Impact of Social Inclusion Provided By Men’s Sheds

on Health & Wellbeing

Luckman Hlambelo (RN, BN,MN,MPH,MBA)

University of Western Sydney,

Australian Men's Shed Association 5th National Conference, Victoria.

29 October 2013

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Outline• Why bother about men’s health?

• Why social inclusion is an important determinant of men’s health?

• What do we know about the impact of social inclusion on cardiovascular, endocrine and neurological systems?

• What we are researching?

• Why we need the support of the ‘Shedders”?

What does the literature say?• Outcomes: Morbidity & Mortality rates higher in men

than women

• Behaviour: Cultural Constructions of men

• Policy: Clinical Concern & andrology

• Health Services: Lack of engagement

• Socio-economic environment: 1/3 of men are not in work (Macdonald, 2006, Lattimore 2007)

The Turning point

Men’s Friendships Social isolation Unemployment Social Exclusion Stress

Macdonald, 2005; 2011; WHO, 2003; Wilkinson & Marmot, 2003

Impact of Stress on Health- (HPA-Axis)

Prolonged Cortisol Secretion

• Abdominal fat (heart attacks, strokes)

• Metabolic syndrome ( levels of “bad” cholesterol (LDL) and levels of “good” cholesterol (HDL)

• Immune deficiency (colds, delayed wound healing)

• Decreased sexual interest

• Blood sugar imbalances

• Cancer

Social Support & Health • Effect on neuroendocrine pathways - stress

reduction• “buffers” or protect health during times of

high stress. • A study conducted by Cohen and Wills found a

relationship between social support and psychological well-being in the presence of stress.

• It is believed that social support increases one’s level of psychological well-being by allowing individuals to feel like that have better control over their stress.

• Social support may be a primary coping mechanism.

Social Inclusion In Men’s Sheds

Theoretical and descriptive case studies/literature (e.g. , Golding et al, 2007; Ballinger et al .2009; Wilson & Cordier, 2013; Golding et al. 2006; 2007, DoHA, 2010; Macdonald, 2013)

Men report enjoyment from participation, camaraderie, socialisation and skill development at Men’s Sheds.

Research Aims1) To examine the impact of Men’s

sheds on the health of the men involved; and

2) To determine whether participation in the Men’s Shed can improve measures of stress, cardiovascular health and well-being.

Research Objectives

• Understand men’s experiences of social inclusion provided by the Men’s Shed

• H1:Men involved in Men’s Sheds will show an increase in resting HRV and a decrease in the basal levels of cortisol.

• H2: Increased HRV will be associated with reduced resting HR and BP and improved psychological health status

Metatheoretical Map

.

MEN’S SHEDS

Person

Group

Experience Interpretation

Measurements

Philosophy

Hermeneutics

Endocrinology

Biology

Cardiology

Physiology

Somatic biofeedback

Phenomenology

Psychoanalysis

Character Psychology

Relational Psychology

Research Design and Methods

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QUANTITATIVE-Data

+ QUALITATIVE-Data

Interpretation

• Philosophical Hermeneutics (Gadamer 1900-2002) framed in the context of narrative

• One-Group-Pre & Post Test to evaluate the effect of Men’s shed on HRV, cortisol level and additional health-related outcome measures in individuals involved.

• Serve as an explorative study and an initial effort to produce biological evidence for the advancement of men’s sheds

Methods of data collection

Indepth interview• Saliva samples

• Heart rate monitorBlood Pressure monitor

• Questionnaires

Conceptual Framework Hermeneutics (Qualitative Study)

Stages Design Collection Conversion Analysis Interpretation

Integration

Theory Open-Ended Questions(n=15)

Recording WrittenAudio

TranscriptionTranslationGenerating Thematic Categories

Thematic AnalysisNarrative Analysis

Analysis of quotations, Story lines

Integrative Analysis, Drawing ConclusionsItems

and Scales(n=46)

Salivary Cortisol, RHRV, SF36 & STAI Ques

CodesScale

Descr & Multivariate Analyses

Model Interpretation

One Group Pre-test-Post Test (Quantitative Study)

• SDH• Salutogenesis• Transaction

theory• Coping and

Hormones

Axial Coding

Item Analysis

Sample Size and Power Calculation

• Qualitative Study (n=15)–Saturation not sought

• Quantitative Study (n=46)–Paired t-test (two-sided, alpha=0.05,

power=0.8, effect size=0.75) test of significance, approximately 42 subjects

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In closing…..what they are saying

• “Surely attending has been of great benefit to my health, and if it wasn’t for the supportive mates, I would have died long back.” (D5)

• “I went through hard times and lost everything…I am beginning to find meaning and coming here has confirmed there is a lot to live for” (D3)

• “Companionship reduced my stress levels” (D2)

Interested in taking part in this Study?

Luckman Hlambelo– Mobile 0408934032– Email: 16269965@student.uws.edu.au

OR

Professor John Macdonald- Mobile 0404008760- Email: J.Macdonald@uws.edu.au

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Take Home Message

• Not all diseases can be cured in the hospital

• Think about Social Determinants of Men’s Health

• The National Male Health Policy endorses a SDH approach to men’s health

• Social inclusion is an important SD of Men’s Health

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References1. Ballinger M.L., Talbot L.A. & Verrinder G.K. (2009) More than a place to do woodwork: a case

study of a community-based Men’s Shed. Journal of Men’s Health 6 (1), 20– 27.

2. Department of Health and Ageing (2010) National Male Health Policy: Building on the Strength of Australian Males. Department of Health and Ageing, Canberra,

3. Golding B. (2011) Older men’s wellbeing through community participation in Australia. International Journal of Men’s Health 10 (1), 26–44. identity and gender in Australia. Social Policy and Society, 6(2), 151-163.

4. Golding B. & Harvey J. (2006) Final report on a Survey of Men’s Sheds Participants in Victoria: Report to Adult, Com- munity and Further Education Board. Adult, Community and Further Education Board of Victoria, Melbourne, FL.

5. Golding B., Brown M., Foley A., Harvey J. & Gleeson L. (2007a) Men’s Sheds in Australia: Learning Through Community Contexts. National Centre for Vocational and Educational Research (NCVER), Adelaide, SA.

6. Macdonald, J. J. (2006). Shifting paradigms: a social-determinants approach to solving problems in men's health policy and practice.

7. Macdonald, J. J. (2011). Building on the Strengths of Australian Males. International Journal of Men's Health, 10(1), 82-96.

8. Wilkinson, R., & Marmot, M. (2003). Social determinants of health: the solid facts: World Health Organization.