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Publication Date: 
December, 2018
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Using a three-round hybrid Delphi methodology, the current study utilized a panel of “expert” birth professionals (n=20 after three rounds) to examine content and logistical factors that may be most effective for inclusion in the design, development, and delivery of pre- and perinatal (PPN) parenting programs of the 21st century.


Using a three-round hybrid Delphi methodology, the current study utilized a panel of “expert” birth professionals (n=20 after three rounds) to examine content and logistical factors that may be most effective for inclusion in the design, development, and delivery of pre- and perinatal (PPN) parenting programs of the 21st century. The purpose was to attain consensus on 235 items generated from literature and the panelists. Consensus per item was deemed achieved where 75% [dis]agreement was reached, which occurred for 157 (66.81%) items. Most notable were factors that may impact the development of prenates during gestation and post-birth that pregnant couples may benefit form learning about, content, barriers to fathers attending, parent cohort who may best benefit from attending, effective methods and locations of program delivery, and who is best qualified to facilitate programs. Consensus was not attained when the factors of program timing and length were considered. Numerous limitations relating to the study design were identified and future research could focus on creating PPN parenting programs that are flexible in design to suit individual needs of mothers, fathers, and couples. The effectiveness of future PPN parenting programs could be measured using randomized clinical trials that include waitlists, control groups, and contrast treatments, for comparison.


Abu-Saad, K., & Fraser, D. (2010). Maternal nutrition and birth outcomes. Epidemiologic Reviews, 32, 5-26. doi: 10.1093/epirev/mxq001

Alalshaikh, S. (2015). Cultural impacts on distance learning, online learning styles, and design. The Quarterly Review of Distance Education, 16(3), 67-75. Retrieved from https://eric.ed.gov/?id=EJ1143825

Alio, A.P., Bond, M.J., Padilla, Y.C., Heidelbaugh, J.J., Lu, M., & Parker, W.J. (2011). Addressing policy barriers to paternal involvement during pregnancy. Maternal and Child Health Journal, 15(4), 425-430. doi: 10.1007/s10995-011-0781-1

Anacker, C., O’Donnell, K.J., & Meaney, M.J. (2014). Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function. Dialogues in Clinical Neuroscience, 16(3), 321-333. doi: 10.1016/ j.biopsych.2014.11.022

Ayiasi, M.R., Van Royen, K., Verstraeten, R., Atuyambe, L., Criel, B., Garimoi, C.O., & Kolsteren, P. (2013). Exploring the focus of prenatal information offered to pregnant mothers regarding newborn care in rural Uganda. BMC Pregnancy and Childbirth, 13, 176-187. doi: 10.1186/1471-2393-13-176

Bäckström, C., Thortensson, S., Martensson, L.B., Grimmings, R., Nyblin, Y., & Golsater, M. (2017). ‘To be able to support her, I must feel calm and safe’: Pregnant women’s partners’ perceptions of professional support during pregnancy. BMC Pregnancy and Childbirth, 17(1), 234. doi: 10.1186/s12884-017-1411-8

Barrett, G., Shawe, J., Howden, B., Patel, D., Ojukwu, O., Pandya, P., & Stephenson, J. (2015). Why do women invest in pre-pregnancy health and care? A qualitative investigation with women attending maternity services. BMC Pregnancy and Childbirth, 15, 236-251. doi: 10.1186/s12884-015-0672-3

Bennington, L.K. (2010). The relationship among maternal infant bonding, spirituality, and maternal perception of childbirth experience (Unpublished doctoral thesis), Virginia Commonwealth University, USA.

Berg, M., Olafsdottir, O.A., & Lundgren, I. (2012). A midwifery model of women-centered childbirth care in Swedish and Icelandic settings. Sexual and Reproductive Healthcare, 3(2), 79-87. doi: 10.1016/j.srhc.2012.03.001

Billingham, K. (2011). Preparing for parenthood: The role of antenatal education. Community Practitioner: The Journal of the Community Practitioners’ & Health Visitors’ Association, 84(5), 36-38. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21667713

Bryson, J.D. (2013). Engaging adult learners: Philosophy, principles and practices. Ontario, Canada: James David Bryson.

Carlson, J., Edelson, J.L., & Kimball, E. (2014). First-time fathers’ experiences of and desire for formal support: A multiple lens perspective. Fathering, 12(3), 242-261. doi: 10.3149/fth.1203.242

Chamberlain, D. B. (2013). Windows to the womb: Revealing the conscious baby from conception to birth. Berkeley, CA: North Atlantic Books.



Charandabi, S.M., Mirghafourvand, M., & Sanaati, F. (2017). The effect of life style-based education on the fathers’ anxiety and depression during pregnancy and postpartum periods: A randomized controlled trial. Community Mental Health Journal, 53(4), 482-489. doi: 10.1007/s10597-017-0103-1

Coley, S.L., & Nichols, T.R. (2016). Understanding factors that influence adolescent mothers’ doula use: A qualitative study. The Journal of Perinatal Education, 25(1), 46-55. doi: 10.1891/1058-1243.25.1.46

Cunningham, S.D., Lewis, J.B., Thomas, J.L., Grilo, S.A., & Ickovics, J.R. (2017). Expect with Me: Development and evaluation design for an innovative model of group prenatal care to improve perinatal outcomes. BMC Pregnancy and Childbirth, 17(1), 147. doi: 10.1186/s12884-017-1327-3

Davis, J., Vyankandondera, J., Luchters, S., Simon, D., & Holmes, W. (2016). Male involvement in reproductive, maternal and child health: A qualitative study of policymaker and practitioner perspectives in the Pacific. Reproductive Health, 13(1), 81-92. doi: 10.1186/s12978-016-0184-2

Dawson, L., Rhodes, P., & Touyz, S.W. (2015). Defining recovering from anorexia nervosa: A Delphi study to determine expert practitioners’ views. Advances in Eating Disorders: Theory, Research and Practice, 3(2), 165-176. doi:10.1080/21662630.2015.1009145

Delbecq, A.L., Van de Ven, A.H., & Gustafson, D.H. (1975). Group techniques for program planning: A guide to nominal and Delphi processes. Glenview, IL, USA: Scott, Foresman and Co.

Deslauriers, J.M., Devault, A., Groulx, A.P., & Sevigny, R. (2012). Rethinking services for young fathers. Fathering, 10(1), 66-90. doi: 10.3149/fth.1001.66

Desroches, S., Lapointe, A., Deschenes, S.M., Bissonnette-Maheux, M., Gravel, K., Thirsk, J., & Legare, F. (2015). Dieticians’ perspectives on interventions to enhance adherence to dietary advice for chronic diseases in adults. Canadian Journal of Dietetic Practice and Research, 76(3), 103-108. doi: 10.3148/cjdpr-2015-009

Dietl, A., Cupisti, S., Beckmann, M.W., Schwab, M., & Zollner, U. (2015). Pregnancy and obstetrical outcomes in women over 40 years of age. Geburtshilfe Frauenheilkd, 75(8), 827-832. doi: 10.1055/s-0035-1546109

Duncan, L., & Bardacke, N. (2010). Mindfulness-based childbirth and parenting education: Promoting family mindfulness during the perinatal period. Journal of Child and Family Studies, 19(2), 190-202. doi: 10.1007/s10826-009-9313-7

Dunneram, Y., & Jeewon, R. (2015). Healthy diet and nutrition education program among women of reproductive age: A necessity of multilevel strategies or community responsibility. Health Promotion Perspectives, 5(2), 116-127. doi: 10.15171/hpp.2015.014

Edvardsson, K., Ivarsson, A., Eurenius, E., Garvare, R., Nystrom, M.E., Small, R., & Mogren, I. (2011). Giving offspring a healthy start: Parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Public Health, 11, 936-949. doi: 10.1186/1471-2458-11-936

Essa, R.M., & Ismail, N.E.I.A. (2015). Effect of early maternal/newborn skin-to-skin contact after birth on the duration of third stage of labor and initiation of breastfeeding. Journal of Nursing Education and Practice, 5(4), 98-108. doi: 10.5430/hnep.v5n4p98

Feinberg, M.E., Roettger, M.E., Jones, D.E., Paul, I.M., & Kan, M.L. (2015). Effects of a psychosocial couple-based prevention program on adverse birth outcomes. Maternal and Child Health Journal, 19(1), 102-111. doi: 10.1007/s10995-014-1500-5

Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapies, 16(2), 201-209. doi: 10.1016/j.jbmt.2011.08.002

Gazmararian, J.A., Dalmida, S.G., Merino, Y., Blake, S., Thompson, W., & Gaydos, L. (2014). What new mothers need to know: Perspectives from women providers in Georgia. Maternal and Child Health Journal, 18, 839-851. doi: 10.1007/s10995-013-1308-8

Glied, S., & Oellerich, D. (2014). Two-generation programs and health. The Future of Children, 24(1), 79-97. doi: 10.1016/j.jhealeco.2006.03.001

Hasson, F., Keeney, S., & McKenna, H. (2000). Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32(4), 1008-1015. doi: 10.1046/j.1365-2648.2000.t01-1-01567.x

Hauck, Y., Fisher, C., Byrne, J., & Bayes, S. (2016). Mindfulness-based childbirth education: Incorporating adult and experiential learning with mindfulness-based stress reduction in childbirth education. The Journal of Perinatal Education, 25(3), 162-173. doi: 10.1891/1058-1243.25.3.162

Hejblum, G., Lambotte, O., Galicier, L., Coppo, P., Marzac, C., Aumont, C., & Fardet, L. (2014). A web-based Delphi study for eliciting helpful criteria in the positive diagnosis of hemophagocytic syndrome in adult patients. PLoS One, 9(4), 1-6. doi: 10.1371/journal.pone.0094024

Holey, E., Feeley, J., Dixon, J., & Whittaker, V. (2007). An exploration of the use of simple statistics to measure consensus and stability in Delphi studies. BMC Medical Research Methodology, 7(1), 52-62. doi: 10.1186/1471-2288-7-52

Humphries, H., & Nolan, M. (2015). Evaluation of a brief intervention to assist health visitors and community practitioners to engage with fathers as part of the healthy child initiative. Primary Health Care Research and Development, 16(4), 367-376. doi: 10.1017/s1463423615000031

Iqbal, S., & Pipon-Young, L. (2009). The Delphi method. Methods, 22(7), 598-600. Retrieved from https://thepsychologist.bps.org.uk/volume-22/edition-7/delphi-method

James, D., & Warren-Forward, H. (2015). Research methods for formal consensus development. Nurse Researcher, 22(3), 35-43. doi: 10.7748/nr.22.3.35.e1297

Jenkins, D.A., & Smith, T.E. (1994). Applying Delphi methodology in family therapy research. Contemporary Family Therapy, 16(5), 411- 430. doi: 10.1007/BF02197902

Johnson, K. (2001). Bonding and spirituality. Midwifery Today, 58, 18-20. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12154706

Jongen, C., McCalman, J., Bainbridge, R., & Tsey, K. (2014). Aboriginal and Torres Strait Islander maternal and child health and well-being: A systematic search of programs and services in Australian primary health care settings. BMC Pregnancy and Childbirth, 14, 251-271. doi:10.1186/1471-2393-14-251

Keeney, S., Hasson, F., & McKenna, H. (2006). Consulting the oracle: Ten lessons from using the Delphi technique in nursing research. Journal of Advanced Nursing, 52(2), 205-212. doi: 10.1111/j.1365-2648.2006.03716.x

Keeney, S., Hasson, F., & McKenna, H. (2011). The Delphi technique in nursing and health research. Oxford, England: Wiley-Blackwell.

Kenny, L.C., Lavender, T., McNamee, R., O’Neill, S.M., Mills, T., & Khashan, A.S. (2013). Advanced maternal age and adverse pregnancy outcome: Evidence from a large contemporary cohort. PLoS One, 8(2), e56583-e56592. doi: 10.137/1/journal.pone.0056583

Kluny, R. (2011). Your baby remembers: Parenting with a deep heart from the start. Austin, TX: 21st Century Baby Press.

Kluny, R., & Dillard, D.M. (2014). Babies remember: Preserving wholeness with prenatal bonding and self-care. International Journal of Childbirth Education, 29(4), 32-38. Retrieved from http://childbirth287.rssing.com/chan-15619910/latest.php

Landy, C.K., Jack, S.M., Wahoush, O., Sheehan, D., & MacMillan, H.L. (2012). Mothers’ experiences in the Nurse-Family Partnership program: A qualitative case study. BMC Nursing, 11, 15-27. doi: 10.1186/1472-6955-11-15

Leung, B.M., Letourneau, N.L., Giesbrecht, G.F., Ntanda, H., Hart, M., & APrON Team. (2017). Predictors of postpartum depression in partnered mothers and fathers from a longitudinal cohort. Community Mental Health Journal, 53(4), 420-431. doi: 10.1007/s10597-016-0060-0

Lipton, B.H. (2008). The biology of belief: Unleashing the power of consciousness, matter and miracles. Carlsbad, CA: Hay House.

Lotrecchiano, G.R., McDonald, P.L., Lyons, L., Long, T., & Zajicek-Farber, M. (2013). Blended learning: Strengths, challenges, and lessons learned in an interprofessional training program. Maternal and Child Health Journal, 17(9), 1725-1734. doi: 10.1007/s10995-012-1175-8

Lovkvist, M. (2012). Somatically informed parent-prenate psychotherapy. Journal of Prenatal and Perinatal Psychology and Health, 27(1), 56-65. Retrieved from https://birthpsychology.com/journals/volume-27-issue-1/somatically-infor...

McKee, C., Stapleton, P., & Pidgeon, A. (2017). Support during pregnancy as an influencing factor on the transition to parenthood. Journal of Prenatal and Perinatal Psychology and Health, 32(2), 99-127. Retrieved from https://birthpsychology.com/journals/support-during-pregnancy-influencin...

McKee, C.L., Stapleton, P.B., & Pidgeon, A.M. (2018). Mindfulness: The power of a parent’s intentional influence on a prenate. The International Journal of Healing and Caring, 17(1), 1-23. Retrieved from http://www.ijhc.org/2017/12/mindfulness-the-power-of-a-parents-intention...

Muller, D., Teismann, T., Havemann, B., Michalak, J., & Seehagen, S. (2013). Ruminative thinking as a predictor of perceived post-partum mother-infant bonding. Cognitive Therapy and Research, 37, 89-96. doi: 10.1007/s10608-012-9454-7

Nolan, M. (2017). Planning, implementing and evaluating a parent education programme. Primary Health Care, 27(4), 19-27. doi: 10.7748/phc.2017.e1217

O’Donnell, K.A., Gaudreau, H., Colalillo, S., Steiner, M., Atkinson, L., Moss, E., … Meaney, M.J. (2014). The maternal adversity, vulnerability and neurodevelopment project: Theory and methodology. Canadian Journal of Psychiatry, 56(9), 497-508. doi: 10.1177/070674371405900906

Petch, J., Halford, W.K., Creedy, D.K., & Gamble, J. (2012). Couple relationship education at the transition to parenthood: A window of opportunity to reach high-risk couples. Family Process, 51(4), 498-511. doi: 10.1111/j.1545-5300.2012.01420.x

Phillips, A,C., Lewis, L.K., McEvoy, M., Galipeau, J., Glasziou, P., Hammick, M., …Williams, M.T. (2014). A Delphi survey to determine how educational interventions for evidence-based practice should be reported: Stage 2 of the development of a reporting guideline. BMC Medical Education, 14, 159-170. doi: 10.1186/1472-6920-14-149

Piotrowska, P.J., Tully, L.A., Kimonis, E., Hawes, D., Moul, C., Frick, P.J., … Dadds, M.R. (2017). Mothers, fathers, and parental systems: A conceptual model of parental engagement in programmes for child mental Health-Connect, Attend, Participate, and Enact (CAPE). Clinical Child and Family Psychology Review, 20(2), 146-161. doi: 10.1007/s10567-016-0219-9

Porges, S.W. (2009). The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic Journal of Medicine, 76(2), S86-S90. doi: 10.3949/ccjm.76.s2.17

Porges, S.W., & Furman, S.A. (2011). The early development of the autonomic nervous system provides a neural platform for social behaviour: A polyvagal perspective. Infant Child Development, 20(1), 106-118. doi: 10.1002/icd.688

Quirk, K., Owen, J., Inch, L.J., France, T., & Bergen, C. (2014). The alliance in relationship education programs. Journal of Marital and Family Therapy, 40(2), 178-192. doi:10.1111/jmft.12019

Rodrigo, M.J., Almeida, A., & Reichle, B. (2016). Evidence-based parent education programs: A European perspective. In J. J. Ponzetti, Jr. (Ed.), Evidence-based parenting education: A global perspective (pp. 85-104). New York: NY, Routledge.

Rosand, G.B., Slinning, K., Eberhard-Gran, M., Roysamb, E., & Tambs, K. (2011). Partner relationship satisfaction and maternal emotional distress in early pregnancy. BMC Public Health, 11, 161-173. doi: 10.1186/1471-2458-11-161

Sahip, Y., & Turan, J. M. (2007). Education for expectant fathers in workplaces in Turkey. Journal of Biosocial Science, 39(6), 843-860. doi: 10.1017/S0021932007002088

Salzmann-Erikson, M., & Eriksson, H. (2013). Fathers sharing about early prenatal support in health care virtual discussions on an internet forum. Health and Social Care in the Community, 21(4), 381-390. doi: 10.1111/hsc.12028

Serpeloni, F., Radtke, K., de Assis, S.G., Henning, F., Natt, D., & Elbert, T. (2017). Grand maternal stress during pregnancy and DNA methylation of the third generation: An epigenome-wide association study. Translational Psychiatry, 7(8), e1202-1210. doi: 10.1038/tp.2017.153



Shribram, S., & Billingham, K. (2008). The Child Health Promotion Program: Pregnancy and the first five years of life. London, England: Department of Health. Retrieved from http://www.fatherhoodinstitute.org/uploads/ publications/399.pdf

Siegel, D.J. (2011). Mindsight. New York, NY: Bantam Books.

Stathakarou, N., Zary, N., & Konowicz, A. A. (2015). Evaluation of three educational use cases for using virtual patients in massive open online courses (MOOCs): A Delphi study. Bio-Algorithms and Med-Systems, 11(2), 113-119. doi: 10.1515/bams-2015-0007)

Verny, T.R., & Kelly, J. (1981). The secret life of the unborn child. New York, NY: Summit Books.

Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: Results of a pilot study. Archives of Women’s Mental Health, 11, 67-74. doi: 10/1007/s00737-008-0214-3

Volling, B.L. (2012). Family transitions following the birth of a sibling: An empirical review of changes in the firstborn’s adjustment. Psychology Bulletin, 138(3), 497-528. doi: 10.1037/a0026921

Warner, L.A. (2014). Using the Delphi technique to achieve consensus: A tool for guiding extension programs. Florida, USA: Institute of Food and Agricultural Services.

Weinstein, A.D. (2016). Prenatal development and parents’ lived experiences. New York, NY: Norton.