Exploring Canadian Registered Dietitians' Confidence, Facilitators, Barriers, and Resource Needs in Father Engagement

Registered dietitians (RDs) play a critical role in delivering family-centered care by engaging both fathers and mothers to support children's optimal long-term growth and development. Although fathers use distinct feeding practices and play an important role in shaping children's diet and growth, existing evidence suggests that they may be less engaged in pediatric nutrition care and services than mothers. Given that RDs are uniquely positioned to promote caregiver alignment in feeding practices and strengthen children's dietary and health outcomes, this study aimed to explore Canadian RDs' perceived confidence, facilitators, barriers, and resource needs related to father engagement in pediatric nutrition care and services.

A cross-sectional online survey was distributed to RDs across Canada between November 2024 and July 2025. The survey included six 5-point Likert scale items assessing RDs' perceived confidence in engaging fathers in pediatric nutrition care and services, informed by the Connect, Attend, Participate, Enact (CAPE) model of parental engagement, as well as closed-ended questions on resource and training needs. Additionally, open-text questions assessed RDs' perceived facilitators and barriers to father engagement. Quantitative data were analyzed descriptively, while qualitative data were examined using an inductive content analysis approach to identify the major facilitator and barrier themes.

A total of 129 RDs (96.9% female; 91.2% white; 69.0% ≥ 6 years of pediatric nutrition experience) participated in this study. While most RDs reported they felt very confident in inviting fathers to appointments (85.3%), encouraging their participation (83.7%), and contribution to care planning work (81.4%), fewer felt confident in retaining fathers in ongoing pediatric nutrition care and services (67.5%). Based on qualitative content analysis of open-text responses, the most commonly reported facilitators to father engagement included fathers' presence and availability (40.4%), interest and openness (35.1%), and high caregiving involvement (23.7%), while the most commonly reported barriers included fathers' absence at appointments (33.3%), limited caregiving roles (33.3%), fathers' limited availability due to work schedule (23.3%), and traditional gender norms undermining father engagement (16.7%). Only 3.1% RDs had received prior training in father-engagement practices. The top three selected resource needs were webinars (92.1%), websites with practice guidelines (66.7%), and self-assessment tools (44.4%).

While RDs reported confidence in various aspects of father engagement, few had received formal training in this area. Study findings highlighted opportunities for targeted professional development resources within dietetics to enhance facilitators and address barriers to engaging fathers in pediatric nutrition care and services.