Funded Projects

Needs Assessment: NICU Dads in Dallas

Project Year

2025

City & State

Dallas, Texas

Program Name

CATCH Planning

Topic

Family Centered Care

Program Description

PROBLEM: Historically, research and QI initiatives in the NICU have predominantly focused on infants and mothers. In contrast, fathers are significantly underrepresented in the neonatal-perinatal medicine literature. For instance, early attachment research primarily examined the mother-infant relationship (Cabrera, 2018), and studies with “parents” in their titles often fail to include the perspectives of fathers (Pohlman, 2005). Furthermore, the few studies that do focus on fathers mainly draw from middle-class White European families (Day, 2004; Stefana, 2018), which significantly limits the generalizability of their findings to more diverse populations. Data on the needs and challenges faced by fathers of preterm infants is particularly scarce, especially among non-White socioeconomically-disadvantaged families. Nevertheless, evidence suggests that paternal involvement at birth and during early childhood is linked to better developmental outcomes for children (Hall, 2014; Yogman, 2016). Thus, identifying and addressing barriers encountered by Dallas fathers is crucial to fostering father-infant bonding and strong father-infant attachments in the community, which in turn can enhance outcomes for this vulnerable group of infants.  PRIMARY SETTING: This project is a needs assessment for fathers of children born before 30 weeks' gestation in Dallas, Texas.  NUMBER OF CHILDREN AFFECTED: Every year, over 35,000 babies are born in Dallas. Of these, nearly 10% are born prematurely, and around 1% are born before 30 weeks' gestation. Although this last group represents a small fraction of all births, these are the infants who typically experience the longest NICU stays and are at the highest risk for complications and developmental delays. Therefore, the proposed project has the potential to directly impact over 350 father-infant relationships annually–although this likely underestimates the broader impact, as father-infant dyads not belonging to the target population would also benefit from a general culture shift that nurtures the father-infant relationship.  PROJECT GOAL: Collaborate with fathers of preterm infants born before 30 weeks’ gestation in Dallas, Texas, to achieve the following aims: I. Identify barriers to active paternal involvement in infant caregiving activities within the NICU and the formation of a secure father-infant attachment II. Examine how fathers’ needs evolve over the course of a NICU admission III. Analyze how fathers’ experiences are shaped by various sociodemographic factors.  PROPOSED INTERVENTION & ANTICIPATED OUTCOMES: The proposed project will include a retrospective survey of fathers whose infants were previously admitted to NICUs in Dallas before 30 weeks' gestation, as well as a prospective longitudinal survey of fathers with preterm infants currently admitted to NICUs affiliated with UTSW Medical Center. Participating fathers will complete online questionnaires distributed via REDCap. Those fathers who participate in the retrospective survey will receive a single questionnaire at the time of recruitment, and those in the prospective survey will receive questionnaires at five time points during or after their infant's NICU admission corresponding to the infant’s chronological age: day of life 7, 30, 60, 90, and 180 (±7 days). Survey questions will gather fathers' perspectives on parenting a preterm infant in the NICU, identify needs and barriers, and assess father-infant attachment strength. To further elucidate their perspectives, interested fathers will also be invited to participate in an interview or focus group (either in-person or online via Zoom) to share more about their NICU experience. As this project is a needs assessment, it will not involve the implementation of any new interventions. However, it is anticipated that the information learned will open doors to additional research opportunities, QI projects, and advocacy initiatives that would further benefit this underserved population. The findings will also be instrumental in guiding the development and implementation of future interventions aimed at fostering father-infant bonding in the NICU and secure father-infant attachments within this community.

Project Goal

Collaborate with Dallas fathers of preterm infants born before 30 weeks’ gestation to conduct a comprehensive needs assessment that identifies barriers to paternal engagement in NICU care and secure father-infant attachment, evaluates fathers' evolving needs during a NICU stay, and examines how sociodemographic factors shape their experiences.

Project Objective 1

By March 31, 2026, collect and analyze data from questionnaires completed by at least 100 English- or Spanish-speaking fathers to identify key barriers to paternal NICU engagement and father-infant attachment.

Project Objective 2

By October 31, 2025, recruit a diverse group of Dallas fathers to participate in at least 5 interviews and 2 focus groups to further explore their lived NICU experiences. Complete a total of 10 interviews and 5 focus groups by March 31, 2026.

Project Objective 3

By May 31, 2026, prepare a manuscript for submission to an academic journal summarizing the findings of the needs assessment and offering actionable recommendations for equitable interventions tailored to Dallas’ diverse population.

AAP District

District VII

Institutional Name

University of Texas Southwestern Medical Center

Contact 1

James Rohwer, MD