Discussion Forums for Expectant Fathers: The Perspectives of Male Educators

Abstract

This article describes the perspectives of men recruited to be educators and to facilitate all-male discussion forums for expectant fathers within antenatal education programs. The 8 participants indicated their general satisfaction with the recruitment process and the preparation for and support of the role. They also expressed their support for the overall concept and design of the forum. Suggestions were made regarding areas for improvement in the design and management of the forums. Results from this study may provide an operational framework to assist service providers in the development of male-facilitated programs for expectant fathers.

Within New South Wales, Australia, antenatal education programs for expectant parents are commonly made available by regional health facilities. The focus of this article is an innovative program offered for expectant fathers at the Central Coast Health Service (CCHS), entitled “Father-Time: Welcome to the Rest of Your Life.” This program incorporates approximately 2-hour-long all-male discussion forums for men attending general antenatal education programs, as well as the distribution of male-specific literature to expectant fathers (see Friedewald & Newing, 2006). A range of topics is incorporated for discussion within the forums (see Friedewald, Fletcher, & Fairbairn, 2005), during which time the female partners are led through various topics by a female facilitator. There is a paucity of evidence in the literature about the wide use of such programs, and reported programs have used group-directed discussions as their basis (Lee & Schmied, 2001; Myors & Mabbutt, 1997; Schmied, Myors, Wills, & Cooke, 2002; Symon & Lee, 2003).

Discussion about the attributes and qualifications of persons involved in the facilitation of such groups is also limited (see Lee & Schmied, 2001; Symon & Lee, 2003). A prequel to this article outlined the strategy initiated by the CCHS for recruitment of male educators, the level of response to the advertisements, and the background of persons recruited to the position (see Friedewald, 2007). Of the original nine males who commenced, eight have remained employed on a “per session” basis for a period of 3 years. This article outlines the perspectives of these eight staff members on a range of areas relating to their position.

GENERAL OVERVIEW

The current study used focus-group interviews as the only method of qualitative data collection. Richter (2002) describes focus groups as a useful qualitative research method to obtain relevant data that cannot be derived by any other technique. Betts, Baranowski, and Hoerr (1996) suggest that focus groups elicit participants' perceptions of a defined area of interest. Focus groups are also considered invaluable to the evaluation process following the completion of a program and to gathering perceptions about outcomes associated with that program (Patton, 1990).

My interest in undertaking the study stemmed from my involvement in the development of the discussion forum component of the “Father-Time” program in 1998 and my initiation of the formal proposal for recruiting an increased number of male educators to support the forums. I facilitated each focus group convened for this study and, when required, encouraged elaboration on points of discussion.

METHODOLOGY

Permission for this study was obtained from the Human Ethics Research Committees at Macquarie University in New South Wales, Australia, and from the CCHS. A formal letter of invitation outlining the purpose and nonremunerative nature of the study was sent to each of the eight male educators, and all agreed to participate. Written consent was obtained from each participant on the night each focus group was conducted.

Two focus groups, each consisting of 4 research participants (RPs), were organized for this study. The format of two groups and the allocation of RPs to a designated focus group were made solely on the basis of participant availability, which varied due to circumstances of primary employment. The questions to both groups remained consistent, and the responses of the first group did not impact the design of questions asked of the second group.

The content prepared for the focus group interviews was semistructured, with open-ended questions designed to elicit discussion in relation to set themes. The topics chosen for discussion encompassed the following areas: (a) the reasons for making a formal application to the advertised position, (b) the view of RPs regarding the preparation for their new role, (c) the view of RPs regarding the organizational support structure, (d) the reasons RPs maintained their employment, and (e) the RPs' opinions on the benefits to participants of the all-male discussion forum. These broad categories were distributed to RPs prior to the scheduled focus groups.

Each focus group was conducted at a local hospital in a conference room away from distractions, and each lasted approximately 2 hours. The content of each was audiotaped, with the permission of all RPs. A short description of the study's purpose and the framework of the evening was given prior to commencement. The RPs requested that none of the ensuing dialogue be shared with outside individuals. All participants were given the opportunity to contribute during the general discussion that was generated.

DATA ANALYSIS

All interviews were transcribed and read repeatedly until key themes of each discussion area were identified. These themes were discussed with the research supervisor and were then categorized with selected, verbatim quotations that encapsulated the essence of each theme. Following the completion of the transcription, a summary of each focus group was forwarded to the relevant RPs for confirmation of accuracy.

RESULTS AND DISCUSSION

Discussion themes are described below and arranged in sections as sequenced during the focus groups. Although each of the sections is addressed separately, the presentation is more for the purpose of organization than to suggest that each can be thought of as a single and distinct entity. In general, similar themes were evident between the two focus groups.

Application for the Position

The RPs were asked to identify the reasons for submitting a formal application for the advertised position of male educator at CCHS in 2003 (see Friedewald, 2007). Two reasons were common among the responses. The first was that the required time availability of the male-educator role could “fit in” with the applicant's substantive employment. The second was that a program that provided information specifically to expectant fathers during the antenatal period was considered to be of value. Other reasons included desiring to make a contribution to the general community (RP-1, RP-8), working with men as a change from working alongside women (RP-5), and taking up the challenge inadvertently set by female colleagues who considered the RP would be unsuitable for the position (RP-4). More than one reason was identified by RP-8:

It was an interesting opportunity to exchange my skills with a group of men with a captured interest. It was also a chance to augment my skills in an area that I was professionally interested in, but also as a father.

The RPs were then asked to reflect on the attributes they considered they would be able to bring to the position. The most common theme that emerged in response to this question was that being a father was perceived as being of benefit to the position (all of the current employees at the time were fathers). Although RP-8 suggested that being a father was not essential to the position, he stated that “being a father provided an insight into the stresses associated with the role.” Other attributes specifically mentioned were noting the advertised role encapsulated general skills already possessed (four responses); being a professional educator (RP-1); having been accredited to conduct several different types of parenting groups and considering that this training would be useful to the “Father-Time” program (RP-8); having engaged previously with representatives of the target group due to substantive employment role (RP-4, RP-7); and having previously been the primary caregiver to four children when they were younger (RP-3).

The final question asked in relation to the RPs' applications considered the extent to which the advertised financial remuneration influenced the decision to apply for the position. Remuneration was explicitly mentioned by two of the RPs as part of their initial interest in considering the application more seriously and was mentioned generally as an attractive aspect of the position:

The casual rates were attractive compared to my ordinary rate. (RP-4)

I wouldn't have done it for nothing. (RP-6)

The responses of participants indicated that there might be many reasons for potential applicants to respond to an advertisement for a male-educator position working with expectant fathers. Although financial remuneration may not be the sole basis for demonstrated interest, it appears necessary to ensure that suitable applicants are attracted.

After Recruitment

RPs were asked about the preparation they received for the role after being recruited. The preparation consisted of attendance at two induction (training) evenings and participation in a scheduled antenatal discussion forum, for which participants were paid. As one who holds formal qualifications in training and workplace assessment, I conducted the training of the participants.

What emerged from responses regarding attendance at the induction evenings was that specific details could not be readily recalled. However, the RPs recollected that some of the general material was useful and that the evenings were a positive experience:

It was a very enjoyable experience. It was quite clear that we were at the forefront as an Area Health Service in this. (RP-3)

A fantastic introduction into what we were supposed to be doing. (RP-6)

I can't remember specifics, but I recall thinking that it was a good introduction—took account of us being adults with experience. (RP-8)

For some of the RPs, participation in an antenatal discussion forum occurred prior to the induction evenings, whereas others attended a forum soon afterward. Each RP was asked about the value of this process in preparing for his new role.

In contrast to the limited recall regarding the induction evenings, all RPs had vivid memories of their participation in an actual antenatal discussion forum with expectant fathers. The general theme that emerged was that experiencing the forum firsthand was beneficial to their understanding of the forum design and gave a clear indication as to how much time should be spent on individual topics. RP-2 and RP-6 recalled feeling somewhat daunted by the amount of the content and its comprehensive design. As RP-2 reported, “I was actually a little bit daunted because of the content, as it is pretty extensive.” Despite these initial feelings, both RP-2 and RP-6 were in agreement with the remainder of the participants, who reported that attendance provided them with confidence in the forum and their ability to perform the role of facilitator:

It demystified it and showed it as a very comfortable presentation format. (RP-8)

It was demonstrated that the content could be completed if facilitated well… done politely and with respect and not letting them [the participants] digress too far. (RP-3)

RPs were then asked to reflect on whether they considered that their personal and/or work background was of use in the role of male educator. RP-1, RP-7, and RP-8 commented directly that their work experience was of benefit to the position. Others commented on different aspects of their background, with maturity perceived to be of benefit. For example, RP-3 reported, “I haven't had any negative feeling whatsoever and, in fact, they [the participants] may even enjoy it a bit more having a slightly older male as facilitator.”

The responses indicate that some degree of formal preparation is necessary for those recruited to such a position. Although the impact of any preparation may vary among individuals, participation in the forum that new staff will actually facilitate should be considered a priority and made available prior to their conducting a forum for the first time.

Organizational Support Structure

The level of support the RPs received from the various levels of management within the organization during their transition to the recruited position was discussed and separated into two time frames. The first period incorporated recruitment and induction to the position (July–October, 2003) and ended with the completion of my employment as the person responsible for coordinating the recruitment and training process (December, 2003).

The unanimous theme among RPs was that during this period, a strong level of support was demonstrated at both an individual and collective level. This perception was encapsulated by the reference made by RP-3 to processes during the period being “extremely proficient, seamless and very, very easy.”

The second period commenced early in 2004 and extended to the time of the scheduled focus groups. Apart from RP-4, who voiced no concerns, all of the other RPs viewed the level of organizational support during this period as being deficient. The term “disconnected” was used to describe the positioning of male educators within the organizational structure. Communication with “management” was considered problematic at an individual and collective level. As RP-2 reported, “I have a feeling of alienation in the role. The only way that it is carried on is by the goodwill of the males.”

Discussion turned to considering the merits of having a specific manager or coordinator of the male-educator group. Although a general theme conveyed that a designated coordinator of the male-educator group was needed, opinion was divided as to the gender of such a person:

I think that it would be beneficial to have a male supporting a male education program, similar to having indigenous people employed to support indigenous groups. It makes sense and would add merit to the program. (RP-2)

Whether it is male or female is not important, but they must be a coordinator and responsible for the monitoring of the quality of delivery. (RP-8)

Issues were raised about the limited feedback received by the RPs from “management” in relation to their performance. Originally, feedback was provided in the form of specific evaluations completed by male participants immediately following attendance at the male forums. However, those responsible for coordinating the overall antenatal programs identified problems with a separate evaluation form being completed by expectant fathers. It was observed that having completed a separate evaluation, expectant fathers were then reluctant to contribute to the completion of another evaluation form relating to the whole program. This resulted in an apparent reduction of data available to evaluate the antenatal education program in its entirety. Evaluation of the expectant fathers' discussion forum has since been integrated into a generic evaluation form completed by both of the expectant parents at the conclusion of the program.

All RPs agreed that the omission of the specific evaluation forms completed by expectant fathers affected access to information about their own performance as facilitators. All RPs considered that the original evaluation forms were of value in that the evaluations enabled them to gauge their facilitation performance. For example, RP-5 stated, “No bad evaluations were ever received. What I did receive back was comments that were very helpful, and now that is completely denied and now I get no feedback whatsoever.”

It was clear from this area of discussion that a group of male educators formed for the purpose of delivering a component of an entire educational program need to be given adequate support and receive regular communication. This could be achieved by ensuring that a specific person is given responsibility to coordinate the male-educator group and to act as a central mediator of communication.

Continued Employment

Reasons for the RPs continuing their per-session employment were explored. The general theme from responses was that all RPs continue to derive a level of enjoyment from their involvement in the “Father-Time” program. RP-5 and RP-8 considered it a privilege to be able to work with men during a period when they were experiencing a role transition in their lives. A strong sense of fulfillment and satisfaction was evident among the RPs in relation to providing this service for male participants:

I think I get something out of it, to be honest, and at the end of the session I can see the difference from when they went into the room 2 hours previously. I get a bit of a buzz out of that, and I feel really quite charged. You feel as if you are doing something useful and constructive. (RP-6)

It is fulfilling, I get a lot of satisfaction out of it. (RP-3)

A strong sense of fulfillment and satisfaction was evident among the research participants in relation to providing antenatal education for male participants.

Other reasons stated for maintaining employment included the per-session work being complementary to substantive employment schedules. The extra remuneration was considered an acceptable benefit (five responses), with some discussion that, if financial remuneration was not provided, there might be a need to reconsider their ongoing commitment to the role. However, RP-5 envisaged that he would continue in the role without payment, given that it does not demand too much preparation, and he stated that “while the money is nice, it isn't a motivating factor.” An emphasis was also placed on the benefit for male participants and their impending family. It was seen that continuation in the role was an important part of sustaining the service provided to expectant fathers.

The RPs were asked whether they had experienced any difficulties with the male-educator position in general or during the facilitation of any specific “Father-Time” discussion forum. In addition to the previously mentioned communication difficulties experienced with “management,” RPs noted that the lack of professional education opportunities relevant to the male-educator group was disappointing and in need of being addressed.

The RPs cited few difficulties encountered at any time during the actual facilitation of the discussion forums. They referred to situations that stood out, with most being of a humorous nature and very few being of serious concern. Specific reference was made to group-regulated control of “difficult” participants; that is, other participants within the group sometimes assisted in reframing any dialogue that may have been misinterpreted by their peers, thereby acting as a type of internal governance.

The “Father-Time” Discussion Forum

The final section of the focus groups explored the concept, design, and benefit of the all-male discussion forum. The RPs were asked their opinion of the semistructured format and its benefit to the overall function of the discussion forum. As the research investigator, I clarified the reasons behind the intent to structure the forum with set topics, in contrast to its being a purely “group-directed” discussion.

All RPs agreed that the current format works well. There was debate about the most accurate description of the forum. Some participants believed “well structured” would be a better description than “semistructured.” Nevertheless, it was considered that the format allows ample flexibility for participants to explore different aspects of the content. Other benefits of a structured format that were mentioned included making the participants aware of the discussion direction and keeping the male educators on track of discussion threads. Additionally, RPs reported that a structured format promotes consistency and complements the written materials provided as part of the overall “Father-Time” program.

It was acknowledged that any comparison of the existing discussion format with a “group-directed” discussion is difficult. However, RPs expressed concern that if the discussion were driven solely by group participants, superfluous discussion would be more likely to arise and would deter the delivery of factual information:

It provides a backstop. I think it works really well. I think if it were open slather, the footy [football] would get talked about a lot more often by the blokes. (RP-2)

I think it is well structured, which allows for discussion to be free. I think if it were not well structured, that's when you could meander and get lost. (RP-6)

I like the approach we are using at present, I think that it is well structured, but the invitation is always there for people to expand on the topics but is also consistent with the printed materials and is a logical progression. (RP-8)

RPs were asked to comment on any topics with which they felt uncomfortable when leading general discussion (forum participants' anatomical or procedural questions that male educators do not have relevant qualifications to answer are referred directly to the primary [female] facilitator). Although RPs cited different topics for a variety of reasons (e.g., RP-3 chose labor and birth; RP-5, breastfeeding; RP-1 and RP-2, circumcision; RP-3, changes in relationships; RP-7, topics raised that are not “scripted,” such as death in utero), the relatively limited amount of time scheduled for discussion about the role of a father was an issue that the RPs felt required review. I provided the background to the deliberate length and placement (as the final topic of discussion) of this particular segment. One main reason was that the birth of the baby had not yet occurred, and discussion was mostly hypothetical. In addition, because the session was educational and not therapeutic, a discussion in any depth might uncover issues for some participants that would be outside the realm of the forum design and the responsibility of facilitators to address.

The appropriate use of personal anecdotes throughout the course of a discussion forum was considered. Although RP-4 questioned the need for using anecdotes at all, the other RPs either used or continued to use personal anecdotes to facilitate discussion among participants:

When it seems appropriate, particularly when they ask a question…especially when you are trying to make them feel comfortable. I think it is inappropriate to say that I am not going to talk about myself because all of a sudden you are putting a barrier between you and them. In a limited way is okay. (RP-6)

However, it was generally recognized that any use of anecdotes needs to be selective to avoid shifting the focus away from the participants' needs or setting up a perception that the male educator was an authority on how things should be done.

The RPs were asked whether having all-male groups (i.e., male participants and a male facilitator) promoted or hindered discussion of the “Father-Time” topics among expectant fathers. There was unanimous agreement that having a male facilitator was of benefit and having the men segregated from their pregnant partners promoted an easier flow of discussion. This benefit of an all-male environment in enabling discussion was reflected in a variety of comments made by the RPs:

I think I would have got a lot more out of [my own attendance at] antenatal education myself if I had had a male-only session. (RP-2)

It empowers the participants to discuss issues. Yes, it is vital that the men have an opportunity to experience the all-male forum. (RP-3)

I don't know that a female facilitator for all blokes will get the same responses from the blokes, and that is with feedback from participants. (RP-4)

It [all-male group] promotes—that is what the old evaluations use to say. (RP-5)

There was unanimous agreement that having a male facilitator was of benefit and having the men segregated from their pregnant partners promoted an easier flow of discussion.

As a point of closure for each of the focus groups, RPs were asked their opinion of the discussion forums in relation to the overall benefit for expectant fathers. All RPs strongly believed that the discussion forum is of tremendous benefit to expectant fathers. The focus of the forum was considered to be placed squarely on the information requirements of the forum participants and not on the knowledge of the male educators:

I think the program is very good; we deliver salient information to them that is up-to-date. The structure of the session is that there is flexibility for open discussion. In an ideal world, this would be just the first step with the men. (RP-3)

When you compare the amount of time men get with what new mothers get, men get nothing. If through this program we can provide them with a bit of information to prepare them for what is ahead, then isn't that worth the value in itself in that amount of time? (RP-2)

I think it is a very valuable service. The underlying message is that communication between partners is paramount. (RP-6)

Men in our culture are a bit directionless, and this acknowledges fatherhood as a rite of passage. I consider that another advantage is that antenatal preparation used to mainly contemplate the birthing process, but time spent on the life beyond birth is the focus of the “Father-Time” program. (RP-5)

It was evident that the RPs were convinced of the benefit of the discussion forums and enthusiastic about its remaining a necessary service for expectant fathers.

CONCLUSION

The results of this study show that male educators consider their involvement in the all-male discussion forum for expectant fathers to be a positive experience. A number of recommendations were made during the focus-group interviews about improving cohesion and direction of the male-educator group. These included available support from the organization, with a central person responsible for coordinating the male-educator group; opportunities for relevant, continuing education; and a method for delivering timely feedback about individual performance.

The all-male discussion forums for expectant fathers remain an integral component of antenatal education within CCHS. The sustainability of the “Father-Time” program and growth in the number of sessions now available for expectant fathers are directly attributable to the ongoing commitment and enthusiasm of the male educators interviewed in this study. The results from this study may serve as an encouragement to service providers considering the employment of male educators and provide an operational framework to assist in the development of the male-educator role and service delivery to expectant fathers.