International Perspectives on the Role of Indigenous Fathers in Caring for Their Infants: A Scoping Study The International Indigenous Policy Journal Volume 13 | Issue 3 December 2022 International Perspectives on the Role of Indigenous Fathers in Caring for Their Infants: A Scoping Study Amy L. Wright University of Toronto, Canada, amyl.wright@utoronto.ca Rachel VanEvery McMaster University, Canada, and Six Nations of the Grand River, bomberrm@mcmaster.ca David Johnson Six Nations of the Grand River, david_845@hotmail.com Landon Martin Six Nations of the Grand River, landon.a.martin@gmail.com Clare McGall McMaster University, Canada, mcgallc@mcmaster.ca Jennifer K. Cano University of Toronto, Canada, jcano090@gmail.com Heather Burnside University of Toronto, Canada, heather.kewageshig@mail.utoronto.ca Recommended Citation Wright et al., (2022). International Perspectives on the Role of Indigenous Fathers in Caring for Their Infants: A Scoping Study. The International Indigenous Policy Journal, 13(3). https://10.18584/iipj.2022.13.3.14491 International Perspectives on the Role of Indigenous Fathers in Caring for Their Infants: A Scoping Study Abstract Effective early childhood development interventions require a thorough understanding parental roles in supporting their infants’ health. Yet, the role of Indigenous fathers is not well illustrated within the literature. This scoping study synthesizes the roles that Indigenous fathers have in promoting the health and development of their infants, using an international perspective. Findings support future research to develop effective early childhood parenting interventions that address the unique needs of Indigenous fathers. Methods Scoping methodology was undertaken with inclusion criteria stipulating infants less than two years of age, and describing the role of Indigenous fathers (or father figures) in meeting the health and/or developmental needs of their infants. Descriptive and pattern coding were used during data extraction and synthesis. Collaboration with Indigenous community partners, including First Nations fathers, promoted ethical research conduct and findings framed within Indigenous ways of knowing. Results Findings highlight a journey to becoming a father, beginning with assuming a new identity as a father, establishing their fathering role, and supporting one another throughout the journey. This process has significant implications for a child’s development and wellbeing and related health policy. Conclusions This review synthesizes the experiences of Indigenous fathers across the globe, and while the journey is not fully understood, these initial findings are helpful to support future research and health policy. It is in the best interests of children if men are proactively supported in their transition to fatherhood as early as possible to promote a positive impact on their children’s development and future wellbeing. Keywords Indigenous fathers, Infants, Parenting, Scoping study Acknowledgments We would like to acknowledge the contributions of one additional First Nations father who wishes to stay anonymous and not participate as an author. Their insight and wisdom related to the journey to fatherhood is greatly appreciated. Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. http://creativecommons.org/licenses/by-nc-nd/4.0/ http://creativecommons.org/licenses/by-nc-nd/4.0/ 1 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 International Perspectives on the Role of Indigenous Fathers in Caring for Their Infants: A Scoping Study Optimizing the healthy growth and development of infants requires a holistic approach involving all parents, with important implications for children, regarding psychological development, school readiness, mental health, self-esteem, and resiliency (Moore et al., 2015; Priest et al., 2012). This is particularly poignant for Indigenous infants who globally experience disparities and whose mothers face difficulties accessing early childhood services due to inequitable access, racist and discriminatory care, and social inequities (Lee et al., 2010; Sivertsen et al., 2020; Wright, Jack, et al., 2019). The unique role of fathers in supporting the developmental needs of their infants remains largely absent in the literature, as research has focused on the role of mothers as primary caregivers and fathers as economic providers (Ball, 2010; Cabrera et al., 2018; Canuto et al., 2019; Gerlach et al., 2017). Yet, research among non- Indigenous families has shown that early involvement of the father in an infant’s life is associated with positive outcomes, including lower rates of infant mortality and cognitive delay, and more secure infant- child attachment (Allport et al., 2018; Bamishigbin et al., 2020). Further, paternal involvement is associated with a decreased likelihood of maternal and paternal depressive symptoms (Allport et al., 2018; Bamishigbin et al., 2020). The invisibility of Indigenous fathers in studies exploring early childhood development is self- perpetuating; with less focus on fatherhood, Indigenous fathers are perceived to be uninvolved in their children’s lives, and resources and programming are directed elsewhere (Ball, 2010; Canuto et al., 2019). With fewer resources supporting Indigenous fathers, their needs may not be met (Ball, 2010). Programming that supports caregivers of young children can promote parent-child attachment, leading to infants developing with better coping mechanisms (Lee et al., 2010; Reilly & Rees, 2018; Sivertsen et al., 2020). Specifically Indigenous-focused prenatal and infant-toddler health programs have contributed to improved health outcomes, positive child development including reduced childhood obesity, reduced problem behaviours among children, improved home safety, better childhood immunization rates, and engagement with Indigenous languages and culture (McCalman et al., 2017; Smylie et al., 2016). Typically, however, parenting programs are developed with a Western approach, and may be culturally inappropriate to meet the needs of Indigenous families (Abawi & Brady, 2017; Canuto et al., 2019; Lee et al., 2010; Murrup-Stewart et al., 2019). When traditional and culturally appropriate parenting programs are unavailable or inaccessible, opportunities to support families in their healing from intergenerational trauma stemming from past and current colonial practices is reduced (Lee et al., 2010). Alternatively, studies conducted in Canada have demonstrated that family support programs are most helpful to Indigenous parents when they are administered by Indigenous people, incorporate traditional or cultural elements, and are located within their home communities (Smylie et al., 2016; Toombs et al., 2018). The consequences of reduced or absent family support services, in combination with imposed Western standards of parenting embedded in health policy such as the child welfare system, are separation of Indigenous children from their families, culture, and home communities (Toombs et al., 2018). Indeed, Indigenous children are overrepresented in the child welfare system globally (Australian Law Reform Commission, 2017; Berger & Slack, 2020; Hyslop, 2017; Little Drum Consulting, 2016; Tilbury, 2015; 2 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Toombs et al., 2018). Yet the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) recognizes “the right of Indigenous families and communities to retain shared responsibility for the upbringing, training, education and well-being of their children, consistent with the rights of the child” (United Nations Educational Scientific and Cultural Organization [UNESCO], 2017). The impact of colonization aimed at assimilation and cultural genocide globally has resulted in the loss of cultural knowledge of traditional parenting practices among Indigenous communities (Greenwood & De Leeuw, 2012; Reilly & Rees, 2018). Survivors endure traumas that manifest today through intergenerational trauma and are perpetuated by systemic racism in health and social policies (Ball & Moselle, 2015; Hyslop, 2017; Lee et al., 2010). Given this, a review of the literature concerning the role of Indigenous fathers in meeting the needs of their infants is necessary to create evidence-based health policy that leads to parenting programs that holistically address the needs of Indigenous families with young children. Given the paucity of literature describing Indigenous fathers’ experiences in Canada, and the similar historical and ongoing colonial practices experienced by Indigenous Peoples in Canada, Australia, New Zealand, and the United States (Little Drum Consulting, 2016), this scoping study includes literature from all four countries. This review aims to 1) describe the research question: What is the role of Indigenous fathers in meeting the health and developmental needs of their infants under two years of age?; and 2) identify gaps in the literature that warrant further study. Methods This scoping study is guided by the Arksey and O’Malley (Arksey & O’Malley, 2005) framework and is enhanced by the work of Levac et al. (Levac et al., 2010). Using five stages Arksey and O’Malley suggest: 1) identifying the research question; 2) identifying relevant studies; 3) selecting studies for inclusion in the review; 4) charting the data; and 5) collating, summarizing, and reporting the results (Arksey & O’Malley, 2005). Levac et al. (Levac et al., 2010) further enhance this framework by: 1) emphasizing the importance of linking a research question to the study purpose; 2) allowing for an adaptable data- charting form as new knowledge becomes known; and 3) using qualitative data analysis methods to add rigour to the data synthesis stage. Strategies from this latter approach have been incorporated in the methodology. This scoping study employs Two-Eyed Seeing, a framework developed by Mi’kmaw Elders Albert and Murdena Marshall that embraces the contribution of both Indigenous and Western world views (Bartlett et al., 2015). Two First Nations research assistants and Indigenous community partners from the local Indigenous Friendship Centre, the Hamilton Regional Indian Centre, provided their world views and lived experiences to the project, including formulating the research question, contributing to data extraction and analysis, and developing the manuscript. Four First Nations fathers applied their perspectives to data analysis and the writing of the manuscript. Two non-Indigenous undergraduate research students designed the search strategy in collaboration with these Indigenous partners and the support of an information scientist. The senior author, also non-Indigenous, has eight years of experience working with the local Indigenous community and provided research expertise and guidance throughout this project. 3 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Identifying Relevant Studies In this stage, the research team aimed to identify relevant peer-reviewed and grey literature through databases and online platforms. A comprehensive search of grey literature was undertaken following expert guidance sought from leading researchers in Indigenous fathers’ health from around the world. Both searches of published and grey literature databases were completed in April 2021. See Table 4 for inclusion criteria and search strategy details. The MEDLINE search strategy is available in the supplementary information files for this published article. Selection of Studies for Inclusion in the Review Studies to be screened underwent deduplication using Bramer’s method (Bramer et al., 2016), and then exported to Covidence (Covidence, 2021) for ease of screening. Covidence software allows for independent screening of studies by title, abstract, and full text review. All studies were screened by two independent reviewers, and any disagreements were resolved by consensus or settled by the first author. Charting the Data Next, pertinent data from included articles were extracted, including authorship, publication year, study design, sample size and demographics, geographical location, general results, and results relevant to the research question. The quality of primary studies was critiqued using a corresponding critical appraisal tool (JBI, 2020). Studies were not excluded based on quality, but rather the quality was used to determine the methodological strength of the results. Extracted data were imported into NVIVO 12, a data management software program (QSR International, 2021). Multiple rounds of coding, using strategies by Saldana (Saldana, 2016) were completed to interpret and synthesize the data, first by a non-Indigenous research assistant and then by the first author, the First Nations research assistant and a team of four First Nations fathers. Open coding strategies were used to initially sort the data, and initial codes were organized into categories. Axial coding strategies and thematic analysis were used to find recurring patterns and initial themes among the codes. These initial patterns and themes were then shared with the team of First Nations fathers to determine their relevancy to their own fathering experiences. Together with a research assistant, the team of fathers formalized the themes and identified gaps in the literature. Results A total of 7094 articles were retrieved from database searches and through hand-searching relevant journals and reference lists. Following deduplication, 4859 sources were exported to Covidence (Covidence, 2021). Articles were then screened for relevancy by title and abstract, and 306 articles were screened by full text. At full-text review, articles were excluded if they: a) were published before the year 2000; b) did not describe children under the age of two years; c) did not mention Indigenous fathers; and/or d) did not describe a caregiving role. A final total of 64 sources met inclusion criteria and were included in the review. Of these, 41 originated from published databases and 23 from grey literature sources. Within the published records, 31 articles represented empirical studies, including 24 qualitative 4 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 studies and 9 cross-sectional studies, and the remainder were reviews, reports, and theses. Grey literature records were comprised of videos, news reports, websites, and reports. The included sources originating from Australia (n=18), Canada (n= 31), New Zealand (n=5), and the United States (n=10). The screening process is described in the PRISMA chart in Figure 1. See Table 1 for details of the included articles. Figure 1. PRISMA Diagram 5 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Table 1. Article Characteristics of Included Sources Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Abel et al. (2001) Auckland, New Zealand Qualitative study Cross-cultural comparison of infant care practices and beliefs Focus groups 150 caregivers with infants, including 38 Indigenous men Infant sleep practices & arrangements Role of father providing partner food and relieving her of caregiving responsibilities Ashbourne et al. (2011) Several sites across Canada Qualitative study Responsiveness in father-child relationships & its influence on fathers Interviews 215 fathers (40 Indigenous) with children <8 years Fathers’ communication and responsive parenting to children’s cues Ball (2009) British Columbia, Canada Qualitative study Challenges and opportunities for caring for children following decades of colonial interventions Conversational interviews 72 First Nations & 8 Métis fathers with children <7 years Traditional healing, Indigenous knowledge and parenting capacities Fatherhood and role identity Ball (2010) British Columbia, Canada Qualitative study Socio-historical conditions that shaped Indigenous men’s experiences of learning to be a father and becoming a man Conversational Interviews 72 First Nations & 8 Métis fathers with children <7 years Fathers roles and perceptions of childcare and parent support programs Ball (2012) Canada Commentary Indigenous fathers’ potential to contribute to their children’s well- being n/a Indigenous fathers in Canada Fatherhood as a life-long journey, contributing to the well-being of their children Ball (2013) Canada Book chapter Multigenerational challenges for Indigenous fathers in Canada n/a Indigenous fathers in Canada The healing journey of fatherhood and associated responsibilities British Columbia Tripartite First Nations and Indigenous Maternal and Child Health Working Group (2015) British Columbia, Canada Report What works in Maternal/Child health programs n/a Program directors & coordinators working with First Nations communities Promoting male involvement by hiring male family visitors. Connecting Elders with fathers and involving them to restore the role of men in raising healthy families Best Start Resource Centre (2013) Ontario, Canada Resource Support pregnant and parenting Indigenous youth n/a Local program directors working with First Nations, Métis & Inuit teens Traditional beliefs and practices related to newborn and parent’s relationships with child. 6 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Bia (2011) Arizona, United States Qualitative study Study of Diné parenting reflecting on birth to four years of age. Critical retrospective inquiry 1 Diné woman Diné culture and practices related to early childhood and raising children. Binns et al. (2004) Perth, Western Australia Cross-sectional study Prevalence of breastfeeding at discharge and determinants of breastfeeding initiation Self-administered survey 425 Indigenous mothers of newborn infants born in hospital Breastfeeding initiation was strongly associated with mothers’ perception of fathers’ preferences for breastfeeding Bowes et al. (2014) Australia Report Parenting programs for Indigenous families n/a Healthcare practitioners & program directors working with Indigenous Australian communities Successful parenting programs catered to Indigenous fathers used appropriate content, language, and structure Campbell et al. (2018) Queensland, Australia Qualitative study Evaluation of experiences of the Baby One program implementation process Semi-structured interviews 4 Indigenous parents, 20 male Indigenous members & 24 health workers and program staff Inclusion of fathers in the program; fathers should share their parenting role Canuto et al. (2019) South Australia Qualitative study Indigenous men’s discourse on parenting Yarning groups with a semi- structured guide 46 Indigenous men who were parents or provided caring for children of all ages, including infants. Father as protector and supporter to partner Need for culturally appropriate opportunities for men to participate in the birthing and parenting process. Being present at birth formed a strong family bond and appreciation for fathering. Carriere et al. (2009) Canada Book chapter Attachment theory, connectedness and Indigenous children in Canada n/a Indigenous children in Canada Fathers need support in the role of protector, provider, and nurturer of the mother and the child. Dadcentral.ca (n.d.) Ontario, Canada Website Website for fathers with parenting manual and videos n/a Indigenous fathers of infants Men develop a positive relationship with their child using traditional beliefs; spending time with children; fathers are engaging in less traditional parenting roles. Daly et al. (2012) Several sites across Canada Qualitative study Examine the diverse experience of father involvement Interviews 215 fathers (40 Indigenous) with children < 8 years Fathers value spending time with their children; deliberate attempt to be different from men of previous generations. 7 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Dodd et al. (2015) Western Australia Qualitative study Emerging issues on bed-sharing Semi-structured Interviews and focus groups Participants 24 mothers (20 Indigenous) of infants 2 to 12 months Viewed co-sleeping as protective, father would leave the bed Dorozio (2019) Alberta, Canada News story Highlighted a Nakoda-Cree-Métis family with young children n/a Nakoda-Cree-Métis family Father participates in baby naming ceremony. Important to raise infant with Nakoda language and as a Nakoda thinker. Elkington (2017) New Zealand Qualitative study Explore the everyday realities of expectant and young Māori fathers and partners Semi-structured interviews 8 Māori fathers (Ages 16-25) Described father’s non-traditional role as primary care givers as their partners worked. Fathering roles influenced by previous experiences. Eni et al. (2013) Manitoba, Canada Qualitative study Community perspectives on teenage pregnancy and parenting Sharing circles 26 First Nations women with history of teenage pregnancy Described traditional roles of mothers and fathers. Young fathers unsure about their roles. Eni et al. (2014) British Columbia, Manitoba & Ontario, Canada Mixed-methods Determinants of breastfeeding for First Nations women Survey & focus groups 65 mothers from 7 First Nations communities Paternal grandmothers educated their sons about child-rearing and belongingness as fathers. Facetubc (2015) British Columbia, Canada Video n/a n/a Indigenous fathers with history of cigarette smoking Sharing experiences with other fathers is supportive. Faulkner et al. (2021) New South Wales, Australia Qualitative study Sources of support for young Indigenous fathers Semi-structured interviews 10 Indigenous and Torres Strait Islander fathers Fatherhood as an opportunity to take responsibility, become a financial supporter and role model, and share their culture. Avoid mistakes as a father when faced with negative stereotypes. Fletcher et al. (2017) New South Wales, Australia Qualitative study Feasibility of developing internet and mobile phone-based resources to support young Indigenous fathers Yarning groups 20 Indigenous fathers (ages 18- 25) with 1+ child Importance of fathers talking to one another for parenting advice and support Herman et al. (2015) Michigan, United States Qualitative study Beliefs about infant safe sleep practices, barriers to acceptance of prevention recommendations, and more effective messaging strategies Focus groups 73 mothers and supporters, including Indigenous women Fathers influential about sleep location and avoiding bedsharing. Open to learning about safe sleep. 8 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Hossain (2001) Southwestern United States Cross-sectional study Division of household labour and family functioning in off-reserve Navajo families Survey 28, two-parent Navajo families Fathers perceived themselves to be as competent as mothers perceive themselves to be, viewed the positive aspects of their families. Participation in cleaning, feeding, and playing with their infants. Irvine et al. (2009) British Columbia, Canada Report n/a n/a Healthcare practitioners & programmers working with Indigenous communities Intergenerational role modelling and family cohesion impact becoming a father; mother- centric programs exclude fathers from accessing parenting programs Iusitini et al. (2011) Auckland, New Zealand Cross-sectional study Nurturing and harsh disciplinary parenting practices of fathers of Pacific Children born in New Zealand Self-administered survey 823 Pacific fathers with a Pacific mother of their child & 1398 Pacific infants Nonresident fathers’ contact with their children tends to be more recreational than instrumental Jones et al. (2017) New Zealand Mixed-methods Approaches Māori parents used to put their infants to sleep and the influencing factors Online surveys and in-person semi-structured interviews 58 Māori parents, infants (2 months-2 years) Various sleeping-arrangement perspectives; preferred parent-assisted sleeping practices over self-soothing; convenience was a crucial factor in determining infant sleep location Kim-Meneen (2018) 10 Treaty 8 Woodland Cree reserves of Alberta, Canada Qualitative study Parenting styles of second-generation adult children of First Nation residential school survivors and the intergenerational effects on parenting styles Interviews 20 Cree parents (11 fathers, 9 mothers) Birth of child motivated fathers to remain alcohol- free Kruske et al. (2012) Northern Australia Qualitative study Experiences and beliefs of Indigenous families as they care for children in their first year of life Interviews 15 Indigenous mothers (15-29 years) Mothers play the most important role in an infant’s life while fathers help support the mother. Kueh et al. (2014) Australia Cross-sectional study Attitudes and roles of expectant Indigenous fathers in antenatal care. Survey 50 Indigenous males; infants not yet born Positive attitudes towards vaccination; ensuring their home was ready and safe for the baby Leo (2012) Saskatchewan, Canada Documentary n/a n/a Indigenous fathers with young children Being there from day one, role replacement, taking time away from children to heal Limb et al. (2014) American Indian perceptions United States Cross-sectional study Perceptions of nonresident Indigenous-American father rights and responsibilities Survey 209 Indigenous mothers, 53 Indigenous fathers Providing financial support to his infant 9 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Limb et al. (2014) Strengthening American Indian Across the United States Cross-sectional study Impact of relationship quality on Indigenous-American parenting and children Survey 222 Indigenous mothers and 144 Indigenous fathers Unmarried fathers were more engaged with their children; the more support Indigenous-American parents received from one another, the more positive interactions they had with their child. Little Drum Consulting (2016) British Columbia, Canada Manual Infant development program practice guidelines n/a Indigenous families with infants in Canada and infant program staff Include fathers in programming; create groups for fathers only that focus on healthy lifestyles, role modelling, and exploring vulnerabilities Monkman (2019) Manitoba, Canada News story n/a n/a Indigenous fathers with young children Appreciate sharing circles with other dads that discuss being a partner, general parenting tips, vulnerabilities; few father programs offered Mussell (2005) Canada Guide Challenges and healing of First Nations men n/a First Nations men in Canada Include infant family activities in ways that enabled them to see, experience and understand life. Fears about inadequate childcare discourages men from cooperating and benefiting from resources. Myers et al. (2014) Victoria, Australia Qualitative study Early childhood nutrition concerns, resources and services for Indigenous families Focus groups 34 Indigenous & 1 Torres Strait Islander parents Confusion with breastfeeding process; gender norms prevent support of child-rearing. Nahwegahbow (2013) Northeastern Ontario Review Model for traditional social framework that illustrates the central role of infants and young children n/a Anishinaabe families Construction of cradleboard provides physical and spiritual support for the infant National History Education Clearinghouse (2018) United States Website n/a n/a Indigenous American families in the 17th century Expectant parents participated in rituals to guarantee a safe delivery, but men were rarely allowed in the birth room and were not allowed to see the birth Native Child and Family Services of Toronto (2020) Ontario, Canada Website n/a n/a Indigenous fathers in Toronto area Programs and counselling for fathers that discuss birth year teachings and ceremonies NCCIH (2011) British Columbia, Canada Report n/a n/a Child and family healthcare practitioners & programmers working with Indigenous communities Children helped fathers on the right path; programs need to give fathers the safety to be open, provide cultural teachings and engage them in hands-on care 10 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review NCCIH (2015) British Columbia, Canada Report n/a n/a Child and family healthcare practitioners & programmers working with Indigenous communities Fatherhood is leadership and it starts with supporting partners NCCIH et al. (2017) Parents as first teachers Manitoba, Canada Resource manual n/a n/a First Nations and Métis parents in Manitoba Engage in responsive care to facilitate cognitive development by talking, playing, singing with infant NCCIH et al. (2019) Family Connections British Columbia, Canada Resource manual n/a n/a First Nations and Métis parents in British Columbia Bond with infants by cuddling, taking them to stores, teaching traditional games, songs and stories NCCIH et al. (2019) Fatherhood is Forever British Columbia, Canada Resource manual n/a n/a First Nations and Métis parents in British Columbia Preparation for baby; cultural connection with child; joining a men’s group to become a healthy role model; part of breastfeeding process, changing diapers, attending to infant at night NCCIH et al. (2019) Growing up Healthy British Columbia, Canada Resource manual n/a n/a First Nations and Métis parents in British Columbia Facilitate healthy infant development by taking them to health professionals, encourage language development, keeping infant active, avoiding hazardous food, and practicing safe sleep NCCIH et al. (2019) Parents as First Teachers British Columbia, Canada Resource Manual n/a n/a First Nations and Métis parents in British Columbia Touch and play with infant to bond Neault et al. (2012) Southwest United States Cross-sectional study Describe substance use patterns among young Indigenous American fathers and examine intersection of substance use with men’s fatherhood roles and responsibilities Survey 87 Indigenous American male partners of adolescent mothers Priorities of fatherhood are being a good role model and educating the child Oster et al. (2018) Alberta, Canada Qualitative study Needs of Cree fathers who supported their partners during pregnancy Semi-structured interviews 6 Cree fathers (18+ years) Include infants in cultural activities; raised infants with their Cree language; culture and Elders support for fathers 11 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Padilla et al. (2013) United States Cross-sectional study Associations among parental relationship, quality, father involvement, and co-residence Survey 107 Indigenous American fathers in urban areas (Navajo, Cherokee, Nez Perce, Crow, Northern Cheyenne) Stronger tie to family system results in increased father’s interaction with family members; Indigenous American fathers need constructive role models Penman (2006) Australia Review The growing up of Indigenous and Torres Strait Islander children n/a Indigenous Australians and Torres Strait Islander children (0-18 years) Responsive care framework for infant; teach ceremony and singing Plunket (2021) New Zealand Website n/a n/a Māori fathers in New Zealand Open communication is critical; caring for breastfeeding partner; parenting as a team and merging gender roles Reilly et al. (2018) Normanton, Australia Qualitative study Examination of barriers and opportunities to strengthen the male parenting role in Indigenous and Torres Strait Islander communities Yarning groups 25 Indigenous and 6 non- Indigenous stakeholders Men’s groups are safe places to talk about fathering; antenatal programs too female-focused; felt underprepared and stigmatized about fathering Reinhardt et al. (2012) United States Cross-sectional study Relationships between Indigenous American fathers and daughters Survey Fathers self-identified as Indigenous American with at least one Indigenous American daughter 42% of fathers reported that their mother or their grandmother was their primary tribal cultural reference for raising a daughter compared to 8% of fathers who mentioned their own father Ryan (2011) Australia Review Traditional Australian Indigenous nurturance of infants & children through an exploration of the meaning of certain words from Central and Western Desert Indigenous languages n/a Indigenous people from the Central and Western Desert regions of Australia Bonding with infant by carrying, talking, singing, telling stories and cooking food for them Scott (2013) British Columbia, Canada Report n/a n/a Child and family healthcare practitioners and programmers working with Indigenous communities Need programs for men by men with similar lived experiences; men encouraged to do 50% of parenting work to improve relationship with spouse Starr et al. (2018) Australia Report n/a n/a Child and family healthcare practitioners and programmers working with Australian Indigenous fathers Having the resources and support prior to becoming a father; cultural responsibilities to attend to in first years of life; strength-based language in programming to empower men 12 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Author (Year) Setting Design/objective Objective Data collection methods Participant and infant characteristics Key findings related to review Stayin’ on Track (n.d.) Australia Website n/a n/a Young Australian Indigenous and Torres Strait Islander fathers Supporting partner and stepping up to their role during pregnancy changed them as a person Abandoned harmful social habits and parenting as a united front with partner Tipene-Leech et al. (2000) Auckland, New Zealand Qualitative study Māori infant care practices as they relate to health messages, infant care services and SIDS prevention Focus groups & one-on-one interview 26 caregivers (from Māori, Tongan, Samoan, Cook Islander, Niuean and European communities in Auckland region) Perceptions of infant-parent co-sleeping and sleep location; various feeding methods (breast vs. bottle-feeding) Urban Indian Health Institute (2011) United States Qualitative study Insight from Indigenous American and Alaska Native parents about keeping babies healthy and safe and effective messages and communication about these topics Focus groups and individual interviews 39 Indigenous American and Alaskan Native parents - 27 mothers, 12 fathers Parenting as a team; protective and ceremonial roles for fathers Lack of cultural awareness made it challenging of maintain Indigenous values when trying to keep infants healthy Waddell et al. (2021) Manitoba, Canada Qualitative study Reflections on resources and barriers to wellness for Indigenous men Sharing circles and in-depth interviews 11 Indigenous men (Dakota and Métis) Fathering provided men motivation to heal and find cultural strength; taking care of their family was considered a modern-day warrior Women’s Health Clinical Support Programs Women and Newborn Health Service et al. (2015) Western Australia Pamphlet n/a n/a Indigenous Australian fathers with a new infant Parent as a team, talk to male relatives about fatherhood Note: Only first authors and year have been provided due to space limitations. Where the same author and date occur for more than one source, the first words of the title have also been provided. 13 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 All studies were assessed as being methodologically strong, except for two cross-sectional studies assessed as having moderate methodological quality because they failed to meet three or more of the nine criteria (Luo et al., 2014; Neault et al., 2012). These criteria included inadequate sample sizes and response rates, invalid measurement methods, and a lack of methodological detail. All studies were included in the review, regardless of quality. The results of the critical appraisals are presented in Tables 2 and 3. The findings resulted in three main themes which describe the journey on which Indigenous fathers embark to become fathers. These themes include: 1) identifying as a father; 2) establishing a new fathering role; and 3) supporting one another. The following elaborates on these themes and their subthemes in more depth. 14 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Table 2. Qualitative Critical Appraisals Question A be l e t a l., 2 00 1 A sh bo ur ne e t a l., 2 01 1 B al l, 20 09 B al l, 20 10 B ia , 2 01 1 C am pb el l e t a l., 2 01 8 C an ut o et a l., 2 01 9 D al y et a l. 20 12 D od d & Ja ck ie w ic z, 2 01 5 E lk in gt on , 2 01 7 E ni & P hi lli ps -B ec k, 2 01 3 E ni e t a l., 2 01 4 Fl et ch er e t a l., 2 01 7 Fa ul kn er e t a l., 2 02 1 H er m an e t a l., 2 01 5 Jo ne s e t a l., 2 01 7 K im -M en ee n, 2 01 8 K ru sk e et a l., 2 01 2 M ye rs e t a l., 2 01 4 O st er e t a l., 2 01 8 R ei lly & R ee s, 20 18 T ip en e- Le ac h et a l., 2 00 0 U rb an In di an H ea lth In st itu te , 2 01 1 W ad de ll et a l., 2 02 1 Is there congruity between the stated philosophical perspective and the research methodology? Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Is there congruity between the research methodology and the research question or objectives? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Is there congruity between the research methodology and the methods used to collect data? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Is there congruity between the research methodology and the representation and analysis of data? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Is there congruity between the research methodology and the interpretation of results? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Is there a statement locating the researcher culturally or theoretically? Y Y Y Y Y Y Y Y Y Y Y Y Y N N Y Y Y Y Y Y Y Y Y Is the influence of the researcher on the research, and vice- versa, addressed? Y Y Y Y Y Y Y Y Y Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Are participants, and their voices, adequately represented? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Is the research ethical according to current criteria or, for recent studies, and is there evidence of ethical approval by an appropriate body? Y Y/ N Y Y Y Y Y Y/ N Y Y Y/ N Y Y Y Y Y Y Y Y Y Y Y Y Y Do the conclusions drawn in the research report flow from the analysis, or interpretation, of the data? Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Adapted from JBI (2020) Checklist for Qualitative Studies Y=Yes, N=No 15 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Table 3. Quantitative Critical Appraisals Question N ea ul t e t a l., 2 01 2 Li m b & T ob le r, 20 14 Li m b et a l., 2 01 4 Pa di lla e t a l., 2 01 3 B in ns e t a l., 2 00 4 K ue h et a l., n .d . H os sa in , 2 00 1 Iu si tin i e t a l., 2 01 1 R ei nh ar dt e t a l., 2 01 2 Was the sample frame appropriate to address the target population? Y Y Y Y Y N N Y Y Were study participants sampled in an appropriate way? Y Y Y Y Y Y Y Y Y Was the sample size adequate? N Y Y Y Y N N Y Y Were the study subjects and the setting described in detail? Y Y Y Y Y N Y Y Y Was the data analysis conducted with sufficient coverage of the identified sample? Y Y Y Y Y N N Y N Were valid methods used for the identification of the condition? N Y Y Y Y N Y Y Y Was the condition measured in a standard, reliable way for all participants? Y Y Y Y Y Y Y Y Y Was there appropriate statistical analysis? Y Y Y Y Y Y Y Y Y Was the response rate adequate, and if not, was the low response rate managed appropriately? U Y Y Y Y N Y Y N Adapted from JBI (2020) Checklist for Prevalence Studies Y=Yes, N=No, U=Unclear 16 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Identifying as a Father The journey to becoming a father begins with grappling with the reality of this new identity and sense of self. Three subthemes describe this process: i) timing varies; ii) being a role model; and iii) drawing on paternal experiences. Timing Varies. First, timing varies, as men described adopting their new identity as a father at varying time points. For some, becoming a father began during pregnancy (Best Start Resource Centre, 2013; Bia, 2011; Dad Central Ontario, n.d.; Faulkner et al., 2021; National Collaborating Centre for Indigenous Health & Manitoba Government, 2017; National History Education Clearinghouse, 2018; Oster et al., 2018; Stayin’ on Track, n.d.), while for others this identity shift began once the child was born (Ball, 2009, 2010, 2013; Daly et al., 2012; Eni & Phillips-Beck, 2013; Faulkner et al., 2021; Matthew et al., 2018; Oster et al., 2018). Pregnancy was viewed as a time of opportunity, during which many men recognized the need to adopt their new identity as a father and assume responsibility for their unborn child (Faulkner et al., 2021; Oster et al., 2018). For some First Nations communities, the belief that the unborn child chooses their parents in the period before birth helped to establish a relationship between fathers and their children during pregnancy that continued after birth and throughout their lives (Best Start Resource Centre, 2013; Dad Central Ontario, n.d.; National History Education Clearinghouse, 2018). Supporting their partners through pregnancy assisted men in assuming their new identity as fathers as they prepared for their new life with a child (Bia, 2011; National Collaborating Centre for Indigenous Health & Manitoba Government, 2017; Stayin’ on Track, n.d.). Still for other men, their acceptance of becoming a father occurred after the birth of their infant, and this timing varied depending on their personal circumstances (Ball, 2010). For example, in a study of fathers in British Columbia, Canada, Ball (Ball, 2009, 2013) described how many fathers shared that their journey to accepting their new identities was a “long and winding road” (Ball, 2013), during which time they came to understand the meaning of being a father, and how to enact their new role. In another study, First Nations teenage mothers described young fathers as having strong apprehensions about identifying as a father because they were still maturing and were unsure of who they were or wanted to be (Eni & Phillips-Beck, 2013). Finally, some fathers required a period of maturation, labelled as “stepping-up” or “manning-up” by some men, before they were able to acknowledge their responsibility for their child; ultimately this maturation led them to finally identifying as a father (Ball, 2010, 2013; Faulkner et al., 2021). Being a Role Model. Identifying as a father also meant becoming a role model for their children (BC Tripartite First Nations and Aboriginal Maternal and Child Health Working Group, 2015; Canuto et al., 2019; Dad Central Ontario, n.d.; Faulkner et al., 2021; Neault et al., 2012; Reilly & Rees, 2018; Urban Indian Health Institute, 2011). A study in the United States found that partners of Indigenous mothers considered being a good role model to their children as their top parenting priority (Neault et al., 2012). Some fathers described being a role model as having a healthy relationship with the child’s mother, providing for their children, being present with their children, and abandoning previous activities that took them away from home or jeopardized their health (Ball, 2012; Campbell et al., 2018; Canuto et al., 2019; Dad Central Ontario, n.d.; Daly et al., 2012; Faulkner et al., 2021; Leo, 2012; Matthew et al., 2018; Neault et al., 2012; Oster et al., 2018; Stayin’ on Track, n.d.; Urban Indian Health Institute, 17 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 2011). Fathers shared that being present for their infants contributed to their own self-esteem and gave them a sense of purpose in life (Canuto et al., 2019; Daly et al., 2012; Faulkner et al., 2021; Oster et al., 2018). Still other fathers chose to be the primary caregiver for their children for a period of time after birth, and while some described this as isolating, they considered this a worthwhile sacrifice because of their role in positively shaping the development of their infants (Elkington, 2017; Plunket, 2021; Stayin’ on Track, n.d.). The importance of Indigenous fathers both as caregivers for their children and as a vital part of their partners’ support network is becoming increasingly realized. As such, parenting programs for Indigenous families are also beginning to encourage men to assume a primary caregiver role for their children during a period of their early years (Campbell et al., 2018; Plunket, 2021). Drawing on Paternal Experiences. Indigenous men spoke of drawing on past experiences with their own fathers when grappling with their new identity as fathers. Some men wanted to be similar (Faulkner et al., 2021; Oster et al., 2018) while most wanted to act differently than their own fathers (Ball, 2009, 2012; Dad Central Ontario, n.d.; Daly et al., 2012; Elkington, 2017; Faulkner et al., 2021; Leo, 2012) who may have been absent, abusive, or neglectful. In a study by Ball (2009), a majority of First Nations and Métis fathers explained that growing up with an absent or abusive father set the stage for their journey of fatherhood. Studies support that men are deliberately attempting to be different from their fathers by making time for their children, to break unhealthy parenting cycles stemming from colonization and the residential school legacy which led to the loss of parental role modeling and the passing down of traditional knowledge and customs, and resulted in intergenerational trauma (Ball, 2009; Daly et al., 2012; Irvine & National Collaborating Centre for Indigenous Health, 2009; Leo, 2012; Mussell & The Aboriginal Healing Foundation, 2005; Padilla et al., 2013; Urban Indian Health Institute, 2011; Waddell et al., 2021). Alternatively, some Indigenous fathers described positive relationships with their fathers and other male relatives, and attributed these experiences to helping them become good fathers and providing motivation to continue a legacy of good fathering (Daly et al., 2012; Faulkner et al., 2021; Oster et al., 2018). In summary, the process of identifying as a father is described as temporal in nature, with some men embodying this new role during pregnancy, others at or shortly after birth, and still others during early childhood. Realizing their responsibility as role models for their children helped men to conceptualize their identity as fathers and what that meant for their parenting. While some men had positive paternal experiences from which to draw to make meaning of their new identity, others had to build this anew. The desire to break the cycle of absent or abusive parenting resulting from colonization and the subsequent loss of culture, language, and positive parenting role models was a strong motivator for men who desired to be present and positive role models for their children. Establishing a New Fathering Role The second theme along the journey to becoming a father is “establishing a new fathering role.” Evidence from the literature suggests Indigenous men established their new fathering role through: a) assuming caregiving responsibilities; b) supporting the infant’s mother; and c) meeting spiritual needs. These components will now be described in further detail. 18 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Assuming Caregiving Responsibilities. Traditionally, Indigenous men were considered providers for the family (Carriere & Richardson, 2009; Eni & Phillips-Beck, 2013; Waddell et al., 2021). While this role is still expected of many fathers, other roles are demanded as well (Limb & Tobler, 2014; Urban Indian Health Institute, 2011). Upon becoming a father, the literature describes assuming caregiving responsibilities to meet the health and developmental needs of their infants. First, a father’s role in infant sleep was commonly discussed in the literature, with no single approach embraced more often than another (Abel et al., 2001; Dodd & Jackiewicz, 2015; Eni et al., 2014; Herman et al., 2015; Jones et al., 2017; Tipene-Leach et al., 2000). In a US study of Indigenous fathers, men were found to be highly influential in decisions made about sleep location, as they felt it was important to implement safe sleeping practices to avoid sudden infant death syndrome (SIDS) (Herman et al., 2015). Some fathers viewed co-sleeping, or parents sleeping with the infant in a family bed, as leading to an infant’s dependence on the mother, and thus it was better for the baby to sleep separately from the mother to promote independence (Abel et al., 2001; Jones et al., 2017; Tipene-Leach et al., 2000). Abel et al. (2001) found that Pacific Island fathers viewed bed-sharing as protective because the baby was near its mother who could react quickly. A second caregiving responsibility of fathers was their support of breastfeeding. In a study of Indigenous fathers in Australia, fathers were highly influential in the mother’s decision to breastfeed (Binns et al., 2004). Mothers who perceived their infant’s father as being in favour of breastfeeding were more than six times as likely to be breastfeeding upon discharge from hospital following delivery than mothers who perceived that their infant’s father preferred bottle feeding or was indifferent (Binns et al., 2004; Eni et al., 2014). Findings were similar in a Canadian study of First Nations mothers, who were more likely to breastfeed if the infant’s father supported their decision (Eni et al., 2014). Generally, fathers were described as understanding the benefits of breastfeeding, and wanting to support the emotional, physical, and practical needs of the mother during the feeding process (Campbell et al., 2018; Eni et al., 2014; Hossain, 2001; Tipene-Leach et al., 2000; Urban Indian Health Institute, 2011). In some cases, however, cultural and societal norms, or a lack of understanding of how to support their infant’s mother prevented fathers from being as supportive as they wanted to be (Eni et al., 2014; Myers et al., 2014; Tipene-Leach et al., 2000). Two parenting resources, one for Mãori parents in New Zealand (Plunket, 2021) and another for Indigenous parents in Canada (National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019b), described ways for fathers to be a part of the breastfeeding experience. Fathers were encouraged to bring the baby to the mother for night feeds, to burp the baby, stay close to the baby and mother, and support the mother by talking to her while she was breastfeeding and bringing her food and drink (National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019b; Plunket, 2021). Third, several sources described the role of the father in promoting learning through providing responsive care. Fathers were encouraged to respond to their children’s needs by being present, cuddling, loving, playing with them, and building trust with their children (National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019a; National Collaborating Centre for Indigenous Health & Manitoba Government, 2017; Plunket, 2021; Vartuli & Winter, 1989). Other studies echoed these important caregiving skills, describing the role of fathers as providing a safe, positive, and nurturing environment for their infants and learning to respond appropriately to their 19 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 different cries (Ashbourne et al., 2011; Bia, 2011; Hossain, 2001; Iusitini et al., 2011; Luo et al., 2014; Mussell & The Aboriginal Healing Foundation, 2005; National Collaborating Centre for Indigenous Health, 2015; Penman, 2006; Ryan, 2011; Urban Indian Health Institute, 2011). In a Canadian study examining responsiveness in child-father relationships, Indigenous fathers said they developed an ability to understand what the child was communicating when they cried (Ashbourne et al., 2011). Several sources described the practical caregiving skills that fathers were increasingly acquiring, including changing diapers, bathing, pushing a stroller, doing housework, settling a crying infant, keeping their infant’s immunizations up to date, and caring for their infant’s oral health (Campbell et al., 2018; Dad Central Ontario, n.d.; National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019b, 2019a, 2019c; Plunket, 2021; Reilly & Rees, 2018; Women’s Health Clinical Support Programs Women and Newborn Health Service & Department of Health Government of Western Australia, 2015). Finally, many studies described the role of fathers in providing financially for the family and, in particular, their continued responsibility to provide for their children even when no longer in a relationship with their child’s mother (Canuto et al., 2019; Carriere & Richardson, 2009; Eni & Phillips- Beck, 2013; Faulkner et al., 2021; Limb & Tobler, 2014; Oster et al., 2018; Urban Indian Health Institute, 2011). Finally, the literature recognizes that while the assumption of a father’s role as being a protector and provider for his family continues to be common, fathering also involves many other important roles. Supporting the Infant’s Mother. The literature also described a father’s role as supporting the infant’s mother by being present, providing her with food and drink, communicating with her, and helping to relieve her of childcare responsibilities wherever possible (Abel et al., 2001; Bia, 2011; Carriere & Richardson, 2009; Kruske et al., 2012; Oster et al., 2018; Plunket, 2021; Stayin’ on Track, n.d.; Urban Indian Health Institute, 2011; Women’s Health Clinical Support Programs Women and Newborn Health Service & Department of Health Government of Western Australia, 2015). In a study of Indigenous parents in the United States by Limb et al. (Limb, White, & Holgate, 2014), parents who supported one another had more positive interactions with their children, as well as when fathers were engaged with their children whether or not they were married to their child’s mother. This emphasis on sharing parenting roles and supporting each other is exemplified by some Indigenous languages. Thomas Snow, a father from Stoney Nakoda First Nation in Canada, shared that there is no word specifically describing fatherhood or motherhood in the Nakoda language (Dorozio, 2019). Instead the word parenthood is used to describe both parents working together to care for children (Dorozio, 2019). Supporting the infant’s mother in beneficial in many ways, as it has been found both to improve the father’s relationship with their spouse and to reduce the mother’s stress (Dad Central Ontario, n.d.; Scott, 2013). Meeting Spiritual Needs. Much of the literature spoke to the important role of fathers in meeting the spiritual needs of their infants and children. Addressing the spiritual needs of children helped the children to feel connected to their community, ancestors, culture, and mother earth; provided children with a sense of identity and belonging; and was a source of comfort, pride, support, and resilience throughout the children’s lives (Canuto et al., 2019; Faulkner et al., 2021; National Collaborating Centre for Indigenous Health, 2011; National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019b; Oster et al., 2018; Reinhardt et al., 2012; Tipene-Leach et al., 2000). 20 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Some ways that fathers met the spiritual needs of their infants included song and prayer, participating in ceremonies and traditions such as smudging, caring for the placenta and umbilical cord, using a cradleboard, and teaching children their traditional language (Ashbourne et al., 2011; Bia, 2011; Dorozio, 2019; Matthew et al., 2018; Mussell & The Aboriginal Healing Foundation, 2005; Nahwegahbow, 2013; National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019a; Native Child and Family Services of Toronto, 2020; Oster et al., 2018; Reinhardt et al., 2012; Tipene-Leach et al., 2000; Urban Indian Health Institute, 2011). How men establish a fathering role is broad and encompasses assuming caregiving responsibilities, supporting the child’s mother, and meeting the child’s spiritual needs. While the role of fathers in the past has been largely influenced by gender, with men acting primarily as protectors and providers for their families, the literature describes Indigenous fathers as striving to engage in the full range of caregiving skills from playing with their infants to bathing them and changing diapers. The influence of the father on a mother’s choice to breastfeed was notable; mothers who felt supported to breastfeed by their infants’ fathers were more likely to do so. Finally, the literature supports the strong role of Indigenous fathers in meeting the spiritual needs of their infants; participating in ceremonies and traditions and teaching them to speak their language foster a sense of identity and connection to the community and the land, and promote pride and resilience. Supporting One Another The final theme along the journey to becoming a father is “supporting one another.” This theme includes three subthemes: a) healing; b) support networks; and c) parenting programs. Healing. Healing was an essential process in the journey to becoming a father. Colonial legacies, including the dispossession of land and loss of traditional life and ways of knowing, have significantly disrupted parenting. For example, in Canada the removal of children from their family homes during the residential school legacy and sixties scoop resulted in a lack of parenting role models, especially positive ones (Ball, 2013; Dad Central Ontario, n.d.). As these positive models were few and far between for Indigenous children growing up in Canada, many men do not have examples from which to draw when they become fathers themselves (Ball, 2013; Dad Central Ontario, n.d.; Waddell et al., 2021). Yet the journey to becoming a father is seen as an opportunity to heal and turn around the negative cycle of parenting that men and often their own parents as well have experienced (Ball, 2009, 2012, 2013; Canuto et al., 2019; Dad Central Ontario, n.d.; Facetubc, 2015; Kim-Meneen, 2018; National Collaborating Centre for Indigenous Health, 2011; Oster et al., 2018; Stayin’ on Track, n.d.; Urban Indian Health Institute, 2011; Waddell et al., 2021). For some fathers, healing involved substance abuse treatment (Ball, 2009; Dad Central Ontario, n.d.; Facetubc, 2015; Kim-Meneen, 2018). For others, healing was fostered through being immersed in culture and community, engaging in self-care that promoted physical, mental, and emotional wellness, and just being around and playing with their children (Ball, 2009, 2013; Canuto et al., 2019; Dad Central Ontario, n.d.; Oster et al., 2018; Plunket, 2021; Stayin’ on Track, n.d.; Waddell et al., 2021; Women’s Health Clinical Support Programs Women and Newborn Health Service & Department of Health Government of Western Australia, 2015). 21 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 Support Networks. Support networks were a second and important aspect of fathers supporting one another. The support networks described in the literature consisted mainly of family members, with an emphasis on the important roles of the infant’s mother and both paternal and maternal grandmothers. These maternal family members were essential in assisting new fathers by being positive role models, teaching vital caregiving knowledge and skills, and assisting with child care (Ball, 2009, 2010, 2013; Eni et al., 2014; Fletcher et al., 2017). Extended family members, including aunties, uncles, grandfathers, and cousins, also supported fathers in similar ways, but were mentioned less frequently in the literature (Abel et al., 2001; Ball, 2009; Canuto et al., 2019; Faulkner et al., 2021; Fletcher et al., 2017; Urban Indian Health Institute, 2011). Support networks consisted of other fathers too, who afforded opportunities to observe positive parenting interactions, to share experiences with and learn from one another, and to support each other on their journeys to becoming fathers (Ball, 2009; Canuto et al., 2019; Dad Central Ontario, n.d.; Fletcher et al., 2017; Monkman, 2019; National Collaborating Centre for Indigenous Health & First Nations Health Authority, 2019b; Women’s Health Clinical Support Programs Women and Newborn Health Service & Department of Health Government of Western Australia, 2015). Finally, two Canadian sources mentioned the important role of Elders in supporting First Nations fathers by providing teachings related to traditional parenting roles and responsibilities, culturally relevant parenting advice, and opportunities to engage in ceremony (BC Tripartite First Nations and Aboriginal Maternal and Child Health Working Group, 2015; Oster et al., 2018). With the support of Elders, First Nations fathers in Canada are described as the vehicles to restore culture and tradition to the Indigenous family model (BC Tripartite First Nations and Aboriginal Maternal and Child Health Working Group, 2015). Parenting Programs. The third and final subtheme of supporting one another was through the assistance of parenting programs. The literature demonstrates that Indigenous men are commonly excluded from parenting programs because programs are either not culturally relevant or they are not designed for men (Ball, 2009, 2010, 2012, 2013; Canuto et al., 2019; Fletcher et al., 2017; Irvine & National Collaborating Centre for Indigenous Health, 2009; Monkman, 2019; Reilly & Rees, 2018; Urban Indian Health Institute, 2011; Waddell et al., 2021). Indigenous men generally lacked a sense of belonging and felt uncomfortable in mother-centric parenting programs because of a lack of relevant information pertaining to them (Ball, 2009, 2010, 2012, 2013; Canuto et al., 2019; Fletcher et al., 2017; Reilly & Rees, 2018; Urban Indian Health Institute, 2011). This was particularly problematic for men who were raising their children as single parents, as they did not have a partner who was attending parenting programs from whom to gain knowledge (Ball, 2009, 2013). Some of the exclusion of men from parenting programs has been attributed to racist and discriminatory policies. For example, as it is more likely not to record fathers’ names on the birth or child protection agency records of Indigenous children, Indigenous fathers may be forced to prove the legitimacy of their paternity (Ball, 2012). Additionally, despite their efforts to be good fathers, men still felt pressured to be viewed as “good dads,” lest they contribute to negative stereotypes of Indigenous fathers as incapable parents (Faulkner et al., 2021; Irvine & National Collaborating Centre for Indigenous Health, 2009; Reilly & Rees, 2018). Indeed, the fear of child protection services removing children from their care has been noted to discourage fathers from participating in parenting programs and using other resources (Mussell & The Aboriginal Healing Foundation, 2005). 22 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 Finally, Indigenous men were more likely to feel safe in spaces that were created by Indigenous fathers for Indigenous fathers (Ball, 2009; Reilly & Rees, 2018). Parenting programs for men were viewed as successful if they took a strengths-based approach to parenting, providing hands-on learning relevant to men and flexible programming, incorporating Elders in sharing lessons on the traditional roles of men and fathers, highlighting wellness through engaging events, offering opportunities for families to be engaged together, and giving space for men to share and to support one another (BC Tripartite First Nations and Aboriginal Maternal and Child Health Working Group, 2015; Bowes & Grace, 2014; Little Drum Consulting, 2016; Matthew et al., 2018; Monkman, 2019; National Collaborating Centre for Indigenous Health, 2011; Scott, 2013). “Supporting one another” was the third integral component along the journey to becoming a father as evidenced in the literature. First, this component described the need of most men to heal from the devastating impacts of colonization on their parenting experiences and their internalized ideas of parenting so that they could become positive role models for their children. Second, supportive networks included immediate and extended family as well as Elders and other fathers, who helped men learn what it meant to be a father, and to become the type of father they wanted to be. Finally, parenting programs, while commonly mother-centric, have been generally unhelpful in supporting Indigenous men in becoming fathers, though there are some examples of Indigenous-specific programming that have successfully engaged Indigenous men and fathers globally. Discussion This scoping study has synthesized what has been documented about the role of Indigenous fathers caring for the health and development of their infants in Australia, Canada, New Zealand, and the United States. Findings highlight a journey to becoming a father, beginning with men grappling to assume their new-found identity as fathers, and establishing what their new fathering roles mean to them and how to enact them, all while supporting one another throughout the journey. This is an important process to understand, as a parent’s influence on their child’s early development has significant implications for a child’s health and wellbeing throughout their lives (Hertzman, 2010; Moore et al., 2015). Therefore, it is not in the best interest of children to react to parenting challenges later in a child’s life, but rather to create health policy and programs to proactively support men in their transition to fatherhood as early as possible. As identified in the themes presented, colonization has had a negative impact on Indigenous parents globally; the loss of culture, traditions, language, and Indigenous ways of being and knowing have left men with few examples of traditional fathering roles. Simultaneously, colonization has shifted society globally toward European values and ways of living, with parenting roles becoming gender-specific and traditional Indigenous lifestyles of hunting, gathering, or growing food becoming inadequate to care for one’s family in a capitalist-driven system (Reilly & Rees, 2018; Urban Indian Health Institute, 2011). Western values of parenting are particularly problematic for Indigenous fathers, who shared their fear of the involvement of child protection services if they should be deemed to not meet them (Faulkner et al., 2021; Mussell & The Aboriginal Healing Foundation, 2005). This fear is not unique to fathers. Indigenous mothers and other caregivers in Canada have also voiced this concern, and this fear makes 23 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 parents wary of participating in programs that may render their parenting vulnerable to surveillance and scrutiny (National Inquiry into Missing and Murdered Indigenous Women and Girls, 2019; Wright, Ballantyne, et al., 2019). Despite the needs and desires of Indigenous men to regain their traditional parenting knowledge, skills, and roles in order to conceptualize positive identities as fathers and establish their fathering roles, parenting programs generally exclude fathers and most are not Indigenous-specific. With the exception of the Stayin’ on Track program in Australia (Stayin’ on Track, n.d.), other parenting programs identified in this review that included material aimed at fathers were either mother-centric, Euro-centric, and/or written by women for men. This gap in Indigenous and male-led resources appears to be a global problem and represents an important area for further research, and policy and resource development. Regardless of the lack of resources available and the challenges arising from the continuing impacts of colonization, the literature demonstrates an evolving determination of Indigenous men to create a legacy of positive fathering for future generations (Elkington, 2017; Faulkner et al., 2021; Oster et al., 2018). Indigenous fathers draw on family supports, particularly from the mothers of their children and their own mothers, but also from other family members and fathers in the community. With these supports, they strive to heal from painful and traumatic experiences, and develop new goals for their parenting. In particular, the role of fathers in teaching their children about their culture and traditions and meeting their spiritual needs was described as beneficial for all parties involved; fathers felt that it positively impacted their own self-esteem, but also contributed to their children developing a positive self-identity, sense of belonging, and pride (Faulkner et al., 2021; Vartuli & Winter, 1989). Future Research and Policy Implications The desire of fathers to be involved, positive parents is shared by the First Nations fathers in Canada who collaborated on this review. They are striving to be the best fathers they can be, despite a lack of role models growing up or knowledge of traditional fathering roles. They too are spiritual leaders within their families, have goals for their children as well as for themselves as fathers, and are very involved in raising their children. Collectively, these fathers identified gaps in the literature and the need for inclusive health policies. First, there is a lack of understanding of the different environments in which fathers have been raised and how these settings influence where and how fathers wish to raise their own children. Additionally, the literature does not describe what characteristics men believe constitute a healthy environment in which to raise their children, or how existing or new policies can be leveraged to create healthy environments for Indigenous families raising children. Second, the literature does not adequately describe how men express and show love to their children. Perhaps this is due to a gendered perspective that considers showing love and affection to be a mother’s role rather than a father’s; however, the role of men as fathers is changing, and how Indigenous men demonstrate love toward their children warrants understanding in order to help new fathers feel confident about how to care for their infants in this way. Third, the exclusion of men in parenting programs is evidence of the inadequacy of policy that privileges maternal parenting knowledge over that of fathers, and warrants investigation and adjustment to more holistically meet the needs of the family. Fourth, there is a lack of discussion surrounding the goals that fathers have for themselves and for their children. Instead, the literature focuses on parenting tasks rather than strategies that fathers cultivate and implement to promote their 24 The International Indigenous Policy Journal, Vol. 13, Iss. 3 Published by Scholarship@Western, 2022 children’s growth and development. Parenting curricula require a broader inclusion of parenting concepts beyond focusing primarily on task-oriented behaviours. Fifth, while the literature does highlight the role of fathers as spiritual and cultural leaders and teachers, it lacks detail; in particular, how men address spiritual and cultural needs through their parenting and what impact this has on their children. Finally, the journey to becoming a father is a complex and multi-faceted process that is influenced by many factors. In order to advance health policy that promotes the development of Indigenous-specific and father-focused programming to support fathers along this journey, a more thorough understanding of their experiences, including addressing these gaps, is necessary. Strengths This scoping study collaborated with the local Indigenous community to ensure that Indigenous perspectives and experiences, particularly those of men, were incorporated throughout the process. This approach was essential to ensuring that culturally relevant search terms were applied, themes reflected Indigenous fathers’ experiences and ways of knowing, and that gaps identified were relevant to Indigenous fathers’ understanding and perspectives of fatherhood, rather than those of women or Western researchers. Second, this review took a global approach, including both published and unpublished literature from countries that have undergone similar periods of colonization—Canada, the United States, Australia, and New Zealand. This global perspective allowed for a more in-depth understanding of the experiences of Indigenous fathers than could be gleaned from one country alone. As demonstrated in the results above, Indigenous men, while representing unique and diverse cultures from around the world, share common experiences in their journey to becoming fathers. Developing health policy and resources to support fathers along this journey will, however, require a nuanced approach that takes diversity and community context into account. Limitations While we consulted with numerous experts, it is possible that local community resources or reports were not identified in our grey literature search. Additionally, only those resources available online were included in the study, so offline resources may exist and were not included. Finally, most records originated from Australia and Canada. Although similar experiences are reported in the literature from New Zealand and the United States, the depth of information is likely to be more reflective of the experiences of fathers in Australia and Canada. More research is necessary to understand the variations in experiences in all four countries. Conclusion This study is an important step to understanding the journey that Indigenous men embark on to becoming fathers. Supporting men through this transition is an important way to support the early development of their children, encourage healthy and positive parenting within Indigenous communities, and promote the health and wellbeing of Indigenous families. While the literature does not provide a fully comprehensive understanding of this journey, it describes a common experience of 25 Wright et al.: International Perspectives on the Role of Indigenous Fathers DOI: 10.18584/iipj.2022.13.3.14491 first identifying as a father, establishing one’s fathering role, and the need for and benefit of supporting one another through this process among Indigenous men. Additionally, and most importantly, the literature describes Indigenous fathers as fully engaged, positive role models for their children, and spiritual and cultural leaders within their families and communities. 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(indigenous or aborigin* or native* or indian*).tw,kf. 3. (first nation or first nations or métis or inuit*).tw,kf. 4. (Māori or torres straight island* or pacific island*).tw,kf. 5. or/1-4 [Indigenous] 6. parents/ or fathers/ 7. Grandparents/ 8. Caregivers/ or Parenting 9. (parent* or father* or dad*).tw,kf. 10. (grandfather* or grand-father* or grandpa* or grand-pa*).tw,kf. 11. or/6-10 [Father] 12. 5 and 11 [Indigenous + Father] 13. exp Infant/ or infant health/ or exp infant care/ or Father-Child Relations/ 14. (infant* or baby or babies or newborn* or neonate*).tw,kf. 15. 13 or 14 [Infant] 16. 12 and 15 [Indigenous + Father + Infant]