, Bair-Merritt MH, Cox G. Systematic review of Fathers' involvement in Programmes for the primary prevention of child maltreatment. Child Abuse Rev. 2012;21(4):237–54.CrossRef
30.
go back to reference Guterman NB, Bellamy JL, Banman A. Promoting father involvement in early home visiting services for vulnerable families: findings from a pilot study of "dads matter". Child Abuse Negl. 2018;76:261–72.CrossRef Guterman NB, Bellamy JL, Banman A. Promoting father involvement in early home visiting services for vulnerable families: findings from a pilot study of "dads matter". Child Abuse Negl. 2018;76:261–72.CrossRef
31.
go back to reference Korfmacher J, Green B, Staerkel F, Peterson C, Cook G, Roggman L, Faldowski RA, Schiffman R. Parent involvement in early childhood home visiting. Child Youth Care Forum. 2008;37(4):171–96.CrossRef Korfmacher J, Green B, Staerkel F, Peterson C, Cook G, Roggman L, Faldowski RA, Schiffman R. Parent involvement in early childhood home visiting. Child Youth Care Forum. 2008;37(4):171–96.CrossRef
32.
go back to reference Gearing ME, Peters EH, Sandstrom H, Heller C. Engaging low-income fathers in home visiting: approaches, challenges, and strategies. Washington, DC: URBAN INSTITUTE; 2015. Gearing ME, Peters EH, Sandstrom H, Heller C. Engaging low-income fathers in home visiting: approaches, challenges, and strategies. Washington, DC: URBAN INSTITUTE; 2015.
33.
go back to reference Sandstrom H, Gearing M, Peters HE, Heller C, Healy O, Pratt E. Approaches to father engagement and fathers’ experiences in home visiting programs. OPRE report no. 2015–103. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, US Department of Health and Human Services; 2015. Sandstrom H, Gearing M, Peters HE, Heller C, Healy O, Pratt E. Approaches to father engagement and fathers’ experiences in home visiting programs. OPRE report no. 2015–103. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, US Department of Health and Human Services; 2015.
34.
go back to reference Olds DL, Kitzman H, Hanks C, Cole R, Anson E, Sidora-Arcoleo K, Luckey DW, Henderson CR Jr, Holmberg J, Tutt RA, et al. Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial. Pediatrics. 2007;120(4):e832–45.CrossRef Olds DL, Kitzman H, Hanks C, Cole R, Anson E, Sidora-Arcoleo K, Luckey DW, Henderson CR Jr, Holmberg J, Tutt RA, et al. Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial. Pediatrics. 2007;120(4):e832–45.CrossRef
35.
go back to reference Aronen ET, Arajarvi T. Effects of early intervention on psychiatric symptoms of young adults in low-risk and high-risk families. Am J Orthop. 2000;70(2):223–32.CrossRef Aronen ET, Arajarvi T. Effects of early intervention on psychiatric symptoms of young adults in low-risk and high-risk families. Am J Orthop. 2000;70(2):223–32.CrossRef
36.
go back to reference Haglund ME, Nestadt PS, Cooper NS, Southwick SM, Charney DS. Psychobiological mechanisms of resilience: relevance to prevention and treatment of stress-related psychopathology. Dev Psychopathol. 2007;19(3):889–920.CrossRef Haglund ME, Nestadt PS, Cooper NS, Southwick SM, Charney DS. Psychobiological mechanisms of resilience: relevance to prevention and treatment of stress-related psychopathology. Dev Psychopathol. 2007;19(3):889–920.CrossRef
37.
go back to reference Charmaz K. Constructing grounded theory : a practical guide through qualitative analysis. London: SAGE; 2006. Charmaz K. Constructing grounded theory : a practical guide through qualitative analysis. London: SAGE; 2006.
38.
go back to reference SBU: Utvärdering av metoder i hälso- och sjukvården: en handbok. Stockholm: Stockholm : Statens beredning för medicinsk utvärdering SBU; 2014. SBU: Utvärdering av metoder i hälso- och sjukvården: en handbok. Stockholm: Stockholm : Statens beredning för medicinsk utvärdering SBU; 2014.
39.
go back to reference Staal IIE, Van Stel HF, Hermanns JMA, Schrijvers AJP. Early detection of parenting and developmental problems in toddlers: a randomized trial of home visits versus well-baby clinic visits in the Netherlands. Prev Med. 2015;81:236.CrossRef Staal IIE, Van Stel HF, Hermanns JMA, Schrijvers AJP. Early detection of parenting and developmental problems in toddlers: a randomized trial of home visits versus well-baby clinic visits in the Netherlands. Prev Med. 2015;81:236.CrossRef
Metadata
Title
Strengthening resilience through an extended postnatal home visiting program in a multicultural suburb in Sweden: fathers striving for stability
Authors
Kirsi Tiitinen Mekhail
Lene Lindberg
Bo Burström
Anneli Marttila
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6440-y

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue