Pregnancy Motivations and Contraceptive Use: Hers,His, or Theirs?

ContextStudies increasingly consider the role of pregnancy motivations on contraceptive use. Few studies include measures of men's pregnancy motivations.MethodsWe used baseline data (from a couples-intervention study) to examine the contribution of women's and men's pregnancy motivations and participation in decision making to contraceptive use by women in relatively stable relationships who were not trying to get pregnant. In addition to conducting multivariate analyses, we assessed agreement between a woman's perceptions of and her partner's reports of his pregnancy motivations.ResultsWe observed moderate agreement between men's pregnancy motivations and their partners' perceptions of those motivations. Levels of agreement about participation in decision making were somewhat lower. In bivariate analyses, effective contraceptive use was significantly associated with two measures of pregnancy motivation for men and women. In multivariate analyses, only women not wanting a child in 2 years (adjusted odds ratio [aOR], 1.73), women's (aOR, 1.80) and men's (aOR, 0.78) participation in decision making, women believing their partners favored contraceptive use (aOR, 2.01), relationships lasting 2 or more years (aOR, 1.98), and ethnicity/race (Latina aOR, 0.27; other race aOR , 0.45) were associated with effective contraceptive use.ConclusionProviders and those developing interventions must recognize that some women who are “not trying to get pregnant” have weak motivations to avoid pregnancy, and so should help women to clarify their motivations and seek support from their partners for contraceptive use. To understand the role of pregnancy motivations, future research may include both qualitative and longitudinal quantitative studies.     

'Because he loves me': Husbands' involvement in maternal health in Guatemala

This study aimed to extend notions of male involvement to maternal health and to understand how Guatemalan men and women think about husband involvement in pregnancy, birth, and the postpartum period. Based on individual interviews and focus groups with men, women, and community health workers in two areas of rural Guatemala, this paper describes the pregnancy-related advice and assistance husbands give, and the reasons men are and are not involved in maternal health. Both men and women reported that male involvement in maternal health is relatively high, desirable, unique and affected by many factors. These include love, men's work demands, economic concerns and men's knowledge. The results help to fill broad gaps in understanding of male involvement in this aspect of family health and to amend stereotypes about husbands' relationship to maternal health and health care.     

Ageing,masculinity and Parkinson's disease: embodied perspectives

Parkinson's disease (PD) presents as an illness which predominantly affects older men. However older men's lived experiences of PD, including how they are influenced by age and gender relations has seen little empirical study. Drawing on Watson's male body schema, this paper explores how men engage with masculinities and ageing in order to make sense and meaning from PD. Data is presented from 30 narrative and semi structured interviews with 15 men of various ages who were living with PD. Findings suggest that PD threatens a visceral embodiment located in the body's basic movements and intimate functions; a pragmatic embodiment expressed through men's everyday occupations and an experiential embodiment concerned with emotions and sensations felt within and through the body. In addition, each dimension of men's embodiment also intersected with the ageing process, a process also shaped in turn by broader social and cultural concerns regarding the positions and possibilities of men's lives as they move through the life course. This paper concludes by discussing the implications of gender and ageing in understanding men's experiences of PD     

Physical activity as a mediator of anxiety and cognitive functioning in Parkinson's disease

IntroductionIndividuals with Parkinson's disease (PD) are at increased risk of developing anxiety, cognitive decline, and reduced physical activity. Although anxiety is a risk factor for cognitive decline, the mechanisms underlying the relationship are unclear. The present study assessed if the relationship between cognition and anxiety symptoms is mediated by physical activity in a sample of individuals with PD followed for up to five years.MethodsParticipants (N = 487) were individuals newly diagnosed with Parkinson's disease followed by the Parkinson's Progression Marker Initiative (PPMI). Participants completed a neuropsychological battery and questionnaires of anxiety and physical activity. Structural equation models examined both the between-person and within-person effects of anxiety and cognition mediated through physical activity.ResultsAnalyses revealed a significant direct effect of anxiety predicting cognitive functioning. Additionally, there was a significant indirect within-person effect; meaning that individuals who became more anxious over time, they also reported becoming less physically active, which was subsequently associated with longitudinal declines in cognitive functioning.DiscussionFindings suggest that worsening anxiety early in the course of PD may be a risk factor for reduced participation in physical activities and subsequent cognitive decline.     

A Guy Thing

Abstract

The Men's Movement, celebrity disclosures about prostate cancer, and recent epidemiologic research identifying gender-related health risks for men have all resulted in, and simultaneously fostered, a burgeoning demand for information on men's health issues. The Internet may serve as a convenient, timely, and interactive service complementing traditional print resources for patients, their families, and their affectional partners looking for information on sexual and reproductive health and other health conditions as they present in men. Included in this article is a select list of Web-based men's health resources, with annotations, available from the Internet.     

Finding Information About Men's Health on the Internet

Summary

It's a well-known fact that men are less likely than women to seek health care. Men tend to wait as long as possible to see a doctor about a health problem, making early diagnosis of a disease difficult if not impossible. When one looks at the statistics related to men's health, the apparent aversion to seeking health care is disconcerting. Given the fact that men seem to be more private about their illnesses, the Internet provides an excellent place for them to seek health care information. A search of “men's health” finds an overwhelming number of sites on the Internet. This article provides a highly selected list of Web sites intended as a starting place for finding information about men's health on the Internet.     

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.     

Social and cultural contexts of concurrency in a township in Cape Town,South Africa

Following the 1994 International Conference on Population and Development, the world has seen a shift in paradigm away from focused family planning programmes towards reproductive and sexual health more generally. This paper considers how the traditional emphasis on women's health and family planning can result in men's sexual health needs being overlooked. A biomedical rationale to target men with health services evolved from the rising interest in control programmes for HIV and sexually transmitted infections (STIs). To plan appropriate health interventions more needs to be known about how men perceive their sexual health. Unique data from Orissa (India) and rural Bangladesh illustrate men's perceptions of their sexual health problems and demonstrate that men are willing to seek care. While public sector programmers and health planners may be focusing their attention on the control of STIs, men in both studies indicated that their major concerns relate more to matters of psychosexual disorders. The failure of public sector programmes to take cognisance of male sexual health problems may lead to men continuing to seek care for all their sexual health problems (including STIs) in the unregulated and possibly ineffective private sector. If programmes addressing the sexual health needs of men are to be effective, they will need to be comprehensive in their scope and coverage, just as they are now aiming to be for women.     

Time to Father

Abstract

This paper reports the qualitative findings from 40 couples involved in a study exploring men's post-natal mental health. Interviews were conducted with individuals soon after the birth of their first child. Findings suggest that new fathers want to be more involved in the direct care and nurturing of their children than their fathers were with them. Discourses which construct fathers and inform social structures have not kept pace with men's changed attitudes and role expectations limiting the options available to men as fathers. In particular men's employment circumstances figure in their experience of adjusting to life as a father. Those fathers having least flexibility and autonomy in their work report experiencing, since the birth of their child, more unhappi-ness, anxiety, and generally higher levels of stress. These findings suggest increasing workplace flexibility and provisions such as parental leave are important for men's post-natal mental health.     

Recruiting low-income healthy women to research: an exploratory study

Objective. The study goals were (1) to assess the feasibility of using an existing telephone health information and referral service for low-income, ethnically diverse women to recruit women for research participation; (2) to assess the feasibility of recruiting low-income, African American and Latino men into health research through the women callers to the telephone service; and (3) to describe the challenges women face and the strategies they use when talking to men about the men's health and research participation.

Design. We recruited women for individual semi-structured qualitative interviews via the Every Woman Counts (EWC) telephone information and referral service, a California Department of Health Services Cancer Detection Program. This paper describes our eligibility and recruitment assessment, and our qualitative data from 23 interviews with low-income African American and Latino women who called EWC.

Results. We found that it was feasible to recruit women, but not to recruit men through women who call this telephone service. Almost 50% (113) of women demographically eligible for recruitment, completed our screening questionnaire, despite calling EWC for a different purpose. Some 48% (54) of those women were eligible for an interview. Of interview-eligible women, 58% (10) of African Americans and 35% (13) of Latinos completed an interview. Only 17% (4) of women referred a man for participation in an interview for our study. Several themes emerged from our analysis of interview data: (1) women's role in men's health can be significant but is often uneasy; (2) challenges when talking to men about their health include health access, gender dynamics, and men's fear of health care; (3) women's understanding of research may be limited; (4) women use a range of strategies to address and overcome men's resistance to taking care of their health and participating in research.

Conclusions. The challenges women face when talking with men about their health affect their ability to effectively speak to men about research participation. However, EWC and similar telephone health services may be an effective means for recruiting low-income women to chemoprevention and other studies requiring healthy participants.     

Percepciones de los hombres sobre las complicaciones asociadas a la mutilación genital femenina

ObjectiveTo explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed.MethodsA qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software.ResultsThose participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice.ConclusionsParticipants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls’ health, and include family-targeted campaigns which involve men in the process of eradicating this practice.     

Determinants of support for female genital cutting among ever-married women in Egypt

Abstract

This study examines the effect of exposure to communication messages on support for female genital cutting (FGC) in Egypt. Data from the 2005 Egypt Demographic and Health Survey are analysed using logistic regression (n=19,106; ever-married women aged 15–49). The analysis reveals that high levels of exposure to FGC-related media messages are essential in reducing support for FGC. Women exposed to two or more FGC media messages are 1.6 times more likely than unexposed women to support discontinuing FGC. Moreover, women's belief that men want the practice discontinued, and their belief that FGC can cause fatal complications, are both positively associated with women's support for discontinuing FGC. By contrast, women's belief that FGC is an important part of religion, and their belief that FGC prevents adultery, are negatively associated with women's support for discontinuing FGC. Almost identical factors affect women's intention to circumcise their daughters. High exposure to FGC-related messages, and women's belief that men want the practice discontinued, are negatively associated with the outcome. Women's belief that FGC is an important part of religion, and their belief that FGC prevents adultery, are positively associated with it. Women's belief that a husband prefers a circumcised wife is not associated with women's intention to circumcise their daughters after controlling for all other variables in the model. Given that high level of exposure to FGC-related messages is key in reducing support for FGC, communication campaigns should be continued and intensified. Campaigns should also aim to change men's perception and support for the practice.     

Older gay men's engagement with physical activity: A scoping review

Older gay men experience an elevated prevalence of adverse health conditions that may be compounded by age-related deterioration. Some of these conditions may be ameliorated by regular adherence to physical activity (PA). However, many gay men participate in less PA than their age-matched heterosexual counterparts. With a focus on gay men aged 60 and over, the aims of this review were to examine the evidence for older gay men's engagement with PA and the research approaches used to describe this group. A systematic search of six academic databases (Academic Search Premier, Cinahl, PubMed, Sport Discus, APA PsychInfo and APA PsychArticles) generated 23 papers from 1970 to 2020 that focused on older gay men's engagement with PA. Although surveys were well represented in the literature, further studies utilising qualitative methodological frameworks have the potential to inform targeted interventional programs aimed at reducing less health disparities. The value of PA in older adults lies principally in improved performance of activities of daily living, independent living, increased longevity, decreased cognitive decline and improved mental well-being.     

Hospitalization and the Risk of Initiation of Antipsychotics in Persons With Parkinson's Disease

ObjectivesThe use of antipsychotics in persons with Parkinson's disease (PD) is common, although their use may aggravate the symptoms of PD. Clozapine and quetiapine are the only antipsychotics recommended in PD treatment guidelines. Information on factors associated with initiation of antipsychotics is needed. We investigated whether recent hospitalization is associated with initiation of antipsychotics in persons with PD, and whether discharge diagnoses differ between those who had antipsychotics initiated and those who did not.DesignNested case-control study in the nationwide register-based Finnish Study on Parkinson's disease (FINPARK).Setting and ParticipantsThe FINPARK study includes 22,189 persons who received an incident, clinically verified PD diagnosed during 1996–2015 and were community-dwelling at the time of diagnosis. The cases were 5088 persons who had antipsychotics initiated after PD diagnosis, identified with 1-year washout. The controls were 5088 age-, sex-, and time from PD diagnosis-matched persons who did not use antipsychotics on the matching date (antipsychotic purchase date). Recent hospitalization was defined as discharge in the 2-week period preceding the matching date.MethodsAssociations were investigated with conditional logistic regression.ResultsQuetiapine was the most commonly initiated antipsychotic (72.0% of cases), followed by risperidone (15.0%). Clozapine was initiated rarely (1.1%). Recent hospitalization associated strongly with antipsychotic initiation [61.2% of cases and 14.9% of controls, odds ratio (OR) 9.42, 95% CI 8.33-10.65], and longer hospitalizations were more common among cases. PD was the most common discharge diagnosis category (51.2% of hospitalized cases and 33.0% controls), followed by mental and behavioral disorders (9.3%) and dementia (9.0%) among cases. Antidementia and other psychotropic medication use were more common among cases.Conclusions and ImplicationsThese results suggest that antipsychotics were initiated because of neuropsychiatric symptoms or aggravation of those symptoms. Antipsychotics should be prescribed after careful consideration to avoid adverse effects in persons with Parkinson's disease.     

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.     

Masculinity in the doctor's office: Masculinity,gendered doctor preference and doctor–patient communication

ObjectiveMortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity.MethodsThree studies (Total N = 546) examined the role of masculinity in men's doctor choices and doctor–patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort.ResultsIn Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity.ConclusionsTaken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor–patient communication may be impaired.     

Men's contribution to the food and nutritional situation in the Tanzanian household

More is presently known about women's than men's role in food production and nutrition in Africa. The present article is an attempt to remedy this shortcoming. A special focus is put on the influence men exert through their labour and decision‐making on the household food situation. Findings from a study in a subsistence agricultural community in Tanzania give a differentiated picture compared to current literature. Most men put a substantial amount of labour into food production, but not as much as their wives, while a minority did almost nothing. When men worked hard in the fields, their wives worked hard too. Both men's and women's labour input in the field was important for household food availability. However, no direct relationship was found between men's work and child nutrition. In decision‐making women had a subordinate position and men were apt to favour cash above food. However, women usually had their way with men to insure that family food needs were met. The potential for improving women's situation by increasing men's contribution is discussed.     

Physical Activity Messages for Youth with Disabilities: An Evaluation of Attitudes,Intentions, and Preferences

ABSTRACT

There is no known research examining the use of strategic messages to motivate youth with physical disabilities (YWPD), or how to create effective messages for them. Guided by the Social Issue Advertising Believability Model (SIABM), the study aimed to: (i) examine the effectiveness of physical activity (PA) messages on YWPD’s attitudes and intentions to participate in PA, and (ii) consider factors related to message effectiveness. YWPD (N = 60) were randomized to view one of three PA messages: (a) no youth, (b) non-inclusive, and (c) targeted. Attitudes and intentions to participate in PA were assessed at baseline and immediately following viewing one of the three messages. Participants also evaluated the messages in terms of relevance, believability, attention, and attitudes. Repeated measures ANOVA and median split analyses indicated that attitudes toward PA increased after message viewing for participants with low baseline attitudes, but decreased for participants with high baseline attitudes. No significant changes in intentions emerged. The targeted message was most preferred and evaluated as most believable. Attention paid to the message was the only significant predictor of intention to participate in PA post-viewing (p = .001). PA campaigns should consider being inclusive of YWPD with low attitudes and intentions to engage in PA when developing messages.     

Community Perspectives on Contraception in the Context of the Zika Virus in the U.S. Virgin Islands: Implications for Communication and Messaging

BackgroundBetween January and October 2016, 575 symptomatic confirmed cases of Zika virus infection were reported in the U.S. Virgin Islands (USVI). Zika virus infection during pregnancy can cause serious birth defects. Preventing unintended pregnancy among women who choose to delay or avoid pregnancy is a primary strategy to reduce these adverse outcomes.MethodsA rapid assessment, using one men's and five women's focus groups (N = 43), was conducted to inform communication efforts to increase awareness of contraception as a means for preventing unintended pregnancy in the context of a Zika outbreak in the USVI.ResultsFindings showed that people of reproductive age were aware of the relationship between Zika virus infection during pregnancy and adverse birth outcomes. However, when discussing methods for prevention, participants did not include preventing unintended pregnancy as a strategy to reduce these adverse outcomes. When asked about family planning in the USVI, participants discussed that, for some, planning pregnancies is not common. Participants wanted communications about contraception to include available methods, side effects, costs, and safety. Optimal communication channels included social media and local spokespersons. Participants identified health care providers as a trusted information source.ConclusionsFindings from this assessment informed the design of a culturally appropriate communication strategy to raise awareness of the prevention of unintended pregnancy as a primary strategy to reduce Zika-related adverse birth outcomes in the USVI.