LEAD Development and Proof-of-Concept: Building a Peer-Delivered Fatherhood Intervention

OVERVIEW

Learn, Engage, Act, Dedicate (LEAD) was developed to address the interconnected challenges of alcohol use, depression, and family conflict among fathers. Using a community-engaged process, researchers and clinicians designed a five-session intervention that combines motivational interviewing, behavioral activation, and masculinity discussion strategies. The intervention was designed for delivery by peers. LEAD was evaluated using a multiple baseline single-case design, with assessments from men, their partners, and children targeting father alcohol use and depression and assessment of family relationships, parenting, couple and child relationship quality, and partner and youth mental health.

ELDORET, KENYA

Project Goals

DESIGN

Design a culturally responsive intervention rooted in core evidence based treatments that builds from the role of father as a motivator for treatment engagement as well as improvements in mental health.

TEST

Test feasibility of a community-embedded peer delivery model.

ENGAGE

Engage and men in care by mirroring natural help seeking.

TARGET

Enhance men’s mental health by targeting depressive symptoms linked to alcohol misuse and family stress.

IMPACT

Improve family functioning and youth mental health by addressing father mental health.

Turning Community Insight Into Measurable Impact

LEAD demonstrated that fathers with problem drinking can be successfully engaged in mental health care through a culturally tailored, task-shifted model addressing alcohol use and depression.
After treatment, men were 5.1 times more likely to abstain from alcohol on any given day, and when they did drink, they consumed 50% less alcohol compared with baseline.
Promising improvements in partner mental health, youth mental health, and overall family functioning.
Peer-fathers delivered treatment with high fidelity and high quality.
- Giusto, A., Green, E. P., Simmons, R. A., Ayuku, D., Patel, P. +, & Puffer, E. S. (2020). A multiple baseline study of a brief alcohol reduction and family engagement intervention for fathers in Kenya. Journal of Consulting and Clinical Psychology, 88, 708 725.
- Giusto, A., Ayuku, D., & Puffer, E. S. (2022). Learn, Engage, Act, Dedicate (LEAD): Development and feasibility testing of a task-shifted intervention to improve alcohol use, depression and family engagement for fathers. International Journal of Mental Health Systems.
- Giusto, A., Mootz, J., Korir, M., Jaguga, F., Mellins, C., Wainberg, M., Puffer, E. S. (2021). “When my children see their father is sober, they are happy”: A qualitative exploration of family system impacts following men’s engagement in an alcohol misuse intervention. SSM-Mental Health.