Heather Strachan

Background The impact of parental drug use on children is a major public health problem. However, opioid-dependent fathers have been largely ignored in parenting research. Objective To implement and test the feasibility and acceptability of the Parents under Pressure programme (PuP4Dads) for opioid-dependent fathers and their families, and to determine whether or not a full-scale evaluation could be conducted. Design A mixed-methods feasibility study. Setting Two non-NHS family support services for parents who use drugs in Scotland. Participants Fathers prescribed opioid substitution therapy ( n = 25), their partners ( n = 17) and children, as well as practitioners, supervisors, service managers and referrers. Intervention A home-visiting programme, including an integrated theoretical framework, case formulation, collaborative goal-setting and modules designed to improve parenting, the caregiving environment and child welfare. The programme was delivered flexibly over 6 months by accredited practitioners. Main outcome measures Feasibility progression criteria included the recruitment target ( n = 24 fathers), acceptability of PuP4Dads, father engagement in the study (including a minimum of 66% of fathers completing PuP and a minimum of 10 fathers completing baseline and post-treatment research interviews), engagement in qualitative interviews (including a minimum of 10 fathers and 90% practitioner uptake and 80% manager uptake), focus groups (with a minimum of 80% referrer uptake), adequate fidelity and no adverse events. Data sources The following researcher-administered validated questionnaires were used: the Brief Child Abuse Potential Inventory, the Parenting Sense of Competence Scale, the Difficulties in Emotion Regulation Scale, the Paternal Antenatal Attachment Scale, the Maternal Antenatal Attachment Scale, the Emotional Availability Scale, the Brief Infant Toddler Social and Emotional Assessment, the Strengths and Difficulties Questionnaire, the Conflict Tactics Scale, Treatment Outcome Profile and the EuroQol-5 Dimensions, five-level version. Other sources included parent-completed service use (an economic measure), social work child protection data, NHS opioid substitution therapy prescription data and practitioner-reported attendance data. We also conducted interviews with fathers ( n = 23), mothers ( n = 14), practitioners ( n = 8), supervisors ( n = 2) and service managers ( n = 7); conducted focus groups with referrers ( n = 28); and held an ‘expert event’ with stakeholders ( n = 39) . <jats:sec