# Feasibility, acceptability, and preliminary efficacy of Text4Father for improving infant and family health

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2020 · $173,548

## Abstract

ABSTRACT
 While father engagement programming is widely advocated, few clinical and public health approaches
engage fathers during the pre- and perinatal periods. A large body of literature shows that fathers play a key role
in promoting child health and development beginning even before their children are born. Interventions to actively
engage fathers, particularly early in pregnancy, have significant promise for improving infant outcomes (e.g.,
physical, social, and emotional health and development), the well-being of mothers and fathers, and transforming
couples' relationships, especially among lower socioeconomic status (SES) individuals. However, readily
scalable approaches that effectively translate evidence-based guidance to engage lower SES fathers during the
prenatal period to improve infant and mother outcomes are lacking. Not engaging fathers not only fails men, but
compromises the quality of care delivered to mothers and children. Our formative work demonstrates that lower
SES fathers identify a variety of infant care knowledge, skill, and support gaps and are interested to receive such
information via a text-messaging platform. Further, substantial research supports the use of text-message
interventions for vulnerable and difficult-to-reach populations. Thus, a readily-scalable, easily adaptable
intervention that could reach lower SES fathers has the potential to substantially impact child, parent, and family
health at the population level.
 Text4Father, a multi-modal text messaging program, is designed to increase first-time lower SES fathers'
knowledge, self-efficacy, and behavioral engagement on infant care and parenting. Text4Father consists of 48-
weeks of twice weekly texts written at a 5th grade reading level. Texts include resource links and instructions to
support behavior change (e.g., videos, infographics), starting mid-pregnancy and continuing through 6 months
of postnatal age. Text content was developed using formative research and feedback from the target population,
consensus building with experts, and an evidence-based review. Text4Father is programmed to push/receive
reminders to tailor text content based on: gestational age, infant's birth, infant's age, and father's resident status.
We propose to pilot test the first 24 weeks of the Text4Father curriculum (6-month follow-up through 1 month of
postnatal age) to examine its feasibility, acceptability, and preliminary efficacy. Mobile health (mHealth)
interventions have broad accessibility; the majority of Americans own a cellphone and use them to text and
evidence supports using text messaging interventions, especially for difficult-to-reach populations. Advantages
to using an mHealth approach is that it can be readily scalable for deployment via maternity providers, as
proposed here, or to other settings (e.g., home visiting, WIC, pediatric care) and platforms (e.g., social media).
If successful, this pilot will inform a larger trial that will evaluate the longer-te...

## Key facts

- **NIH application ID:** 9999658
- **Project number:** 5R21HD097453-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Arik V Marcell
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $173,548
- **Award type:** 5
- **Project period:** 2019-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9999658

## Citation

> US National Institutes of Health, RePORTER application 9999658, Feasibility, acceptability, and preliminary efficacy of Text4Father for improving infant and family health (5R21HD097453-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9999658. Licensed CC0.

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