Steve Robertson

'Not living life in too much of an excess': lay men understanding health and well-being.

While research on lay perspectives of health now has a wellestablished history, specific empirical data on male lay perspectives of health and well-being are largely absent. Drawing on focus group data and in-depth interviews with 20 lay men (including sub-samples of gay men and disabled men), and seven health professionals, this article explores how the men conceptualized ‘health’ and the gendered nature of such conceptualizations. Specific emphasis is given to considering notions of ‘control’ and ‘release’, and the associated issues of ‘risk’ and ‘responsibility’, in the participants’ health narratives. A conceptual model for understanding ‘masculinity’ and ‘health’ is presented.

Men’s health promotion: a new frontier in Australia and the UK?

The field of mens health has grown markedly over the past few decades. Increased activity specifically relating to mens health promotion in both Australia and the UK has been noted during this period. There has, however, been a reticence to critically examine mens health promotion work within a broader discourse relating to gender and gender relations. Indeed, the vast majority of health-related gender discussion to date has been focused on womens health experiences and their health practices. In this paper, we argue that grounding mens health within this broad gender discourse is important for building an evidence base in, and advancing, mens health promotion work at a range of levels. We specifically explore the research, practice and policy contexts relating to mens health in Australia and the UK, and describe the facilitators for, and barriers to, promoting mens health. We conclude by suggesting that a critical gender lens ought to be applied to current mens health promotion work and provide strategies for researchers, practitioners and policy makers to move towards this new frontier.

Men and health promotion in the UK: Ten years further on?

Within the UK, health promotion work with men is well established with examples now dating back for over twenty years. Ten years ago, Robertson1 wrote a review of the state of health promotion services for men in the UK. However, much has changed in policy and practice since this time. This brief paper therefore provides a periodic review of how such services have developed and progressed in the last ten years. The reasons for these developments are explored before consideration is given to what current challenges remain in health promotion work with men. The paper suggests that, despite innovative changes in practice, and a policy agenda that facilitates more holistic approaches, there is little change in mens health related practices and subsequent health outcomes. The reasons for this are considered, as are the opportunities that currently exist to help improve future health promotion services for men.

‘It is fun, fitness and football really’: a process evaluation of a football-based health intervention for men

Concerns about gender inequalities in longevity, particularly premature male mortality, have prompted a range of innovative approaches to health promotion work dating back to the 1980s. In developing such work, sport, and football in particular, has emerged as a gendered cultural field that has utility for engaging men in community health initiatives. Evaluations of such work have shown that health initiatives using football settings, football interventions or even club branding can have positive impact on various health measures in the short and longer term. However, little work to date has looked at the underlying mechanisms that generate success in such projects. This paper presents secondary analysis of data collected during the evaluation of the Premier League Health (PLH) programme specifically focusing on these underlying mechanisms and how/where gender (masculinities) appears in these processes. We draw on interview data with 16 staff who had been involved in the delivery of the PLH initiative and 58 men who took part. Thematic analysis highlighted two overarching (and underpinning) themes: ‘Trust’, what processes it was key to and how it was developed and sustained; and ‘Change’, including what it was facilitated by and what impact it had. The paper adds to our understanding of how active listening, flexibility and sustained engagement are key to community-based sports projects’ success. Furthermore, it demonstrates how the physicality and sociability of involvement, rather than any direct focus on ‘health’, are important in acting as a springboard for facilitating reflection and aiding lifestyle changes for men.

Connecting Masculinity and Depression Among International Male University Students

International university students can experience isolation amid academic pressures. Such circumstances can manifest as or exacerbate depression. This qualitative study involved 15 international male students at a Canadian university who were diagnosed or self-identified as having depression. Individual interviews revealed men’s perspectives about causes, implications, and management of depression. Participants intertwined sex- and gender-based factors in detailing causes, and emphasized the potential for parents to impact depression. Implications of depression for embodying traditional masculine roles of breadwinner and career man influenced many men to filter details about their illness within “home” cultures. This practice often prevailed within Canada despite the men’s perceptions that greater societal acceptance existed. Masculine ideals underpinned self-management strategies to fight depression and regain control. Counter to men’s reluctance to disclose illness details were participants’ self-management preference for peer-based support. Study findings highlight how masculine ideals and cultural constructs can influence depression experiences and expressions.

Men's health, inequalities and policy: contradictions, masculinities and public health in England

The aim of this paper is to consider ‘New’ Labours socio-economic and health policies, discuss how they influence preventive health strategies aimed at men, and identify the implications for managers, researchers and practitioners working to improve public health in the primary care sector in England. Policy, theoretical work and empirical research are analysed, critically, to develop the arguments in the paper. Although men may be perceived as a ‘hard to reach group’, insufficient consideration has been given to how health policy facilitates or restricts successful preventive health work with men. The ‘gender duty’, which has recently been introduced in England, presents an opportunity to build on earlier successful public health work with men. There is some evidence that innovative public health strategies, informed by an understanding of gender, with men are being developed. This may enable primary care trusts to more successfully, and creatively, target and engage men in health improvement activities. However, the current dominant ideology in public health policy in England is grounded in a perspective that emphasises biomedical, neo-liberal and psychological explanations of health and which neglects the relationship between gender and health inequalities. Recognition of the links between gender, poverty, and the concomitant inequalities, is a priority when planning preventive health work with men. If such inequalities are to be redressed, social and economic policies underpinned by values of equity and social justice are needed, incorporating a more nuanced understanding of the role of gender in health.

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 mens 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 mens 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.

The men's health policy contexts in Australia, the UK and Ireland: advancement or abandonment?

The state of mens health, internationally, is a deep public health concern. Despite pressure from the World Health Organisation that all health policy should consider the specific needs of both men and women through their push for ‘gender mainstreaming’, and increased interest in mens health, there have been relatively few gendered policy responses relating to mens health. In this article, we compare the mens health policy contexts in Australia, the UK and Ireland. We show that different advocacy groups have lobbied for mens health policies in these three jurisdictions and that different approaches have been adopted in order to advance or abandon mens health policy work. The absence of mens health policies or gender mainstreaming has severely limited the capacity to develop well-co-ordinated national programmes that meet the health needs of men and their families.

Men's health promotion in Canada: Current context and future direction

The issue of ‘men’s health’, and how best to promote it, has been gaining increasing attention in both academic and media arenas across the globe. Whilst commentaries on the state of health promotion for men have been provided in countries including Australia and the United Kingdom, no corresponding Canadian-specific insights have yet been published. This article provides such an overview, focusing on research, policy and practice and suggesting what future direction men’s health promotion in Canada might take.

Working towards men's health: Findings from the Sefton men's health project

Objective: To evaluate a health improvement initiative aimed at enhancing the health of men in deprived areas. Design: A healthy lifestyle programme was undertaken with men to increase their health knowledge, and encourage behaviour modification and access to health improvement services. A peer mentoring programme was implemented and a training programme delivered to community and public sector staff. Setting: The programme was delivered in the most deprived wards in Sefton (Liverpool, UK). Method: Qualitative interviews were conducted with men in the lifestyle and peer mentoring programme five months into the programme (n = 6). Further telephone interviews with men took place towards the project’s end (n = 14). Interviews with community staff and health professionals who attended the training were completed (n = 5), fully transcribed and analysed thematically to meet the evaluation aims. Results: The key themes emerging were issues related to influences on participation (including settings and social networks), experiences of participation (including, for men, issues around control and physical activity) and for staff, the opportunity for reflection. Outcomes for men included: changed bio-medical body condition; increased functional capacity; and improved emotional and experiential well-being. Outcomes for staff included: planned change around individual practice; and networking and organizational change. Conclusion: Men liked the convenient settings for the healthy lifestyle programme and its activities, although peer mentoring involves challenges over recruitment and support, and staff also benefited. Men made recommendations for acceptable locations, support for marginalized men, and appropriate incentives.