A Perspective from your Trans-Tasman Mates - The

Prof Gary WittertFreemasons Foundation Centre for Men’s Health Research, University of Adelaide

South Australian Health and Medical Research Institute

. A Perspective from your Trans-Tasman Mates - The Freemasons Foundation Centre for Men’s Health Experience

• Why a dedicated men’s health centre?

• Origins and evolution

• Structure and governance

• People

• Research and research translation

• Collaborative networks

• Funding

Outline

Men’s health

Encompasses all conditions or diseases that are either unique or more prevalent in men, with particular biological and

psycho-social risk factors and for which different behavioural or medical interventions are required.

Based on British Health Development Agency 2001

The male health disadvantage

ABS 2016

Men have higher mortality rates cf woment

0

200

400

600

800

1000

1200

1400

Age Standardised Death Rate / 100,000

Metro males Rural remote Lower SES Aboriginal Female

6

Indirect Economic Consequences

Men and Health Service Use: False Facts (FF)

• FF 1 Men are neglectful of their health

• FF 2 Men don’t go to the Doctor

• FF 3 Men don’t talk to their Doctor

• FF 4. The problem is masculinity

Men are not generally neglectful of their health

SA Men’s Health Services Preferences Survey: FFCMH / SA Health 2012; 2109 men

0

10

20

30

40

50

60

70

80

90

100

Concernedabout heath

Motivated toimprove health

Perc

ent

Florey Adelaide Male Ageing Study

4839.0 - Patient Experiences in Australia: ABS, 2012-13; AIHW: Ch 14 Consultation time and GP satisfaction

Shorter consults (~ 2 mins) than for females from 15+ years

Attention to other health concerns

• GP visits less so for preventative health• Other health concerns often not addressed

Health Services - Less Satisfactory Outcomes for Men

Taking action is based on

• Previous illness experience

• Knowledge, health literacy

• Perceived illness severity

• Perceived priorities

• Access to and nature of available service

Men tend to self-monitor

Smith & Wittert et al, 2008a; 2008b

In the right environment and if the conversation is appropriately facilitated

• Convey a sense of time available to talk

• Adopt a frank approach & ask directly

• Show competence, empathy

• Use humour thoughtfully

• Resolve health issues promptly

Men will talk about their health

Smith and Wittert, 2008a; 2008b

Young Men - poorer Health Literacy than young women

• 41% of Australians aged 15–74 had a level of health literacy that was adequate or above.

• Lower health literacy• disadvantaged areas and areas outside Major cities

• poorer self-assessed health status

AIHW, Australia's Health in 2012 ISSN 1032-6138Health Literacy, Australia, ABS 2006

Health literacy is about how people understand health information, use it to make informed decisions, and how they act upon these decisions to manage their health and well-being

% of people with adequate or better Health Literacy

Men with Low health literacy Less likely to be diagnosed with OSALi et al, Sleep 2013;37:571-578

Some disorders present differently in men

• 59% of depression in men undiagnosed

• Despite men with depression symptoms being more frequent GP attenders than men without such symptoms (OR:3.2; 95%CI:1.3-7.7)

Masculinity is a solution not a problem

14

Concerns may relate more role efficacyAs husband/partnerAs a fatherIn the work placeAs a provider Maintenance of independence

Why a Centre for Men’s Health

Freemasons Foundation Centre for Men's Health

“Men behave differently, not badly.

Health services need to respondaccordingly”

Strategies to optimise Health Care for men

• Design health services to accommodate needs and preferences of men.

• Communicate with men in a gender appropriate manner.

• Embrace masculinity –

• Emphasise responsibility, problem-solving and self-management.

• Masculinise Physical environment, Facilitate anonymity

• Extended clinic hours

• Facilitate time off work for health checks

• Support the preference for self-monitoring and facilitate self management

• Improve health literacy

• Male-relevant health messaging

• E-health (evidence-based websites, APPs)16

Establishment of the FFCMH

No More Secrets2006

Dr Greg LevenstonNSW Freemasons

Freemasons Foundation Centre for Men’s Health 2008 -

Organisational Structure and Governance

Freemasons Foundation Centre for Men’s Health

Governance

EDDVCR

Research Streams

Executive OfficerSpecial projects supportVolunteers

Staffing

Statistician

Multidisciplinary network of men’s

health researchers, clinicians, educators, students, volunteers

and consumers

Unique to Australia…Internationally

Funding

Return $8 per 1$ invested

Research

• Build transdisciplinary research program

• Platforms and capacity development

• Informed by consumers and other stakeholders

• Pathways to translation

2002-20072008

2010

Three Main Research Streams

2012

2010

2014

2016

2016

2017

Sleep

LUTS

2016

2017

Publications Oct 2008-Oct 2017

Collaborative Networks

People

• Build early to mid career research capacity

• Attract high quality researchers from interstate and overseas with salary top ups if already have funding

• Family friendly policies and aim for gender balance

• Support career development

• Support transition to independent funding

• Provide security

ECR/MCR support

• Research support packages

• Mentoring

• Conference travel funding

• Leverage funding for fellowship and grant awards

• Salary gap funding

• Research administration support

• Student supervision

• Community stakeholder engagement

• Profile development

ECR MCR

PhD and Honours 2008 - 2016

PhD Honours

HDR Scholarships by year of award

Vacation Research Students/Scholarships

• Conversion to Honours or PhD 10

• Return Students

• Publications 6

Community Engagement,Knowledge Transfer and

Translation to Health Outcomes

Uro-Reproductive Health Prostate Cancer

Chronic Disease & Risk

Health Services

Community engagement

Activities to support engagement and translation

• Consumers invited to men’s health research seminars

• E-Newsletter 6-8/year

• Public Research symposia/events 2-3/year

• Mens Health Week press release and other education activity

• Biennual Men’s health business breakfast

• Guest men’s health speakers for community, business, NGO, charity events

• Resources for community events

• Print media, radio, TV

• Social Media

• Podcasts

Advocacy

Medical Education

Policy Guidelines

Changing PracticeDisease

preventions and Health Promotion

Translational activities run across streams

• Get in Touch Reach Top Heath (GIRTH)

• SA Health – Healthy Workers Healthy Futures

• Development of an undergraduate curriculum for training health service providers

• Participate in summits/clinical committees

• Practice guidelines

Acknowledgements

FundingNational Health and Medical Research CouncilFreemasons Foundation, Premiers Science Research Fund, South Australia Department of Health, Florey Foundation, Resmed, Northern Community Health Foundation. Bequest of Geoffrey Ernest Stolz

Freemasons Foundation Centre for Men’s HealthSean MartinAndrew VincentEvan AtlantisGeorge HatzinikolasMatthew Haren (UniSA)Peter 'O'LoughlinLeanne Owen

NH&MRC Centre for Nutritional PhysiologyKylie Lange

Population Research Outcome Studies CentreAnne TaylorJanet GrantSandy PickeringZumin Shi

New England Research Institutes MA John McKinlayAndre Araujo

Health ObservatoryRobert AdamsSarah AppletonJoule Li

Adelaide Institute for Sleep Health.Andrew Vakulin

T4 DM Team

TQEHDavid JesudasonJim WangJason Tan

Prof Michelle LaneDr Nichole McPherson