Intervention Summary

InsideOut Dad

InsideOut Dad is an intervention developed by National Fatherhood Initiative (NFI) to help incarcerated fathers improve their parenting skills and develop stronger relationships with their children while in prison and after release. The objectives of the program are to (1) increase fathers' self-efficacy, (2) increase fathers' awareness, knowledge, and attitudes about being an involved, responsible, and committed father, and (3) increase contact between fathers and their children. The program consists of twelve 2-hour core sessions delivered weekly to groups of up to 12 fathers. The core sessions include:

Getting Started
Family History and the InsideOut Dad
What It Means To Be a Man
Showing and Handling Feelings
Men's Health
Communication
The Father's Role
Children's Growth
Discipline
Working With Mom and Co-parenting
Fathering From the Inside
Closing

Three optional sessions focus on reentry issues (reconnecting with family, fathers' rights and responsibilities, child support, visits with children). A fourth optional session addresses the role of spirituality in fatherhood. Sessions are led by one or two facilitators (two recommended for groups of 8 or more). Facilitators can be correctional facility staff or volunteers from the community. No specific qualifications are required of facilitators; training on the program through NFI is recommended but not required.

Materials required for implementation include the InsideOut Dad Facilitator's Manual, the InsideOut Dad Fathering Handbook, and handouts. These materials are packaged in a complete program kit that also includes optional videos and a self-assessment survey for fathers.

Descriptive Information

Areas of Interest	Mental health promotion
Outcomes	1: Self-efficacy 2: Parenting knowledge 3: Parental attitude 4: Proactive contact with children
Outcome Categories	Family/relationships Social functioning
Ages	26-55 (Adult)
Genders	Male
Races/Ethnicities	Black or African American Hispanic or Latino White Race/ethnicity unspecified
Settings	Correctional
Geographic Locations	No geographic locations were identified by the developer.
Implementation History	NFI released the first edition of InsideOut Dad and the second edition in. InsideOut Dad is used as standard programming in 25 State departments of correction and in several local corrections systems, including that of New York City. It has been implemented in at least 447 facilities across the United States, the District of Columbia, the U.S. Virgin Islands, and Puerto Rico, as well as in Bermuda, Canada, Norway, and the United Kingdom. Three independent evaluations of the program have been conducted in the United States.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: No Evaluated in comparative effectiveness research studies: No
Adaptations	Spanish-language and Christian versions of InsideOut Dad are available. NFI also offers a free "InsideOut Dad Second Edition Guide for Jails," which contains session outlines for a 12-hour version of the program (condensed from the standard 24 hours) for short-stay facilities, as well as recommendations for shortening the 12-hour version to 8 hours if needed.
Adverse Effects	No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories	Selective

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Economic Development Research Group, Rutgers University School of Public Affairs and Administration. Assessing the impact of the InsideOut Dad Program on Newark Community Education Center residents. Unpublished evaluation report.

Outcomes

Outcome 1: Self-efficacy
Description of Measures	Fathers' self-efficacy was measured using 9 items from the Coping Self-Efficacy Scale (CSES), a 26-item instrument assessing a person's ability to cope with stressors that occur in life. Items were prefaced with the question "When things are not going well for you, how confident are you that you can…" and included statements such as: "Talk positively to yourself" "Sort out what can be changed, and what cannot be changed" "Make a plan of action and follow it when confronted with a problem" "See things from the other person's point of view during a heated argument" Instead of the 0-10 response scale typically used for the CSES, three response options were provided for each statement: "cannot do at all," "moderately certain can do," and "certain can do," coded on a scale from 1 to 3, respectively. Scores for the 9 items were averaged to yield an overall score ranging from 1 to 3, with higher scores indicating greater self-efficacy.
Key Findings	Participants in the study were incarcerated fathers in residential correctional facilities who had a minor child or children. Fathers who signed up to be in the program received the intervention and completed pre- and posttest assessments while incarcerated. Fathers in the control group completed pre- and posttest assessments but received no intervention during the study. From pre- to posttest, fathers in the intervention group showed a significant improvement in self-efficacy (pretest = 2.42, posttest = 2.53) compared with those in the control group (pretest = 2.44, posttest = 2.45) (p < .05).
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.4 (0.0-4.0 scale)

Outcome 2: Parenting knowledge
Description of Measures	A 26-item questionnaire created for the study, the InsideOut Dad Knowledge Assessment, was used to measure fathers' knowledge of aspects of parenting and fathering covered in the program. The questionnaire includes multiple-choice and true/false items. Items are scored 1 for correct answers and 0 for incorrect answers; item scores are then summed and converted to a percentage, with higher percentages indicating greater parenting knowledge. Examples of the items include: "Men often find it easier to show feeling of hurt than do women." "True" "False" "Don't know" "There is nothing I can do to be involved with my child while locked-up." "True" "False" "Don't know" "After disciplining or punishing your child you should:" "Ignore your child" "Tell your child you love him or her no matter what" "Wait for your child to repeat the mistake" "Don't know" "One way to break a 'habit thought' is to:" "Clear your mind of everything and don't think at all" "Think an opposite thought" "Believe whatever you are thinking even if it is bad" "Don't know"
Key Findings	Participants in the study were incarcerated fathers in residential correctional facilities who had a minor child or children. Fathers who signed up to be in the program received the intervention and completed pre- and posttest assessments. Fathers in the control group completed pre- and posttest assessments but received no intervention during the study. From pre- to posttest, fathers in the intervention group showed a significant increase in parenting knowledge (pretest = 71.5%, posttest = 76.2%) compared with those in the control group (pretest = 71.2%, posttest = 70.0%) (p < .001).
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.3 (0.0-4.0 scale)

Outcome 3: Parental attitude
Description of Measures	Fathers' attitude toward parenting and child behavior was assessed using 8 items from the 115-item Parental Attitude Research Instrument (PARI). The 8 items included statements such as: "A child who is not afraid to show emotions will do well in life." "If a child acts mean, he/she needs understanding rather than punishment." "A good father lets his child learn the hard way about life." "A child should be taught to fear adults." Response options include "strongly disagree," "disagree," "uncertain," "agree," and "strongly agree," coded on a scale from 1 to 5, with some items using reverse coding. Item scores are averaged to yield an overall score ranging from 1 to 5, with higher scores indicating more positive parental attitude.
Key Findings	Participants in the study were incarcerated fathers in residential correctional facilities who had a minor child or children. Fathers who signed up to be in the program received the intervention and completed pre- and posttest assessments. Fathers in the control group completed pre- and posttest assessments but received no intervention during the study. From pre- to posttest, fathers in the intervention group showed significant improvement in parental attitude (pretest = 3.86, posttest = 3.90) compared with those in the control group (pretest = 3.98, posttest = 3.80) (p < .05).
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	1.9 (0.0-4.0 scale)

Outcome 4: Proactive contact with children
Description of Measures	The frequency of fathers' proactive contact with their children was measured using 3 items in a 7-item questionnaire assessing parenting practices and level of involvement with children. The items ask respondents how frequently they (1) call, (2) write to, and (3) visit their children, using the following response options: "I don't (call/write/visit) at all," "less than once a month," "once a month," "once a week," "more than once a week," and "not applicable." Items are scored 1 for reported contact or 0 for no reported contact. No composite score was calculated; each form of contact (calling, writing, visiting) was analyzed independently.
Key Findings	Participants in the study were incarcerated fathers in residential correctional facilities who had a minor child or children. Fathers who signed up to be in the program received the intervention and completed pre- and posttest assessments. Fathers in the control group completed pre- and posttest assessments but received no intervention during the study. From pre- to posttest, fathers in the intervention group significantly increased how often they called their children (pretest = .883, posttest = .911) compared with those in the control group (pretest = .942, posttest = .892) (p < .05). No statistically significant findings were identified for writing and visits with children.
Studies Measuring Outcome	Study 1
Study Designs	Quasi-experimental
Quality of Research Rating	2.0 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study	Age	Gender	Race/Ethnicity
Study 1	26-55 (Adult)	100% Male	77% Black or African American 14% Hispanic or Latino 10% White 3% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

Reliability of measures
Validity of measures
Intervention fidelity
Missing data and attrition
Potential confounding variables
Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome	Reliability of Measures	Validity of Measures	Fidelity	Missing Data/Attrition	Confounding Variables	Data Analysis	Overall Rating
1: Self-efficacy	3.0	2.5	2.5	1.0	2.0	3.5	2.4
2: Parenting knowledge	1.5	2.0	2.5	2.0	2.0	3.5	2.3
3: Parental attitude	0.0	2.0	2.5	1.5	2.0	3.5	1.9
4: Proactive contact with children	0.0	2.0	2.5	2.0	2.0	3.5	2.0

Study Strengths

The adapted version of the CSES used in the study had acceptable psychometric properties. A manual was used to standardize the intervention, the facilitators who delivered the intervention received training, and session logs were used. The statistical methods used were appropriate for the study. Sample size was adequate.

Study Weaknesses

No psychometric information other than internal consistency and face validity were provided for the InsideOut Dad Knowledge Assessment. The PARI had low reliability values. No psychometric information was provided for the self-report items used to assess contact with children. Only qualitative information was provided about the fidelity of self-reported information. The CSES and PARI had lower posttest completion rates compared with the other measures used in the study. There was no random assignment to study conditions.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

Availability of implementation materials
Availability of training and support resources
Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation Materials	Training and Support Resources	Quality Assurance Procedures	Overall Rating
4.0	3.0	2.3	3.1

Dissemination Strengths

Program materials are attractive, easy to use, and incorporate a variety of teaching strategies. The Facilitator's Manual includes information on the history, rationale, and framework for the program, as well as implementation guidance. It also includes information on the characteristics and behaviors of an ideal facilitator and self-reflection questions that allow implementers to explore whether they meet these criteria. Guidance is provided on the challenges an implementer may face while working in a correctional facility. The Fathering Handbook provides useful information and is of high quality. Developers are available to conduct training and offer technical assistance to new implementers. Pre-and postintervention self-assessment surveys for fathers (provided with scoring instructions and worksheet) are available.

Dissemination Weaknesses

No formal oversight, certification, or supervision process is in place to ensure that the program is implemented competently and with fidelity. The fathering survey is optional and provides limited participant outcome data. No feedback processes are in place to support quality assurance.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description	Cost	Required by Developer
InsideOut Dad Second Edition Complete Program Kit (includes 1 Facilitator Manual; 10 Fathering Handbooks; a CD-ROM that includes evaluation and marketing tools and sample certificate of completion; and DVD with optional videos to enhance sessions)	$599 each	Yes
Fathering Handbook (additional copies)	$9.95 each	Yes
1- or 2-day, on-site training	$3,999 for 1 day or $4,999 for 2 days, maximum of 30 participants	No
1-day training at NFI offices in Germantown, Maryland	Contact the developer
Email and phone technical assistance and consultation	Free	No
Evaluation survey, scoring instructions, and scoring worksheet (on CD-ROM)	Included in complete program kit	No