Including fathers in preventing non-accidental head injury

Health visitors identified fathers as a marginalised, difficult-to-reach group when aiming for universal implementation of a public health programme to prevent non-accidental head injury (NAHI) in babies. Follow-on research with 30 fathers from disadvantaged backgrounds, including some in prison, explored barriers and facilitating factors to preventing NAHI through focus groups and interviews. Fathers expressed both responsibility and helplessness in managing a baby, but many felt excluded from gaining skills and knowledge by healthcare staff. Barriers to implementing a prevention programme included a lack of knowledge about head injuries in babies and poor understanding of prevention as a reduction of risk factors. Fear of blame for a head injury could lead to injury concealment, indicating a taboo subject. Facilitators for fathers to learn about preventing head injuries in babies included concerns of their masculinity being at odds with the frailty of the newborn, recognition of fathers' needs to be valued in their own right, and a need for individualised plans for gaining information and increasing confidence. The modifiable barriers to prevention, from the fathers' perspectives, add to the theoretical and applied evidence base for the prevention of NAHI.