Practical Strategies for Improving Men's Health: Maximizing the Patient-Provider Encounter

Main Article Content

James E Leone
Michael J Rovito, PhD, MA, CHES, FMHI
Kimberly A Gray, PhD, MS, ATC, CSCS, CHES, RYT
Ryan Mallo, PhD, DNP, NP-C

Abstract

Inconsistent access to a healthcare provider (HCP), which can lead to advanced morbidity, is an oft-cited barrier to advancing health. Extensive review of the literature consistently suggests men are far less likely to engage within the healthcare system. This is particularly problematic pertaining to preventive services. As many health conditions are preventable and/or treatable in earlier stages, delay in screening and treatment often leads to long-term negative health outcomes. Lack of early and frequent preventive healthcare (e.g. primordial, primary, and secondary prevention) may even be perceived as “normative” where poorer health outcomes in males are expected.1 In fact, some evidence demonstrates a clear connection that seeking help via healthcare runs contrary to masculinity and dominant masculine principles, such as being strong/sturdy, working through pain, avoiding weakness or anything perceived as feminine, among other psychosocial phenomena.2,3


 Changing healthcare “culture” concerning the care of men (i.e. gender-sensitive care) may provide a salient avenue to encourage more consistent and preventive contact or “touch points” in the patient-provider dynamic. There is a need to understand how social norms and practices in healthcare and medical settings can be effectively leveraged to address life-long male health outcomes versus focusing on late(r)-stage palliative care.


 The purpose of this article is to advance dialogue concerning practical considerations, such as resources (e.g. time, money) and methods (e.g. practitioners considering whether men respond best to immediate efforts to establish rapport versus a traditional power-based dynamic during the medical interaction) so as to inform gender-sensitive touchpoints in the healthcare of men. Location and types of facilities where men are willing to seek care (preventative or palliative) also need to be considered in a holistic, gender-sensitive patient-provider model of healthcare.  Implications, policies, and evidence-based practical strategies for leveraging medical education, prevention programming, proper and improper recognition and management, and long-term treatment are presented and discussed with the practitioner in mind.


 

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Author Biographies

James E Leone, Bridgewater State University, Bridgewater, MA, USA

Professor, Public Health Studies, Department of Movement Arts, Health Studies and Leisure Studies, College of Education and Health Sciences, Bridgewater State University, Bridgewater, MA 02325, USA

Adjunct Lecturer, Master of Public Health Program, Bouvé College of Health Science, Northeastern University, Boston, MA
Board of Directors and Fellow, Men’s Wellness Collective, Inc. Orlando, FL

Michael J Rovito, PhD, MA, CHES, FMHI, University of Central Florida

Associate Professor, Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
Lecturer, Southern Illinois University, Carbondale, IL

Kimberly A Gray, PhD, MS, ATC, CSCS, CHES, RYT, Southern Illinois University Carbondale, IL

Lecturer, Southern Illinois University, Carbondale, IL

Ryan Mallo, PhD, DNP, NP-C, Averett University and University of Michigan Flint

Director of Nurse Practitioner Programs and Associate Professor, Averett University, Danville, VA

Adjunct Faculty, Nurse Practitioner Programs, University of Michigan Flint, Flint, MI
Primary Care Nurse Practitioner, Private Practice, Evart, MI

 

References

1. Leone JE, Rovito, MJ. “Normative content” and health inequity enculturation: a logic model of men’s health advocacy. Am J Men’s Health 2013;7(3):243-54.
2. Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychologist 2003;58(1):5-14. doi:10.1037/0003-066X.58.1.5
3. Connell RW, Messerschmidt JW. Hegemonic masculinity: rethinking the concept. Gender & Society 2005;19(6):829-59. DOI: 10.1177/0891243205278639
4. Pinkhasov RM, Wong J, Kashanian J, et al. Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States. Int J Clin Pract 2010;64(4), 475-87.
5. Leone JE, Rovito MJ, Mullin EM, Mohammed SD, Lee CS. Development and testing of a conceptual model regarding men’s access to health care. Am J Men’s Health 2017;11(2):262-74.
6. Schlichthorst M, Sanci LA, Pirkis J, Spittal MJ, Hocking JS. Why do men go to the doctor? Socio-demographic and lifestyle factors associated with healthcare utilization among a cohort of Australian men. BMC Public Health 2016;16(3):1028.
7. Gavarkovs AG, Burke SM, Reilly KC, Petrella RJ. Barriers to recruiting men into chronic disease prevention and management programs in rural areas: perspectives of program delivery staff. Am J Men's Health 2016;10(6):NP155-NP157.
8. O’Brien R, Hunt K, Hart G. ‘It's caveman stuff, but that is to a certain extent how guys still operate’: men's accounts of masculinity and help seeking. Soc Sci & Med 2005;61(3):503-16.
9. Cohn L, Murray SB, Walen A, Wooldridge T. Including the excluded: males and gender minorities in eating disorder prevention. Eat Disord 2016;24(1):114-20.
10. Tokhi M, Comrie-Thomson L, Davis J, Portela A, Chersich M, Luchters S. Involving men to improve newborn and maternal health: a systematic review of the effectiveness of interventions. PLoS ONE 2018;13(1):e0191620. https://doi.org/10.1371/journal.pone.0191620
11. Miller VM, Kararigas G, Seeland U, et al. Integrating topics of sex and gender into medical curricula: lessons from the international community. Biol Sex Differences 2016;7(suppl 1):44. https://doi.org/10.1186/s13293-016-0093-7
12. National Center for Health Statistics. Health: United States 2016, with chartbook on long-term trends in health. Hyattsville, MD, 2017.
13. Brott A, Dougherty A, Williams ST, Matope JH, Fadich A, Taddelle M. The economic burden shouldered by public and private entities as a consequence of health disparities between men and women. Am J Men's Health 2011;5(6):528-39. doi:10.1177/1557988311421214
14. Rovito MJ. Eclipsed by the prostate: expanding testicular cancer scholarship through years of potential life lost and economic productivity. Am J Men's Health 2017;11(3):674-77.
15. Hoff TJ. Next in line: lowered care expectations in the age of retail and value-based health. London: Oxford University Press; 2017. DOI:10.1093/oso/9780190626341.001.0001.
16. Evans J, Frank B, Oliffe JL, Gregory D. Health, illness, men and masculinities (HIMM): a theoretical framework for understanding men and their health. J Men's Health 2011;8(1):7-15.
17. Garcia CM, Ptak SJ, Stelzer EB, Harwood EM, Brady SS. 'I connect with the ringleader:' health professionals' perspectives on promoting the sexual health of adolescent males. Res in Nurs & Health 2014;37(6):454-65. doi:10.1002/nur.21627
18. Garfield CF, Isacco A, Rogers TE. A review of men's health and masculinity. Am J Lifestyle Med 2008;2(6):474-87.
19. Aslan M, Wanamaker M. Tuskegee and the health of black men. The Quarterly J Econ 2018;133(1):407-55.
20. Gornick ME. A decade of research on disparities in Medicare utilization: lessons for the health and health care of vulnerable men. Am J Pub Health 2003;93(5):753-59.
21. Balfe M, Brugha R. What prompts young adults in Ireland to attend health services for STI testing? BMC Public Health 2009;9(311):1-10. doi:10.1186/1471-2458-9-311
22. Lanier Y, Sutton MY. Reframing the context of preventive healthcare services and prevention of HIV and other sexually transmitted infections for young men: new opportunities to reduce racial/ethnic sexual health disparities. Am J Pub Health 2013;103(2):262-69. doi:10.2105/AJPH.2012.300921
23. Mak J, Mayhew SH, von Maercker A, Colombini M. Men's use of sexual health and HIV services in Swaziland: a mixed methods study. Sexual Health 2016;13(3):265-74. doi:10.1071/SH15244
24. Witty K, White A. Tackling men's health: implementation of a male health service in a rugby stadium setting. Comm Pract 2011;84(4):29-32.
25. Yousaf O, Grunfeld EA, Hunter MS. A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Heal Psychol Rev 2015;9(2):264-76.
26. Cordier R, Wilson NJ. Community-based men's sheds: promoting male health, wellbeing and social inclusion in an international context. Health Promo International 2013a;29(3):483-93. doi:heapro/dat033
27. Cordier R, Wilson NJ. Mentoring at men's sheds: an international survey about a community approach to health and well-being. Health Soc Care in the Comm 2013b;22(3):249-58. doi:10.1111/hsc.12076
28. Pringle A, Zwolinsky S, McKenna J, Robertson S, Daly-Smith A, White, A. Health improvement for men and hard-to-engage-men delivered in English premier league football clubs. Health Educ Res 2014;29(3):503-20. doi:her/cyu009
29. Baker P, Shand T. Men’s health: time for a new approach to policy and practice? J Global Health 2017;7(1), 1-5.
30. Springer KW, Mouzon DM. “Macho men” and preventive healthcare: implications for older men in different social classes. J Health Soc Behav 2011;52(2):212-27.
31. Heath PJ, Seidman AJ, Vogel DL, Cornish MA, Wade NG. Help-seeking stigma among men in the military: the interaction of restrictive emotionality and distress. Psychol Men Masc 2017;18(3):193-97.
32. Perry RCW, Kayekjian KC, Braun RA, Cantu M, Sheoran B, Chung PJ. Adolescents' perspectives on the use of a text messaging service for preventive sexual health promotion. J Adolesc Health 2012;51(3):220-25. doi:10.1016/j.jadohealth.2011.11.012
33. Cohen CE, Coyne KM, Mandalia S, Waters A, Sullivan AK. Time to use text reminders in genitourinary medicine clinics. Int J STD & AIDS 2008;19(1):12-13.
34. Watkins DC, Griffith DM. Practical solutions to addressing men's health disparities: guest editorial. Int J Men's Health 2013;12(3):187-94. doi:10.3149/jmh.1203.187
35. Blumberg SJ, Vahratian A, Blumberg JH. Marriage, cohabitation, and men's use of preventive healthcare services (NCHS data brief, no.154). Hyattsville, MD: National Center for Health Statistics; 2014.
36. Bottorff JL, Oliffe JL, Kelly MT, et al. Men’s business, women’s work: gender influences and fathers’ smoking. Soci Health & Illness 2010;32(4):583-96.
37. Wentzell E, Salmerón J. Prevalence of erectile dysfunction and its treatment in a Mexican population: distinguishing between erectile function change and dysfunction. J Men's Health 2009;6(1):56-62.
38. Manchester A. Men are dying from self-induced illnesses. Nursing New Zealand 2015;21(6):13-14.
39. Rovito MJ, Leonard B, Llamas R, et al. A call for gender-inclusive global health strategies. Am J Men’s Health 2017;11(6):1804-08. https://doi.org/10.1177/1557988317723424
40. Gough B. The psychology of men’s health: maximizing masculine capital. Health Psychology 2013;32(1):1-4.
41. Lykens JE, LeBlanc AJ, Bockting WO. Healthcare experiences among young adults who identify as genderqueer or nonbinary. LGBT Health 2018;5(3): https://doi.org/10.1089/lgbt.2017.0215.
42. U.S. Department of Health and Human Services. (2013a). HealthyPeople.gov. Retrieved from www.healthypeople.gov/2020/default.aspx