Fathers’ perspectives on brain health education and the promotion of dementia risk reduction for their primary school aged children

Abstract

Background

Fathers occupy a distinctive and influential role in shaping children’s developmental trajectories and health-related behaviours. However, their perspectives on brain health education and dementia risk reduction remains largely absent from the literature. Despite growing recognition that modifiable risk factors for dementia operate across the life course, little is known about how fathers view brain health or perceive their role in fostering protective behaviours in their children. The present study seeks to examine how fathers conceptualise brain health, their attitudes towards dementia prevention, and their perceived responsibilities in promoting brain health and reducing dementia risk in their children.

Methods

Semi-structured interviews were conducted with Australian fathers of primary school-aged children. Interviews explored understandings of brain health, attitudes toward dementia risk reduction, and perceived paternal responsibilities in promoting children’s long-term cognitive wellbeing. Data were analysed using inductive thematic analysis to identify patterns and themes across accounts.

Results

Twenty fathers participated (Mean age = 39.70, SD = 6.62, Range = 27–53). Three themes were identified: paternal insight and decision-making influence, which included awareness of dementia risk and its impact on health-related choices; perceived barriers and opportunities in childhood brain health education, including developmental timing, feasibility, and contextual constraints; and constructions of the paternal role, highlighting responsibility, role modelling, and intergenerational influence. Fathers articulated both willingness and uncertainty regarding engagement in dementia risk reduction messaging.

Conclusion

Fathers represent critical yet under-recognised agents in intergenerational brain health promotion. Their modelling of behaviours and health attitudes may shape children’s long-term dementia risk trajectories. Interventions seeking to embed dementia risk reduction within early-life contexts should incorporate father-inclusive strategies and further investigate the distinctive contributions fathers make to cognitive and developmental health.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28266-4.

Background

Dementia is a progressive neurodegenerative condition that significantly impairs cognitive functioning, affecting memory, reasoning, language and the capacity to perform everyday activities [1]. Unlike the transient cognitive changes associated with normal ageing, dementia represents a pathological decline, leading to substantial loss of independence and, in advanced stages, death [2]. Global prevalence continues to rise, driven largely by population ageing. In 2019, ~ 57.4 million people were living with dementia worldwide, a figure projected to nearly triple to 152.8 million by 2050 [1]. In Australia, dementia is now the leading cause of death and imposes a substantial economic burden, with care costs estimated at $3.7 billion in 2021 [1, 3].

Historically, dementia was conceptualised as an inevitable consequence of ageing or genetic predisposition. However, over the past two decades, converging epidemiological evidence has established that a substantial proportion of dementia cases may be attributable to modifiable risk factors operating across the life course [4]. Reports of the Lancet Commission on Dementia Prevention, Intervention, and Care [5, 6] estimate that up to 45% of dementia cases globally may be linked to potentially modifiable determinants. These include early-life educational attainment, midlife cardiovascular risk factors, and later-life social isolation and physical inactivity. Such findings have reoriented the field toward risk reduction and emphasised the importance of adopting a lifespan framework [7, 8].

The temporal distribution of risk factors has important implications. Early-life factors, such as educational attainment, establish the cognitive reserve upon which individuals later rely [9]. Individuals with greater cognitive reserve may experience delayed onset of clinical dementia symptoms, even in the presence of underlying pathology. Despite this evidence, dementia continues to be socially constructed primarily as a disease of later life [10]. Public understanding of dementia risk is variable, and misconceptions regarding etiology, prognosis and treatment persist [11]. Beliefs that dementia is an inevitable consequence of ageing are associated with reduced help-seeking, diminished engagement in preventive behaviours, and fatalistic attitudes [12]. Accordingly, a lifespan approach to dementia prevention, one that situates risk reduction within family, community, and educational systems, has become increasingly salient in public health discourse [7].

Parents are central architects of children’s early environments [13]. Through role modelling, structuring of routines, educational engagement, and health-related decision-making, parents influence cognitive stimulation, physical activity, diet, and social exposure; all factors linked to long-term brain health [9, 14, 15]. Parental beliefs and self-efficacy further shape the degree to which such behaviours are prioritised and sustained. Where awareness of modifiable dementia risk factors is limited, opportunities for early prevention may be missed.

There is an established association between the amount of family and parental involvement in interventions that promote physical activity and positive long term health outcomes [16]. For example, parental behaviours (smoking, alcohol consumption, physical inactivity) have a significant influence on cardiovascular risk factors (obesity, hypertension, diabetes) for their children [17]. Likewise, decision making in children, both positive and negative, is influenced by different parental approaches [18]. Given this relationship, it is likely that beyond direct behavioural promotion, the way that parents model accessing health care would influence the timely treatment of dementia risk factors [19].

Recent studies have begun to explore parental receptivity to childhood brain health education. Findings suggest that parents are generally supportive of health-promoting initiatives but may experience uncertainty regarding age-appropriateness, content framing, and practical implementation [20, 21]. However, these investigations have overwhelmingly sampled mothers, with fathers substantially underrepresented. This imbalance reflects a broader trend in health research and intervention design, wherein caregiving responsibility is implicitly maternalised [22]. Yet, fathers have a most unique and important contribution to their children’s development [23]. Paternal involvement has been associated with better academic performance, improved emotional regulation, and greater resilience in children [24]. Importantly, fathers’ engagement in their children’s development appears to be qualitatively distinct and offers additional, complementary benefits (e.g., [25, 26]). For example, fathers often engage in more physical and play-based interactions, which support the development of their children's executive functioning, problem-solving, and social skills, all of which are linked to cognitive health [27, 28]. Panter-Brick et al. [24] warn against a ‘one size fits all’ approach, which may disproportionately neglect paternal skills, values, and attitudes. Interventions that consider the unique role of fathers are more likely to be effective [29] with paternal attitudes and behaviours positive predictors of children’s health outcomes [30].

Without understanding how fathers conceptualise brain health, perceive dementia risk, and interpret their responsibilities within the family system, interventions risk reinforcing gendered assumptions and failing to capitalise on paternal strengths. The present study addresses this gap by exploring Australian fathers’ perspectives on childhood brain health education and dementia risk reduction. Specifically, it seeks to: (i) examine how fathers conceptualise brain health and dementia prevention within the context of child development; (ii) investigate attitudes toward the acceptability and developmental appropriateness of brain health education for primary school-aged children; (iii) identify perceived barriers and facilitators to paternal engagement in such initiatives; and (iv) explore constructions of the paternal role in shaping long-term cognitive health trajectories.

Methods

Design

This study employed a qualitative, cross-sectional design using semi-structured interviews to explore fathers’ perspectives on children’s brain health education.

Ethics

All procedures were reviewed and approved by the Western Sydney University Human Research Ethics Committee (reference number H15440). The study followed the National Statement on Ethical Conduct in Human Research [31]. Informed consent was obtained in writing and verbally from all participants. Participants were reminded that participation was voluntary, responses would remain confidential, and they could withdraw at any point without penalty.

Participants

Eligibility criteria required that participants be aged 18 years or older, the biological or stepfather of at least one child of primary school age, and able to provide informed consent. Participants were recruited using word-of-mouth and snowball sampling methods, which are appropriate for reaching participants in socially networked groups. While recruitment targeted fathers of primary school-aged children, the word of mouth and snowball sampling resulted in some fathers with children outside this range also participating.

Materials

Data collection involved two components: a demographics survey and a semi-structured interview.

Demographics survey and interview guide

The demographics survey collected descriptive information on participants’ age, marital status, number and ages of children, education history, and personal or family history of pre-existing health conditions (including chronic diseases and neurological disorders).

The semi-structured interview guide consisted of 20 open-ended questions with additional prompts to facilitate elaboration. Questions were developed based on existing literature on parental roles, child development, and brain health promotion [20] and were piloted to ensure a smooth structure and validity of the questions. Key areas of inquiry included fathers’ perceptions of their role in health education, their understanding of children’s brain health, and their attitudes towards incorporating brain health promotion into everyday parenting practices (e.g. Do you believe that dementia is modifiable? Do you believe that what we do in childhood can impact brain health in adulthood or old age? Why/why not? Who or what influences your thinking about health and parenting? Prompt for family, culture, school, media, healthcare providers. Do you think fathers have a particular role in supporting their children’s development? How so?). Closed-ended items encouraged focus, while open-ended questions allowed participants to expand on beliefs, challenges, and experiences in greater depth. The interview guide is available in Supplementary Materials.

Procedure

Data collection occurred between June and July 2025. Recruitment commenced through targeted word of mouth approaches within professional and community networks known to include fathers of young children (e.g., parenting groups, community organisations, and personal/professional contacts of the research team). Individuals who expressed interest and met the eligibility criteria were invited to participate and were encouraged to share study information with other potentially eligible fathers, resulting in a snowball sampling approach. Eligible fathers were then provided with an information sheet electronically outlining study aims, procedures and participation requirements. Participation was entirely voluntary, and interested individuals contacted the research team directly to maintain privacy and minimise any perceived coercion. Those who agreed to participated scheduled a one-on-one interview conducted via Zoom.

At the beginning of each session, participants reviewed the information sheet and gave informed consent (written and verbal). Interviews began with completion of the demographic survey, followed by the interview questions. Sessions were conversational in tone, with an interviewer (AG, trainee clinical psychologist) encouraging participants to elaborate on topics they identified as important. Interviews ranged in duration from 25 to 40 min. Upon completion, participants were thanked for their time and reimbursed with a $30 e-gift card.

Data analysis

All interviews were recorded and transcribed using Zoom live transcription software. Transcripts were checked against the recordings for accuracy, corrected where necessary, and de-identified prior to analysis. A inductive thematic analysis was conducted, using the six steps outlined by Braun and Clark [32] using NVivo software (v15.2). This research design was used to explore the lived experiences of fathers, and to compare and contrast the perspectives of fathers with preexisting research.

Online interviews, data checking, data de-identification, and data familiarization were all conducted by the same researcher (AG), leading to familiarization. Code development and theme identification were conducted iteratively, with themes and subthemes identified (e.g. codes ‘professional experience’, ‘personal experience’, and ‘manage diet’ were combined into the subtheme ‘Dementia Awareness and Prevention’, which was one of two subthemes under the main theme ‘Fathers’ Insights and Influences on Decision Making’.

To enhance trustworthiness, coding decisions and thematic interpretations were discussed between two researchers (AG and JS). Each independently reviewed the coded data and emerging themes. If discrepancies were found, a third reviewer (ED) would be available for discussion. No discrepancies were found. The final themes captured both convergent and divergent perspectives on fathers’ understandings of children’s brain health education. Results are presented with supporting quotations to illustrate the richness of participants’ accounts. Where necessary, participant quotations have been edited for brevity using ellipses to remove extraneous text; this was done solely to enhance clarity and in no way alters the essential meaning of what was expressed by participants.

Results

Participants

Twenty fathers aged between 27 and 53 years (M = 39.70, SD = 6.62) participated in the study (Table 1). All participants were currently married or in de facto relationships. Child age ranged from 1 to 24 years (M = 8.00, SD = 5.25), and three participants reported having stepchildren or children from a previous partnership. As shown in Table 1, participants reported a range of educational backgrounds, with 45% holding a diploma, advanced diploma, or trade certificate, 20% holding an undergraduate degree, and 35% holding a postgraduate qualification. All participants were partnered, and most had two or three children. A subset of participants reported pre-existing health conditions or family histories of chronic diseases such as dementia, cancer, diabetes, and cardiovascular disease.

Table 1.

Participant demographics

Variable	Category	n	%	M (SD)
Participants (age)		20	–	39.7 (6.62)
Highest Education Level	Diploma/Adv. Diploma/Trade Certificate	9	45.0	–
	Undergraduate Degree	4	20.0	–
	Postgraduate Degree	7	35.0	–
Marital Status	Married or De Facto	20	100.0	–
Number of Children	1	1	5.0	–
	2	10	50.0	–
	3	7	35.0	–
	4 or more	2	10.0	–
Age of Children (years)		–	–	8.00 (5.25)
Child Education/Year Level
	Pre-K	13	–	–
	Kindergarten	10	–	–
	Grade 1	3	–	–
	Grade 2	5	–	–
	Grade 3	2	–	–
	Grade 4	2	–	–
	Grade 5	3	–	–
	Grade 6	5	–	–
	Grade 7	1	–	–
	Grade 8	0	–	–
	Grade 9	1	–	–
	Grade 10	1	–	–
	Grade 11	1	–	–
	Grade 12	0	–	–
	Finished School	4	–	–
Pre-existing Health Conditions
	Asthma	2	–	–
	Bronchitis	1	–	–
	Cancer	2	–	–
	Dementia	10	–	–
	Diabetes	3	–	–
	Heart Disease	5	–	–
	Hypertension	1	–	–
	Liver Disease	1	–	–
	Mental/Neurodevelopmental Health	6	–	–

Percentages are not shown for some categories because they may apply more than once to individual participants

M mean, SD standard deviation

Qualitative findings

Analysis identified three core themes and eight subthemes that captured fathers’ perspectives on children’s brain health and dementia prevention. These themes illustrate how fathers make sense of dementia, how they navigate barriers and opportunities for early brain health education, and how they perceive their roles in supporting their children’s development. Figure 1 provides an overview of the thematic structure.

Fig. 1.

Summary of themes and subthemes

Theme 1: Fathers’ insights and influences on decision making

Fathers had a broad range of experiences, many personal, dealing with people who have dementia. However, insights into the causes of dementia were limited and vague, which coloured fathers’ attitudes and reported decisions.

Subtheme 1.1: Dementia awareness and prevention

Fathers were aware of the negative outcomes associated with dementia, and were ostensibly in favour of prevention, “I've got high hopes that it's preventable. Um, you know, prevention… prevention's better than cure” (Participant 103). Despite most participants having some experience dealing with dementia, there were clear gaps in the overall understanding of risk factors, with many assumptions that dementia was indeterminately related to overall health, “I would suggest that, yeah there's probably just general overall mental and physical health things that you can do throughout your life that will likely extend – will prevent the effects of (dementia)…” (Participant 105) or dietary risk factors, which appeared highly salient: “We recognise the value of food as fuel (…) and educating (children) about, you know fuelling their body, um, and fuelling it with the right things…” (Participant 114).

Subtheme 1.2: Variable influences on fathers’ decisions

Fathers described multiple factors influencing their decision making on health behaviours. Given participants’ understanding of dementia, fathers described wanting to avoid negative outcomes, “I think one of the things that scares me for my own kids and for myself is to end up like my grandparents” (Participant 104). Fathers expressed a desire for their children to live healthy lives, “I want my children to have a better life than what I have, you know what I mean? I always want the better for my children” (Participant 109). Fathers described being influenced by partners, friends, family, personal upbringing, and by various media, “Uh…. I suppose it's just, like, cumulative knowledge of exposure to a lot of TV, a lot of reading, a lot of articles, a lot of stories” (Participant 116). It is apposite that three participants referred to accessing research, all of whom possessed post graduate qualifications: “I'm sort of a relatively interested amateur in that space, in the sense that I do read articles, (…) I'll read it, maybe the popular psychology journals, magazines, I'll read the odd article there” (Participant 113).

Theme 2: Obstacles and limitations vs advantages and opportunities

Fathers expressed both obstacles and opportunities in educating children about brain health and dementia risk. While most valued the idea of early education, fathers described practical and conceptual barriers which often delayed or limited action.

Subtheme 2.1: Age to begin education

Fathers had variable attitudes about introducing the topic of dementia and brain health. The majority of participants suggested that older primary school or high school was the right time. Many fathers expressed that the complexity of dementia would be a barrier for children, and therefore the topic should be left until children are older. Further, the complexity of getting children engaged was a perceived barrier: “I would argue that a lot of health-based things can be really hard to get kids (…) to actually care about (…) because they're young and invincible, and who cares?” (Participant 110). Alternatively, many participants saw brain health as relevant at primary school age, “I mean, (my son’s) got school friends that play tackle footy, so it could be argued that they need to know about it now, definitely they're in the risk category…” (Participant 116).

Subtheme 2.2: Barriers to brain health promotion

There were many identified barriers to promoting brain health among children. A lack of awareness among participants meant that fathers struggle to manage their own personal risk or model to their children effectively: “Until I started getting looked at myself, I didn't know that even the concussion side of things can actually lead to dementia … even adults don't actually know a lot of the factors around (prevention)” (Participant 102). Many fathers expressed strong interest in their children understanding others already diagnosed with dementia. Relatedly, a strong focus on managing symptoms only after diagnosis demonstrates that participants struggle to grasp the accumulative nature of lifelong risk factors, “I think it probably… there are ways we can manage it as well. I think, once… when the diagnosis comes in” (Participant 113).

Many fathers saw dementia prevention exclusively as part of promoting general health and wellbeing, “…children should be educated on (dementia) in terms of living a healthy lifestyle, but for a multitude of reasons, not necessarily specifically dementia…” (Participant 108) and further expressed dementia was a ‘future problem’ not directly relevant to children, “That's you know, sixty or seventy years away… It doesn't matter. While I think about it now, I'm good now, so that'll do” (Participant 110). Being time poor was also a noted barrier, with dementia seen as a problem for the distant future: “And to be completely honest with you (…) it's not something that's immediate, for (children) to worry about, they tend to not take it seriously (…) that's probably a big barrier” (Participant 102).

Subtheme 2.3: Facilitators

Consistently, fathers agreed that children would benefit from education about brain health and dementia. Fathers expressed being in favour of children learning about brain health at school, though some fathers expressed doubt that busy school schedules could accommodate more content. Participants articulated opinions on how information should be presented to children including that it is visually appealing, light-hearted, easy to understand, salient to children and experiential. On multiple occasions fathers suggested brain health education should be presented slowly, in small amounts over multiple years, consistent with other health topics at school. The difference between dementia prevention compared to other health problems was further highlighted, showing that fathers are receptive to health messages: “So we're really good at teaching kids to put on sunscreen. We're really worried about protecting their skin and the issues there. Do we also teach 6 year olds (about brain health)?” (Participant 106).

Fathers often expressed wanting more information for their own awareness so that they could effectively support their children. Even though a lack of knowledge among fathers is a barrier, the clear willingness to learn more demonstrates that fathers want to support their children’s learning, “I guess if there's things that we can understand about what they're learning, that would help. So, I think education isn't just done at school, it's also at home” (Participant 118) and: “I guess educating yourself probably becomes a responsibility as well. You can't (be) a role model for physical and brain and mental health if you're unaware of the risk factors…” (Participant 105).

Fathers described their responsibilities to include bearing in mind long-term outcomes on their children’s behalf. Fathers were clearly aware that their children lack the knowledge and experience that they need to make informed choices, and instilling discipline and informing decision making is something that fathers see as their role, “…which, again, ties back into discipline and probably a personal value of the ‘long game’, which is a hard lesson, particularly for kids, when they want instant gratification, to be considering something longer term” (Participant 107), and: “Courage, healthy and positive routines. And that means you should identify early on when a routine or a health habit is detrimental to them” (Participant 104).

An area fathers appeared much more knowledgeable about was the prevention and mitigation of head injuries, especially those caused through physical trauma. Many fathers discussed how they considered sport participation and their perceived role enforcing helmet wearing.

I think it's, you know, we've learned growing up about different things. A good example would be helmets and riding your bike. To protect your head we've learnt (…) that's what we do – we wear helmets. It's just second nature. As a tradesman, I've learnt to wear safety glasses, and it's now just second nature, whereas people older than me find it hard to get used to that habit of putting them on. (…) early education is better, always better, because then the kids grow up learning about it and knowing about it, rather than trying to teach them when they're older (Participant 118).

Theme 3: Fathers’ roles in children’s development

Participants consistently emphasised their roles in guiding children’s health and development, positioning themselves as both protectors and role models.

Subtheme 3.1: Key roles and responsibilities

Participants had a consistent focus on fathers being there for their children. This included being physically and emotionally present, as well as developing relationships with children, and engaging with teachers, medical professionals, and proactively taking on the responsibilities of parenting. Some contrasted their own parenting with prior generations and described greater involvement and emotional openness, “I'm really conscious of being a part of (parenting), rather than being, kind of a backseat which previous generations may have taken (…) I'm just doing that by trying to expose them to certain things, and be around for certain things that perhaps my dad didn't” (Participant 116).

Many fathers described their role as one where they should model emotional vulnerability and healthy patterns of managing their own emotional well-being, “Big one for fathers, I think, is supporting their kids' emotional health. Um, that it's okay if you're not having a good day, that's fine, that's perfectly normal…” (Participant 117). Fathers further saw it as their role to promote both mental and physical activity. This included rough and tumble play, and promoting activity at the border of children's capabilities. Fathers also described seeing themselves as models of appropriate risk-taking, with a specific role to encourage and develop appropriate risk-taking behaviours in children, “Maybe that source of potential, kind of like, rough play as well. Um which is, which kind of I guess, brings out a bit of a different side to a kid…” (Participant 106) and:

(Fathers) encourage (children) to take risks. To have that, I guess that resilience and that risk appetite (…) usually a father's way of things (is like) ‘come on, we're gonna get your bike out, we're gonna build this jump. Um, you know, you are going to fall off. You are going to scrape your knee.’ This is all good, this is all character-building sort of things (Participant 117).

Subtheme 3.2: Setting the example

Many fathers saw it as their responsibility to set an example for their children, including setting an example in terms of managing health and well-being. Promoting wellbeing with modelling was seen as essential by participants, who saw a lack of consistency between actions and words as obvious and counterproductive, “So if you came to your kid and told them of all these advantages of living a healthy lifestyle, but you yourself aren’t modelling that, they’ll sniff that out” (Participant 107) and: “You know, maybe not necessarily what the dad says, but what the dad does is fairly informative for the kids” (Participant 110) and: "(Fathers) have a very pivotal role in the development of (children’s) character, and their identity (…) and especially on their kids’ lives" (Participant 102).

Subtheme 3.3: Fathers’ perceived roles in the family

Views were mixed on whether fathers’ roles differed meaningfully from mothers. Some emphasized that mothers and fathers have comparable roles, as articulated by Participant 115: “Yeah, I don't think that there's a particular role that father specifically have, um as opposed to mothers (…) it wouldn't specifically be that this is ‘dad's role’, this is ‘mum's role’.” Conversely, others suggested that fathers had distinct responsibilities: “I'd probably say equal importance, uh, but different, maybe, skill sets…” (Participant 107). Participants explained that fathers were responsible for the communication of values, instilling discipline, and modelling masculinity to sons, “I think a father needs to instill the values that are important (…) particularly as a father to sons, showing what manliness means, (and) how to be a good person in today's society” (Participant 105). In both perspectives, however, fathers saw themselves as integral to shaping children’s long-term health behaviours and life trajectories.

Discussion

The current study sought to examine the perspectives of fathers of primary school aged children on brain health and dementia prevention, with specific reference to their views on educational barriers and facilitators, and their perceived role in supporting their children’s engagement with brain health promoting behaviours. Overall, fathers expressed broad awareness of the negative consequences of dementia and endorsed the value of prevention.

Fathers consistently articulated support for interventions that might improve their children’s health and wellbeing and explained ways they were already attentive to health promotion in their families (e.g. through diet, exercise, healthcare access and protection from head injury). Fathers endorsed the principle of long-term, age-appropriate education about brain health, and many emphasised their own need for additional knowledge to act as effective role models. Fathers saw it as their responsibility to consider long-term outcomes for their children with many fathers noting that they had unique attributes to bring to parenting, including appropriate risk-taking skills and being able to set a good example in their families.

This study further identified that fathers saw brain health as something desirable, but demonstrated a lack of understanding about dementia risk reduction, and at times struggled to see the relevance of risk mitigation. Fathers often saw dementia risk reduction as time-consuming, not easily achievable, only ambiguously related to general health, and a relatively low priority. Fathers expressed that the perceived complexity and emotional valence of the topic of dementia made it a subject not appropriate for younger children (not yet in primary school). This is likely connected to fathers expressing that dementia is a topic difficult to engage children with at all, and something that fathers identified they would struggle to promote given their own lack of knowledge and experience.

The results from this study are consistent with previous research in this area, showing that the challenges faced by mothers and fathers in the promotion of brain health are often similar. Previous research around brain health promotion indicates that fathers want their children to engage in behaviours that maximise their long-term health [20, 21]. In alignment with previous studies, fathers expressed that there were significant time constraints, a lack of awareness regarding dementia and brain health, and perceived complexity that made it difficult for fathers to be comfortable modelling brain health promoting behaviours. Fathers, like mothers, saw that promoting brain health is a topic not necessarily appropriate for younger children, and something that they wanted much more information and education on for themselves.

Fathers conveyed a sense of possessing unique capabilities and strengths, frequently described their role in terms of appropriate modelling, including modelling emotional vulnerability, personal discipline, the development of resilience, and the modelling of appropriate risk taking. Interestingly, many fathers regarded health-related behaviours as stemming from their child’s character, which they felt responsible for fostering. This perspective was especially true of fathers with sons, who further noted that modelling healthy ‘manliness’ characteristics was profoundly important. Fathers also viewed themselves as more experienced and willing to take risks than mothers, believing this gave them greater capacity in making careful risk-related decisions. When discussing these types of risks, fathers often referred to physical risks (e.g. risky bike riding, rough and tumble play, other extreme sports), though sometimes implicitly indicated that being emotionally vulnerable was an important risk that was important to model to their children. These differences noted by fathers are consistent with preexisting literature, that father’s involvement in children’s development is qualitatively distinct from that of mothers [22], and that fathers have a clear role in supporting the developmental needs of their children [23, 27].

These results demonstrate that fathers are aware that they are role models for behavioural change. There is a clear connection with these results and social cognitive theory [33, 34] which suggests that learning and behavioural change comes about through learning from behavioural models and the imitation of behaviours observed in others. Participants frequently highlighted the specific and differentiated role of fathers, distinctly different from mothers, a perspective echoed in earlier studies [24, 27]. Social cognitive theory suggests that children are likely to make key changes to promote their brain health if they can see it effectively modelled. The results from this study suggest that fathers represent an important, yet often under-recognised, part of behavioural modelling for brain health, and along with mothers, are a preeminent influence on children more broadly. Fathers involvement and support of brain health promotion messages across the lifecourse is therefore highly desirable.

Strengths and limitations

This study has several strengths and limitations that warrant consideration. Strengths include a relatively large qualitative sample of men, all of whom have children of primary school age. This sample has provided an in-depth perspective of the view of fathers, generating qualitative themes demonstrating clearly that fathers have many similar struggles, beliefs, and desires to promote positive health messages as mothers do. Results further demonstrated that fathers possess unique attributes and skills that can promote positive development in children. Limitations include the convenience and snowball sampling which inevitably lead to a limited geographical spread of participants. Although recruitment targeted fathers of primary school-aged children, the use of word-of-mouth and snowball sampling meant that some fathers with children outside this age range (e.g., with children in high school) also participated, which is a limitation of the sampling approach. This sample only included heterosexual men and had limited racial variation and cultural background. Socioeconomic status was not measured but was also likely restricted given the geographically limited range of participants, and an above average amount of tertiary qualifications. Future studies may benefit from samples that include larger variation in location across Australia (urban, suburban, rural, and remote), and the measurement of socioeconomic status. Further, though data were deidentified, it is likely that participants may have answered interview questions in socially acceptable ways.

Implications and future directions

The findings have several implications within the field of psychology and for brain health promotion. As in previous studies, fathers like mothers are in favour of brain health education and promotion but also identified similar barriers in the promotion of brain health. Fathers in this study highlighted that they have a powerful example to share with children, and that their support and participation in promoting brain health is worth pursuing. Fathers want to increase their own knowledge and capabilities in promoting brain health so that they can be effective models and support to their children. Providing fathers with appropriate and targeted education for their own knowledge is likely to promote and support brain health education in children. Ensuring educational efforts targeted at fathers are specifically designed for them is likely important, given that previous research demonstrated that fathers support their children qualitatively differently. Further, fathers suggested that educational programs should be engaging, visually appealing, and experiential. Fathers identified that they believe they are experienced and capable of modelling appropriate risk taking. Future research should explore the validity and mechanisms of these perspectives, especially in relation to managing dementia risks over the lifespan. Likewise, future studies may want to consider what factors in health promoting behaviours resonate with fathers and are effective at creating positive change across families.

Conclusion

The promotion of brain health across the lifespan is a goal fathers in this study endorsed and were willing to support. While knowledge gaps and perceived barriers constrained their engagement, fathers consistently described themselves as active, engaged parents with unique contributions to make. They emphasised their desire for more knowledge to act as credible role models and called for educational programs for children that are engaging, developmentally appropriate, and sustained across years of schooling. These findings suggest that fathers represent an underutilised but potentially powerful resource for brain health promotion, and that engaging fathers more deliberately in preventive health initiatives may strengthen efforts to improve long-term outcomes for children.

Authors' contributions

JS conceived this project, contributed to the acquisition of data, conducted data analysis, interpreted the data and drafted the first version of manuscript with AG. AG contributed to acquisition of data and interpretation of the data. ED made substantial revisions to the manuscript. All authors read and approved the final manuscript.

Funding

This project received no funding.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki. Western Sydney University Human Ethics Committee has provided approval of this study (ref H15440). All participants provided written informed consent prior to participation.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.