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Issue Addressed: 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., Methods: Scoping reviews were conducted seeking empirical evidence from (1) Australian studies and (2) international literature reviews., Results: 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., Conclusions: 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., (© 2024 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Background and Aims: East African countries have high rates of maternal and child mortality and morbidity. Studies have shown that the involvement of male partners in reproductive health can benefit maternal and child health (MCH). This scoping review aims to provide an overview of the evidence across East Africa that describes male partner involvement and its effect on maternal, reproductive, and child well-being., Methods: Ten databases were searched to identify quantitative data on male's involvement in East Africa. Studies reporting qualitative data, "intention to use" data or only reporting on male partner's education or economic status were excluded. Studies were organized into five a priori categories: antenatal care (ANC), human immunodeficiency virus, breastfeeding, family planning, and intimate partner violence with further categories developed based on studies included., Results: A total of 2787 records were identified; 644 full texts were reviewed, and 96 studies were included in this review. Data were reported on 118,967 mothers/pregnant women and 15,361 male partners. Most of the studies ( n  = 83) were reported from four countries Ethiopia ( n  = 49), Kenya ( n  = 14), Tanzania ( n  = 12) and Uganda ( n  = 10). The evidence indicates that male partner involvement and support is associated with improved reproductive, MCH across a wide range of outcomes. However, the studies were heterogeneous, using diverse exposure and outcome measures. Also, male partners' lack of practical and emotional support, and engagement in violent behaviors towards partners, were associated with profound negative impacts on MCH and well-being., Conclusions: The body of evidence, although heterogeneous, provides compelling support for male involvement in reproductive health programs designed to support MCH. To advance research in this field, an agreement is needed on a measure of male partner "involvement." To optimize benefits of male partners' involvement, developing core outcome sets and regional coordination are recommended., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Issue Addressed: Australian maternal, family and child services increasingly espouse the value of being 'father-inclusive'. However, fathers report feeling excluded or marginalised during healthcare visits with their partners/infants, and experience barriers to engaging in perinatal healthcare at the community, individual and healthcare service level. These barriers may be amplified in men who are members of minority groups, such as those from culturally and linguistically diverse (CALD) backgrounds., Methods: This research investigated healthcare professionals' perceptions and experiences of providing perinatal health services to families from CALD backgrounds. Semi-structured interviews were held with healthcare professionals from multiple disciplinary backgrounds providing services to families in the perinatal period. Interviews were audio recorded, transcribed and analysed thematically to identify key themes and sub-themes., Results: Ten healthcare professionals were interviewed. Participants acknowledged that inclusion of fathers in care is important as involvement enables fathers to support their pregnant partners and children, manage their own mental health, and helps to transform harmful gender roles., Conclusions: Overall, healthcare professionals are willing to include culturally diverse fathers. However, the ability of culturally diverse families to engage with healthcare services is impacted by the cultural competency of the services. So what? Healthcare delivered during pregnancy, childbirth and postpartum year may be improved by adopting a whole-family approach, which considers the needs and perspectives of fathers and partners. However, particular attention is needed to ensure healthcare policies and practices are culturally competent to meet the needs of fathers from culturally diverse backgrounds., (© 2023 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Background: The Translating Research in Elder Care (TREC) program is a partnered health services research team that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in nursing homes. This team includes academic researchers, trainees, research staff, citizens (persons living with dementia and family/friend caregivers of persons living in nursing homes), and decision-makers (ministries of health, health authorities, operators of nursing homes). The TREC team has experience working with health system partners but wanted to undertake activities to enhance the collaboration between the academic researchers and citizen members. The aim of this paper is to describe the TREC team members' experiences and perceptions of citizen engagement and identify necessary supports to promote meaningful engagement in health research teams., Methods: We administered two online surveys (May 2018, July 2019) to all TREC team members (researchers, trainees, staff, decision-makers, citizens). The surveys included closed and open-ended questions guided by regional and international measures of engagement and related to respondents' experience with citizen engagement, their perceptions of the benefits and challenges of citizen engagement, and their needs for training and other tools to support engagement. We analyzed the closed-ended responses using descriptive statistics., Results: We had a 78% response rate (68/87) to the baseline survey, and 27% response rate (21/77) to the follow-up survey. At baseline, 30 (44%) of respondents reported they were currently engaged in a research project with citizen partners compared to 11(52%) in the follow-up survey. Nearly half (10(48%)) of the respondents in the follow-up reported an increase in citizen engagement over the previous year. Respondents identified many benefits to citizen engagement (unique perspectives, assistance with dissemination) and challenges (the need for specific communication skills, meeting organizing and facilitation, and financial/budget support), with little change between the two time points. Respondents reported that the amount of citizen engagement in their research (or related projects) had increased or stayed the same., Conclusions: Despite increasing recognition of the benefits of including persons with lived experience and large-scale promotion efforts, the research team still lack sufficient training and resources to engage non-academic partners. Our research identified specific areas that could be addressed to improve the engagement of citizens in health research., (© 2021. The Author(s).)

Background: Family-centred maternity care models include the expectation that fathers prepare for and attend the birth. In Australia over 20% of the population is from a culturally and linguistically diverse background. Public policies espouse culturally competent healthcare. Little is known about the experiences of perinatal health care of men from culturally and linguistically diverse (CALD) communities living in high income countries. The aim was to understand the experiences, attitudes and beliefs about father's inclusion in perinatal healthcare, from the growing, and recently settled community of Ethiopian families living in Australia., Methods: A qualitative study using semi-structured individual interviews with Ethiopian-Australian men and women who had experienced Australian maternity care and were sampled for diversity of time since migration, and parity. Interviews were in English, audio-recorded, transcribed and then analysed thematically., Results: Participants were seven women and six men all born in Ethiopia, including two couples. Key themes included: the loss of extended family through migration, new roles for both parents and the need to establish 'family-like' relationships with friendship groups in Australia. There was a willingness to involve male partners in the Ethiopian community in Australia, although it was recognised as a cultural change. Experiences of male partner involvement were mixed among healthcare types, with men attending Maternal and Child Health (MCH) appointments less frequently than antenatal (ANC) appointments., Conclusions: Results suggests men may be missing out on the education provided during antenatal appointments and may benefit from an alternative. There were not universally high levels of cultural competency among healthcare professionals, with further training still required. Commitment to paid employment remains a barrier to men's involvement, suggesting that flexible working conditions and increased paternity leave would support their involvement. Alternatively services could utilise flexible delivery methods such as phone and zoom to include fathers., (© 2021. The Author(s).)

Background: Maternal mortality remains a pressing concern across Sub-Sahara Africa. The 'Three Delays Model' suggests that maternal deaths are a consequence of delays in: seeking care, reaching medical care and receiving care. Birth Preparedness and Complication Readiness (BPCR) refers to a plan organised during pregnancy in preparation for a normal birth and in case of complications. Male partners in many Sub-Saharan African communities could play a pivotal role in a woman's ability to prepare for birth and respond to obstetric complications. This review aimed identify: the extent and quality of research performed on the topic of male partner involvement in BPCR in Sub-Saharan Africa; the degree to which populations and geographic areas are represented; how male partner involvement has been conceptualized; how male partners response to obstetric complications has been conceptualised; how the variation in male partners involvement has been measured and if any interventions have been performed., Methods: In this scoping review, articles were identified through a systematic search of databases MEDLINE, EMBASE and Maternity and Infant Care and a manual scan of relevant papers, journals and websites. All authors contributed to the screening process and a quality assessment using the Kmet checklist. The PRISMA checking list for Scoping Reviews was used to guide the search, data charting and reporting of the review The protocol was registered with PROSPERO (ID: CRD42019126263)., Results: Thirty-five articles met inclusion criteria, reporting: 13 qualitative, 13 cross-sectional, 5 mixed method and 4 intervention studies. Data were contributed by approximately 14,550 participants (numbers were not always reported for focus groups) including: women who were pregnant or who had experienced pregnancy or childbirth within the previous 3 years, their male partners and key informants such as health workers and community leaders., Conclusions: The diversity of study designs, aims and source countries in this body of literature reflects an emerging stage of research; as a result, the review yielded strong evidence in some areas and gaps in others. Male partner's involvement in BPCR and responding to obstetric emergencies can be conceptualised as being centrally involved in responding to complications and having some role in preparing for birth through their position in the chain of decisions and provision of logistic support. However, their knowledge of pregnancy complications and level of preparation for birth is low, suggesting they are making decisions without being fully informed. There is limited evidence on interventions to improve their knowledge. Future research efforts should be focused on producing standardised, culturally appropriate, higher level evidence.

Background: Complications during pregnancy, childbirth and the postpartum period present a significant and complex public health problem in low income countries such as Ethiopia. One strategy endorsed by the World Health Organisation (WHO) to improve maternal and child health outcomes is to encourage male partner involvement in pregnancy care. This research aimed to explore the relationships between 1) male attendance at antenatal care and 2) socio-economic and women's empowerment factors and adherence to focused antenatal care guidelines among women receiving care in Ethiopia., Methods: Secondary analysis of 2011 Ethiopian Demographic and Health Survey (DHS) data. A sub-sample of couples with a child aged 0-2 years old, for whom women attended at least one antenatal care (ANC) appointment was selected. Predictor variables on socio-economic position, demographic and women's empowerment factors, and male attendance at antenatal care were identified. Six outcome variables were constructed to indicate whether or not women: commenced ANC in the first trimester, attended at least four ANC appointments, received a urine test, received a blood test, were counselled on potential complications during pregnancy and met these focused antenatal care guidelines. Binary logistic regression was performed to estimate the relationship between the predictor and outcome variables., Results: After controlling for other factors, women whose partners attended ANC were significantly more likely to receive urine and blood tests and be counselled about pregnancy complications compared to women who attended alone. Male attendance was not associated with women commencing care in the first trimester or attending at least four appointments. Although more women whose male partners had attended appointments received all recommended components of ANC than those who attended alone, this association was not significant., Conclusions: The results revealed some benefits and did not detect harms from including male partners in focused antenatal care. Including men may require changes to maternal healthcare systems and training of healthcare workers, to adopt 'father inclusive' practices. Given the limited research in this area, large population studies including the DHS routinely carried out in Ethiopia could enhance knowledge by including more detailed indicators of male involvement in pregnancy, maternal and child healthcare and early child development.

Cognitive impairment is recognized as an important determinant of outcome in schizophrenia, but mental health services generally have little capacity to provide detailed neuropsychological assessments. Computerized testing would overcome this difficulty, provided that such testing was equivalent to testing by a clinician. Given that negative symptoms can include impaired motivation and attention, it is also important to know whether computerized testing is valid in people with more severe negative symptoms. Our study was designed to compare clinician-administered and computerized testing of two domains commonly impaired in schizophrenia, verbal memory and verbal fluency. We also evaluated the effect of negative symptoms on performance on computerized cognitive tests. Sixty-two participants with schizophrenia completed clinician-administered and computerized verbal memory and verbal fluency tasks. The Positive and Negative Syndrome Scale assessed negative symptom severity. The study found no difference in cognitive performance associated with the method of test administration. This finding held regardless of the severity of negative symptoms. We found that computerized cognitive testing was equivalent to clinician-delivered testing in assessing verbal memory and verbal fluency. This finding was not affected by the presence of negative symptoms. Our results support the use of computerized cognitive testing for people with schizophrenia.