Carroll P., Kirwan L., Lambe B. Centre for Health Behaviour Research

1. Community Based Health Promotion for Men: A Guide for Practitioners Carroll P., Kirwan L., Lambe B. Centre for Health Behaviour Research Waterford Institute of Technology PCarroll@wit.ie

2. Why Community-Based Health Promotion for Men? • While male life expectancy is lower than that of women (4.8 years) and men have higher death rates than women for most of the leading causes of death and at all ages, even greater disparities in health outcomes and life expectancy exist between different categories of men. • Those men in the lowest socio-economic group carry a disproportionate burden of ill health, mortality and premature death.‘This variability demonstrates clearly that men’s health disadvantage is an issue of inequity and not biological inevitability’ [European Communities, 2011. p3] • Men of different ages, ethnicities and social backgrounds access health services less frequently than women do for both physical and mental heatlh problems [Addis and Mahalik, 2003]. • Therefore, in order to engage men with their health it is necessary to use non-traditional settings and go to where men live, work and play.

3. CMHP Strategic Areas • Raising Health Awareness • Delivering Community Based Health Promotion Programmes • Both the delivery of the strategy and the process of how the partnership worked to deliver the strategy were independently investigated over a 15-month period

4. The Practitioners Guide Section 1: Community –Based Health Checks Section 2: Engaging Men in Community Based Health Promotion Programmes Section 3: Using Community Based Media to Communicate Health Messages to Men Section 4: The Partnership Process for Community Based Health Promotion for Men

5. Overview of Each Section Brief Rationale The Approach Taken The Findings The Lessons Learned

6. Section 1: Community Based Health Checks Figure 1: The % of men who experienced health problems (n=162) Figure 2: How the health check influenced men at 1-week post (n=79)

7. Lessons Learned • Community-based health checks are a useful way to gather valuable information to inform the development of a community-based health promotion strategy. • Community-based health checks are a useful way to engage ‘hard to reach’ men for a lengthy period about their health and to raise health awareness and to prompt them to seek further support. • Locating community-based health checks in strategic locations where ‘hard to reach’ men convene appears to reduce the likelihood of the ‘worried well’ attending the health check. This can often happen when such services are offered in more generic locations e.g. shopping centers.

8. Section 2: Engaging Men in Community-Based Health Promotion Programmes

9. Lessons Learned • The majority of ‘Hard to reach’ men prefer structured programmes that are clearly outlined and have defined tangible outcomes. • A mechanism for ongoing consultation with the men should be built into the programme planning • The approach of the facilitator is key to creating group safety and a positive group dynamic and ensuring that individual men’s needs are met. • The generation of a positive group dynamic should be central to the programme delivery as it both motivates men to engage and is beneficial for their education • Homogeneity among the group of men on at least one level is essential in order to support group safety. • Using incentives, removing costs and choosing easily accessible venues in non-traditional settings may remove barriers to engagement for this priority group. • Offer programmes in the evening. This would enable men to engage if they did gain employment while also removing the stigma of being unemployed and being available to attend during the day.

10. Section 3: Using Community Based Media to Communicate Health Messages to Men • 57% (n=158) of the men surveyed read ‘The Carlow Nationalist’ and 32% of those saw at least 1 of the articles. • Of the men who read the article/s 47% said it made them think differently about their health • 14% said they had made health changes as a result of reading article/s [walking, eating healthier and going to the GP for a checkup] • Many recommended the article be placed in sports section of paper plus across many of the new media outlets (e.g. car and sports websites)

11. Lessons Learned • Build partnerships with local media outlets • Use images and quotes of men with whom the priority population can identify • Assess all health information in terms of literacy demand • Allow time to conduct formative evaluation with priority population • Ensure there is an avenue for further contact • Incorporate media campaigns into a multi-component, community based initiative • Think creatively about how and where to deliver health messages to men and consult with priority population • Build in monitoring component to campaign to access effectiveness

12. Section 4: The Partnership Process for Community-Based Health Promotion for ‘Hard to Reach’ Men

13. Lesson’s Learned • There must be concensus among the partners with respect to the purpose of the partnership. • The dynamics of the partnership can be positvely supported by a) adopting an informed and democratic decision making process, b) using planning (REAIM) and implementation tools (operational plan), c) engaging in ongoing evaluation of practice and d) adopting a ‘hands on approach’ to the work. • Group membership needs careful consideration. • Community based health promotion partnerships for ‘hard to reach’ men may experience unique challenges; • Partnerships may seek to overcome the challenge of the limited resources available to men’s health work by evaluating their work and demonstrating outcomes for funders. • Partnerships may seek to overcome the challenge of the difficulty of engaging men in community based health promotion by using a creative ‘hook’ and engaging in ongoing consultation with men to ensure that their needs are being met.

14. Other Publications Carroll P., Kirwan L., Lambe B. (2014) Engaging ‘hard to reach’ men in community based health promotion. International Journal of Health Promotion and Education, 52(3): 120-130. Kirwan L, Lambe B, Carroll P. (2013) An investigation into the partnership process of community based health promotion for men. International Journal of Health Promotion and Education 51(2): 108-120 Carroll P. (2013). Men’s Health Matters: A Practical Guide to Healthcare for Men. Waterford: Centre for Health Behaviour Research, Waterford Institute of Technology.