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Sheds for Life Impact Report The Impact of implementation phase one on the health and Wellbeing outcomes of participants
Abstract and Figures
This report highlights the impact 'Sheds for Life', a community-based men's health promotion initiative in the Men's Sheds, has had on the health and wellbeing outcomes of men who participated
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... The phrase 'health by stealth' (Milligan et al., 2012) characterises the approach to improving health and wellbeing among participants, whether indirectly through the positive effects of social interaction on wellbeing, or directly through health promotion campaigns. Sheds have been noted as important community settings, especially for those who may be 'hard to reach' in conventional healthcare settings (Kelly & Steiner, 2021;McGrath, et al., 2021). Many men's shed activities involve engaging with nature, including walking, gardening and other outdoor activities. ...
... Internationally and within Ireland, there is a strong evidence base for the positive impact of men's sheds on the physical and mental wellbeing of participants (e.g., Kelly, et al., 2019;McGrath, et al., 2021; ...
... They include men from a variety of backgrounds and are particularly valuable for those who may be socially excluded, those experiencing unemployment or those affected by negative life experiences . Studies have indicated that sheds attract 'hard-to-reach' older men who are sometimes difficult to engage in conventional healthcare settings (Kelly & Steiner, 2021;McGrath, et al., 2021). This presents valuable opportunities to generate awareness, knowledge and understanding of common health issues through health promotion campaigns, and to 'normalise' health as a topic of conversation in the sheds. ...
In 2019 the Irish Men’s Sheds Association (IMSA) was designated a Sustainable Development Goals (SDGs) Champion by the Republic of Ireland’s Minister for Communications, Climate Action and the Environment. This report evaluates the effectiveness of community-based men’s sheds on the island of Ireland as agents of social and environmental sustainability and identifies potential to develop this role. Recommendations are offered for consideration by men’s sheds across the island.
As an academic study, the key novel contribution is the finding that men’s sheds in Ireland in addition to supporting social sustainability, are also already engaged in activities that support environmental sustainability. There is scope to further develop their role as champions of environmental sustainability in their communities. While men’s sheds have received significant attention from researchers interested in their role in health, wellbeing and social inclusion, their current and potential role in environmental sustainability has been largely absent from the academic literature on men’s sheds.
Background
Men’s Sheds (“Sheds”) offer a unique opportunity to reach a captive audience of “hard-to-reach” men. However, attempts to engage Sheds in structured health promotion programmes must respect the ethos of Sheds as highly variable, autonomous, non-structured spaces. This paper captures the key methodologies used in “Sheds for Life’ (SFL), a men’s health initiative tailored to the Shed setting.
Methods
A hybrid effectiveness-implementation study design is used to test effectiveness and implementation outcomes across multiple levels (participant, provider, organisational and systems levels). A dynamic, iterative and collaborative process seeks to address barriers and translation into the real world context. Using a community-based participatory research approach and guided by established implementation frameworks, Shed members (‘Shedders’) assume the role of key decision makers throughout the evaluation process to promote the systematic uptake of SFL across Shed settings. The protocols pertaining to the development, design and implementation of SFL and the evaluation of impact on participants’ health and wellbeing outcomes up to 12 months are outlined.
Conclusions
There is a dynamic interplay between the intervention characteristics of SFL and the need to assess and understand the diverse contexts of Sheds and the wider implementation environment. A pragmatic and context-specific design is therefore favoured over a tightly controlled efficacy trial. Documenting the protocols used to evaluate and implement a complex multi-level co-developed intervention such as SFL helps to inform gender-specific, community-based men’s health promotion and translational research more broadly.
Trial registration
This study has been retrospectively registered with the ‘International Standard Randomised Controlled Trial Number’ registry (ISRCTN79921361) as of the 5th of March 2021.
Background
Men’s health is a globally underrepresented area of research and policy. With men facing numerous healthcare barriers, there are calls for more ‘male friendly’ approaches to health improvement that take into consideration differing male behaviours and attitudes towards health. Men’s Sheds are community-based organisations delivering practical and social activities that encourage positive health behaviours. While Sheds have been recognised for their health and wellbeing benefits to men, research has yet to explore the impacts of Sheds on male health improvement and their potential role as a preventative gendered public health measure.
Methods
The study used in-depth interviews with 62 Shed members from five Sheds to investigate the impacts of Shed activity on the health improvement behaviours and attitudes of Shed users. Findings from the qualitative study were used to propose a set of pathways in which Sheds activity led to positive health engagement.
Results
The proposed pathways suggest that there are many different and interlinked ways in which Shed activities can impact on the health behaviours and attitudes of Shed users. Through participation in various practical and social activities in an inclusive environment, Shed users reported increases in their health seeking behaviours, improved perspectives on and management of their personal health, and an increased ability to overcome illness and recover.
Conclusions
Where male friendly health provision has been lacking, this study suggests how Men’s Shed activities can provide positive male health outcomes, often in unexpected and non-obvious ways. In particular, the proposed visual pathways are important to inform policymakers and practitioners of the ways in that Sheds may contribute to engaging men in health improvement practices and increase their health knowledge. This study also provides a structure from which further studies can measure and evaluate Shed health impacts.
Thesis Statement
Men experience poorer health outcomes than females and gender specific targeted health promotion needs to adequately address this gender bias.
Methodology
This prospective observational study audited all printed health promotional materials in all health facility waiting rooms within a defined geographic region. A total of 24 sites were surveyed which included general practice centres, community health centres and hospitals. The surveyed health literature included posters, brochures, and booklets.
Results
There were 1143 health materials audited across the sites. Of these, 3.15% (n = 36) were male-specific literature, 15.31% (n = 175) were female specific health literature and 81.54% (n = 932) were gender neutral. Literature which had a gendered focus was overwhelmingly female to male with a ratio of approximately 5:1.
Conclusions and Implications
This research highlighted that despite the known outcomes of lower male life expectancy and higher burden of disease, male specific literature is significantly under-represented within health facility waiting spaces. There remains potential for health clinicians to provide targeted male health education and thereby improve male health literacy.
Key messages
Men's health both within Australia and globally remains under-represented despite lower health expectancy and higher burden of disease. Health facilities ought to actively control the health promotion messaging to vulnerable population groups.
COVID-19 disproportionately affects males especially those who are older and more socioeconomically disadvantaged. This study assessed wellbeing outcomes among men's shed members (Shedders) in Ireland at baseline (T1), 3 (T2), 6 (T3) and 12 months (T4) in response to a 10-week health promotion program 'Sheds for Life' (SFL). Two cohorts participated in SFL commencing in March and September 2019. This study compares the T3 findings from one cohort carried out during the COVID- 19 pandemic [COVID cohort (n=185)] with T3 findings from a comparator cohort [pre-COVID cohort (n=195)], completed pre-COVID-19. Questionnaires assessing wellbeing [life satisfaction, mental health, loneliness, physical activity (PA), self-rated health and other lifestyle measures] were analyzed in both cohorts T1, T2 and T3. Self-rated Health and life satisfaction decreased in the COVID cohort at T3 (p<0.001), while loneliness scores increased (p<0.0005). Higher loneliness scores were correlated with lower health ratings, life satisfaction and PA during COVID-19 (p<0.001). Days PA decreased in the COVID cluster at T3 from T2 (p<0.01) with those in urban areas reporting lower activity levels than rural areas (p<0.05). Those sufficiently active at baseline managed to maintain PA during COVID-19 while those not meeting guidelines were more likely to report decreases (p<0.001). Shedders experiencing COVID-19 restrictions are at an increased risk of poorer wellbeing and increased levels of loneliness. Support and guidance are needed to safely encourage this cohort back into men's sheds, settings that protect against loneliness and positively promote health and wellbeing.
Men aged 85 years and over have the highest rate of suicide of any age or gender group in Australia. However, little is known about their trajectory toward suicide. The objective of this study was to understand the role of masculine norms and other life factors in the suicidality of older men. Thirty-three men aged 80 years or more took part in a semistructured focus group or interview, and/or completed a survey. Participants were asked about the issues facing older men, well-being and aging, physical health challenges, social support, mental health and help-seeking, and suicide and suicide prevention. Five themes emerged: “finding out we’re not invincible,” “active and tough,” “strong silent types,” “decision makers,” and “right to die.” Participants spoke about masculine norms that had influenced their lives as providers and decision makers, and now influenced how they coped with aging and their journey toward death. For some participants, suicide was seen to be a rational alternative to dependence in their final years. Suicide prevention should adopt a gendered approach and be cognizant of the influence of gender roles and masculinity in older men’s lives. Further research and prevention efforts should be mindful of the impact of masculine norms of self-reliance and control on an older man’s decision to end his life. Suicide prevention efforts should work to reduce stigma around the challenges of aging, maximize opportunities for control, facilitate social connection, and improve residential aged care.
This article examines how older adults use and perceive digital technologies in Finland and Ireland. These two countries are at different stages regarding two important global trends – demographic ageing and digitalization. Finland, being the fastest ageing society in Europe, is also one of the leaders in implementing digital technologies in social and health care services. In contrast, Ireland is a demographically younger and less digitalized society. Drawing on focus group discussions on the usage of digital technologies, conducted with older adults in both countries, we analyse how digital technologies are adopted and viewed by older generations. The analyses showed that older adults associate digitalization with both advantages and drawbacks. To encapsulate these two contrasting aspects, we developed the term Janus-faced conceptions of technology. This concept encapsulates how the successful adoption of digital technology facilitates everyday activities whereas the inability to utilise technologies results in feelings of alienation and being out-of-touch. The digital divide was found to occur not only between generations but also between different socioeconomic groups of older adults.
Objective
We investigated whether male high school students displaying high traditional masculinity (HTM), defined briefly as overacting male roles, possessed distinctive social origins and adult lifestyle trajectories differentiating them from others.
Method
Based upon four survey waves of the National Longitudinal Study of Adolescent to Adult Health cross‐linked to the National Death Index, we contrasted surveys 1 and 2 respondents reporting HTM, n = 3138, 31%, with the remaining 69% (n = 6849) on various sociodemographic characteristics, problem behaviors, suicides, and other premature mortalities.
Results
High traditional masculinity males showed higher suicide rates, but no other differences in premature mortalities, compared with non‐HTM peers. More likely to be White, younger, less close to their fathers, they were more likely to run away from home, get into fights, act delinquently, and engage in problem drinking and drug use. At survey wave 3, more had been arrested. By wave 4, when approaching their early thirties, HTM males showed higher drug uses, more delinquency, completed less schooling, and were less likely to marry.
Conclusions
These data not only suggest higher suicide risks among this population after high school, but judging from the durability of HTM characteristics, but also they appear at risk of “deaths of despair” during later life.
Men with the poorest health outcomes are, paradoxically, the least likely to access health services or to engage with health promotion interventions. This has focused attention on developing gender-sensitive and strengths-based approaches to engage so-called 'hard-to-reach' men. Men's Sheds ('Sheds') are recognized as an alternative space in which to engage older and more marginalized groups of men in health. The aim of this study was to establish key principles that could align the ethos of Sheds with a national health promotion initiative ('Sheds for Life'; SFL) in terms of methods of engagement, programme content and models of delivery. Qualitative methods incorporating semi-structured interviews, focus groups and observations were conducted with men in Sheds ('Shedders'; n = 38), oversight/advisory groups (n = 11) and partner organizations (n = 8). The principles of grounded theory were used to inform data collection and analysis. Findings revealed a range of mediating factors in terms of how Shedders engage with or 'do' health that were grounded in a recognition of the health-enhancing 'essence' of Sheds and in 'making men's health men's business'. Key learnings arising from the process of engaging with Shedders included the importance of investing in relationships, establishing credibility and tailoring SFL programme content and delivery to individual Sheds. In terms of conceptualizing SFL, attention was drawn to the need for a coherent and formalized SFL strategy and 'rules of engagement', as well as a robust and sustainable system for implementation. This is the first study that informs a more systematic and formal approach to health promotion in Sheds.
The COVID-19 pandemic has excluded older adults from a society based on physical social contact. Vulnerable populations like older adults also tend to be excluded from digital services because they opt not to use the internet, lack necessary devices and network connectivity, or inexperience using the technology. Older adults who are frail and are not online, many of whom are in long-term care facilities, struggle with the double burden of social and digital exclusion. This paper discusses the potential outcomes of this exclusion and provides recommendations for rectifying the situation, with a particular focus on older adults in long-term care facilities.