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.     

‘Don't fix what ain't broke’: evaluating the effectiveness of a Men's Shed in inner‐regional Australia

Men's Sheds and similar community programmes are known to encourage help‐seeking behaviour and thus improve the health and well‐being outcomes for the men who attend. This paper investigates this issue through a community needs assessment of a Men's Shed programme in inner‐regional Australia. The immediate purpose of this research was to help direct future funding initiatives, and provide recommendations for potential changes and improvements to the programme. A community‐level needs assessment is a systematic process used to determine and address gaps or needs between current and desired conditions within a particular community. We sought to explore how particular formats and structures of Men's Sheds programmes contribute to improve social and medical well‐being, and whether there are key programme characteristics that could be emulated. In total, 22 surveys and 20 interviews were conducted with the men who participated in the programme. The report finds 95% of men are satisfied with the current running of the programme. While there were areas that have been identified for improvement, most men reported that they are content with the current format and would not like to see major changes to its implementation. The results of this research confirm the known benefits of these types of programmes. This paper provides other community programmes with some insight into the key success factors for running a Men's Shed.     

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.     

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.     

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 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.     

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.     

Narrative synthesis of equine‐assisted psychotherapy literature: Current knowledge and future research directions

Equine‐assisted psychotherapy (EAP) is an innovative emerging approach to mental health treatment. This narrative synthesis explores the current state of knowledge and areas for future research in EAP. Specifically reviewed are qualitative and quantitative empirical studies, including both articles published in peer‐reviewed journals and research presented in theses and dissertations. We selected 24 studies for final inclusion in this study, dating between 2005 and 2013, and including the first EAP empirical research completed in 2005. Four of these studies are peer‐reviewed journal articles, while 20 are master's theses or doctoral dissertations. The reviewed qualitative research provides initial evidence for the value of EAP for enhancing adolescents' communication and relationship skills. The reviewed experimental and quasi‐experimental research provides initial evidence for the value of EAP for enhancing children's and adolescents' emotional, social and behavioural functioning. Yet, conclusions about the effectiveness of EAP must still be considered preliminary due to various methodological limitations in the reviewed research. The narrative review describes these methodological limitations and concludes with recommendations for future research.     

Fact or fallacy? Immunisation arguments in the New Zealand print media

Objective: To explore New Zealand's four major daily newspapers' coverage of immunisation with regards to errors of fact and fallacy in construction of immunisation‐related arguments. Methods: All articles from 2002 to 2007 were assessed for errors of fact and logic. Fact was defined as that which was supported by the most current evidence‐based medical literature. Errors of logic were assessed using a classical taxonomy broadly based in Aristotle's classifications. Results: Numerous errors of both fact and logic were identified, predominantly used by anti‐immunisation proponents, but occasionally by health authorities. The proportion of media articles reporting exclusively fact changes over time during the life of a vaccine where new vaccines incur little fallacious reporting and established vaccines generate inaccurate claims. Fallacious arguments can be deconstructed and classified into a classical taxonomy including non sequitur and argumentum ad Hominem. Conclusion: Most media ‘balance’ given to immunisation relies on ‘he said, she said’ arguments using quotes from opposing spokespersons with a failure to verify the scientific validity of both the material and the source. Implications: Health professionals and media need training so that recognising and critiquing public health arguments becomes accepted practice: Stronger public relations strategies should challenge poor quality articles to journalists' code of ethics and the health sector needs to be proactive in predicting and pre‐empting the expected responses to introduction of new public health initiatives such as a new vaccine.     

Spillover Effects in Health Service Use: Evidence From Mental Health Care Using First‐Year College Housing Assignments

Spillover effects in health service use may represent an important externality of individual treatment decisions and are important for understanding the consequences of interventions to improve access to health care. This study is the first to our knowledge to examine causal spillover effects for mental health service use. We exploit the natural experiment of first‐year student housing assignments at two universities using survey data that we collected. When the peer group is defined at the roommate level, we do not find any spillover effects on service use. When the peer group is defined at the hall level, we find positive spillover effects—peers' service use increases one's own service use—and this effect is driven by individuals with prior experience with mental health services. We also find some evidence that the mechanism behind this effect is improved beliefs about treatment effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.     

Using a Guided Journal Club as a Teaching Strategy to Enhance Learning Skills for Evidence-Based Practice

Journal clubs are used in both clinical and academic settings in order for clinicians and students to utilize current best-practices, become competent in evidence based practice and develop critical appraisal skills. Journal clubs encourage students to practice searching for relevant research, critically appraising articles, and contributing to open discussions with peers. Establishing the practice of reading and critiquing literature in the classroom can enable the creation of a habit of using current evidence when students enter practice. This article describes a strategy for delivering a structured academic journal club to support the learning of evidence based practice skills and students' perception of the journal club, including their overall satisfaction, knowledge base skills, and presentation skills. Students had an overall positive experience and perception of the guided journal club activity. From the instructor's perspective, this assignment was an excellent opportunity to engage students in learning the process of evidence based practice.     

Promoting safer sexual practices among expectant fathers in the Lao People's Democratic Republic

Men's decisions and behaviours influence the sexual, reproductive and maternal health of women and the health of their families, but men are rarely included in reproductive and maternal health care services. Men's attendance at antenatal care has the potential to prevent women from becoming infected with HIV during pregnancy and post-partum, when they are more vulnerable to infection and have a high risk of transmission to the infant. Greater involvement of men requires an understanding of social, cultural and organisational barriers in different contexts. In 2006, the Burnet Institute undertook fieldwork to inform a pilot project to encourage expectant fathers to attend antenatal care. A local Lao team conducted focus group discussions and interviews in Vientiane with expectant fathers, pregnant women, older women and health care providers. It was found that myths about the dangers of sex during pregnancy and women's decreased desire resulted in periods of sexual abstinence. Participants reported that unprotected extramarital sex was common but difficult for couples to discuss. Men lacked knowledge about sexually transmitted infections, including HIV. Men wanted information so they could better protect the health of their partners and babies during and after pregnancy, and reported being willing to attend antenatal care when invited. Our findings have useful implications for policy and implementation.     

Maternal general health and children's cognitive development and behaviour in the early years: findings from the Millennium Cohort Study

Background Mothers often experience physical and psychological difficulties during the post‐natal period and these may continue through the early years of raising children and have negative effects on engagement and caregiving. Pathways between maternal depression, parental engagement and caregiving and children's subsequent development have been described in longitudinal studies; yet, less is known about how other aspects of maternal health may influence children's development. Methods A longitudinal analysis within the Millennium Cohort Study was conducted including 7906 families from England. Maternal general health and psychological well‐being were assessed when their children were 9 months and 3 years old, socio‐demographic characteristics were assessed at 9 months, and engagement and caregiving were assessed at 3 years. These were examined as predictors of children's learning and development and behaviour at age 5. Results There are clear associations between maternal general health and children's development with regard to both learning and development and behaviour. These effects are reduced if psychological distress is taken into account; yet, maternal general health maintains importance as a predictor for children's subsequent development. There is evidence of an association via engagement and caregiving which links maternal health to children's development and evidence of the influence of underlying socio‐demographic disadvantage. Conclusion General maternal health as well as psychological well‐being during the early years of raising children may be influential for children's development. This study suggests the need for a broader recognition of maternal health as well as psychological well‐being as a foundation for family well‐being, and speaks to support for mothers in maintaining engagement and caregiving for their children during periods of ill health.     

Quality of care in public health well child clinics: A neglected issue

The process of well child care in public health clinics was evaluated using a peer review approach based on explicit criteria formulated by the peers themselves. The criteria defined what should be done in order to ensure good preventive care during a client‐provider encounter. The data from this study suggest that the traditional goals of public health are being pursued, but that a broader spectrum of preventive care, including attention to the child's psycho‐social development, is still lacking.     

The experience of community engagement for individuals: a rapid review of evidence

Community engagement is central to strategies to promote health and well‐being and reduce health inequalities in many countries, particularly interventions which focus on improving health in disadvantaged populations. Despite the widespread use of community engagement approaches, however, there have been relatively few attempts to review the evidence on the impact that participation has on the lives of individuals involved. Drawing on a wider review of evidence carried out on behalf of the National Institute for Health and Clinical Excellence (NICE), this article reports on a rapid review of evidence of the effectiveness of initiatives which seek to engage communities in action to address the wider social determinants of health, to explore individuals’ subjective experiences of engagement. The rapid review process was guided by NICE’s public health methods manual, adapted to suit the diversity of the evidence. A total of 22 studies were identified containing empirical data on subjective experiences of community engagement for individuals. The findings of the rapid review suggest that the majority of ‘engaged’ individuals perceived benefits for their physical and psychological health, self‐confidence, self‐esteem, sense of personal empowerment and social relationships. Set against these positive outcomes, however, the evidence suggests that there are unintended negative consequences of community engagement for some individuals, which may pose a risk to well‐being. These consequences included exhaustion and stress, as involvement drained participants’ energy levels as well as time and financial resources. The physical demands of engagement were reported as particularly onerous by individuals with disabilities. Consultation fatigue and disappointment were negative consequences for some participants who had experienced successive waves of engagement initiatives. For some individuals, engagement may involve a process of negotiation between gains and losses. This complexity needs to be more widely recognised among those who seek to engage communities.     

The effect of sex work regulation on health and well‐being of sex workers: Evidence from Senegal

Senegal is the only African country where sex work is legal and regulated by a health policy. Senegalese female sex workers (FSWs) are required to register with a health facility and to attend monthly routine health checks aimed at testing and treating sexually transmitted infections (STIs). Compliance to those routine visits is recorded on a registration card that must be carried by FSWs in order to avoid sanctions in case of police arrests. Although this policy was first introduced in 1969 to limit the spread of STIs, there is no evidence so far of its impact on FSWs' health and well‐being. The paper aims to fill this gap by exploiting a unique data set of registered and unregistered Senegalese FSWs. Using propensity score matching, we find that registration has a positive effect on FSWs' health. However, we find that registration reduces FSWs' subjective well‐being. This finding is explained by the fact that registered FSWs are found to engage in more sex acts, in riskier sex acts, have less social support from their peers, and are more likely to experience violence from clients and police officers. We prove that those results are robust to the violation of the conditional independence assumption, to misspecification of the propensity score model, and that covariate balance is achieved. The results suggest that more efforts should be deployed to reduce the stigma associated with registration and to address the poor well‐being of FSWs, which is counterproductive to HIV prevention efforts.     

Institutional logic in self‐management support: coexistence and diversity

The prevalence of chronic conditions in Europe has been the subject of health‐political reforms that have increasingly targeted collaboration between public, private and voluntary organisations for the purpose of supporting self‐management of long‐term diseases. The international literature describes collaboration across sectors as challenging, which implies that their respective logics are conflicting or incompatible. In line with the European context, recent Norwegian health policy advocates inter‐sectorial partnerships. The aim of this policy is to create networks supporting better self‐management for people with chronic conditions. The purpose of our qualitative study was to map different understandings of self‐management support in private for‐profit, volunteer and public organisations. These organisations are seen as potential self‐management support networks for individuals with chronic conditions in Norway. From December 2012 to April 2013, we conducted 50 semi‐structured interviews with representatives from relevant health and well‐being organisations in different parts of Norway. According to the theoretical framework of institutional logic, representatives’ statements are embedded with organisational understandings. In the analysis, we systematically assessed the representatives’ different understandings of self‐management support. The institutional logic we identified revealed traits of organisational historical backgrounds, and transitions in understanding. We found that the merging of individualism and fellowship in contemporary health policy generates different types of logic in different organisational contexts. The private for‐profit organisations were concerned with the logic of a healthy appearance and mindset, whereas the private non‐profit organisations emphasised fellowship and moral responsibility. Finally, the public, illness‐oriented organisations tended to highlight individual conditions for illness management. Different types of logic may attract different users, and simultaneously, a diversity of logic types may challenge collaboration at the user's expense. Moral implications embed institutional logic implying a change towards individual responsibility for disease. Policy makers ought to consider complexities of logic in order to tailor the different needs of users.     

Perceived stress,resilience, and health‐related quality of life among Parkinson's disease caregivers in Mexico

The stress process model of caregiving posits that caregivers' internal psychosocial resources may serve as buffers between the stress associated with caregiving and well‐being. Empirical support for the stress process model exists for several caregiving contexts, but little research has investigated the Parkinson's disease caregiving experience in Mexico. Using a cross‐sectional, correlational design, the objective of this study was to examine whether resilience moderates the relation between perceived stress and health‐related quality of life (HRQOL) among Parkinson's disease caregivers in Mexico. Data were collected from April 2015 to February 2016 during outpatient neurology appointments in Mexico City, Mexico. Participants included informal caregivers (N = 95) for a family member with Parkinson's disease. Participants completed a battery of questionnaires assessing their level of perceived stress, resilience, and HRQOL. Regression analyses indicated that resilience moderated the inverse relation between perceived stress and mental HRQOL. However, contrary to hypotheses, resilience did not moderate the relation between stress and physical HRQOL. Findings shed light on resilience as a potential protective factor for mental HRQOL among Parkinson's disease caregivers in Mexico and indicate that resilience may be beneficial to target in mental health promotion interventions.     

Exploring the link between impulsivity and peer relations in 5- and 6-year-old children

Background In recent years there has been an increased interest in the behavioural correlates of poor peer relations in childhood. It is now apparent that early poor peer relations are associated with negative future outcomes. The present study investigated whether behaviours that reflect impulsivity or require response inhibition are uniquely linked to children's peer relations. Methods Five‐ and 6‐year‐old children's impulsivity was assessed using the teacher‐rated impulsivity scale (TRIS), while the stop signal task and a modified version of Manly et al.'s opposite worlds task were employed as measures of response inhibition. In addition, peer relations measures were obtained for each child by asking their peers to indicate on a peer rating scale how much they would like to play with them. Results It was found that children's scores on the TRIS correlated significantly with peer relations measures (sociometric preference, peer acceptance and peer rejection) after controlling for gender, age and intelligence. Children rated by their teachers to be more impulsive had poorer peer relations. While there was a significant correlation between TRIS and stop‐signal task performance, little relationship was found between either of the response inhibition measures and children's peer relations. Conclusions The findings indicate that impulsivity is associated with children's poor relations with their peers and that this association is dependent upon the measure of impulsivity used. Whereas the more subjective teacher‐ratings of impulsiveness did correlate with peer relations, the more objective behavioural measures of response inhibition, (thought to directly measure impulsivity), did not. The difference between these measures needs further investigation. While the data are correlational and causal direction can only be speculated, a practical implication of the finding of an association between impulsivity and peer acceptance is that adoption of strategies to minimize impulsive behaviour may improve the poor peer relations of children.