John L. Oliffe

Further Than the Eye Can See? Photo Elicitation and Research With Men:

Photo elicitation studies have attracted modest attention in qualitative health research. However, few researchers have focused exclusively on mens health and/or illness experiences. In this article, the authors discuss the benefits of using photo elicitation among a subcohort of 19 prostate cancer survivors from a larger ethnographic study. Specifically, participants were asked to imagine that they were being paid to mount a photographic exhibition entitled Living With My Prostate Cancer, an exhibition that would show prostate cancer from their unique perspective. The authors subsequently discussed the photographs with the participants during individual interviews using photo elicitation techniques. The methods provided some unique and unanticipated benefits, the details of which the authors share to guide researchers considering similar approaches. In addition, the authors make specific recommendations for future photo elicitation applications to mens health research.

You feel like you can’t live anymore: suicide from the perspectives of Canadian men who experience depression

Severe depression is a known risk factor for suicide, yet worldwide mens suicide rates continue to outnumber reported rates of mens depression. While acknowledging that the pathways to suicide are diverse, and being mindful of the complex challenges inherent to studying suicide, we interviewed men who experienced depression as a means to better understanding the processes they used to counter and contemplate suicide. This novel qualitative study provides insights on how masculine roles, identities and relations mediate depression-related suicidal ideation in a cohort of 38 men in Canada, ranging in age from 24 to 50 years-old. Constant comparative analyses yielded the core category of reconciling despair in which men responded to severe depression and suicidal ideation by following two pathways. To counter suicide actions, connecting with family, peers and health care professionals and/or drawing on religious and moral beliefs were important interim steps for quelling thoughts about suicide and eventually dislocating depression from self-harm. This pathway revealed how connecting with family through masculine protector and father roles enabled men to avoid suicide while positioning help-seeking as a wise, rational action in re-establishing self-control. The other pathway, contemplating escape, rendered men socially isolated and the overuse of alcohol and other drugs were often employed to relieve emotional, mental and physical pain. Rather than providing respite, these risky practices were the gateway to mens heightened vulnerability for nonfatal suicidal behaviour. Men on this pathway embodied solitary and/or risk taker identities synonymous with masculine ideals but juxtaposed nonfatal suicidal behaviours as feminine terrain.

Theorising masculinities and men's health: a brief history with a view to practice

Abstract Sex comparisons reveal men as more likely than women to die earlier and experience debilitating injury. Historically, this trend has been positioned as somewhat inevitable, an outcome of men’s ‘natural’ biologically charged tendencies for risk-taking and reluctance around help-seeking. More recently, gender research has emerged to describe cultural norms about masculinity and explore their relationships to men’s health and illness practices. Empirically, masculinities and men’s health research has revealed diverse practices that suggest some men’s risky health behaviours are amenable to change. This article provides a brief review of how masculinity has been understood in men’s health research before making recommendations for where we might next go in theorising social constructions of masculinities. Specifically, a vignette drawn from a study examining young men’s responses to the death of a peer is used to illustrate how the communities of practice framework can be applied, and might conceptually advance future masculinities and men’s health research.

Men’s discourses of help‐seeking in the context of depression

Depression is an illness increasingly constructed as a gendered mood disorder and consequently diagnosed in women more than men. The diagnostic criteria used for its assessment often perpetrate and reproduce gender stereotypes. The stigma associated with mental illness and the gendered elements of depression suggest there are likely numerous discourses that position, explain, and justify help-seeking practices. This qualitative study explored mens discourses of seeking help for depression. The methodological approach was informed by a social constructionist perspective of language, discourse and gender that drew on methods from discourse analysis. We conducted individual in-depth, semi-structured interviews with 38 men with depression, either formally diagnosed or self reported. The analysis revealed five discursive frames that influenced the mens talk about help-seeking and depression: manly self-reliance; treatment-seeking as responsible independent action; guarded vulnerability; desperation; and genuine connection. The findings are discussed within a broader context of social discourses of gender, the limitations of current help-seeking literature and the evidence for how men seek help in ways that extend traditional notions of medical treatment.

The Self-Management of Uncertainty Among Men Undertaking Active Surveillance for Low-Risk Prostate Cancer

Asymptomatic men with low-risk, early-stage prostate cancer are eligible for active surveillance (AS), which offers a means to monitor the cancer while delaying treatment. However, AS operates within a unique set of circumstances that advocate monitoring, rather than immediate treatment, and mens health practices are central to coping with the inherent uncertainty of living with an untreated cancer. A qualitative study was completed to describe the range of mens self-management strategies used to overcome AS-related uncertainty. The study findings reveal two strategies. First, positioning prostate cancer as benign through stoicism and solitary discourses were common to men intent on “living a normal life.” Second, men committed to “doing something extra” complemented AS protocols, and often collaborated with their wives to focus on diet as an adjunct therapy. Although most participants exhibited typical mens health practices, it is clear that tailored AS psychosocial interventions will benefit men and their families.

Connecting humor, health, and masculinities at prostate cancer support groups

Objective: Many commentaries about mens health practices and masculinities indicate that men do not typically engage with self‐health or acknowledge illness, let alone openly discuss their health concerns with other men. Prostate cancer support groups (PCSGs) appear to run contrary to such ideals, yet the factors that influence mens attendance and engagement at group meetings are poorly understood. As part of a larger PCSG study, we noticed that humor was central to many group interactions and this prompted us to examine the connections between humor, health, and masculinities.

Health Behaviors, Prostate Cancer, and Masculinities A Life Course Perspective

Epidemiological data indicate that men are overrepresented in mortality rates attributed to both natural causes (e.g., ischemic heart disease) and certain deaths caused by external causes (e.g., motor vehicle accidents). Mens health behaviors are consistently linked to their poor health outcomes, and diverse explanations about what underpins mens health behaviors have been presented by commentators and researchers alike. Recently connections between mens behaviors and dominant ideals of masculinity have provided empirical snapshots about the intersections of gender and health and specific illness events. This study uses a retrospective life course method to describe the connections between health behaviors and masculinity across time among three Anglo-Australian men who were born in the 1920s and 1930s and grew up in Victoria, Australia. The findings from this study illustrate how health behaviors intersect with shifting social constructions of masculinity and are mediated by factors including age, history, social class, culture, and illness.

Analyzing participant produced photographs from an ethnographic study of fatherhood and smoking.

As part of an ongoing ethnographic study, we examined the photographs and narratives that new fathers produced to ascertain how they created social, psychological, and relational space for continued smoking. A four-part process for analyzing the photographs consisting of preview, review, cross-photo comparison, and theorizing revealed how visual data analyses can be used to develop insights into mens health behaviors and beliefs. There is ongoing epistemological debate and methodological uncertainty about how photographic data should be treated in health sciences research. By conducting formal layered analyses, researchers can expand and extend both what is said about, and interpreted through, photographs.

‘Not the swab!’ Young men’s experiences with STI testing

In Canada, STI rates are high and rising, especially amongst young men. Meanwhile, the needs of young men regarding STI testing services are poorly understood, as are the socio-cultural and structural factors that influence young mens sexual health-seeking behaviours. To better understand this phenomenon, we draw on interviews with 45 men (ages 15-25) from British Columbia, Canada. Our research reveals how structural forces (e.g. STI testing procedures) interact with socio-cultural factors (e.g. perceptions of masculinities and feminities) to shape young mens experiences with STI testing. STI testing was characterised as both a potentially sexualised experience (e.g. fears of getting an erection during genital examinations), and as a process where young men experience multiple vulnerabilities associated with exposing the male body in clinical service sites. In response, participants drew on dominant ideals of masculinity to reaffirm their predominately hetero-normative gender identities. Despite growing up in an era where sexual health promotion efforts have been undertaken, participants did not feel they had permission to engage in discussions with other men about sexual health issues. Attending to young mens perspectives on STI testing represents a starting point in reforming our approaches to addressing how socio-cultural and structural factors shape these experiences.

Association Between Mobility, Participation, and Wheelchair-Related Factors in Long-Term Care Residents Who Use Wheelchairs as Their Primary Means of Mobility

To explore how wheelchair‐related factors, mobility, and participation are associated in a sample of long‐term care residents who use wheelchairs as their primary means of mobility.