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Men's Health and Wellbeing Programme at Place4U Evaluation Report

Authors:

Abstract

Evaluation of a men's health and well being programme in a provincial town
Men's Health and Wellbeing
Programme at Place4U
Evaluation Report
Executive Summary
Aisling McGrath
Dr. Niamh Murphy
Dr. Noel Richardson
Prepared by:
Place4U, Clonmel
October 2018
For:
The growth and implementation of the Men's Health and Wellbeing Programme that underpins this
research document represents the combined efforts of a wide-ranging group of dedicated people and
organisations. This brief acknowledgment cannot praise enough their vital contribution to the realisation of
the programme.
Anne Flannery of the Larkin Centre in Dublin was a real and substantial catalyst in helping us develop the
vision of delivering the men's health initiative in South Tipperary and her help was invaluable to us in
developing the concept and planning its mobilisation.
Every successful change initiative requires a passionate promoter and we found ours in the Board of Place4u
- it supported and had faith in this programme from the outset. It had the foresight to realise that the
programme would be of benefit not only to all those involved but the wider community and it could not have
moved from a concept to a tangible reality without the Board’s steadfast backing. The Board’s ongoing
commitment to the programme was, and continues to be, instrumental in ensuring its success and
longevity.
A huge thank you must go to Veronica Crowe of the Tipperary Education and Training Board for her
unwavering support and assistance in mobilising this initiative right from its conception. The additional
critical infrastructure required to deliver this health initiative was spontaneously and generously
forthcoming from our partners, the VHI, the GAA and in particular Moyle Rovers GAA club and Local Link
transport. “Give a man a fish and you feed him for a day, teach him how to fish and you feed him for a
lifetime”, is a well known proverb. Our thanks goes to our superb pantheon of tutors who did just that across
a wide range of skills and disciplines for our programme participants.
Delivering such a multifaceted project requires incredible diligence, efficiency and organisational skills
these were provided in abundance by Mary Hillery who anchored the delivery of the programme on the
ground, supported of course by a wonderfully dedicated band of volunteers and great steering group, Mary
Campbell, P.J. Dolan, Phil Prendergast and Catherine Senior.
We are deeply indebted also to Dr Noel Richardson, Centre for Men's Health, Institute of Technology Carlow,
for the provision of his expertise and for collaborating on this research project. Our researcher Aisling
McGrath who worked under the supervision of Dr Niamh Murphy, Director of the Centre for Health
Behaviour Research in Waterford Institute of Technology, is to be congratulated for producing such a
coherent and comprehensive report. Naturally, research work of this calibre can only be enabled through
the support of some pivotal sponsorship, and we were blessed to receive that support from Tipperary
County Council, the HSE and the South Tipperary Development Company who recognised the importance of
publishing the programme’s findings to the wider community.
My final word of thanks must be reserved for the wonderful group of men who took part in the programme. I
cannot applaud highly enough their openness, commitment and dedication – and indeed their ability to
instill a culture of humour, banter, fun, friendship and enthusiasm in the initiative, which contributed in no
small part to its success.
Thank you again to everyone who made this project possible.
Ann Binchy,
Men's Health and Wellbeing Programme Coordinator.
Acknowledgements
3
Introduction
Programme Design
The Men's Health and Wellbeing Programme (MHWP) is an ongoing, community-based health promotion
programme that currently runs in Place4U, a community hub in Clonmel, Co. Tipperary, in conjunction with
Tipperary Education and Trainig Board (ETB) and other partner organisations from the local area. The
programme which is aimed at men over the age of thirty, is modelled on a successful programme which
began in the Larkin Centre in Ballybough, Dublin. The programme provides participants with opportunities
to engage with health and wellbeing through social interaction, health screening, health talks, fitness and
cookery classes. The aim of the programme is to facilitate a safe, supportive and non-clinical environment
for men to engage with their health and wellbeing. This summary report highlights the main findings from an
evaluation of the first pilot ten-week programme which ran between September and November 2017.
The programme content was designed and tailored based on the original programme in the Larkin Centre.
Several partnerships were created to work alongside the Board of Place4U and facilitate the programme.
These included: the Tipperary Education and Training Board, VHI health services, Connecting for Life, South
Tipperary, the Larkin Centre, the Men's Development Network, Tipperary Link, Moyle Rover's GAA club,
Tipp FM and The Nationalist newspaper. The County Tipperary hurling
manager also endorsed the programme and met with the participants
of the programme along with the Tipperary GAA who presented
participants with jerseys. The MHWP was free of charge to attend and
the pilot programme invited thirty men within the community to take-
part for the ten weeks, three times a week, for four hours per week.
The participants were divided into two groups of fifteen and as well as
formal contact through participation in classes, were also encouraged
to mingle and socialise informally at Place4U. The programme began
and ended with health screening for each participant.
Executive Summary
“There's loads and
loads of
organisations but
this is kind of
unique because
it's men only and
it thrived on that”-
Kevin, Programme
Participant
4
“We talked about stress and a few others talked about a few more
things, suicide and a lot of things connected with mental health. It
gives you a chance to speak out about it”- Tom, Programme
Participant
5
To view the full dissertation on this programme's evaluation please visit:
http://library.wit.ie/etheses/BAThesisHP172.pdf
The emergence and recognition of men's health as a significant public health issue is still relatively
recent [1]. What has been known for some time is that men suffer poorer health outcomes compared
to women [2]. Health outcomes among males are generally worse than females globally with women
out-living men by an average of six years [3]. The death rate in Ireland also remains highest in men
compared to women across all age groups, with male mortality in the 15-24 year age group three
times higher than females. Men are more likely to die prematurely from cardiovascular disease than
women, more likely to be overweight, twice as likely to have diabetes, have a higher chance of dying
from non-gender-specific cancers, and are four and half times more likely to die from suicide [4].
There are many factors that lead to this gender disparity but what is clear from the wide variety of
evidence available is that gender has a significant role to play in health engagement and the
determinants of a person's health.
There is therefore an increasing need for gender-specific health promotion strategies that target
lifestyle and health behaviour change in men [5,6]. Men who are at particular risk of poor health
outcomes i.e. those who are unemployed, socially disadvantaged, isolated and have low educational
attainment, are paradoxically the least likely to engage with health promoting initiatives [7]. Engaging
this cohort of “hard-to-reach” men remains the biggest challenge for men's health promotion [8]. The
community-based setting has been identified as an effective way of promoting health in the male
population and engaging hard-to-reach men [9]. This setting allows a bottom-up, multi-sectoral
approach that can effectively tackle the influence of male-gendering on men's health behaviours in
what men may consider a safe and familiar environment [10].
Although knowledge of the disparities in men's health is increasingly available, there is difficulty in
applying the knowledge into the realities of health planning and programme implementation [11].
This calls for a need to document and disseminate effective gender-sensitive interventions to
promote health. Evaluating health promotion programmes is an effective way of achieving this while
assessing the programme's strengths and limitations and informing future practice. Research also
highlights a gap in resources to support community-based men's health programmes and evaluation
methods are recommended to combat this [12].
Rationale for the Research
6
The aim of this study was to evaluate the MHWP in order to test the
feasibility of the programme, inform future community-based men's
health work, capture the process involved in planning a community-
based men's health initiative, and identify ways of successfully
prioritising and addressing the needs of the men to enable stronger
future initiatives.
Aim
“Greg was struggling, he would tell you that
himself. His head was down, he was not in a good
place. And last week I talked to him at the
beg inn ing of th e coo ke ry clas s and he
spontaneously decided to inform me about how
wonderful this programme had been, and he was
just so positive and if he said once, he said five
times to me how great this programme was. When
I met Greg first I'm not sure I would have seen the
potential for him to be where he is today and that's
fantastic. And I know that he's not the only guy and
that's really wonderful. And I know that a few of
the guys are in a much better place as a result of
doing the course.”- Programme Coordinator
* Stakeholders refer to all those involved in the programme i.e. Place4U, ETB, volunteers,
programme coordinators, programme participants and community partners
RESEARCH
QUESTIONS
1: Is the Men's health
and wellbeing
programme feasible?
2: Does participation
in the programme
improve knowledge,
attitudes and health
outcomes among the
participants?
3: What is the process
involved in planning a
community-based
men's health
initiative?
4: What do key
stakeholders* identify
as key strengths and
weaknesses of the
programme?
7
Methodology
8
Mixed methods were used to conduct this research. All participants of the MHWP were invited to
take part in the evaluation. Participation in the research was voluntary. Informed consent was
obtained, and full ethical clearance was granted. Data was collected via questionnaires which were
administered to the participants (n=29) at the beginning and end of the programme. This method
was selected to provide information on the background of the participants, an insight into their
health and wellbeing and health behaviours, and to allow a comparison of health and fitness
measures gathered during health screenings at
the beginning and end of the programme.
Focus groups were also conducted with the
participants at the beginning and end of the
programme. This method was used to facilitate
an opportunity for participants to discuss
opinions and experiences of the programme
and how these evolved over the programme
duration. One-to-one interviews (n=3) were
conducted with programme coordinators. The
main area of interest in this component of the
research was to capture the process of
planning a community-based men's health
programme. The use of interviews allowed
detailed responses about experiences,
perceptions, opinions, feelings and knowledge
in relation to the programme development.
Feedback was collected from key stakeholders
(n=6) involved in delivering the programme.
This was collected at the end of the programme
via Survey Monkey with the option of a follow-
up phone call. Finally, some observational
res ea rch wa s con du ct e d du ri n g th e
programme to gain insights into the structure
of the programme, capture leve l s of
participation and involvement as well the
int e rac ti o n bet wee n f a ci lit a to r s a nd
participants.
The findings of this study address four broad areas in line with Research Questions. For a more in-depth
overview of the results see: http://library.wit.ie/etheses/BAThesisHP172.pdf
The Feasibility of the MHWP
Based on participants' demographics (i.e. older and unemployed or retired), results suggest that by
adopting a gender-sensitive, community development approach, the MHWP effectively engaged a cohort
of men generally regarded as “hard-to-reach” and potentially at risk of isolation, disadvantage or
marginalisation. While the participant number was small (n=30), this needs to be considered within the
context of the challenging nature of reaching this target cohort of men as well as the capacity (and largely
voluntary nature) of the centre to host the intervention. The programme's appeal to a mainly older cohort is
noteworthy and it may be preferable for future programmes to
have more diversity in terms of age. Other aspects of diversity
may also be worth considering in future programmes to
increase the reach of the target “at risk” group of men by
considering social class, ethnicity, race and sexual orientation.
Adapting the recruitment strategy and scheduling the
programme at evening times might extend the appeal and
reach of the programme to a younger more diverse target
group.
Results from the focus groups and interviews suggest that the programme was well received and fully
endorsed by all stakeholders. The demand for the programme was also reflected in the high retention rate,
with twenty eight out of thirty participants completing the programme, and the positive comments about
the programme reflected in the findings. A notable finding is the successful adaptation of the programme
from its inner-city Dublin origins and base in the Larkin Centre, to a medium-sized town and largely
volunteer-based community space in Place4U. This demonstrates that programme content can be moulded
to suit local context and resources, but more importantly that the approach and methodology has the
potential to be transferred across different settings and population groups. No formal evaluation of
programme costs was undertaken as many of those participating in workshop and programme delivery gave
their time free of charge or in a voluntary capacity. Any direct costs involved were borne mainly by
community partners such as the ETB covering costs of tutors and venues. However, the programme did
demonstrate strong practicality in terms of cost effectiveness by utilising resources that were available
within the community. This partnership approach suggests that the programme will be sustainable with
Results
“The Place4U volunteers are the
unsung heroes absolutely. The
programme wouldn't be there
without the volunteers. They had a
connection with the place and they
knew that their place on the
course mattered” - Programme
Coordinator
9
continued involvement and support from the community.
The effectiveness of the programme was also evident in the
observed changes (which are discussed in the efficacy of
the programme) in the participants and their positive
feedback. Overall, the findings suggest that the
programme meets the criteria of feasibility and is an
effective strategy for working with male groups in the
community.
Efficacy of the MHWP- Did it work? Changes in
attitudes, knowledge and health outcomes
A key way of determining programme effectiveness was to asses
whether participation in the programme resulted in changes in
knowledge, attitudes and health outcomes among the
participants. To do this, a number of variables and concepts
were measured and explored such as changes in the
participants health screening measures (blood pressure, BMI
etc.), levels of health service engagement, mental wellbeing, help seeking and loneliness, self-efficacy,
physical activity levels, eating behaviours and nutrition, health attitudes and perspectives, barriers to
engagement with health and opinions on the MHWP.
Findings highlighted how, overall, the men in the MHWP were keen to engage with and maintain their
health. A number of barriers also emerged, which affected their ability to engage with health and health
promotion programmes. These included difficulty with emotional expression associated with more
traditional gender norms, along with fear, apprehension, avoidance, denial and cost considerations in
dealing with health issues. Whilst the men's engagement with and assessment of health information did not
improve as a result of the intervention, the men did report an increased awareness of certain health topics
and increased motivation to engage with health in the focus
groups as a result of the MHWP. Results also showed that the
men's willingness to seek help if experiencing a problem
improved, indicating a change of mindset and increased
openness to seeking help. This may have been as a result of
the safe environment provided by the programme that
facilitated social support and open expression.
POSITIVE OUTCOMES
OF THE MHWP
Health service engagement
Health awareness
Help seeking behaviours
Reduced loneliness
Improved mental wellbeing
(not statistically significant)
Reduced stress (not
statistically significant)
Increased willingness to
maintain a healthy diet
Significant increase in
participants meeting the
physical activity guidelines
Significant reduction in
hypertension levels
“I find in general with men it is
very, very hard to motivate us.
I see a great improvement to
when I first started, I do little
bits now that I couldn't do
before” – Kevin, Programme
Participant
10
The men identified their mental wellbeing as being particularly important to them. This was a positive
finding considering that some men typically struggle with discussing issues around mental health. The safe
space identified by the men may have facilitated this open discussion as the men suggested that they were
able to talk openly about their feelings within the environment of the programme. Whilst mental wellbeing
and stress scores improved slightly but not significantly, the men did identify that they were more confident
in discussing mental health issues as a result of the programme, which they attributed to the connection and
support they had with other men. There was also a significant reduction in their loneliness scores at the end
of the programme which suggests that the social support within the programme improved feelings of
belonginess which is protective for both mental, and overall wellbeing.
The men's knowledge and awareness of healthy eating and their eating behaviours increased, as did their
confidence and desire to prepare and cook meals. This suggests that the programme was effective in
changing attitudes and knowledge around the men's eating behaviours. This may have been facilitated by
what the men identified as an encouraging, interactive, relaxed and engaging environment within the
cookery classes. The male only environment put the men at ease and made them feel like they were all
learning at the same level.
The men identified an increased desire to be
physically active and felt encouraged and
motivated to be more active with some joining the
a gym as a result of the programme. Although the
increase in the men's reported physical activity
was not significant, there was a significant
increase in the number of men meeting the
physical activity guidelines, suggesting that the
programme was successful in improving physical
activity outcomes. A conflicting result was found
in the men's physical activity self-efficacy which
was significantly reduced from baseline to follow-
up. This might be explained by an older cohort of men finding it challenging to take part in physical activity
after a significant period of inactivity.
Health measures such as HBa1C, cholesterol, weight and BMI, measured at screenings did not incur a
significant change, a finding that was not surprising given the relatively short duration of the ten-week
programme. There was a significant reduction in systolic blood pressure and hypertension levels and a
significant reduction in the number of participants needing to be referred to a GP at follow-up. These
11
The Process of Planning the MHWP
Findings suggest that the successful engagement of community partners was a key factor in the success of
the programme. Working in collaboration with community partners allowed the programme coordinators
identify available resources and form strategic partnerships. By aligning their own goals and objectives with
those of the programme, this in turn enabled community partners to recognise the value of the programme
and strengthen the programme's capacity. The challenge initially of gaining the trust and acceptance of
community partners was highlighted. This may have been due to the fact that the programme was running
for the first time and organisations may have been more amenable to partnerships once Place4U and the
programme had become more established.
Findings also highlight the importance of promotion
and recruitment during the planning stages of the
programme in order to engage the target group with
the programme. Feedback suggests that the use of
incentives to do this appeared to be the success
factor in engaging the target group. Factors such as
having a hook to draw participants to the
programme by offering a free health screening,
endorsement by the Tipperary hurling manager and
removal of cost barriers appeared particularly
effective.
The leadership that was offered by the programme coordinators within Place4U was key to the
programme's success. The networking and seeking of resources along with the delegation and persistence
of the leaders in the programme helped to nurture the programme and lead a vision of the MHWP that
quickly became shared by all stakeholders.
Overall, findings suggest that the planning of the programme was challenging and took a considerable
amount of commitment and time with lack of experience and knowledge in the area of health promotion
planning contributing to the complexity of implementing the programme. However, it was clear from the
findings that the inherent strength of the programme and support networks in place ensured its viability.
findings are suggestive of an improvement in overall wellbeing. It is also worth noting that the GP referrals
prompted a number of the participants to make follow-up appointments, meaning that they actively
engaged with the health services.
“I found the project team and the
Project Coordinator very
committed and passionate in their
determination to undertake this
ambitious project. This passion I
found was also shared by
Tipperary ETB and the individual
contributors to the project. This
collective drive has been key to
the success of the project.-
Project Coordinator, The Larkin
Centre
12
Strengths and Limitations of the MHWP
Identifying strengths and limitations of the programme from the point of view of all stakeholders was
important in terms of informing recommendations for future practice. Findings suggest that this approach
may have given the men a sense of ownership around the programme. The men were given the chance to
review programme content and outline topics they would like addressed in future. This approach of
engaging the men in reviewing programme content and having their say engendered a spirit of collaboration
and partnership, and was a key element in enabling the men to feel valued as partners in the programme.
A significant strength of the programme identified by all involved was that the programme catered
specifically for men. This appeared to provide a sense of safety and the reciprocal nature within the
programme was reported as a positive experience and conducive to the men discussing issues about their
wellbeing. Previous research has highlighted that men do not always feel safe or welcome in formal health
spaces and the alternative space provided within the MHWP offered the men an outlet to address issues of
health and wellbeing. Findings suggest that this environment also facilitated a strong sense of comradery
among the men. It was clear that social support encouraged the men to stay involved in the programme and
made the experience enjoyable. Simply being able to attend the programme in the company and support of
other men, appeared to offer the men a sense of belonginginess and purpose. The strong facilitation of the
programme and the support of the volunteers involved was conducive to a supportive and welcoming
environment that encouraged participation in the programme.
Findings suggest that the men appeared to engage well with the topics covered and found them important
and relatable. This highlights how men are willing to and want to engage with health discussions in the right
environment. The men identified mental health as being an important area of discussion and requested
more emphasis on this in the future. Results also suggest that the men found the mix of ages in the group
conducive to their learning and group dynamics. There were suggestions to facilitate a younger cohort to
join the MHWP in future to prevent the programme being categorised as a programme for older men.
“It's a reason for getting up. Otherwise you would be lying
down and you would say “Ah, I'll get up in a few minutes”.
Now you know you have to get up and get on with it”- Greg,
Programme Participant
13
The sample size of the participants was small, meaning
that findings may not be generalisable. Furthermore, the
quantitative element of the research relied largely on self-
reported data meaning that there was the potential for
misinterpretation, self-report bias and recall error.
The researcher endeavoured to encourage honest and
open sharing of experiences in the focus groups and
interviews by ensuring confidentiality and spending time
with the participants and by fostering positive
relationships and trust. Nevertheless, it must be
acknowledged that participants may have been guarded
in their disclosure out of fear of being negative or
vulnerable. Social desirability may also have been a
limitation as the participants worked closely with one
another and may have reflected to an extent what they
thought the group, or the researcher wanted to hear. The
sample size was representative within the context of the
programme considering size, location and timing.
Limitations of the research
“Personally, I would say it has
spurred me on to exercise a lot
more than I used to. And to do
it without being under pressure
doing it you know. I suppose
the crowd here, we probably
would have thought the gym is
for young fellas. I was
introduced above you know. It
takes the mystery out of it. You
would have a bit more
confidence going in. It takes the
shame out of it. ” - Shane,
Programme Participant.
14
The MHWP demonstrates a successful and effective gender-specific approach to men's health promotion.
Considering that few gender-specific health promotion interventions for men have been developed or
evaluated [13], the implications of these findings are relevant not only to inform the future practice of the
MHWP, but also the wider field of community-based men's health promotion.
The findings from the evaluation demonstrate that the MHWP is feasible within the context of Place4U but is
also transferable to other community settings as it can be largely a volunteer-led and community run,
sustainable programme. Although implementation can be challenging with limited resources and reliance
on vo lunteers, this pro gramme has
demonstrated that strong leadership,
working relationships and partnerships are
effective in meeting the objectives of the
programme.
The effectiveness of the programme is
demonstrated by the enhanced wellbeing
of the men who engaged with it and the
positive outcomes that were recorded.
Indeed, the programme is an example of
best practice on how to engage with men
through utilising reliable methods such as
removal of cost barriers, the use of a “hook”
to attract then men to the programme, the creation of a safe and welcoming environment, the adoption of
informal approaches and peer support. In the wider context of men's health promotion, this evaluation
highlights that, with the right approach, so-called “hard-to-reach” male populations can and are willing to,
engage with health promoting practices and suggests that community-based programmes have a key role to
play in promoting wellbeing in men.
Programme Feasibility
Programme Effectiveness
Conclusions
15
Programme Process
Programme Strengths and Weaknesses
This study demonstrates that the process involved in running a programme like the MHWP requires
dedication, commitment and leadership from the outset in order to ensure successful implementation. It
highlights the importance of volunteers within community-based health promotion, as the volunteers
within the MHWP were instrumental in the programme's success and future sustainability. Engaging the
community and forming strategic partnerships is also highlighted as a key process for successful
implementation as it not only offers resources but also facilitates “buy-in” and helps the wider community
to realise the significance of community-based men's health promotion.
Findings add to an existing body of knowledge which shows that men feel at ease in a male-only
environment and that a relaxed and informal approach
to men's health promotion is conducive to men speaking
openly about, and taking ownership of, their wellbeing.
This fostered a safe and nurturing environment that
allowed the men to feel at ease and facilitated natural
conversation about issues relating to their health. The
sense of social support and comradery in the peer
approach to the delivery of the MHWP stimulated a
sense of belonginess, particularly evident in the
participants' significant reduction in loneliness scores,
which fostered an overall sense of improved emotional
wellbeing. There were calls in the discussions with the
men for an increased emphasis on mental wellbeing,
reflecting the need for this area of health to be
addressed in men's health promotion.
This evaluation draws attention to the under
representation of men in community-based health
promotion programmes [14] and highlights the need for programmes such as the MHWP in the community
setting. This study demonstrates the efficacy of the MHWP in responding to calls at a policy level for an
increased focus on gender-specific and community-based approaches that account for the wider social
determinants of men's health [15,16]. Overall, the MHWP is an example of a practical and transferrable
method of successfully promoting health in the male population.
16
“What I found was that I did
really enjoy it. And perhaps it
did help me to focus on my
own wellbeing. And what I
did really enjoy was all the
conversations with the men. I
learned so much from
everybody here. And now we
are all so eager to be a part
of life and be positive”-
Edward, Programme
Participant
The following recommendations, aligned to the main research questions, emerged as a result of the
evaluation which may help to inform practice in the future:
Continue ongoing consultation with community partners to strengthen and increase partnerships
within the MHWP.
Consider calculating the true cost of the programme (time and monetary) in order to justify
prospective funding and realign and mobilise resources.
Consider increasing the programme's reach to other “at-risk” male population groups by increasing
diversity in terms of age, social class, race, ethnicity, disability and sexual orientation.
Facilitate an evening course to cater for men that may be employed or unable to attend during the day
which may help to increase reach.
Have a more explicit focus on mental wellbeing in the outline of future programmes as requested by
the participants.
Consider taking waist circumference measurements and performing fitness tests on the participants
to allow a more informed comparison of objective measures from baseline to follow-up.
Tailor the fitness classes more specifically to suit the cohort of men which may help to prevent future
reductions in physical activity self-efficacy.
In the instance of having separate groups attend the programme, facilitate an opportunity for
increased social interaction between groups to further enhance the sense of comradery.
For future research it may be useful to repeat measurements collected at baseline and the end of the
programme at a further follow-up period to identify sustained changes in behaviour, attitudes or
health outcomes.
Feasibility of the MHWP
The effectiveness of the MHWP
Recommendations
17
Planning the MHWP
Strengths and Weaknesses of the MHWP
Maintain detailed records of attendance, funding and resources used, from the outset to inform
future programmes and justify resources/funding.
Future research might consider identifying methods to capture the planning process of the
programme from the outset, involving key stakeholders at each level. This may allow the identification
of implementation barriers and facilitators which will help to improve the programmes potential for
scale-up.
Communicate with all involved in delivery of the programme clear guidelines and defined roles in
order to enhance the programmes efficiency.
In order to strengthen the sustainability of the MHWP it would be beneficial to secure more
partnerships within the community that may offer resources or enhance funding that could help to
improve the programmes reach and ability to deliver effective content.
Continue to cater the programme specifically for men and review content and programme delivery on
an ongoing basis to maintain the informal approach that is conducive to the programme's successful
outcomes.
Facilitate opportunities for social interaction between participants during and between programme
delivery to maintain the sense of comradery and social support that encourages programme
attendance and adherence.
To view the full dissertation on this programme's evaluation please visit:
http://library.wit.ie/etheses/BAThesisHP172.pdf
18
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Clonmel,
Co. Tipperary.
Tel.: 087 4407935
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