Men's Sheds: enabling environments for Australian men living with and without long‐term disabilities

The health of Australian men has recently received greater attention. Men's Sheds are named in national policy as an exemplar community‐based organisation for the betterment of men's psychosocial health; yet, the evidence base to support this is limited. This study investigates the comparative experience of men with long‐term disabilities and men without long‐term disabilities who go to a Men's Shed and to what extent this provides these men with an enabling, as opposed to disabling, environment. Data were collected from 12 individual interviews with men with long‐term disabilities (5) and men without long‐term disabilities (6), including 1 interview with the male Men's Shed Coordinator (MSC); participant observation within the shed; and a document received from the female MSC regarding the funding the Shed receives. Interviews explored the men's experiences at the Shed and their sense of belonging and social inclusion. Participants had any type of long‐term disability and had been attending the shed for a minimum of 1 month. Data were collected between May and September 2013 and were analysed using the constant comparative method of grounded theory. The core theme that emerged was an enabling community space. The four sub‐themes were: a community and social hub; an equalising space; a safe and supportive male environment; and meaningful male activities. The current literature exemplifies Men's Sheds to be important community‐based organisations beneficial to men's health and well‐being. For men living with long‐term disabilities, this study illuminates that Men's Sheds offer an environment of equality, facilitating a collegial and egalitarian culture. Men can partake in enabling activities and enjoy the company of other men enhancing their sense of belonging and social inclusion as well as interact with other community groups that occupy the same space as the Men's Shed.     

Formal intergenerational mentoring at Australian Men's Sheds: a targeted survey about mentees,mentors, programmes and quality

Intergenerational mentoring enables a purposeful exchange of skills and knowledge to enhance individual and social outcomes for sub‐groups at risk of health and social disparities. Male intergenerational mentoring may be an approach to help address these disparities in young men. Over 1000 Men's Sheds operate in Australia with 39% providing some form of mentoring mainly to youth. Yet, little is known about the variables intrinsic to creating and running quality programmes. This study aimed to identify the characteristics of formal intergenerational mentoring programmes, review their quality against the Australian Youth Mentoring Network (AYMN) quality benchmarks, and identify the factors that predict quality in these programmes. All known Australian Men's Sheds were invited to participate in an online cross‐sectional survey. Forty sheds with formal mentor programmes completed the survey for a total of 387 mentees (mean = 9.7 mentees/programme), the majority being male. The majority of mentor programme facilitators were unpaid male volunteers aged 61 years and older, and programmes were unfunded. Promoting social and emotional well‐being of the mentees was the primary focus in more than half of the programmes, and working on a shared construction project was the most common activity. Respondents rated the three most important factors that influenced programme effectiveness as being: (i) meaningful activities; (ii) mentors’ approach; and (iii) a safe environment. Univariate analyses revealed that mentoring programmes that had a system in place for screening mentors, trained mentors and evaluated the programme were most likely to rate highly against the AYMN quality benchmarks.     

Men's Sheds: A conceptual exploration of the causal pathways for health and well‐being

Although men have a lower life expectancy than women, and are more susceptible to illness, they have been found to be less likely to engage in health‐seeking behaviour. Men's Sheds, as a gendered intervention, has been identified as an effective way to engage men in meaningful activity and gain social support from others. However, links between sheds and health and well‐being are not well‐documented, and evidence is lacking of the potential causal pathways to health generation. This study aims to develop a plausible empirically based causal theory of how Men's Sheds influence the health and well‐being of their participants and to set out future research directions to test this theory. Drawing on a scoping review of academic, peer‐reviewed journal articles published between 1990 and 2018, potential causal linkages between shed activity and health and well‐being outcomes are synthesised into a logic model framework. Sixteen relevant peer‐reviewed journal were identified from the academic literature. The data from the articles are predominantly self‐reported, and characterised by small sample sizes and/ or low response rates. Further, information is lacking on the demographics of Men's Shed participants and the contexts in which they exist. Most notably, while there is some evidence on the potential mental health and social well‐being impacts of shed activities, physical health is less documented. The study shows that there is a lack of reliable and systematic evidence of the potential causal pathways between Men's Shed activities and health and well‐being outcomes. In order to address research gaps, further research is required to test and develop the proposed theory and logic model.     

Mentoring at Men's Sheds: an international survey about a community approach to health and well‐being

Men's Sheds are named within the Australian and Irish National Male Health Policies as an exemplar of male health and well‐being and offer a range of formal and informal mentoring to counter the known consequences of social exclusion. The study aimed to report on whether Men's Sheds undertake mentoring programmes, and if so, who is being mentored; are mentors being trained, and if so by whom; and the perceived effectiveness of the mentoring programme. Furthermore, the study aimed to explore associations between sheds with a mentoring programme and factors that reflect an inclusive and a health‐focused environment. All known Men's Sheds were invited to participate in the survey; of those, 324 (42.8%) Men's Sheds in Australia and 59 (48.0%) International sheds participated in the study between April and August 2012. Overall, 39.2% (n = 127) of Australian sheds and 23.7% (n = 14) of International sheds undertook formal mentoring. Youth was the most common group being mentored in both Australia (60.6%; n = 77) and Internationally (71.4%; n = 10). Over half of Australian shed co‐ordinators rated their mentoring programme as moderately effective (52.8%; n = 67) and over a third as highly effective (36.2%; n = 46), while half of International shed co‐ordinators rated theirs as highly effective (50.0%; n = 7). The findings from this paper support the notion that a large number of Men's Sheds offer formal mentoring programmes targeting a range of disadvantaged sub‐populations, thus supporting social inclusion. Inter‐generational mentoring is the most frequently occurring type of mentoring programme. While training mentors occurs at some sheds, the efficacy of this training and programme outcomes are unknown. A typology of shed types appears to be emerging based on a divergence of sheds with a more utilitarian focus and sheds that appear to embrace a health and well‐being focus.     

Men's perspectives on fall risk and fall prevention following participation in a group‐based programme conducted at Men's Sheds,Australia

Research on older men's views regarding fall prevention is limited. The purpose of this qualitative study was to explore the experiences and perspectives of older men regarding fall risk and prevention so that fall prevention programmes can better engage older men. Eleven men who had taken part in a group‐based fall prevention programme called Stepping On conducted at Men's Sheds in Sydney, Australia, participated in semi‐structured interviews during June and July 2015 which were audio‐recorded and transcribed. Data were coded and analysed using constant comparative methods. Over‐arching theoretical categories were developed into a conceptual framework linking programme context and content with effects of programme participation on men. Men's Sheds facilitated participation in the programme by being inclusive, male‐friendly places, where Stepping On was programmed into regular activities and was conducted in an enjoyable, supportive atmosphere. Programme content challenged participants to think differently about themselves and their personal fall risk, and provided practical options to address fall risk. Two major themes were identified: adjusting the mindset where men adopted a more cautious mindset paying greater attention to potential fall risks, being careful, concentrating and slowing down; and changing the ways where men acted purposefully on environmental hazards at home and incorporated fall prevention exercises into their routine schedules. Practitioners can engage and support older men to address falls by better understanding men's perspectives on personal fall risk and motivations for action.     

The personal and community impact of a Scottish Men's Shed

Social isolation and loneliness are known to be associated with increased morbidity and mortality. Therefore, reducing social isolation and loneliness may improve such outcomes. In relation to men's health, “Men's Sheds” have been shown as one mechanism to achieve this. Studies in Australia and England have shown social, health and personal benefits; however, this remains an area that has not yet been researched in Scotland. This study, therefore, aimed to assess the characteristics of attendees, self‐reported motivations for and the values and benefits of attending the Shed from the views of the attendees themselves. The participants of the study were the members of a Men's Shed in the North of Scotland, which was initially set‐up by a small number of core Shedders. A convenience sample was recruited by opportunistic interviewing of participants when they attended the Shed using a mixed methods approach from 1 to 15 November 2016. In the absence of a validated questionnaire, a bespoke questionnaire was developed in several iterative stages. The answers to the questionnaire were transferred to an electronic database and analysed by frequency and thematic analysis. The participants (n = 31) had a mean age (SD) of 69.7 ± 9.5 with 96.8% being retired, thus the majority of the Shed users were older and retired. The results suggest that there were several benefits from attending the Shed, with an overwhelming majority of the sample reporting personal, social and health benefits—however, more research is needed to determine the magnitude of these. This study has also shown that the men attending the Shed frequently discussed health, which could potentially have a beneficial effect. The Shed therefore, as a community project, has the potential to have a positive impact on health welfare by focusing on the social aspects of life.     

The impact of community Men’s Sheds on the physical health of their users

With men more susceptible than women to illness and mortality, and less likely to access primary healthcare services, there have been calls for more male friendly spaces within communities to engage ‘hard to reach’ men in physical health improvement. Research has shown that Men’s Shed (Shed) activity can provide localised support for the mental health and social wellbeing of men within communities, yet less is known about Sheds’ impacts on physical health. Drawing on qualitative interviews with 62 Sheds users, this study conceptualises proposed pathways from which Shed activity can lead to positive physical health outcomes. Findings showed that in attending a community Men’s Shed and taking part in activities users reported (i) increased mobility and decreased sedentary behavior, (ii) increased ability to overcome physical illness or injury, (iii) improved diet, (iv) decreased alcohol use, and (v) improved physical health knowledge. These findings support wider recommendations for community-based male friendly approaches to physical health improvement, and stress the importance of health and care service delivery beyond boundaries of ‘standard’ NHS settings, especially when targeting those viewed as ‘hard to reach’. While initiatives like Sheds do not offer a replacement of primary healthcare services, they have the potential to fit within existing health and social care practices as an alternative local health-engagement space for men.     

Parents' training: effects of the self‐help skills programme with Down's syndrome babies

This article reviews studies evaluating the effectiveness of two types of early intervention programmes for babies with Down's syndrome (DS). Evaluation of self‐help early intervention programmes was done with two types of training with the parents: in the first the parents learned the training programme from observing the clinician, and in the second the parents were taught self‐help skills through described instructions. A sample of 16 DS babies was used. The analyses of the results established positive changes. Differences were seen in the self‐help skills development of DS babies whose parents were exposed to observed early intervention.     

Older men’s participation in community‐based men’s sheds programmes

The purpose of this qualitative study was to investigate the lived experience of older men taking part in community‐based shed programmes. Five men, aged 65 and over, who attended two different community sheds participated in semi‐structured in‐depth interviews in 2007. Data were analysed thematically with six main themes emerging as follows: ‘company of fellas’; ‘everybody’s got a story to tell’; ‘still got some kick’; ‘passing on your experiences’; ‘get on your goat’ and; ‘nobody’s boss’. Participation in community‐based men’s sheds positively influences the health and well‐being of older Australian men through provision of a ‘men’s space’ in which meaningful activities occur. Provision of community‐based men’s shed programmes as among a range of activity options in the community may contribute positively to the physical, mental, social and occupational health of older men.     

Paediatric spinal fusion surgery and the transition to home‐based care: provider expectations and carer experiences

There are more than 12 million children with special healthcare needs (CSHCNs) in the United States, many of whom require specialised health‐care to treat chronic physical and developmental conditions. This study is a qualitative investigation of programme, surgical and at‐home recovery experiences among CSHCNs and their family carers who participated in a spine surgical care programme at a paediatric hospital in the Western United States. The programme is designed to manage increased surgical risk and the transition of care from hospital to home for children with severe scoliosis undergoing spinal fusion surgery. We conducted 30 semi‐structured in‐depth interviews with 14 surgical team members and 16 family carers of children who had programme evaluations and spinal surgeries in 2006. Data were collected in 2008 and 2009 in hospital or at home locations to gather programme participation feedback from families and inform the adequacy of programme support to families during at‐home recovery. Data were analysed by reflexive team and content analysis methodologies. Results showed the programme was effective at improving preoperative surgical evaluation and helping families to anticipate some aspects of the surgical experience and hospital discharge. However, the impact of spinal fusion surgery and the subsequent transition to home‐based care was profoundly emotional for patients and their carers. Our data indicate that programme providers underestimated the extent of emotional trauma experienced by patients and families, particularly during the at‐home recovery process. The data also suggest meaningful differences in providers' and carers' expectations for surgery. Carers' disappointment with their recovery experiences and the perceived lack of post‐discharge support impacted their interpretations of and perspectives on their surgical experience. Implications of this research for surgical care programmes include the need for assessment and provision of support for physical, social, and emotional burdens experienced by patients and carers at pre‐surgical, surgical and at‐home recovery phases.     

Country‐wide community participation for nutrition improvement: Lessons learned from Thailand

This case study highlights a community‐based programming approach, based on the Thai experience. Several essential elements need to be present for this approach to be successful including a strong community participation and empowerment, inter‐sectoral collaboration within the context of poverty reduction and development, nutritional improvement as an important policy goal and political support at national and local level, and effective social mobilisation which emphasises the mobilisation of the community's human resources. Capacity building empowers the community to take appropriate decisions and implement effective actions to reach a common goal of nutrition improvement among vulnerable groups in the community. A combined ‘top‐down’ and ‘bottom‐up’ planning and implementation process identifies, implements and evaluates programmes and activities that fit the community's needs and circumstances. More than 95% of villages use basic minimum needs indicators to guide programme development and monitor and evaluate programme impacts.     

An open trial of equine‐assisted therapy for children exposed to problematic parental substance use

Children exposed to problematic parental substance use (PPSU) often face a number of deleterious developmental outcomes, yet these children are less likely to become known to child protection and welfare services. Although there is a growing evidence base for equine‐assisted therapy (EAT) as an effective treatment modality for atypically developing children and adolescents, scant research has explored the benefit of EAT for children exposed to PPSU. The current study is the first to explore the benefit of EAT for children exposed to PPSU in Victoria, Australia. Five 12‐week EAT programmes were delivered from 2012 to 2015 with a total of 41 children (mean age of 10.26 years) taking part. Children's parents (n = 41) and schoolteachers (n = 31) completed the Strengths and Difficulties Questionnaire pre‐ and post‐intervention. Parents reported that children's total difficult behaviour and emotional problems decreased following the 12‐week EAT programme. In addition, parents and teachers observed a significant decrease in children's hyperactivity. The findings obtained highlight the benefit of EAT for children exposed to PPSU and thus, extends the existing evidence base for this treatment modality.     

Assessing Community-Based Injury Prevention Services in U.S. Children's Hospitals

ObjectiveNot-for-profit hospitals are required to meet federal reporting requirements detailing their community benefit activities, which support their tax-exempt status. Children''s hospitals have long provided community injury prevention (IP) programming and thus can inform public health outreach work in other areas. This work describes IP programming as a community service offered by children''s hospitals in the U.S.MethodsThe IP specialist at 232 US-based member institutions of the Children''s Hospital Association were invited to complete an assessment of their hospital''s IP outreach programming.Results47.7 percent of hospitals request financial data from IP programming for tax reporting purposes. Almost all offer injury prevention (IP) services; the majority are in the community (60.3%) and 34.5% are hospital-based. Most IP units are independent (60.3%) and 71.8% are responsible for their own budgets.ConclusionsBy integrating dissemination and implementation sciences and community health needs assessments, these findings can help advance community services provided by hospitals to impact public health.     

Men's Perspectives on Their Role in Family Planning in Nyanza Province,Kenya

Research has indicated that gender dynamics—and in particular men's disapproval of family planning—have had an influence on the low levels of contraceptive use in sub‐Saharan Africa. Limited evidence exists, however, on effective strategies to increase male approval. We conducted 12 focus group discussions with married men aged 20–66 (N = 106) in Kenya to explore FP perceptions. Men's disapproval of FP was associated with anxieties regarding male identity and gender roles. Men often distrusted FP information provided by their wives because they suspected infidelity or feared being viewed as “herded.” Men also feared that providers might pressure them into vasectomies or into disclosing extramarital sexual activity or HIV diagnoses to their wives. Suggested strategies include programs targeting couples jointly and FP education for men provided by male outreach workers. To encourage men's acceptance, community‐based programs directly targeting men are needed to reduce stigma and misconceptions and to increase awareness of the benefits of FP.     

Delivering men's health interventions in English Premier League football clubs: key design characteristics

Objectives

To investigate the key design characteristics of Premier League Health (PLH), a national programme of men's health improvement delivered in/by 16 English Premier League (EPL) football clubs.

Study design

Health Trainers (HTs) were hired by EPL clubs to deliver PLH. HTs were the focus of investigations aimed at identifying the active design characteristics of male-specific health promotion interventions.

Methods

Semi-structured interviews led by researchers were performed with 13/16 HTs and identified the key design characteristics influential in (I) reaching and (II) helping participants adopt health improvement interventions delivered in professional football club settings.

Results

HTs believed that combining the appeal of football alongside EPL clubs, offered a unique opportunity to reach adult males, including hard-to-engage-men (HTEM). Awareness raising events held on match days aimed to connect with men, but outreach activities were especially important for engaging participants. Following initial reach, familiar settings, such as the club stadia and community venues were also important for ensuring regular involvement in health improvement sessions. Interventions shaped around men's health needs and delivered at times when participants could more easily attend, were factors which helped to engage men. Supportive social environments and a range of exercise modes and delivery options were also seen by HTs as being similarly important. Both the informality and familiarity of EPL clubs were viewed by HTs as having substantial advantages over conventional NHS settings for reaching and engaging men. Importantly, HTs contributed substantial skills to the delivery of PLH.

Conclusion

Although, top flight professional football clubs can recruit men, including those regarded as hard-to-engage into health improvement programmes, considerable attention to delivery refinement is needed to support male participants adopting interventions aimed at promoting healthy lifestyles.     

Designing community sports-based programmes for men with mental illness: A qualitative study of the Offload rugby league programme

Despite the increasing appeal of community sport programmes which focus on men's mental health, the key design characteristics of these programmes, and the roles played by delivery staff in their conception and development, have not yet been systematically or widely studied. In this qualitative paper we address this gap in knowledge by reporting on interviews with stakeholders (n = 18) from north-west of England involved in designing a men's rugby league community-based mental health programme, Offload. Findings suggest that tacit forms of knowledge, developed through years of professional practice and co-production activity, was critical to how men's mental health was conceptualised and the use of existing non-clinical community assets (e.g. professional club stadia) as delivery sites for the programme. The use of non-stigmatising language, supported by opportunities for men to engage in non-threatening and solutions-focused activities, were central to programme design. The use of former professional sportspeople who recall their own lived experience of mental illness, and personal adversity, in programme sessions was deemed important for engendering trust among men and enabling them to engage in modelling alternative forms of masculine behaviour which can enhance mental health and encourage greater help-seeking. The paper concludes by arguing for a relational understanding of community sport and mental health programmes, since our data indicate that by focusing on the networks of relationships involved in Offload and the social contexts in which it was to be delivered, the programme designers effectively leveraged the benefits of their collective expertise to maximise men's engagement.     

Latino men's qualitative perspectives on a lay health advisor intervention to promote their sexual health

Lay health advisor (LHA) approaches are a promising strategy to reduce health disparities among communities considered ‘hard to reach’ by researchers and practitioners. LHAs have addressed a variety of health issues, but limited studies have included men as LHAs. The purpose of this study was to better understand the roles of male LHAs and their male‐helping relationships. We used an inductive approach to explore Latino men's perspectives on serving as LHAs for other Latino men and Latino men's views on receiving sexual health information from a male LHA. We collected qualitative data in 2009 and 2010 as part of an LHA intervention designed to reduce the risk of HIV infection among immigrant Latinos through the social networks of soccer teams. We analysed and interpreted data from 30 in‐depth interviews with Latino men who served as LHAs and their social networks in North Carolina, USA. Participants shared perceptions on social network importance for immigrant Latinos, facilitators and challenges of helping other men, recommendations for intervention modification and suggestions for future work involving the Latino community. Findings revealed that Latino men are receptive to fulfilling the roles of health advisors and opinion leaders, and can effectively serve as LHAs. Social network members valued the social support they received. Working through sports teams and identifying existing leaders to be LHAs may be a culturally congruent approach to meeting Latino community needs. More research is needed on the potential of male LHAs to address other health issues.     

Love in Africa

Research reveals how homophobia and stigma link closely to HIV among men who have sex with men in sub-Saharan Africa. This paper considers the varying impact of homophobic stigma on HIV prevention programmes among men who have sex with men in South Africa. It explores how a community-based HIV prevention programme based in the peri-urban townships of Cape Town was ‘translated’ to peri-urban Johannesburg. Drawing on interviews with volunteers and programme facilitators in Johannesburg, it argues that an altered homophobic environment to that found in Cape Town gave different opportunities to engage both with other men who have sex with men and the broader community. It also argues that programme facilitators should be mindful of how varying degrees of homophobic stigma may relate to broader theoretical debates about sexual binary relationships, which can help us understand why particular programmes choose to focus on certain activities rather than others.     

‘Women now wear trousers’: men's perceptions of family planning in the context of changing gender relations in western Kenya

Gender inequity has been closely linked with unmet need for family planning among women in sub-Saharan Africa but the factors related to male family planning disapproval are not well-understood. This qualitative study explored men's perspectives of gender roles and cultural norms as they pertain to family planning. Twelve small group meetings were held with 106 married men in Nyanza Province, Kenya. Shifting gender relations made the definitions of manhood more tenuous than ever. Men's previous identities as sole breadwinners, which gave them significant control over decision-making, were being undermined by women's increasing labour force participation. While many men viewed family planning positively, fears that family planning would lead to more female sexual agency and promiscuity or that male roles would be further jeopardised were widespread and were major deterrents to male family planning approval. By addressing such fears, gender-sensitive programmes could help more men to accept family planning. Increased family planning education for men is needed to dispel misconceptions regarding family planning side-effects. Focusing on the advantages of family planning, namely financial benefits and reduced conflict among couples, could resonate with men. Community leaders, outreach workers and healthcare providers could help shift men's approval of joint decision-making around family size to other reproductive domains, such as family planning use.