The study, one of the first of its kind to examine the factors that influence a father's participation in their child's health care, is published in the March issue of Pediatrics.
It found that urban fathers say they want to play a more active part in their children's health care, but work and other barriers frequently stand in the way. The study found that less than half of the fathers surveyed regularly attended doctor's appointments with their young children.
"Suppose a father takes his child to the emergency room and doesn't know the complete medical history, such as whether his child is up-to-date on immunizations or has any allergies. Not having that information can lead to less than optimal care," says Trevena Moore, M.D., principal research investigator, assistant professor of pediatrics at Saint Louis University School of Medicine and a pediatrician at SSM Cardinal Glennon Children's Hospital.
"Both mothers and fathers are the child's caregivers, and it's important for both to know information about their child's growth and development."
Researchers interviewed 108 English-speaking men who had children younger than 7 years of age at a hospital, community health centers and neighborhood facilities serving a large number of urban, low-income families of culturally diverse backgrounds.
About a quarter of the fathers surveyed said their boss wouldn't give them time off from work to attend their child's routine medical exams. About 60 percent said they were more likely to accompany their child to the doctor when their employer was supportive or made vacation, sick time or flexible working hours available so they could take time off. "As a society, we just haven't expected fathers to have that role. The traditional role for fathers is to be the disciplinarian or breadwinner. The need for both parents to attend well-child visits increases as more mothers enter the work force, and fathers share more of the day-to-day care giving responsibilities for their children," Dr. Moore says.
She called for more family-friendly employment policies so working parents can take a more active role in their child's health care. She suggested other states follow the lead of Massachusetts and enact laws that allow employees to have 24 hours of unpaid time off a year to accompany an elderly person or child to routine medical or dental appointments or to participate in a child's school-related activities.
"It would give parents some leeway in terms of not feeling as though their job is in jeopardy if they do take the time off from work to take a child to the doctor," Dr. Moore says.
Doctors also should focus on encouraging involvement by targeting fathers who have more than one child or who are older. These dads are even less likely to attend doctor's appointments than fathers of only children who are younger, her research shows.
Dr. Moore suggested physicians take advantage of the times that fathers show an active interest in their child to encourage them to stay involved. Fathers who attend their children's births, for instance, are more likely to be actively involved in their child's health care.
"It may well be an especially powerful time to support father involvement," Dr. Moore says. "Informing mothers and fathers of the important benefits of father involvement to their child's development is critical. When fathers don't come to doctor's appointments with their children, I see it as missed opportunities for fathers to learn about their child's behavior and development."
Dr. Moore said her findings have changed the way she practices pediatrics.
"If I see a father at a visit who is sitting quietly in the corner, I try to draw him out and elicit the input of the father. Fathers appreciate that, but I don't think they expect it," she says.
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PEDIATRICS