Father and non-birth parent experience of child and family health services: a systematic review and meta-synthesis.

Background This study aimed to synthesise global research examining the experiences of fathers and non-birth parents using child and family health services, and to identify the facilitators and barriers to father- and non-birth parent-inclusive practice. Methods A systematic review, using the Joanna Briggs Institute mixed-methods approach, and meta-synthesis of the data were performed. We undertook a quality appraisal of the research using the Quality Assessment with Diverse Studies (QuADS) tool. An initial systematic search was conducted of four scientific databases (ProQuest Central, CINAHL, MEDLINE, EMBASE) in January 2023, and updated in February 2024. Results were reported according to the PRISMA guidelines with no patient or public contribution. Results We identified thirty-five studies for inclusion. Thirty-one papers identified barriers to inclusive practice, such as program design (n =15), traditional gender roles and gatekeeping (n =11), and lack of workforce knowledge and skills (n =11). Facilitators of inclusive practice included factors such as explicit inclusion (n =14), support with transition to parenthood (n =11), connection with other fathers (6), and attention to the father's health and well-being (n =13). The four papers that concerned same-sex parents identified additional and specific barriers experienced by same-sex parents, including discrimination and homophobic attitudes. Conclusion We found barriers and facilitators of father and non-birth parent engagement in child and family health services at individual, community, and health service levels, with organisational and cultural barriers impacting inclusive practice. Inclusive practice for fathers and non-birth parents entails the development of environments, policies, and programs that actively involve and support the father and non-birth parent in all aspects of parenting and family life. Strategies include systematic outreach to fathers and non-birth parents, customising activities to fathers' and non-birth parents' preferences, and addressing their needs.