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An Unequal Chance to Parent: Examples on Support Fathers Receive from the Swedish Child Health Field
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Father involvement benefits children, mothers, and themselves in a number of ways. Swedish legislation and Swedish society have promoted father involvement. At the same time, the Swedish child health field has also unequivocally states that both parents should feel welcomed and supported within that sphere. Despite these statements and policies, fathers feel neglected and invisible within and throughout the Swedish child health field, which includes prenatal clinics, birth and labor wards, postnatal clinics, child health centers, and parent support programs. Less is known however about the factors that influence father involvement in the child health centers, especially from the child health nurses’ perspective and the influence of the built environment. Additionally, parent support programs are another way through which parents receive support regarding their young child’s mental health, but very little research has focused on why fathers participate or the thoughts parents have regarding their participation, especially within a Swedish context.

The overall aim of this dissertation was to better understand some of the barriers fathers have when trying to participate in the female-dominated world of the Swedish child health field, especially during the child’s preschool years. In Study I, 17 child health nurses were interviewed regarding their thoughts on fathers, and in Study II, 31 child health centers’ built environments were assessed to see how inclusive they were of fathers. In Study III, a parent support program was assessed to see if mothers and fathers had different background characteristics for participating, and Study IV sought to understand the extent to which parents appreciated and used the information from the program.

These studies showed that child health nurses welcomed fathers, but did not actively invite them to participate. In addition, 75% of the child health centers did not have representations of fathers, but most child health centers had representations of mothers and/or children. Paternal behaviors positively changed if they were in an environment with either explicit paternal representations or only child representations. Mothers participated in the parent support program for several reasons, including if their child had perceived behavior problems, while fathers participated if they were stressed and perceived their child as having emotional problems. Parents believed the information they learned in the parent support program was valuable, and they continued using some strategies a year after the intervention.

Swedish family policies can affect parental involvement within the child health field, but the child health field is less inclusive of fathers than mothers, and it fails to meet the needs of fathers, which can then, in turn, negatively affect maternal, paternal, and child outcomes. Therefore, the Swedish child health field needs to continue working on improving their practices of treating both parents equally.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. , 88 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1079
Keyword [en]
Sweden, gender equality, father involvement, child health field, nurses, midwives, parental leave, family policy
National Category
URN: urn:nbn:se:uu:diva-246565ISBN: 978-91-554-9189-5OAI: diva2:793891
Public defence
2015-04-29, Universitetshuset sal IX, Biskopsgatan 3, Uppsala, 13:15 (English)
Available from: 2015-04-07 Created: 2015-03-09 Last updated: 2015-04-17
List of papers
1. Swedish child health nurses' views of early father involvement: a qualitative study
Open this publication in new window or tab >>Swedish child health nurses' views of early father involvement: a qualitative study
2013 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 7, 755-761 p.Article in journal (Refereed) Published
Abstract [en]

Aim To explore Swedish child health nurses' views on their role of involving fathers at the Child Health Centres (CHCs). Methods Interviews with 17 experienced Swedish Child Health nurses nurses were recorded, transcribed and analysed using systematic text condensation. Following the first analysis, the transtheoretical model of behavioural change was used to interpret the results. Results Four themes emerged during the analysis: (1) the nurses' own agenda; (2) nurses' opinion about the father's role; (3) nurses' gatekeeping; and (4) wanting more father involvement. Most nurses were in the precontemplation stage according to the transtheoretical model when they expressed their roles as nurses (Theme 1), how they perceived the father's role within the family (Theme 2) and how they actively encouraged mothers, but not fathers, to visit the CHCs (Theme 3/Mothers are our priority). Nurses in the contemplation stage started to consider involving fathers in the CHCs (Theme 3/The gate is closed...). Still others were in the preparation (Theme 4/Fathers are worthy of change) and action stages (Theme 4/Active in involving fathers), respectively. Conclusion Child Health nurses place more emphasis on engaging mothers than fathers in the services. To increase father involvement, nurses need support to become aware, initiate and maintain action.

Attitudes, Child Health Center, Parents, Qualitative interview, Sweden
National Category
Health Sciences
urn:nbn:se:uu:diva-203517 (URN)10.1111/apa.12246 (DOI)000319741800031 ()23551155 (PubMedID)
Available from: 2013-07-17 Created: 2013-07-15 Last updated: 2015-04-17Bibliographically approved
2. Gender equality in Swedish child health centers: An analysis of their physical environments and parental behaviors
Open this publication in new window or tab >>Gender equality in Swedish child health centers: An analysis of their physical environments and parental behaviors
2015 (English)In: Semiotica, ISSN 0037-1998, E-ISSN 1613-3692, no 204, 1-20 p.Article in journal (Refereed) Published
Abstract [en]


The aim of this study is to investigate the level of gender equality within the Swedish child health centers’ (CHCs) waiting rooms.


A total of 31 CHCs waiting rooms were analyzed using semiotic visual analysis to explore who the waiting rooms represented by coding the pictures, brochures, and magazines by gender using a manifest analysis, where the researchers coded what the pictures physically entailed, and a latent analysis, where the meaning of those pictures was discerned. In addition, 281 parental observations were completed at 25 of the CHCs by two observers. Inter-rater reliability was established and consensus was reached by using prescribed definitions of the waiting rooms.


Only 8 CHCs were categorized as Family-Centered, while 12 were Mother-Child Centered, 6 Child-Centered, 2 Women-Centered, and 3 were Neutral environments. The different designs between the categorized waiting rooms affected fathers’, but not the mothers’ involvement with respect to playing with their child and reading the posted information. When analyzing within one categorized environment, fathers were more likely to play with their child compared to mothers.


CHCs should consciously redesign their environments to also be inclusive of fathers so that they more habitually participate in their child’s health.

Sweden, child health centers, environmental factors, parenting behavior, family policy, gender equality
National Category
Other Medical Sciences not elsewhere specified Pediatrics
urn:nbn:se:uu:diva-246553 (URN)10.1515/sem-2014-0046 (DOI)000351927800001 ()
Available from: 2015-03-09 Created: 2015-03-09 Last updated: 2015-05-05Bibliographically approved
3. Mothers’ and fathers’ attendance in a community-based universally offered parenting program in Sweden
Open this publication in new window or tab >>Mothers’ and fathers’ attendance in a community-based universally offered parenting program in Sweden
2016 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 3, 274-280 p.Article in journal (Refereed) Published
Abstract [en]

Aim: Using a public health perspective, this study examined the characteristics of mothers and fathers who attended, compared to those who did not attend, a community-based practitioner-led universally offered parenting program.

Method: Mothers (141) and fathers (96) of 4- to 5-year-olds completed a set of questionnaires, including their demographic characteristics, their child’s behavioral and emotional problems, and their own parenting behavior. They were all then given the opportunity to attend level 2 of the Triple P – Positive Parenting Program. During the first six months of the study, 33 mothers and 11 fathers opted to attend the program.

Results: The relation between program attendance and parental characteristics was similar for mothers and fathers. In general, fathers, non-native and lower educated parents were less likely to attend the program. Mothers, but not fathers, were more likely to attend if they reported more child behavior problems, while fathers, but not mothers, were observed at a trend level to attend if they perceived their child as having more emotional problems. In addition, parents in general were more likely to attend if they used more harsh parenting strategies.

Conclusions: Although the universal offer did not reach parents universally, generally those parents who needed it were more likely to attend. Furthermore, this study shows that different factors may impact mothers’ and fathers’ attendance; therefore, parental data should be analyzed separately and different recruitment strategies should be used for mothers and fathers.

Universal programs, parenting programs, child behavior problems, child emotional problems, mother attendance, father attendance, parental attendance, Triple P
National Category
Other Health Sciences Pediatrics
urn:nbn:se:uu:diva-246564 (URN)10.1177/1403494815618841 (DOI)000373591600008 ()26644160 (PubMedID)
Available from: 2015-03-09 Created: 2015-03-09 Last updated: 2016-06-08Bibliographically approved
4. Conscious Parenting: A Qualitative Study on Swedish Parents’ Motives to Participate in a Parenting Program
Open this publication in new window or tab >>Conscious Parenting: A Qualitative Study on Swedish Parents’ Motives to Participate in a Parenting Program
2014 (English)In: Journal of Child and Family Studies, ISSN 1062-1024, E-ISSN 1573-2843, Vol. 23, no 5, 934-944 p.Article in journal (Refereed) Published
Abstract [en]

Triple P is a parenting program that aims to prevent behavioral, emotional, and developmental problems in children. Because Triple P is a new parenting program in Sweden, it is important to see how parents felt about the intervention. The aim of this study was to find out why parents of preschool children chose to participate in Triple P in Sweden, what they thought of the Triple P curriculum, and how the program related to their parenting philosophy in general. This is a qualitative study using semi-structured interviews with seven mothers and three fathers who participated in Triple P. The interviews were transcribed verbatim and were analysed using Malterud's method of Systematic Text Condensation. Parents chose to participate in Triple P for several reasons: they wanted to learn more about the intervention; they had specific problems that they sought help for; or they felt encouraged to participate due to advertisements and recommendations from friends. Of the Triple P curriculum, the participants especially enjoyed the "directed discussion" technique, the positive reinforcement sections, and the instructions on how to communicate effectively with their child by staying calm, close, and maintaining eye contact. It was important for many of the parents to feel validated and respected, and they liked having discussions with the preschool teacher rather than being told what to do. Parents in this Swedish sample generally liked and selectively used the strategies they learned from participating in Triple P, depending on how well these fit with their own parenting experiences and philosophy.

Sweden, Qualitative research, Triple P, Child behavior, Parents program
National Category
Psychology Psychiatry
urn:nbn:se:uu:diva-214655 (URN)10.1007/s10826-013-9750-1 (DOI)000337085000016 ()
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2015-04-17Bibliographically approved

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