Identifying male college students' perceived health needs, barriers to seeking help, and recommendations to help men adopt healthier lifestyles

Novel Men's Health Curriculum Increases Fraternity Members' Knowledge, Confidence, and Willingness to Seek Help for Health Concerns

OBJECTIVE

To evaluate fraternity members' men's health knowledge, confidence in understanding, and the likelihood of seeking help for men's health concerns and to assess the impact of a novel men's health curriculum on each of these measures.

METHODS

Members of 6 undergraduate fraternities (n = 189) viewed a 45-minute presentation about men's health topics and completed before and after surveys.

RESULTS

The presentation increased men's health knowledge, confidence in understanding men's health concerns and when/where to seek help, and the likelihood of seeking help for men's health concerns. Health knowledge did not correlate with confidence or likelihood of seeking help. Confidence positively correlated with the likelihood of seeking help before and after the presentation.

CONCLUSION

A short presentation on common men's health topics increases health knowledge, confidence, and the likelihood of seeking help for these concerns. Increased confidence in understanding, rather than health knowledge, was associated with an increased willingness to seek help.

Pathways from Men's Shed engagement to wellbeing, health-related quality of life, and lower loneliness

Extensive qualitative evidence, but limited quantitative evidence, indicates that mutual aid organizations such as Men's Sheds have positive impacts on wellbeing, health-related quality of life, and loneliness. A recently developed theoretical model proposes that Men's Sheds may have these impacts via mediating factors such as broadening social networks, increasing behavioural activation and physical activity, reducing alcohol use, and providing meaning in life. The aim of this study was to quantitatively test a model whereby psychological safety (feeling safe, accepted, and valued) is associated with Men's Shed engagement (frequency of attendance, duration of membership, diversity of activities), which is associated with the hypothesized mediators, which, in turn, are associated with wellbeing, health-related quality of life, and loneliness. Men's Shed members (N = 333, Mage = 70.90 years, SD = 10.34, 98% male) completed a survey assessing the factors in the model. The hypothesized path model provided an excellent fit to the data. Findings indicated that higher psychological safety was associated with higher engagement, which, in turn, was associated with larger social networks and more meaning in life, which were associated with higher wellbeing and lower loneliness. Higher behavioural activation and less alcohol use were also associated with higher wellbeing. Higher Men's Shed engagement was not associated with higher behavioural activation and physical activity, or less alcohol use, but behavioural activation and alcohol use were directly associated with health-related quality of life. Implications for optimizing health outcomes within Men's Sheds are discussed.

Perceived health interests of college students

Objective: Investigate how college students perceive positive aspects of health as compared to neutral and/or negative aspects of health. Participants: 20 college students (55% female, 50% Black, M age = 23 years, SD = 4.1 years) completed a card-sorting activity as part of a focus group. Methods: Each participant ranked 57 cards by perceived importance. The cards included positive (n = 19), neutral (n = 19), and negative (n = 19) health topics. Results: Positive and neutral health attributes were significantly more important than negative aspects of health, with student rankings indicating declining importance from positive to neutral to negative aspects of health. Conclusions: Findings suggest that campus health professionals should consider salutogenic approaches to health promotion that enable college students to achieve short-term health gains and health maintenance in addition to disease prevention and harm reduction.

Every guy needs his team: the promise of peer-led mentoring groups for college men

Objective: Our study conducted a preliminary evaluation of a peer-mentoring group program for college men (Freshmen League). Participants & Methods: We interviewed first-year men who participated in Freshmen League (n = 16) and others who did not (n = 10), asking them questions about authenticity, relationships, masculinity, and community. Using consensual qualitative research, we identified themes in constructions of their experiences and development throughout the year, and compared them across groups. Findings: Men in both groups reflected on becoming their authentic selves, feeling pressure to fit a mold, valuing friendship, and wanting to positively impact their community. However, Freshmen League participants were more likely to talk about vulnerability, positive influences of upperclassmen, connecting with others, alternative social norms, and social justice. Conclusions: Peer-led mentoring groups represent a promising direction as interventions to promote college men's health and campus culture. Directions for future research and considerations for program implementation are discussed.

The Association of Gender Role Attitudes and Risky Drinking: Changes in the Relationship between Masculinity and Drinking in Korean Young Men

Recently, younger men in Korean society tend not to view drinking as a proud feature of men who work. The relationship between gender role attitudes and high-risk drinking is expected to change accordingly. An online survey was conducted in January-February 2022, and the frequency of drinking, the amount of drinking, and traditional gender role attitudes, such as "men should be independent and women should take care of the children", were measured. Participants were 786 men aged between 19 and 69 years. When comparing men in their 20s and 30s with those in their 40s to 60s, the younger men reported drinking relatively high amounts of alcohol in one place, and older men had a relatively high frequency of drinking. High-risk drinking was significantly higher in the older group. Gender role attitudes were more traditional in the older group and were a predictor of high-risk drinking in older men, but there was no significant relationship between the two variables in the younger age group. The results indicate that different generations have different perceptions of how men should drink. In addition to more detailed qualitative research on drinking motivation by generation, research on whether similar changes are occurring in other countries is needed.

College student symptoms as assessed by a student health survey

ObjectiveWe sought to identify the general health of college students.ParticipantsA total of 4402 university freshmen and sophomores were recruited to report their general health through an online questionnaire.MethodsResponses from the DePaul Symptom Questionnaire were analyzed. We then conducted latent class analyses to evaluate 54 different symptoms among participants.ResultsA four class solution was identified, consisting of a group of asymptomatic students (35.65%), a second group of students reporting mild fatigue and sleep symptoms (38.87%), a third group reporting moderate sleep and fatigue symptoms (20.36%), and a group reporting moderate and severe complaints on the majority of symptoms (5.11%). Female students had 2.07 times the relative risk of the severe symptom class of men. Indigenous students have 2.88 times the relative risk of occupying the severe symptom class than non-indigenous students.ConclusionsThe results suggest that about 5% of college students have varied symptoms of a moderate to severe degree. Future research is needed to better assess whether there are biological associations with these self-report findings, as well as to determine longer-term implications of these symptoms.

Association between university students' two-staged health screening and student health care utilisation: register based observational study

OBJECTIVES

The aim of this study was to explore how university students' participation in a two-staged health screening at the beginning of university studies associates with student health care utilisation in a 6-year follow-up.

DESIGN

Nationwide, observational, register-based cohort study with a 6-year follow-up.

SETTING

Student health care in Finland. Finnish Student Health Service (FSHS) provides statutory student health services to university students in Finland. The two-staged health screening of FSHS includes the electronic health questionnaire (eHQ) provided annually to university entrants and a subsequent health check, when necessary, based on students eHQ response.

PARTICIPANTS

A national cohort of university entrants from the 2011-2012 academic year (N=15 723) was assessed. After exclusions the study population consisted of 12 972 students, n (female)=7368, n (male)=5604.

OUTCOME MEASURES

The primary outcome measures were students' health service utilisation pattern obtained by clustering analyses method and the students' participation in different stages of the health examination process.

RESULTS

Four distinguishable health care utilisation patterns were identified: (1) constant low use, (2) constant high use, (3) increasing use and (4) decreasing use. The students' OR for belonging to the constant high use group was significantly higher among females (OR 4.0, 95% CI 3.5 to 4.6) and students who attended the health check (OR 4.7, 95% CI 3.9 to 5.6).

CONCLUSIONS

Participating in the two-staged health screening was associated with increase in health care utilisation. The process detects students with health problems.

A health risk assessment and early alcohol intervention program for non-mandated students

OBJECTIVE

We examined the effects of a two-part intervention including an online health risk assessment with personalized feedback and a brief in-person alcohol intervention for high-risk students.

PARTICIPANTS

Participants were 1,987 sophomore students, with 259 completing the alcohol intervention and 91 completing all follow-up surveys.

METHODS

Students were invited to take an initial online health assessment covering a range of health behaviors and subsequent 3-month follow-up survey. Students who reported high-risk alcohol behaviors on the assessment were invited to participate in two one-on-one sessions utilizing motivational interviewing. Follow-up surveys occurred 3, 6 and 12 months later.

RESULTS

Students who completed the health risk assessment reported knowledge and behavior changes. Students who completed the in-person alcohol intervention showed significant reductions in alcohol risk behavior 3-, 6- and 12-months post-intervention.

CONCLUSIONS

A two-part intervention for non-mandated students including a health risk assessment and one-on-one intervention shows promise in reducing alcohol risk.

Development of a Men's Health course for first-year undergraduates using culturally responsive teaching strategies

Purpose

A novel first-year experience course was developed using culturally responsive teaching strategies at an undergraduate liberal arts college in the southeastern USA to promote health advocacy and to provide students with an overview of male health. The course focuses on the biological, sociocultural, economic and gender influences that shape men's health beliefs and practices. It also emphasizes health disparities in the USA among Black/African American men compared to other racial groups and intervention strategies to improve health outcomes.

Design/methodology/approach

The lecture and laboratory components of the course were designed as a blended learning environment with a modified flipped class model. Culturally relevant strategies guided the course design with three focus domains: academic success, cultural competence and sociopolitical consciousness. A community engagement model and service-learning activities were also incorporated in the design. The authors used course grades to gauge learning and implemented a survey to assess students' perception of the knowledge gained in three realms: men's health, health sciences and physical sciences.

Findings

This report describes the course design, highlights the value of using culturally responsive teaching strategies and service-learning projects to encourage students' active learning. Course activity examples are discussed with student responses. The authors found that students' perception of their knowledge in men's health, health sciences and physical sciences increased and the students performed well in the course.

Originality/value

This is one of few biology courses in the nation that intentionally focuses on the unique health challenges of Black men, while empowering college students to develop culturally competent strategies to improve their health outcomes. The findings suggest that the students learned the material and that their perceived knowledge on men's health increased. The authors urge other academic institutions and healthcare providers to consider implementation of similar courses in an effort to enhance male health equity.

User needs gathering for the design of information and communications technology-supported occupational stress management intervention: A quantitative study

Introduction

The software industry is considered a growing industry with a high propensity to cause stress reactions among employees due to its demanding and technology-driven nature. There are convincing shreds of evidence that information and communications technology (ICT) interventions can effectively solve stress-related disorders. However, several identified constraints have hindered its potential benefits, such as poor adherence, lack of engagement, high attrition and lack of personalisation.

Objective

The study presented in this article aims to gather the user needs of software employees in Sri Lanka to identify design ideas for an ICT-supported intervention for occupational stress management (ICTSMI) in the software industry.

Materials and methods

The study followed a quantitative approach using an online questionnaire in which three key areas were investigated: (1) stressors, (2) coping strategies and (3) design preferences. A total of 408 valid responses were collected and analysed using SPSS software.

Results

Findings revealed that the majority of software employees were with a moderate level of stress. They perceived work stressors and role stressors as common causes of stress. The most frequently used coping strategy was to seek social support, followed by digital activities and sports and physical exercises. The male and female design preferences varied to a greater extent but only slightly varied based on their job category. However, findings suggested the necessity of further elicitation of user needs to support the design process.

"A country boy can survive:" Rural culture and male-targeted suicide prevention messaging

The low rate of help-seeking and high rate of suicide completion among men has prompted public health officials to create suicide prevention campaigns that specifically target men. Drawing from data collected as part of a larger study of fire recovery in a rural county in Northern California, this paper utilizes 68 interviews with fire survivors (24 men and 44 women) and 40 interviews with mental health service providers to examine how rural residents interpret this type of campaign. To track patterns of help-seeking over time, I also draw upon 26 follow-up interviews - 20 with fire survivors (7 men and 13 women) and 6 with service providers - conducted one year after the first wave of interviews. In total, 134 in-depth interviews were conducted. This paper also draws on a secondary data source; I conducted content analysis of an internal Health and Human Services Agency focus group report used in the development of a local male-targeted suicide prevention campaign, Captain Awesome. As I show, male-targeted suicide prevention efforts have little salience in rural communities in which treatment resources are limited and stigma abounds. Perceptions about material conditions - i.e., treatment resources being few and far between - contribute to residents establishing a norm of not seeking help. Rural culture which emphasizes self-sufficiency and independence contributes to a pattern of both men and women repeating a narrative that frames men who seek help as weak. While research has identified women as key drivers for men's physical health maintenance, my research suggests that the same pattern might not hold around mental health maintenance in rural settings. In sum, I argue that male-targeted campaigns have limited resonance and efficacy in rural communities where material conditions and cultural narratives create physical and psychological barriers to accessing to treatment.

Healthcare-seeking behaviours in college students and young adults: a review

BACKGROUND/AIMS

To review the literature on college students' healthcare-seeking behaviours to uncover the current evidence and promote better healthcare-seeking behaviours and essentially better health outcomes in young adults.

METHODS

The researchers conducted an extensive literature review using CINAHL, Cochrane, PubMed, EBSCOhost and Google Scholar in the years 2018 and 2019. The search was limited to the past 18 years (2000-2018) and to studies reported in the English language focused on the general healthcare-seeking behaviour of college students. The search was also extended to young adults (aged 18-39 years).

RESULTS

A total of 56 articles were identified for abstract review and only 28 articles met the inclusion criteria for the final review. The following themes emerged to organise our findings: healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviours and barriers to accessing care among college students.

CONCLUSIONS

This review summarises the current body of knowledge related to healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviour and barriers to accessing care among this population. Important measures further to address the health needs and interventions for addressing these needs among the college student population are discussed.

Campus Service Use Among Students With Disabilities Who Have Experienced Sexual Violence: A Conceptual Model

Students with disabilities are one student group with elevated risk of sexual violence. Although they would benefit from streamlined access to campus support, little is known about their patterns of campus service use. This qualitative analysis includes data from semi-structured interviews with 51 students with disabilities who experienced sexual violence focused on service use across campus. The resultant conceptual model shows that greater accessibility is associated with positive experiences, and lower accessibility is associated with negative experiences. Students with disabilities who experienced or expected negative reactions (e.g., judgment) were less likely to use services and were less satisfied. Advocacy and support in connecting students with disability or sexual violence services was associated with positive experiences and increased accessibility. These findings highlight key facilitators and barriers to campus service use for students with disabilities with sexual violence histories and suggest key intervention points for increasing accessibility, reducing stigma, and improving student experiences with campus providers, staff, and faculty.

"There may be a problem, but I'm not going because…": examining classes of men and their rationales for not seeking mental health treatment

BACKGROUND

Men are less likely than women to seek out mental health treatment, despite men also having mental health struggles.

AIM

We examined typologies of men's reasons for not seeking treatment even though they perceived a need for treatment.

METHOD

We conducted a latent class analysis using a U.S. national sample of 836 men who specifically indicated a need for mental health services, but did not seek treatment from the National Study on Drug Use and Health.

RESULTS

We identified three distinct types of men and their unique rationales for not seeking treatment: positive attitudes class, perceived high behavioral control class, and negative attitudes class.

CONCLUSIONS

Unique strategies to market clinical services to each of the various needs and concerns of these types of men may prove more beneficial than a generic outreach approach. We encourage mental health professionals to proactively educate men about their services and aim to reduce barriers for men seeking treatment.

Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019

Background

Canadian post-secondary students are considered to be at risk for chronic stress and languishing mental health, but there has been no longitudinal analysis of the available population-level data. The purpose of this study was to examine trends in the overall and sex-specific prevalence of self-reported stress, distress, mental illness, and help seeking behaviours among Canadian post-secondary students over the past several years.

Methods

Using the 2013, 2016, and 2019 iterations of the National College Health Assessment II Canadian Reference data, we conducted a trend analysis for each variable of interest, stratified by sex. The significance and magnitude of the changes were modelled using cumulative linked ordinal regression models and log binomial regression models.

Results

With few exceptions, we observed significant increases over time in the proportion of students reporting symptoms of psychological distress, mental illness diagnoses, and help seeking for mental health related challenges. Female students reported a higher level of stress than male students, with a statistically significant increase in the stress level reported by female students observed over time. In all cases, larger proportions of female students were observed compared to male students, with the proportion of female students who self-reported mental illness diagnoses nearly doubling that of males.

Conclusions

Our analysis indicated that the proportion of students self-reporting mental health related challenges, including stress, psychological distress, and diagnosed mental illnesses increased between the 2013, 2016 and 2019 iterations of the NCHA II conducted among Canadian post-secondary students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10622-1.

Disjunctures in Experiences of Support During the Transition to Fatherhood of Men Who Have Used Intimate Partner Violence

The transition to fatherhood has been shown to be a stressful time for men, and their experiences of identifying and accessing formal and informal support are mixed. However, research on the experience of men who use intimate partner violence (IPV) during the transition to fatherhood is limited. The evidence documenting the prevalence and short- and long-term impact of violence perpetrated by men against women during pregnancy and postpartum demonstrates the seriousness of this public health issue. To understand the mechanisms of interrupting IPV by engaging men, the gap between what is known about experiences of identifying the need for and access to support during the transition to fatherhood of men with past and current histories of using IPV must be bridged. The study described explores experiences of support during the transition to fatherhood of men who have used IPV. Descriptive findings revealed that men had a range of types of supports from multiple sources; however, most also identified crucial unmet instrumental and socioemotional needs. Four themes surfaced disjunctures in how participants described resources they needed, accessed, and desired. Specifically, these disjunctures were related to men's adherence to a self-reliant identity, a lack of male-specific peer or role model support, the tendency for childbirth classes to be geared toward mothers and not seen by fathers as sources of support, and a gap between men's goals for themselves as fathers, and the actual tools, resources, and modeling that were accessible and "acceptable." The implications include suggestions for group-based programmatic efforts, and three initial steps for organizations to assess and build current capacity to engage-with safety and accountability at the forefront-fathers who use IPV.

Psychometric evaluation of the Arabic version of the higher education inventory scale for nursing students

BACKGROUND

Studies in the literature have relied on a single instrument to assess stress levels and sources among nursing students in Jordan and in other Arab countries. Thus, there is a need to develop Arabic versions of psychometrically validated instruments for evaluating a wider range of aspects related to stress and stressors. The Higher Education Stress Inventory (HESI) is an instrument used to assess various aspects of stress and stressors related to higher education in different educational settings and among different student populations. To date, no exploratory or confirmatory factor analyses have been conducted to study the factor structure of the Arabic version of the HESI. Therefore, the current study aimed to evaluate the psychometric properties of the Arabic version of the HESI (Arabic-HESI) among nursing students in Jordan.

METHODS

The structure of the instrument was tested using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and maximum likelihood estimation among a sample of 355 nursing students at five Jordanian universities.

RESULTS

The Arabic-HESI proved to have excellent content validity index (CVI = 0.92). The instrument showed good internal consistency reliability (Cronbach's α = 0.75), as well as for the two emerged factors "challenges" and "dissatisfaction" (Cronbach's α were 0.75, 0.72 respectively). The results support the two-factor model for the Arabic-HESI, as the instrument was found to have robust structure and acceptable goodness-of-fit indices.

CONCLUSION

The Arabic-HESI is a reliable and valid instrument for assessing stress levels and stressors among nursing students in Jordan. Using the shortened version of the HESI to assess stress among nursing students is recommended. Identifying new features of stress and stressors among nursing students in Jordan will enable universities and nursing faculties to better support their students.

Exercise and fruit/vegetable intake, and their associations with body weight status in university students

Introduction

Background: evidence suggests that exposure to risk factors related to excess body weight is more frequent in the second and third decades of life. Thus, one of the most propitious environments for the acquisition of habits that can inhibit overweight is the university. Objective: to identify the frequency of aerobic and strength exercises and of fruit/vegetable intake in university students, and subsequently establish associations between both health behaviors and excess body weight. Methods: the sample was comprised of 5,310 university students. An online questionnaire was used to collect the frequency of exercises and fruit/vegetable intake. The body mass index was used to define body weight status. The data were analyzed statistically by employing a bivariate analysis and binary logistic regression. Results: the practice of aerobic and strength exercises was reported by 80.4 % and 51.6 % of the sample, respectively. Only 13 % of the surveyed university students had an adequate fruit/vegetable intake. The proportion of excess body weight was 39.1 %, the condition being significantly higher in men. The risk for excess body weight identified in the university students who reported not consuming fruits/vegetables daily was two to three times higher than in their peers who reported an adequate intake (women: OR = 2.92 [95 % CI 2.07-4.12]; men: OR = 1.98 [95 % CI 1.41-3.02]). Exposure to the risk for excess body weight was progressively lower as the reported frequency of aerobic exercise became higher. Conclusion: these findings suggest the need to promote initiatives aimed at the preparation and implementation of health education and promotion programs in the university context, through actions of guidance about exercise and food intake that may help to minimize the risks of onset and development of excess body weight.

Engaging male students with mental health support: a qualitative focus group study

Background

Males are less likely to seek help for mental health difficulties compared to females. Despite considerable interest, a paucity of evidence-based solutions exists to address this. Concerns about students’ mental health has led to the United Kingdom’s Department of Education to make this a priority. Studies have shown that male students hold more negative attitudes towards the use of psychological services compared to female students and are less likely to seek help. A major concern is that male students make up 69% of university suicides, which is often associated with lower rates of help-seeking. This focus group study therefore sought to identify potential approaches that would be relevant to improving mental health help-seeking in male students.

Methods

Three focus groups comprising of 24 male students at a London University were conducted. Participants were asked questions exploring: the barriers to seeking help, what would encourage help-seeking, how an appropriate intervention should be designed, and how to publicise this intervention to male students. Thematic analysis was conducted to evaluate participants responses.

Results

Five distinct themes were identified. These were: 1) protecting male vulnerability, 2) providing a masculine narrative of help-seeking, 3) differences over intervention format, 4) difficulty knowing when and how to seek help, and 5) strategies to sensitively engage male students.

Conclusions

These themes represent important considerations that can be used, together with the existing literature about male help-seeking, to develop more male friendly interventions that are suitable for male students. This could help improve help-seeking attitudes and the uptake of mental health interventions for male students experiencing emotional distress.

Improving Mental Health Help-Seeking Behaviours for Male Students: A Framework for Developing a Complex Intervention

Men are less likely to seek help for mental health difficulties and this process is often used to help explain the disproportionally higher suicide rates compared to women. Furthermore, university students are often regarded as a vulnerable population group with a lower propensity to seek help. Thus, male students are a very high-risk group that is even more reluctant to seek help for mental health difficulties, placing them at high risk of suicide. Often, student mental health problems are highlighted in the media, but very few evidence-based solutions specifically designed for male students exist. The current paper seeks to provide a comprehensive framework about how to better design mental health interventions that seek to improve male students' willingness to access psychological support. The Medical Research Council's (MRC's) framework for developing a complex intervention was used to develop an intervention relevant to male students. In this paper, previous help-seeking interventions and their evaluation methods are first described, secondly, a theoretical framework outlining the important factors male students face when accessing support, and thirdly, how these factors can be mapped onto a model of behaviour change to inform the development of an evidence-based intervention are discussed. Finally, an example intervention with specific functions and behaviour change techniques is provided to demonstrate how this framework can be implemented and evaluated. It is hoped that this framework can be used to help reduce the disparity between male and female students seeking mental health support.

Investigating Disparities by Sex and LGBTQ Identity: A Content Analysis of Sexual Health Information on College Student Health Center Websites

Student Health Centers (SHCs) are important resources on U.S. college campuses. In light of recent calls for creating more opportunities for health care services to young men and sexual/gender minorities, this content analytic study evaluated how sexual health information and resources are communicated on SHC websites. Utilizing a stratified random sample of 400 U.S. colleges/universities, we assessed how often sexual health is explicitly labeled for particular groups, the types of sexual health topics on SHC websites, the depth of sexual health information, and the sexual health resources offered on SHC websites. Our findings revealed that women's health webpages far outnumbered men's health webpages, sexual health topics were more common on women's health webpages, and sexual health topics were covered at greater depth on women's health webpages compared to men's health webpages. Similar disparities were found for sexual/gender minorities. General sexual health webpages on SHC websites addressed significantly more sexual health topics in greater depth and offered more sexual health resources than LGBTQ health webpages. The practical implications for college student health and potential health disparities are discussed.

Post-Secondary Stress and Mental Well-Being: A Scoping Review of the Academic Literature

Post-secondary students have been identified as an at-risk population for chronic stress and poor mental health. We conducted a scoping review of the academic literature surrounding student stress and mental well-being as the first phase of research in the development of Canada’s National Standard for the Psychological Health and Safety of Post-Secondary Students. Major thematic findings included student stress, resilience through effective coping and help-seeking, and programs or strategies to improve campus mental health. Recommendations include a call for increased mental health promotion and mental illness prevention activities that are sensitive to diverse cultures, ethnicities, religions, and sexualities.

Using social media for smoking cessation interventions: a systematic review

Background:

Previous studies have shown that smoking tobacco significantly increases both incidence and mortality rates for many diseases. Social media has become one of the most influential platforms for various smoking cessation interventions. However, results from smoking cessation interventions have differed from study to study. Limited studies have summarised cessation outcomes from social media–based interventions. Therefore, the objective of this review is to explore the effectiveness of using social media for smoking cessation.

Methods:

We searched PubMed, MEDLINE, PsycINFO, and CINAHL for articles between June 2008 and June 2018, and also assessed the references of selected articles. We included studies that used social media as intervention platforms, provided a baseline assessment before the intervention, and provided smoking cessation outcomes after the intervention.

Results:

We identified 13 original studies that enrolled between 16 and 1698 participants; 7-day Point Prevalence Abstinence (PPA) rate was the most frequently used measure of abstinence, with a range of 7%–75%, regardless of the measurement time, study design, and analysis methods. Social media–based smoking cessation interventions were effective, because (1) smokers reported higher 7-day PPA rates after intervention compared to baseline and (2) smokers reported higher 7-day PPA rates in intervention groups than in control groups. Moreover, at each time point, approximately half of all smokers in studies reporting abstinence were found to be biochemically abstinent. There were no significant differences in the effectiveness of smoking cessation outcomes between those that used existing popular social networking platforms (e.g. Pechmann et al’s studies) and those that used individually designed interactive platforms (e.g. MyLastDip, iQuit system, Quitxt system).

Conclusions:

This review highlights the effectiveness of social media–based smoking cessation intervention studies. Due to the widespread use of social media, as well as its low cost, we suggest embedding smoking cessation interventions within existing popular social media platforms.

Body Appreciation and Health Care Avoidance: A Brief Report

Research suggests that body image is related to health behaviors and health care use, but possible mechanisms for this relationship remain unclear. The current study examined the presence of a relationship between body appreciation and avoiding the doctor to avoid being weighed, using a diverse sample of women (N = 499). Controlling for body size and determinants of health care utilization, logistic regression results suggested that women with higher body appreciation were less likely to avoid health care to avoid being weighed (odds ratio = 0.38, p < .001). In addition, differences in avoiding the doctor to avoid being weighed were found for the covariates (that is, age, race, body mass index, and socioeconomic status). These results inform knowledge regarding barriers to health care use and the relationship between body image and health care use. The article concludes with a discussion of the implications for future research, social work interventions, and social work education to promote women's health and well-being.

Men's Sheds: A conceptual exploration of the causal pathways for health and well-being

Although men have a lower life expectancy than women, and are more susceptible to illness, they have been found to be less likely to engage in health-seeking behaviour. Men's Sheds, as a gendered intervention, has been identified as an effective way to engage men in meaningful activity and gain social support from others. However, links between sheds and health and well-being are not well-documented, and evidence is lacking of the potential causal pathways to health generation. This study aims to develop a plausible empirically based causal theory of how Men's Sheds influence the health and well-being of their participants and to set out future research directions to test this theory. Drawing on a scoping review of academic, peer-reviewed journal articles published between 1990 and 2018, potential causal linkages between shed activity and health and well-being outcomes are synthesised into a logic model framework. Sixteen relevant peer-reviewed journal were identified from the academic literature. The data from the articles are predominantly self-reported, and characterised by small sample sizes and/ or low response rates. Further, information is lacking on the demographics of Men's Shed participants and the contexts in which they exist. Most notably, while there is some evidence on the potential mental health and social well-being impacts of shed activities, physical health is less documented. The study shows that there is a lack of reliable and systematic evidence of the potential causal pathways between Men's Shed activities and health and well-being outcomes. In order to address research gaps, further research is required to test and develop the proposed theory and logic model.

Short term effects of a weight loss and healthy lifestyle programme for overweight and obese men delivered by German football clubs

Numbers of obese and overweight people continue to grow in Germany as they do worldwide. Men are affected more often but do less about it and few weight loss services attract men in particular. To evaluate the effectiveness of a men-only weight loss programme, Football Fans in Training (FFIT), delivered by football clubs in the German Bundesliga, we did a non-randomized trial with a waiting list control group. Participants' data were collected between January 2017 and July 2018. FFIT is a 12-week, group-based, weight loss programme and was delivered in stadia and facilities of 15 professional German Bundesliga clubs. Inclusion criteria were age 35-65 years, BMI ≥ 28 and waist circumference ≥100 cm. Clubs recruited participants through Social Media, E-Mail and match day advertisement. 477 German male football fans were allocated to the intervention group by order of registration date at their respective clubs. 84 participants on the waiting list were allocated to the control group. Primary outcome was mean difference in weight loss with treatment condition over time as independent variable. We performed a multilevel mixed-effects linear regression analysis. Results were based on Intention-to-treat (ITT) analysis with Multiple Imputation. After 12 weeks, the mean weight loss of the intervention group adjusted for club, course and participants' age was 6.24 kg (95% CI 5.82-6.66) against 0.50 kg (-0.47-1.49) in the comparison group (p < 0.001). The results indicate that Football Fans in Training effectively helped German men to reduce their weight and waist circumference.

Toward total student health: A qualitative pilot study

Objective: Colleges should aim to cultivate healthy behaviors among students by addressing alterations in wellness students view as important. The purpose of this study was to determine the self-perceived wellness-related concerns and behaviors of college students. Participants: Thirty-seven undergraduate students participated in this study between January and March 2017. Methods: Focus groups served as a data collection method. Groups were recorded and transcribed verbatim. Directed and conventional approaches to data analyses were employed. Results: Participants expressed concern regarding four campus wellness topics: nutrition, economics, mental health, and campus safety. Participants offered solutions for improving campus wellness, representing a fifth theme. Conclusions: Health concerns for college students and realistic solutions to address concerns were identified across focus groups. Overall, students cared about their own health, as well as the well-being of other students. Future directions include conducting a Web-based survey among students to assess prevalence and impact of select health and wellness topics.

Black College Women and the Health of Black College Men

The purpose of this study was to understand the influence Black college women have on the health behaviors of Black men. Using the Health Belief Model and the socioecological model as guides, focus groups and interviews were conducted with Black college men (n = 35) and Black college females (n = 25) at a Historically Black College and University in the Southern United States. Participants provided responses to questions on what impacts their health behaviors and whose health they influence. Results indicate that Black college men believed Black peer women influence decisions they make regarding their diet, physical activity, and general health behaviors. However, Black college women believe they only influenced physical activity and sexual health in Black college men. While they understood they had some influence on their health, the women were unsure if they had long-term influence. These findings highlight the need for programming that informs young Black women on the important role they play in the health of men in their lives, particularly young Black men. These findings also highlight the need for peer health educator training to cross-train educators on health issues of all gender groups.

Knowledge and Awareness of Human Papillomavirus Among College Students in South Carolina

Despite the existence of a safe and effective vaccine, human papillomavirus (HPV) remains prevalent in the United States, with late adolescence and early adulthood being periods of increased risk. Thus, targeting college-aged individuals for HPV prevention and vaccination promotion is critical—particularly in regions such as the Deep South where vaccination rates remain low. This study sought to examine awareness and knowledge of HPV as well as experiences and attitudes regarding HPV vaccination among college students in the Deep South. Specifically, we completed a cross-sectional survey of 256 undergraduate students from a large public university in South Carolina. Although a majority of participants were aware of HPV, significant knowledge gaps existed, particularly regarding prevention, symptoms, and consequences of HPV infection. Participants were also largely unaware of men’s susceptibility for negative HPV outcomes. Multivariate regression modeling was used to identify predictors of HPV knowledge, with results indicating that participants who were female and white, as well as those who were vaccinated, had higher levels of HPV knowledge. Findings highlight the need for comprehensive HPV education on college campuses and offer insights to priority populations that may be appropriate focuses of efforts to increase HPV knowledge and vaccination rates.

Sex Differences and Psychological Factors Associated with General Health Examinations Participation: Results from a Vietnamese Cross-Section Dataset

This study focuses on the association of sex differences and psychological factors with periodic general health examination (GHE) behaviors. We conducted a survey in Hanoi and the surrounding areas, collecting 2068 valid observations; the cross-section dataset was then analyzed using the baseline category logit model. The study shows that most people are afraid of discovering diseases through general health examinations (76.64%), and the fear of illness detection appears to be stronger for females than for males (β1(male) = −0.409, p < 0.001). People whose friends/relatives have experienced prolonged treatment tend to show more hesitation in participating in physical check-ups (β2 = 0.221, p < 0.05). On the ideal frequency of GHEs, 90% of the participants agree on once or twice a year. The probability of considering a certain period of time as an appropriate frequency for GHEs changes in accordance with the last doctor visit (low probability of a health examination every 18 months) and one’s fear of potential health problems post-checkup (no fear raises probability of viewing a health examination every 6 months by 9–13 percentage points). The results add to the literature on periodic GHE in particular and on preventive health behaviors in general.

Improving student knowledge and perceptions of primary care providers at campus health centers

OBJECTIVE

To examine current knowledge and perceptions toward primary care providers commonly staffed at student health centers (PAs and NPs), and also assess the effectiveness of information-rich provider biographies to improve knowledge and perceptions.

PARTICIPANTS

One thousand six hundred forty six students from 2 universities in 2 states participated in this study from February to November, 2016.

METHODS

An online survey. Students were exposed to an improved biography of an NP discussing how she can perform many of the same duties as primary care physicians. Changes in knowledge and perceptions were assessed pre- and post-biography exposure.

RESULTS

More than half of students are unaware NPs and PAs can prescribe medications and diagnose illnesses. Students exposed to the biography increased their knowledge of NPs, and perceptions of their expertise.

CONCLUSIONS

Results suggest improved provider biographies on student health centers' websites can help reduce the knowledge deficit that exists among students regarding common primary care providers.

From training to practice: the impact of ENGAGE, Ireland's national men's health training programme

Ireland's National Men's Health Policy recommended developing training programmes tailored to the needs of those working in health and allied health professionals and ENGAGE was developed to meet that recommendation. This study evaluated the impact of ENGAGE on frontline service providers' self-reported knowledge, skills, capacity and practice up to 5-months post training. Between 2012 and 2015, ENGAGE Trainers (n = 57) delivered 62 1-day training programmes to 810 participants. This study was conducted on a subset of those training days (n = 26) and participants. Quantitative methodologies were used to collect pre (n = 295), post (n = 295) and 5-month post (n = 128) training questionnaire data. Overall, participants were highly satisfied with the training immediately post training (8.60 ± 1.60 out of 10) and at 5-month follow up (8.06 ± 1.43 out of 10). Participants' self-reported level of knowledge, skill and capacity in identifying priorities, engaging men and influencing practice beyond their own organisation increased immediately following training (P < 0.001) and, with the exception of improving capacity to engage men and influencing practice beyond their organisation, these improvements were sustained at 5-month post training (P < 0.001). The vast majority of service providers (93.4%) reported that ENGAGE had impacted their work practice up to 5-month post training. The findings suggest that ENGAGE has succeeded in improving service providers' capacity to engage and work with men; improving gender competency in the delivery of health and health related services may increase the utilisation of such services by men and thereby improve health outcomes for men.

Illict drug use and academia in North Kosovo: Prevalence, patterns, predictors and health-related quality of life

PURPOSE

The purpose of this study were to estimate the prevalence and patterns of illicit drug use in a sample of University students from North Kosovo, to assess factors associated with illicit drug use and to assess health-related quality of life (HRQoL) among students according to illicit drug use.

METHODS

A cross-sectional study was conducted at the Student Public Health Center, where 514 University students were enrolled from April to June 2015 in North Kosovo. Participants completed the general socio-demographic and behavioral questionnaire, Beck Depression Inventory (BDI) and the SF-36 questionnaire for HRQoL assessment. Data on lifetime illicit drug use were self-reported.

RESULTS

As much as 16.0% of students reported ever illicit drug use. The most frequently used drugs were marijuana (9.3%) and bromazepam (7.6%). Factors associated with ever illicit drug use were: being smoker and alcohol user, having chronic diseases and having higher depressive symptoms score. Ever illicit drug users reported all domains of HRQoL as worse.

CONCLUSION

These results could serve as a tool for implementation of preventive strategies and University policies to promote healthy lifestyles and behaviors. Measurement of HRQoL could also be used as indicator of the effect of interventions designed to reduce and/or prevent illicit drug use at institutions of higher education.

Campus Health Centers' Lack of Information Regarding Providers: A Content Analysis of Division-I Campus Health Centers' Provider Websites

Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.

Adverse Childhood Experiences (ACEs), Stress and Mental Health in College Students

The goal of this short-term longitudinal study was to examine whether adverse childhood experiences (ACEs) could be used to identify college students at risk for mental health problems and whether current level of stress mediates the relationship between ACEs and mental health. Data on ACEs and mental health (depression, anxiety and suicidality) were collected at the beginning of the semester, and data on current stressors and mental health were collected toward the end of the semester (n = 239). Findings indicated that ACEs predicted worsening of mental health over the course of a semester and suggested current number of stressors as a mediator of the relationship between ACEs and mental health. Results suggest that screening for ACEs might be useful to identify students at high risk for deterioration in mental health. Results further suggest that stress-related interventions would be beneficial for students with high levels of ACEs and point to the need for more research and strategies to increase help-seeking in college students.

Diabetes-related behaviours among elderly people with pre-diabetes in rural communities of Hunan, China: a cross-sectional study

OBJECTIVE

To explore diabetes-related behaviours and their influencing factors among elderly individuals with pre-diabetes in rural areas of China.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional survey was conducted among elderly individuals (≥60 years) in rural communities in Yiyang City of China. Multistaged cluster random sampling was carried out to select 42 areas, and interviews were conducted among 434 elderly individuals with pre-diabetes (fasting plasma glucose 6.1-7.0 mmol/L and/or 2-hour post-glucose load of 7.8-11.1 mmol/L) using questionnaires on diabetes-related behaviours. The diabetes-related behaviours included eight categories: average daily sedentary time; frequency of physical activities per week; regular or irregular diet; whether paying attention to diet control or not; daily dietary preferences; frequency of physical examinations per year; current smoking status; and current consumption of alcohol. Each of the risky behaviours was scored -1 and each of the healthy behaviours was scored +1. Each individual's score of diabetes-related behaviours was the sum of the score for all behaviours.

MAIN OUTCOME MEASURES

Participants were asked about general information (age, gender, marital status, history of hyperglycaemia, family history of diabetes mellitus, presence of other diseases, body mass index, waist-to-hip ratio and education) and their diabetes-related behaviours. Multivariate linear regression analysis was performed to identify the risk factors for diabetes-related behaviour among elderly individuals with pre-diabetes.

RESULTS

The average score of diabetes-related behaviours of elderly individuals with pre-diabetes in rural China was 2.7. The prevalences of risky diabetes-related behaviours were as follows: <1 physical examination per year (57.6%), insufficient physical activities (55.3%), lack of attention paid to diet control (51.4%), high-salt and high-fat diets (41.0%), sedentary lifestyle (35.9%), smoking (22.8%), regular alcohol uptake (15.0%) and irregular diet (3.9%). Gender and a history of hyperglycaemia were found to be influencing factors of the diabetes-related behaviour score.

CONCLUSIONS

The prevalence of risky diabetes-related behaviours was high among pre-diabetic elderly individuals in rural China. More effort should be made to promote the prevention and control of diabetes in rural China. Future studies should be undertaken on diabetes prevention strategies tailored specially for this population.

TRIAL REGISTRATION NUMBER

ChiCTR-IOR-15007033; Results.

Adverse Events Following Vaccination With Bivalent rLP2086 (Trumenba®): An Observational, Longitudinal Study During a College Outbreak and a Systematic Review

BACKGROUND

In February 2015, two unlinked culture-confirmed cases of Neisseria meningitidis serogroup B (MenB) disease occurred at a local college in Rhode Island ("college X") within 3 days. This represented a 489-fold increase in the incidence of MenB disease, and an outbreak was declared. For the first time, bivalent rLP2086 (Trumenba) was selected as a mandatory intervention response. A mass vaccination clinic was coordinated, which provided a unique opportunity to collect safety data in a real-world population of college-age participants. Though the Advisory Committee on Immunization Practices recommends MenB vaccination for college-age individuals (16-23 year olds), there is limited quantifiable safety data available for this population.

METHODS

The Dillman total design survey method was used. Adverse events of bivalent rLP2086 were solicited and quantified retrospectively 2-4 months following each dose of vaccine. Safety data from six clinical trials were used as comparison tools.

RESULTS

The most commonly reported adverse event following vaccination was injection site pain. Reported rates of injection site pain, fatigue, myalgia, fever, and chills were similar than those reported in clinical trials. Reported rates of headache were lower than in clinical trials.

CONCLUSIONS

This study is the first to examine adverse events of bivalent rLP2086 in a real-world setting where more than 90% of a college-age population was vaccinated.

Predictors of need for help with weight loss among overweight and obese men and women in the Netherlands: a cross-sectional study

BACKGROUND

Need for help is perceived as an important first step towards weight related health-care use among overweight and obese individuals and several studies have reported gender as an important predisposing characteristic of need for help. Therefore, the goal of the current study is to gain insight into factors that might determine need for help for weight loss in men and women.

METHODS

In the current study, data from the Dutch cross-sectional survey Health Monitor 2012 was used. Overweight and obese men (N = 2218) and women (N = 2002) aged 19-64 years were selected for the current study. Potential predictors of need for help were age, ethnicity, marital status, educational level, perceived health, weight status, comorbidities, physical activity level, and income. Multiple logistic regression analyses were conducted separately among men and women to establish prediction models of need for help for weight loss.

RESULTS

The mean age of the adult women in this study population was 47.7 years and 68% was medium educated, whereas the mean age of men was 49.0 years and 63.0% was medium educated. Of the respondents, 24.9% indicated they either felt a need for help for weight loss, 6.4% already received help and 68.7% felt no need for help. Women were more likely to indicate a need for help than men (OR = 2.17). Among both genders, need for help was significantly predicted by obesity (OR_men = 3.80, OR_women = 2.20) and "poor" perceived health (ORmen = 2.14, OR_women = 1.94). Besides, "unmarried" (OR_men = 1.57) and suffering from comorbidities (OR_men = 1.26) predicted need for help among men. Whereas among women, need for help was predicted by younger age (i.e. 19-34 years (OR_women = 2.07) and 35-49 years (OR_women = 1.35)).

CONCLUSION

The current study revealed specific predictors of need for help for weight loss for men and women. Among men, the strongest predictors were obesity and poor perceived health, whereas among women need for help was most strongly predicted by obesity and young age. Insight into these specific predictors enables health professionals to reach overweight individuals with a need for help for weight loss by connecting their need to available support.

Understanding barriers to healthy behaviors in black college men

OBJECTIVE

Due to the short life expectancy of black men, it is important to understand what impacts health behaviors in this group so that interventions and programs can be developed to improve their health behaviors which may help in increasing the life expectancy of black men. The purpose of this study was to understand what perceived barriers exist for black college men that prevent them from engaging in healthy behaviors.

PARTICIPANTS AND METHODS

Thirty-five black male students at a southern Historically Black College and University participated in five focus groups and four interviews. A qualitative analysis was used to analyze data for similar themes and codes.

RESULTS

Perceived barriers to engaging in healthy behaviors appear to be influenced by image, food cost, and education. Cues to action for not engaging in healthy behaviors appear to be related to role models.

CONCLUSIONS

Black college men are not adequately informed or educated about elements that can impact their health and how they can improve it. College administrators and researchers should develop interventions that include elements of increasing health knowledge and age-appropriate role models to improve health behavior change among this group.

Deficits in young men's knowledge about accessing sexual and reproductive health services

OBJECTIVE

The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points.

METHODS AND PARTICIPANTS

Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino).

RESULTS

Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without.

CONCLUSIONS

Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.

An Integrated Framework for Disseminating Health Information to Students in Zimbabwe

University students in Zimbabwe lack immediate access to accurate health information. There is lack of explicit and integrated structures for disseminating health information to students in Zimbabwe. Informed by the salutogenic theory of health, the study assessed the health information needs of students and evaluated existing health information dissemination methods at National University of Science and Technology (NUST), Zimbabwe, in developing a framework for disseminating health information. A case study strategy was used to gather data within the pragmatic paradigm of grounded constructivism. The findings reveal that students need health information on a wide range of health topics and prefer mobile electronic media, workshops, qualified health professionals and peers for their health needs. There are significant gaps between the strategies that are being used by NUST to disseminate health information and the health information needs of the students. Therefore, this paper proposes a needs-based, integrated information dissemination framework for promoting health amongst students. The proposed framework emphasizes utilization of synchronous information and communication technologies, the need for integration of activities, a viable policy, health information literacy training and the use of a mix of persuasion techniques as an effective health promotion strategy.

Why do men go to the doctor? Socio-demographic and lifestyle factors associated with healthcare utilisation among a cohort of Australian men

BACKGROUND

Men use health services less often than women and frequently delay seeking help even if experiencing serious health problems. This may put men at higher risk for developing serious health problems which, in part, may explain men's higher rates of some serious illnesses and shorter life span relative to women. This paper identifies factors that contribute to health care utilisation in a cohort of Australian men by exploring associations between socio-economic, health and lifestyle factors and the use of general practitioner (GP) services.

METHODS

We used data from Ten to Men, the Australian Longitudinal Study on Male Health. Health care utilisation was defined in two ways: at least one GP visit in the past 12 months and having at least yearly health check-ups with a doctor. Associations between these two measures and a range of contextual socio demographic factors (education, location, marital status, country of birth, employment, financial problems etc.) as well as individual health and lifestyle factors (self-rated health, smoking, drinking, healthy weight, pain medication) were examined using logistic regression analysis. The sample included 13,763 adult men aged 18 to 55 years. Analysis was stratified by age (18 to 34 year versus 35 to 55 years).

RESULTS

Overall, 81 % (95 % CI: 80.3-81.6) of men saw a GP for consultation in the 12 months prior to the study. The odds of visiting a GP increased with increasing age (p < 0.01), but decreased with increasing remoteness of residence (p < 0.01). Older men, smokers and those who rate their health as excellent were less likely to visit a GP in the last 12 months, but those on daily pain medication or with co-morbidities were more likely to have visited a GP. However, these factors were not associated with consulting a GP in the last 12 months among young men. Overall, 39 % (95 % CI: 38.3-39.9) reported having an annual health check. The odds of having an annual health check increased with increasing age (p < 0.01), but showed no association with area of residence (p = 0.60). Across both age groups, the odds of a regular health check increased with obesity and daily pain medication, but decreased with harmful levels of alcohol consumption.

CONCLUSION

The majority of men (61 %) did not engage in regular health check-up visits, representing a missed opportunity for preventative health care discussions. Lower consultation rates may translate into lost opportunities to detect and intervene with problems early and this is where men may be missing out compared to women.

Development and Testing of a Conceptual Model Regarding Men's Access to Health Care

Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly ( ps < .05) predicted whether they had seen a health care provider in the past year: "I/Men do not access healthcare because I do not think there is anything wrong with me," "My health is only about me," and "I/Men do not access healthcare because most men in my family do not access healthcare." Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed.

The unmet emotional, care/support, and informational needs of adult survivors of pediatric malignancies

PURPOSE

This study describes the prevalence and predisposing factors for potentially modifiable unmet emotional, care/support, and information needs among adult survivors of childhood malignancies.

METHODS

A randomly selected/stratified sample of participants in the Childhood Cancer Survivor Study (CCSS) responded to the CCSS-Needs Assessment Questionnaire (CCSS-NAQ) (n = 1189; mean [SD] current age, 39.7 [7.7], range = 26-61 years; 60.9 % women; mean [SD] years since diagnosis, 31.6 [4.7]). Survivors self-reported demographic information, health concerns, and needs; diagnosis/treatment data were obtained from medical records. Adjusted proportional risk ratios (prevalence ratios, PRs) were used to evaluate 77 separate needs.

RESULTS

Fifty-four percent of survivors reported unmet psycho-emotional, 41 % coping, and 35 % care/support needs; 51, 35, and 33 %, respectively, reported unmet information needs related to cancer/treatment, the health care system, and surveillance. Female sex and annual income <$60K were associated with multiple needs; fewer needs were linked to diagnosis/years since/or age at diagnosis. Having moderate/extreme cancer-related anxiety/fear was associated with all needs, including a >6-fold increased prevalence for help dealing with "worry" (PR = 6.06; 95 % confidence interval [CI], 3.79-9.69) and anxiety (PR = 6.10; 95 % CI, 3.82-9.72) and a >5-fold increased prevalence for "needing to move on with life" (PR = 5.56; 95 % CI, 3.34-9.25) and dealing with "uncertainty about the future" (PR = 5.50; 95 % CI, 3.44-8.77). Radiation exposure and perceived health status were related to 42 and 29 needs, respectively.

CONCLUSIONS

Demographic factors, disease/treatment characteristics, and intrapersonal factors can be used to profile survivors' unmet emotional, care/support, and information needs.

IMPLICATIONS FOR CANCER SURVIVORS

These data can be used to enhance provider-survivor communication, identify at-risk subsamples, and appraise core intervention content.

Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor-patient communication

OBJECTIVE

Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity.

METHODS

Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort.

RESULTS

In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity.

CONCLUSIONS

Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired.

Feasibility and Quit Rates of the Tobacco Status Project: A Facebook Smoking Cessation Intervention for Young Adults

Background

Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence.

Objective

We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook.

Methods

The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ≥50% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention.

Results

Retention was 82% (65/79) at 6 months and 72% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13%; 36/79, 46%, P<.001). Over a third (28/79, 35%) reduced their cigarette consumption by 50% or greater, and 66% (52/79) made at least one 24-hour quit attempt during the study. In an intent-to-treat analysis, 13% (10/79) self-reported 7-day abstinence (6/79, 8% verified biochemically) at 12-months follow-up. In their quit attempts, 11% (9/79) used a nicotine replacement therapy approved by the Food and Drug Administration, while 18% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were for post ease (57/79, 72%) and thinking about what they read (52/79, 66%); 71% (56/79) recommended the program to others. Only 5 participants attended the optional cognitive-behavioral counseling sessions, though their attendance was high (6/7 sessions overall) and the sessions were rated as easy to understand, useful, and helpful (all 90-100% agreed).

Conclusions

A Facebook quit smoking intervention is attractive and feasible to deliver, and early efficacy data are encouraging. However, the 1.5-fold greater use of electronic cigarettes over nicotine replacement products for quitting is concerning.