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Langford R, Brockman R, Banks J, Jago R, Gillison F, Coulman K, Moore T, Nobles J. Co-designing adult weight management services: a qualitative study exploring barriers, facilitators, and considerations for future commissioning. BMC Public Health 2024; 24:778. [PMID: 38475750 DOI: 10.1186/s12889-024-18031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Weight management services have not always benefitted everyone equally. People who live in more deprived areas, racially minoritised communities, those with complex additional needs (e.g., a physical or mental disability), and men are less likely to take part in weight management services. This can subsequently widen health inequalities. One way to counter this is to co-design services with under-served groups to better meet their needs. Using a case study approach, we explored how co-designed adult weight management services were developed, the barriers and facilitators to co-design, and the implications for future commissioning. METHODS We selected four case studies of adult weight management services in Southwest England where co-design had been planned, representing a range of populations and settings. In each case, we recruited commissioners and providers of the services, and where possible, community members involved in co-design activities. Interviews were conducted online, audio-recorded, transcribed verbatim, and analysed using thematic analysis. RESULTS We interviewed 18 participants (8 female; 10 male): seven commissioners, eight providers, and three community members involved in co-designing the services. The case studies used a range of co-design activities (planned and actualised), from light-touch to more in-depth approaches. In two case studies, co-design activities were planned but were not fully implemented due to organisational time or funding constraints. Co-design was viewed positively by participants as a way of creating more appropriate services and better engagement, thus potentially leading to reduced inequalities. Building relationships- with communities, individual community members, and with partner organisations- was critical for successful co-design and took time and effort. Short-term and unpredictable funding often hindered co-design efforts and could damage relationships with communities. Some commissioners raised concerns over the limited evidence for co-design, while others described having to embrace "a different way of thinking" when commissioning for co-design. CONCLUSIONS Co-design is an increasingly popular approach to designing health in services but can be difficult to achieve within traditional funding and commissioning practices. Drawing on our case studies, we present key considerations for those wanting to co-design health services, noting the importance of building strong relationships, creating supportive organisational cultures, and developing the evidence base.
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Affiliation(s)
- Rebecca Langford
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK.
| | - Rowan Brockman
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - Jonathan Banks
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - Russell Jago
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, Bristol, UK
| | - Fiona Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, BA2 7AY, Bath, UK
| | - Karen Coulman
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, BS8 1NU, Bristol, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - James Nobles
- Health, Nutrition & Environment, Leeds Beckett University, Calverley Building, City Campus, LS1 3HE, Leeds, UK
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Bayes J, Schloss J, Sibbritt D. The use of diet for preventing and treating depression in young men: current evidence and existing challenges. Br J Nutr 2024; 131:214-218. [PMID: 37519245 PMCID: PMC10751942 DOI: 10.1017/s000711452300168x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/12/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Emerging evidence suggests that diet therapy (nutrients, foods and dietary patterns) could be effective as a potential adjunctive treatment option for major depressive disorder. Numerous mechanisms have been proposed, including the role inflammation, oxidative stress, brain-derived neurotrophic factor, the gastrointestinal tract microbiome and tryptophan/serotonin metabolism. Despite known differences in depression characteristics and treatment responses between males and females, there are limited sex-specific studies examining the role of diet in young men specifically. This is important as young men are often reluctant to seek mental health support, so finding treatment strategies which appeal to this demographic is crucial. This brief report provides an overview of the most recent advances in the use of diet for preventing and treating depression in young men, highlighting existing challenges and opportunities for future research. We recommend that clinicians discuss the role of diet with depressed young men, so that diet may be used alongside current treatment options.
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Affiliation(s)
- Jessica Bayes
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW2480, Australia
| | - Janet Schloss
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW2480, Australia
| | - David Sibbritt
- School of Public Health, University of Technology Sydney, Ultimo, NSW2007, Australia
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Jelicich R, Braun V. "Your Diet Defines Who You Are, Especially as a Man": Masculinity in Online Media Focused on Healthy Eating for Men. Am J Mens Health 2023; 17:15579883231213588. [PMID: 38130065 DOI: 10.1177/15579883231213588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
In contexts marked by neoliberal ideology and a claimed "crisis" in men's health, men are responsibilized to be/come healthy. Eating has long been a gendered practice in Western cultures, and recent cultural shifts have produced ways of eating that are both masculinized and (claimed) healthy. Online healthy eating advice, which encourages and supports men to eat healthily, is an important information source. However, such information draws on, reproduces, and/or disrupts existing meanings about men and eating. To understand contemporary representations of men and healthy eating, we examined 30 online media articles oriented specifically to this topic. Using reflexive thematic analysis from a social constructionist position, we developed two themes: A lad's looks and lifestyle and Mind over matter: The masculine mindset. These themes together told an overarching story that healthy eating is effectively sold to men by drawing on traditional or hegemonic ideals of masculinity and effectively evoking access to an enhanced masculinity through healthy eating. While these representational practices may sell healthy eating to men, with likely positive health benefits, they also reinforce hegemonic ideals of masculinity which can be problematic from a health perspective.
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Affiliation(s)
- Ruby Jelicich
- School of Psychology, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
| | - Virginia Braun
- School of Psychology, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
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Tang CSK, Gan KQ, Lui WK. The Associations between Obsessive Compulsive Personality Traits, Self-Efficacy, and Exercise Addiction. Behav Sci (Basel) 2023; 13:857. [PMID: 37887507 PMCID: PMC10603988 DOI: 10.3390/bs13100857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/08/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Exercise addiction refers to maladaptive exercise patterns involving compulsivity and addiction-like behaviors. Exercise addiction has been found to relate to negative physical and mental health outcomes such as heart abnormalities, physical injuries, and interpersonal conflicts. Based on the social cognitive theory, this study investigated the extent to which the interplay of obsessive compulsive personality disorder (OCPD) traits and self-efficacy beliefs would influence the development and maintenance of exercise addiction. A total of 1228 college students in the United States responded to an online survey. Based on cut-off scores of the Revised Exercise Addiction Inventory, the prevalence estimates of exercise addiction were 4.0% for males and 1.8% for females. Results showed that males are more prone to exercise addiction than females. Also, OCPD traits and self-efficacy significantly predicted exercise addiction after controlling for age and sex. Self-efficacy acted as a moderator in influencing the relationship between OCPD traits and exercise addiction, especially for females. At high levels of self-efficacy, more OCPD traits were significantly associated with a higher risk of exercise addiction. However, at low levels of self-efficacy, there was no association between OCPD traits and exercise addiction. The findings suggest that public education and intervention for exercise addiction should attend to the interplay between personality factors and sex.
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Affiliation(s)
- Catherine So Kum Tang
- Department of Counselling & Psychology, Hong Kong Shue Yan University, 10 Wai Tsui Crescent, Braemar Hill, North Point, Hong Kong, China
| | - Kai Qi Gan
- Department of Psychology, National University of Singapore, 21 Lower Kent Ridge Road, Singapore 119077, Singapore
| | - Wai Kin Lui
- Department of Counselling & Psychology, Hong Kong Shue Yan University, 10 Wai Tsui Crescent, Braemar Hill, North Point, Hong Kong, China
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Crane MM, Walton SM, Suzuki S, Appelhans BM. Quantifying weight loss program preferences of men working in trade and labor occupations: A discrete choice experiment. Obes Sci Pract 2023; 9:243-252. [PMID: 37287515 PMCID: PMC10242269 DOI: 10.1002/osp4.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/02/2022] [Accepted: 09/19/2022] [Indexed: 06/09/2023] Open
Abstract
Objective Men who work in skilled and unskilled trades and labor occupations (i.e., blue-collar occupations), have high rates of obesity and associated comorbidities but are underrepresented in weight loss programs. A first step in engaging this group is to better understand their preferences for weight loss programs. Methods Respondents were men working in trade and labor occupations, with overweight/obesity, and an interest in losing weight. A discrete choice experiment was developed, and the data were analyzed using mixed logit model. Respondent characteristics were tested as effect modifiers. Results Respondents (N = 221, age (M ± SD) 45.0 ± 12.6, BMI 33.3 ± 6.3, 77% non-Hispanic white) working in a variety of occupations (construction 31%, manufacturing 30%, transportation 25%, maintenance/repair 14%) participated in this study. Results indicate preferences for programs that encourage making smaller dietary changes, are delivered online, and do not incorporate competition. Results were consistent across sensitivity analyses and most respondent groups. Conclusions The results suggest specific ways to make weight loss programs more appealing to men in trade and labor occupations. Using experimental methods to quantify preferences using larger, more representative samples would further assist in tailoring behavioral weight loss programs for under-reached populations.
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Affiliation(s)
- Melissa M. Crane
- Department of Family and Preventive MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Surrey M. Walton
- Department of Pharmacy Systems Outcomes and PolicyUniversity of Illinois ChicagoChicagoIllinoisUSA
| | - Sumihiro Suzuki
- Department of Family and Preventive MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Bradley M. Appelhans
- Department of Family and Preventive MedicineRush University Medical CenterChicagoIllinoisUSA
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Crane MM, Newman K, Hebert-Beirne J, Abril EP, Powell LH, Appelhans BM. Weight Loss Program Preferences of Men Working in Blue-Collar Occupations: A Qualitative Inquiry. Am J Mens Health 2022; 16:15579883221117932. [PMID: 36154524 PMCID: PMC9515537 DOI: 10.1177/15579883221117932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Men who work in blue-collar occupations (skilled and unskilled trades) experience high rates of obesity and comorbid conditions. This group is underrepresented in behavioral interventions for weight management, which may stem from a mismatch between the features of available programs and these men's preferences. This qualitative study explored the views of these men, their experiences with weight loss, their preferences for weight loss programs, and messaging related to these programs. We conducted remote interviews with 20 men (age: 43 ± 13 years, M ± SD) currently working in blue-collar occupations (50% construction, 25% transportation, and 25% manufacturing) who had body mass indices (BMIs) in the overweight/obese categories (BMI: 33 ± 6 kg/m2). Deductive codes and summary themes were developed and discussed by the first two authors. A selection of transcripts was reviewed following theme development to confirm accuracy of the themes. Most participants (n = 16, 80%) reported a prior weight loss attempt. The most common approaches to weight loss reported were increased exercise and following their own approach to changing diet (e.g., "eating less junk food"). For program and message preferences, two major themes emerged: participants wanted accurate and trustworthy information and wanted programs that fit their lifestyle. Results suggest that weight loss programs targeting men working in blue-collar occupations should emphasize the accuracy of information related to the program and the ease of incorporating it into participants' lifestyles. There is an urgent need to incorporate these preferences into effective programs.
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Affiliation(s)
- Melissa M. Crane
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA,Melissa M. Crane, Assistant Professor,
Department of Family and Preventive Medicine, Rush University Medical Center,
1700 W. Van Buren St., Ste 470, Chicago, IL 60612, USA.
| | - Katerina Newman
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jeni Hebert-Beirne
- Division of Community Health Sciences,
School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Eulàlia P. Abril
- Department of Communication, University
of Illinois Chicago, Chicago, IL, USA
| | - Lynda H. Powell
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Bradley M. Appelhans
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA
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Robertson C, Aceves-Martins M, Cruickshank M, Imamura M, Avenell A. Does weight management research for adults with severe obesity represent them? Analysis of systematic review data. BMJ Open 2022; 12:e054459. [PMID: 35641006 PMCID: PMC9157335 DOI: 10.1136/bmjopen-2021-054459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Our objective was to determine the extent to which current evidence from long-term randomised controlled trials (RCTs) of weight management is generalisable and applicable to underserved adult groups with obesity (body mass index (BMI) ≥35 kg/m2). METHODS Descriptive analysis of 131 RCTs, published after 1990-May 2017 with ≥1 year of follow-up, included in a systematic review of long-term weight management interventions for adults with BMI ≥35 kg/m2 (the REBALANCE Project). Studies were identified from MEDLINE, EMBASE, PsychINFO, SCI, CENTRAL and from hand searching. Reporting of trial inclusion and exclusion criteria, trial recruitment strategies, baseline characteristics and outcomes were analysed using a predefined list of characteristics informed by the PROGRESS (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital)-Plus framework and the UK Equality Act 2010. RESULTS Few (6.1%) trials reported adapting recruitment to appeal to underserved groups. 10.0% reported culturally adapting their trial materials. Only 6.1% of trials gave any justification for their exclusion criteria, yet over half excluded participation for age or mental health reasons. Just over half (58%) of the trials reported participants' race or ethnicity, and one-fifth reported socioeconomic status. Where outcomes were reported for underserved groups, the most common analysis was by sex (47.3%), followed by race or ethnicity (16.8%). 3.1% of trials reported outcomes according to socioeconomic status. DISCUSSION Although we were limited by poor trial reporting, our results indicate inadequate representation of people most at risk of obesity. Guidance for considering underserved groups may improve the appropriateness of research and inform greater engagement with health and social care services. FUNDING National Institute for Health Research Health Technology Assessment Programme (project number: 15/09/04). PROSPERO REGISTRATION NUMBER CRD42016040190.
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Affiliation(s)
- Clare Robertson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | | | - Mari Imamura
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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"I didn't want to do it on my own": A qualitative study of women's perceptions of facilitating and risk factors for weight control on a UK commercial community program. Appetite 2021; 165:105308. [PMID: 34010725 DOI: 10.1016/j.appet.2021.105308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022]
Abstract
Overweight and obesity remain serious public health concerns. Outcomes from community based commercial weight management programmes vary, relapse is common and drop out is high. Outcomes could be improved by better understanding experiences on these programmes. The aim of our study was to generate accounts of people's experience on a commercial weight-management program to identify what experiences were perceived as facilitating, and what posed risks, to programme effectiveness and compliance. We conducted individual, semi-structured interviews with eighteen Caucasian women (mean age 45.4y) who were members of nation-wide UK commercial, fee-paying, community weight management programme. Interview data was analysed via framework analysis. Participants' experiences indicated that the programme helped by triggering several intra- and interpersonal processes that catalysed change across psychological, physiological, dietary and behavioural areas of their life. Risks to program adherence and effectiveness spanned well-known risks such as self-regulation fatigue and the difficulty of recovering from negative self-criticism, as well as new factors such as the confusing nature of weight change, the relatively powerful impact of everyday events, and the difficulty in getting the balance right between personalised support vs. intrusion. The complexity of reported experiences challenges the linear, predictive pathways of change proposed by many health behaviour models of weight management. To improve effectiveness, programmes need to go well beyond behavioural and dietary support. It is recommended that community, commercial programmes educate people about the physiological and psychological tensions they will encounter, why people lose weight at different rates, the likelihood of weight relapse and strategies to manage these, including evidence-based support for managing self-criticism.
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Punt SE, Kurz DL, Befort CA. Recruitment of Men Into a Pragmatic Rural Primary Care Weight Loss Trial. Am J Mens Health 2020; 14:1557988320971917. [PMID: 33174488 PMCID: PMC7673057 DOI: 10.1177/1557988320971917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Men remain underrepresented in behavioral weight loss trials and are more difficult to recruit compared to women. We describe recruitment response of men and women into a mixed-gender behavioral weight loss trial conducted within 36 rural primary care clinics. Participants were recruited through primary care clinics via direct mailings (n = 15,076) and in-clinic referrals by their primary care provider (PCP). Gender differences were examined in response rate to direct mailings, study referral source, and rates of proceeding to study screening, being eligible, and enrolling. Men had a lower response rate to direct mailings than women (7.8% vs. 17.7%, p < .001). Men (vs. women) responding to the mailing were more likely to respond by opt-in postcard (64.6% vs. 56.8%) and less likely to respond by phone (33.9% vs. 39.6%), p = .002. Among potential participants contacting the study (n = 2413), men were less likely to report being referred by PCPs (15.2% vs. 21.6%; p < .001), but were just as likely to proceed to screening, be eligible, and enroll. Men and women were more likely to proceed to screening when referred by PCPs (93.3% vs. 95.4%) compared to direct mailings (74.2% vs. 73.9%). Enrolled men were older (p < .001), more likely to be married (p = .04), and had higher levels of education (p = .01). Men were less likely than women to respond to direct mailings and to be referred by their PCP, but after contacting the study, had similar screening, eligibility, and enrollment rates. Encouraging and training providers to refer men during clinic visits may help recruit more men into primary care-based weight loss trials.
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Affiliation(s)
- Stephanie E Punt
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Daniel L Kurz
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
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Seymour-Smith S, Gough B, Matthews CR, Rutherford Z. Food assessment: a discursive analysis of diet talk in interviews with older men who are obese. Psychol Health 2020; 35:946-967. [PMID: 32148091 DOI: 10.1080/08870446.2019.1701673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Obesity rates are increasing faster in men than in women, with particular concerns raised regarding older men. However, men are less likely than women to engage in weight-loss activities such as dieting, typically constructed as a feminine practice. Previous research has argued that men's food consumption is notably different and unhealthier than women's. The novel contribution of this article is an analysis of food assessments in order to explore how older men (mostly) undergoing weight management programmes make sense of changes in their nutritional intake. Design: Semi-structured interviews were conducted with 30 men who were obese, 27 of whom were engaged in weight loss programmes. Discursive psychology was employed to analyse the data. Results: In contrast to other research, participants constructed nutritional advice as enlightening. Participants worked up 'ownership' and pleasure assessments to certain food choices which they contrasted with new, less calorific, eating practices. Moreover, new diets were constructed as acceptable. Conclusion: Our study contributes new insights about how nutritional advice impacts upon preconceived (mis)understandings of healthy eating practices. During the interviews, men positioned themselves as educators - health promoters might usefully develop nutritional advice in collaboration with men who have successfully changed their diets for optimum effect.
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Affiliation(s)
- Sarah Seymour-Smith
- Psychology Division, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Brendan Gough
- Calverly Building, School of Social Sciences, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - Christopher R Matthews
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Zoe Rutherford
- Centre for Active Lifestyles, Leeds Beckett University, Leeds, United Kingdom of Great Britain and Northern Ireland
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Harcourt KA, Appleton J, Clegg ME, Hunter L. The Influence of Social Relationships on Men's Weight. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:106-113. [PMID: 31611050 DOI: 10.1016/j.jneb.2019.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore how men's social relationships influence their dietary, physical activity, and weight loss intentions and behaviors. DESIGN Qualitative study using semistructured interviews. SETTING One county in the southwest of England. PARTICIPANTS Men (n = 19) aged 18-60 years with a body mass index ≥24 kg/m2 who were otherwise healthy. PHENOMENON OF INTEREST Men's perceptions of dieting, physical activity and weight loss, and how social relationships influence these behaviors. ANALYSIS Interviews were audiorecorded and transcribed verbatim. Transcripts were coded line by line using NVivo software. Themes and subthemes were inductively generated using thematic analysis. RESULTS Four themes were derived: (1) how experiences shape beliefs, (2) being a proper bloke, (3) adapting to family life, and (4) support from outside the home. Men discussed how partners were a greater influence on diet than physical activity. Attitudes toward diet and physical activity were influenced by life events such as becoming a father. It was framed as acceptable for men to talk to their friends about exercise and food intake in general, but they emphasized that this was not for "support." CONCLUSIONS AND IMPLICATIONS Family members were key influences on men's behaviors. Future qualitative research could include interviews with men's families. Findings may inform family weight loss interventions.
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Affiliation(s)
| | - Jane Appleton
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, England
| | - Miriam E Clegg
- Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom.
| | - Louise Hunter
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, England
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Sarfan LD, Clerkin EM, Teachman BA, Smith AR. Do thoughts about dieting matter? Testing the relationship between thoughts about dieting, body shape concerns, and state self-esteem. J Behav Ther Exp Psychiatry 2019; 62:7-14. [PMID: 30149204 DOI: 10.1016/j.jbtep.2018.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/14/2018] [Accepted: 08/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Dieters are likely primed to think about their diet throughout the day (e.g., as they feel hungry). However, prior research has not tested whether and how thinking about dieting might have negative effects, like poor self-esteem and body shape concerns. METHODS We experimentally primed dieters' thoughts about their diets and tested whether: 1) dieting thoughts are related to poor state self-esteem through body shape concerns; and 2) dieting thoughts are related to body shape concerns through poor state self-esteem. Dieting participants (N = 225) were randomly assigned to complete a dieting or neutral prime. RESULTS Unexpectedly, there was a different pattern of results across male (n = 72) and female (n = 144) dieters. When accounting for body shape concerns, males primed to think about dieting (vs. neutral condition) reported greater state self-esteem. Further, the dieting prime indirectly led to lower body shape concerns through greater state global self-esteem. However, for females, the dieting prime indirectly led to poorer state self-esteem through its effects on body shape concerns. LIMITATIONS The sample was collected online and was predominantly female and Caucasian. Other limitations include self-report of dieting status and body mass index. CONCLUSIONS The findings suggest that for males, thoughts about dieting may actually be associated with greater state self-esteem, which may indirectly predict lower body shape concerns. In contrast, for females, when thoughts about dieting activate body shape concerns, poorer state self-esteem may follow. These results highlight important, potentially gender-specific relationships between thoughts about dieting, body shape concerns, and state self-esteem.
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Affiliation(s)
- Laurel D Sarfan
- Department of Psychology, Miami University, 90 N. Patterson Ave, Oxford, OH, 45224, USA.
| | - Elise M Clerkin
- Department of Psychology, Miami University, 90 N. Patterson Ave, Oxford, OH, 45224, USA
| | - Bethany A Teachman
- Department of Psychology, University of Virginia, 485 McCormick Road, Charlottesville, VA, 22903, USA
| | - April R Smith
- Department of Psychology, Miami University, 90 N. Patterson Ave, Oxford, OH, 45224, USA
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Pedersen S, Sniehotta FF, Sainsbury K, Evans EH, Marques MM, Stubbs RJ, Heitmann BL, Lähteenmäki L. The complexity of self-regulating food intake in weight loss maintenance. A qualitative study among short- and long-term weight loss maintainers. Soc Sci Med 2018; 208:18-24. [DOI: 10.1016/j.socscimed.2018.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 04/23/2018] [Accepted: 05/04/2018] [Indexed: 02/04/2023]
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Campos L, Bernardes S, Godinho C. Food as a way to convey masculinities: How conformity to hegemonic masculinity norms influences men’s and women’s food consumption. J Health Psychol 2018; 25:1842-1856. [DOI: 10.1177/1359105318772643] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This study investigated how conformity to hegemonic masculinity norms affects men’s and women’s food consumption and whether such influence was contextually modulated. A total of 519 individuals (65% women; M = 44 years old) participated in a 2 (gender salience: low vs high) × 2 (participants’ sex: male vs female) quasi-experimental between-subjects design, completing the Conformity to Masculinity Norms Inventory (Portuguese version) and reporting their past week’s food consumption. Gender salience moderated the relation between men’s conformity to masculinity norms and food consumption; sex-related differences in food consumption were partially mediated by conformity to masculinity norms. Implications for food consumption interventions are discussed.
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Affiliation(s)
- Lúcia Campos
- CIS-IUL – Instituto Universitário de Lisboa, Portugal
| | | | - Cristina Godinho
- CIS-IUL – Instituto Universitário de Lisboa, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
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Sutcliffe K, Melendez-Torres GJ, Burchett HED, Richardson M, Rees R, Thomas J. The importance of service-users' perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes. Health Expect 2018. [PMID: 29537117 PMCID: PMC5980498 DOI: 10.1111/hex.12657] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Extensive research effort shows that weight management programmes (WMPs) targeting both diet and exercise are broadly effective. However, the critical features of WMPs remain unclear. Objective To develop a deeper understanding of WMPs critical features, we undertook a systematic review of qualitative evidence. We sought to understand from a service‐user perspective how programmes are experienced, and may be effective, on the ground. Search strategy We identified qualitative studies from existing reviews and updated the searches of one review. Inclusion criteria We included UK studies capturing the views of adult WMP users. Data extraction and synthesis Thematic analysis was used inductively to code and synthesize the evidence. Main results Service users were emphatic that supportive relationships, with service providers or WMP peers, are the most critical aspect of WMPs. Supportive relationships were described as providing an extrinsic motivator or “hook” which helped to overcome barriers such as scepticism about dietary advice or a lack confidence to engage in physical activity. Discussion and conclusions The evidence revealed that service‐users’ understandings of the critical features of WMPs differ from the focus of health promotion guidance or descriptions of evaluated programmes which largely emphasize educational or goal setting aspects of WMPs. Existing programme guidance may not therefore fully address the needs of service users. The study illustrates that the perspectives of service users can reveal unanticipated intervention mechanisms or underemphasized critical features and underscores the value of a holistic understanding about “what happens” in complex psychosocial interventions such as WMPs.
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Affiliation(s)
- Katy Sutcliffe
- EPPI-Centre, UCL Institute of Education, University College London, London, UK
| | - G J Melendez-Torres
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Helen E D Burchett
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle Richardson
- EPPI-Centre, UCL Institute of Education, University College London, London, UK
| | - Rebecca Rees
- EPPI-Centre, UCL Institute of Education, University College London, London, UK
| | - James Thomas
- EPPI-Centre, UCL Institute of Education, University College London, London, UK
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Taylor R, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Sattar N, Welsh P, Peters C, Zhyzhneuskaya S, Hollingsworth KG, Al-Mrabeh A, Rodrigues AM, Rehackova L, Adamson AJ, Sniehotta FF, Mathers JC, Ross HM, McIlvenna Y, Kean S, Ford I, McConnachie A, Lean MEJ. Clinical and metabolic features of the randomised controlled Diabetes Remission Clinical Trial (DiRECT) cohort. Diabetologia 2018; 61:589-598. [PMID: 29188339 PMCID: PMC6448967 DOI: 10.1007/s00125-017-4503-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 10/25/2017] [Indexed: 12/26/2022]
Abstract
AIMS/HYPOTHESIS Substantial weight loss in type 2 diabetes can achieve a return to non-diabetic biochemical status, without the need for medication. The Diabetes Remission Clinical Trial (DiRECT), a cluster-randomised controlled trial, is testing a structured intervention designed to achieve and sustain this over 2 years in a primary care setting to determine practicability for routine clinical practice. This paper reports the characteristics of the baseline cohort. METHODS People with type 2 diabetes for <6 years with a BMI of 27-45 kg/m2 were recruited in 49 UK primary care practices, randomised to either best-practice diabetes care alone or with an additional evidence-based weight management programme (Counterweight-Plus). The co-primary outcomes, at 12 months, are weight loss ≥15 kg and diabetes remission (HbA1c <48 mmol/mol [6.5%]) without glucose-lowering therapy for at least 2 months. Outcome assessors are blinded to group assignment. RESULTS Of 1510 people invited, 423 (28%) accepted; of whom, 306 (72%) were eligible at screening and gave informed consent. Seven participants were later found to have been randomised in error and one withdrew consent, leaving 298 (176 men, 122 women) who will form the intention to treat (ITT) population for analysis. Mean (SD) age was 54.4 (7.6) years, duration of diabetes 3.0 (1.7) years, BMI 34.6 (4.4) kg/m2 for all participants (34.2 (4.2) kg/m2 in men and 35.3 (4.6) kg/m2 in women) and baseline HbA1c (on treatment) 59.3 (12.7) mmol/mol (7.6% [1.2%]). The recruitment rate in the intervention and control groups, and comparisons between the subgroups recruited in Scotland and England, showed few differences. CONCLUSIONS/INTERPRETATION DiRECT has recruited a cohort of people with type 2 diabetes with characteristics similar to those seen in routine practice, indicating potential widespread applicability. Over 25% of the eligible population wished to participate in the study, including a high proportion of men, in line with the prevalence distribution of type 2 diabetes. TRIAL REGISTRATION www.controlled-trials.com/ISRCTN03267836 ; date of registration 20 December 2013.
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Affiliation(s)
- Roy Taylor
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Wilma S Leslie
- Human Nutrition, School of Medicine, Dentistry and Nursing - GRI Campus, College of Medical, Veterinary and Life Sciences, University of Glasgow, 2nd Floor, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Alison C Barnes
- Human Nutrition Research Centre, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Naomi Brosnahan
- Human Nutrition, School of Medicine, Dentistry and Nursing - GRI Campus, College of Medical, Veterinary and Life Sciences, University of Glasgow, 2nd Floor, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
- Counterweight Ltd, Corby, Northants, UK
| | - George Thom
- Human Nutrition, School of Medicine, Dentistry and Nursing - GRI Campus, College of Medical, Veterinary and Life Sciences, University of Glasgow, 2nd Floor, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Louise McCombie
- Human Nutrition, School of Medicine, Dentistry and Nursing - GRI Campus, College of Medical, Veterinary and Life Sciences, University of Glasgow, 2nd Floor, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Carl Peters
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Sviatlana Zhyzhneuskaya
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Kieren G Hollingsworth
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Ahmad Al-Mrabeh
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Angela M Rodrigues
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Lucia Rehackova
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ashley J Adamson
- Human Nutrition Research Centre, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | | | - Yvonne McIlvenna
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sharon Kean
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ian Ford
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing - GRI Campus, College of Medical, Veterinary and Life Sciences, University of Glasgow, 2nd Floor, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK.
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Er V, Lane JA, Martin RM, Persad R, Chinegwundoh F, Njoku V, Sutton E. Barriers and facilitators to healthy lifestyle and acceptability of a dietary and physical activity intervention among African Caribbean prostate cancer survivors in the UK: a qualitative study. BMJ Open 2017; 7:e017217. [PMID: 29038181 PMCID: PMC5652511 DOI: 10.1136/bmjopen-2017-017217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Diet and lifestyle may have a role in delaying prostate cancer progression, but little is known about the health behaviours of Black British prostate cancer survivors despite this group having a higher prostate cancer mortality rate than their White counterparts. We explored the barriers and facilitators to dietary and lifestyle changes and the acceptability of a diet and physical activity intervention in African Caribbean prostate cancer survivors. DESIGN We conducted semistructured in-depth interviews and used thematic analysis to code and group the data. PARTICIPANTS AND SETTING We recruited 14 African Caribbean prostate cancer survivors via letter or at oncology follow-up appointments using purposive and convenience sampling. RESULTS A prostate cancer diagnosis did not trigger dietary and lifestyle changes in most men. This lack of change was underpinned by five themes: precancer diet and lifestyle, evidence, coping with prostate cancer, ageing, and autonomy. Men perceived their diet and lifestyle to be healthy and were uncertain about the therapeutic benefits of these factors on prostate cancer recurrence. They considered a lifestyle intervention as unnecessary because their prostate-specific antigen (PSA) level was kept under control by the treatments they had received. They believed dietary and lifestyle changes should be self-initiated and motivated, but were willing to make additional changes if they were perceived to be beneficial to health. Nonetheless, some men cited advice from health professionals and social support in coping with prostate cancer as facilitators to positive dietary and lifestyle changes. A prostate cancer diagnosis and ageing also heightened men's awareness of their health, particularly in regards to their body weight. CONCLUSIONS A dietary and physical activity intervention framed as helping men to regain fitness and aid post-treatment recovery aimed at men with elevated PSA may be appealing and acceptable to African Caribbean prostate cancer survivors.
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Affiliation(s)
- Vanessa Er
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Athene Lane
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR Bristol Nutrition Biomedical Research Unit, University Hospitals Bristol Education & Research Centre, Bristol, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR Bristol Nutrition Biomedical Research Unit, University Hospitals Bristol Education & Research Centre, Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol, UK
| | - Raj Persad
- Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Frank Chinegwundoh
- Department of Urology, Barts Health NHS Trust, The Royal London Hospital, London, UK
- School of Health Sciences, University of London, London, UK
| | - Victoria Njoku
- Department of Urology, Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Eileen Sutton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Maclin-Akinyemi C, Krukowski RA, Kocak M, Talcott GW, Beauvais A, Klesges RC. Motivations for Weight Loss Among Active Duty Military Personnel. Mil Med 2017; 182:e1816-e1823. [PMID: 28885942 PMCID: PMC6085087 DOI: 10.7205/milmed-d-16-00380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Rates of overweight and obesity among Active Duty Military Personnel remain high despite fitness test requirements, negative consequences of fitness test failure, and emphasis on weight and appearance standards. Specific motivating factors for weight loss influence weight loss program interest and often differ by gender, race, ethnicity, or age. This study investigates the weight loss motivations endorsed by a diverse population of Active Duty Military Personnel initiating a behavioral weight loss study, to inform the development of future recruitment efforts and program development. MATERIALS AND METHODS Active Duty Military Personnel (n = 248) completed a 16-item questionnaire of weight loss motivations before initiating a behavioral weight loss study. We evaluated endorsement patterns by demographic characteristics (body mass index [BMI], gender, race, ethnicity, age, and military rank). Data collection for this study was approved by the Institutional Review Board of Wilford Hall Ambulatory Surgical Center and acknowledged by the Institutional Review Board of the University of Tennessee Health Science Center. RESULTS Results indicated that improved physical health, improved fitness, improved quality of life, and to live long were endorsed as "very important" motivations by at least three-fourths of the sample. "To pass the fitness test" was endorsed less frequently as a "very important" motivation, by 69% of the sample. A greater proportion of women as compared to men endorsed being very motivated by improving mood/well-being, quality of life, physical mobility, job performance, appearance, and sex life, as well as fitting into clothes. Participants categorized in the "Other" racial group and African Americans more frequently endorsed motivations to improve fitness and physical strength when compared to Caucasians. Moreover, participants in the "Other" race category were significantly more likely to rate their ability to physically defend themselves, improve physical mobility, and improve interactions with friends as motivators. Participants who identified as Hispanic endorsed significantly higher frequency of being motivated to improve their ability to physically defend themselves, interactions with friends, physical mobility, and sex life compared to those who identified as non-Hispanic. A significantly lower percentage of officers of lower rank (i.e., O1-3) endorsed being motivated to improve their quality of life. Improving confidence was a significant motivator for younger and lower ranking enlisted personnel (i.e., E1-4). Younger participants were also significantly more likely to want to improve their ability to physically defend themselves. CONCLUSION We conclude that overweight and obese Military Personnel are motivated by various reasons to engage in weight loss, including their military physical fitness test. Findings may assist the development of recruitment efforts or motivationally focused intervention materials for weight loss interventions tailored for the diverse population of Active Duty Military Personnel.
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Affiliation(s)
| | - Rebecca A. Krukowski
- University of Tennessee Health Sciences, Department of Preventive Medicine, Center for Population Sciences, 66 Pauline, Memphis, TN 38105
| | - Mehmet Kocak
- University of Tennessee Health Sciences, Department of Preventive Medicine, Center for Population Sciences, 66 Pauline, Memphis, TN 38105
| | - G. Wayne Talcott
- University of Tennessee Health Sciences, Department of Preventive Medicine, Center for Population Sciences, 66 Pauline, Memphis, TN 38105
| | - Alexis Beauvais
- San Antonio Uniformed Services Health Education Consortium, Department of Internal Medicine, San Antonio, TX
| | - Robert C. Klesges
- University of Tennessee Health Sciences, Department of Preventive Medicine, Center for Population Sciences, 66 Pauline, Memphis, TN 38105
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“I don't need supporting, me, I just do it.” A qualitative study of the social influences in male weight loss behaviours. Proc Nutr Soc 2017. [DOI: 10.1017/s0029665117003354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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20
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Crane MM, Jeffery RW, Sherwood NE. Exploring Gender Differences in a Randomized Trial of Weight Loss Maintenance. Am J Mens Health 2016; 11:369-375. [PMID: 27923968 PMCID: PMC5313337 DOI: 10.1177/1557988316681221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study is to explore gender differences in reasons for losing weight, weight loss methods, and weight loss behaviors prior to and during a weight loss maintenance trial. This is a secondary analysis of data from a 24-month randomized controlled trial comparing Self-Directed or Guided phone-based weight loss maintenance interventions among adults who had intentionally lost ≥10% of their body weight in the year prior to enrollment. Participants reported their weight loss methods and reasons for recently losing weight at baseline. Dietary intake, physical activity, and dietary patterns were assessed at baseline, 12, and 24 months. Participants included 419 adults (18.4% men, age 47.0 ± 10.8, BMI 28.4 ± 5.0). Women were more likely than men to report having used an organized weight loss program during their weight loss (55.9% vs. 24.7%, p < .001) and to report improving personal esteem as a motivator (51.2% vs. 35.1%, p = .01). Men were more likely than women to report eating food from convenience stores at baseline (22.1% vs. 13.2%, p = .05) and throughout the study but otherwise reported similar meal patterns (ps > .05). Men reported higher energy intake than women while physical activity was similar. Although more men self-directed their initial weight loss and more women utilized organized weight loss programs, behaviors reported during weight loss maintenance were similar. Futures studies are needed to understand if these results generalize to other men who have successfully lost weight and are participants in other weight loss maintenance interventions.
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21
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Marzano L. I. Is My Work `Feminist' Enough? Tensions and Dilemmas in Researching Male Prisoners who Self-harm. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/0959353507079082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lisa Marzano
- Middlesex University, School of Health and Social Sciences,
Queensway, Enfield EN3 4SA, UK.,
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22
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Recruitment of young adults for weight gain prevention: randomized comparison of direct mail strategies. Trials 2016; 17:282. [PMID: 27278474 PMCID: PMC4897900 DOI: 10.1186/s13063-016-1411-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/27/2016] [Indexed: 12/22/2022] Open
Abstract
Background Recruiting young adults (ages 18–35 years) into weight gain prevention intervention studies is challenging and men are particularly difficult to reach. This paper describes two studies designed to improve recruitment for a randomized trial of weight gain prevention interventions. Study 1 used a quasi-experimental design to test the effect of two types of direct mailings on their overall reach. Study 2 used a randomized design to test the effect of using targeted messages to increase recruitment of men into the trial. Methods For Study 1, 60,000 male and female young-adult households were randomly assigned to receive either a recruitment brochure or postcard. Visits to recruitment websites during each mailing period were used to assess response to each mailing. Study 2 focused on postcard recruitment only. These households received either a targeted or generic recruitment postcard, where targeted postcards included the word “Men” in the headline text. Response rates to each type of card were categorized based on participant report of mailing received. Results The reach of the postcards and brochures were similar (421 and 386 website visits, respectively; P = 0.22). Individuals who received the brochure were more likely to initiate the online screener than those who received a postcard (P = 0.01). In Study 2, of those who completed the telephone screening, 60.9 % of men (n = 23) had received the targeted postcard as compared to the generic postcard (39.1 %, P = 0.30). The reverse was true for women (n = 62, 38.7 vs. 61.3 %, P = 0.08). Conclusions These studies suggest there was little difference in the reach of postcards versus brochures. However, recipients of brochures were more likely to continue to the next stage of study participation. As expected, men’s response to the weight gain prevention messages was lower than women’s response; but using targeted messages appears to have modestly increased the proportion of male respondents. These studies add to the limited experimental literature on recruitment messaging and provide further indication for using targeted messages to reach underrepresented populations while providing initial evidence on the effect of mailing type on message reach. Trial registration The Study of Novel Approaches to Weight Gain Prevention was registered with ClinicalTrials.gov (identifier: NCT01183689) on 13 August 2010. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1411-4) contains supplementary material, which is available to authorized users.
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Crane MM, Lutes LD, Ward DS, Bowling JM, Tate DF. A randomized trial testing the efficacy of a novel approach to weight loss among men with overweight and obesity. Obesity (Silver Spring) 2015; 23:2398-405. [PMID: 26727117 PMCID: PMC4700541 DOI: 10.1002/oby.21265] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/06/2015] [Accepted: 07/22/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To test the efficacy of a weight loss intervention designed to appeal to men. METHODS A randomized trial tested the efficacy of the Rethinking Eating and FITness (REFIT) weight loss program compared to a wait-list control. The 6-month intervention was delivered via two face-to-face sessions followed by Internet contacts. REFIT encouraged participants to create calorie deficits by making six 100-calorie changes to their eating daily while increasing physical activity, and the program encouraged customization through selection of specific diet strategies evaluated each week. RESULTS Participants (N = 107, 44.2 years, 31.4 kg/m(2) , 76.6% white) were randomized into the study, and 90.6% provided data at 6 months. REFIT participants lost -5.0 kg (95% CI: -6.1, -3.9) at 3 months, which was maintained through 6 months (-5.3 kg, 95% CI: -6.5, -4.2); this was greater than the control group (p < 0.001; 6 months: -0.6, 95% CI: -1.8, 0.5). More REFIT participants (49%) achieved a 5% weight loss than control participants (19%; OR 9.4; 95% CI: 3.2, 27.4). An average of 11.2 (±2.7) of 13 of the online intervention contacts were completed. CONCLUSIONS The novel REFIT intervention produced clinically significant weight losses. This approach holds promise as an alternative to traditional behavioral therapy for men.
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Affiliation(s)
- Melissa M. Crane
- Department of Health Behavior, Gillings School of Global Public
Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,
USA
| | - Lesley D. Lutes
- Department of Psychology, East Carolina University, Greenville,
North Carolina, USA
| | - Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public Health,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - J. Michael Bowling
- Department of Health Behavior, Gillings School of Global Public
Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,
USA
| | - Deborah F. Tate
- Department of Health Behavior, Gillings School of Global Public
Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,
USA
- Department of Nutrition, Gillings School of Global Public Health,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Archibald D, Douglas F, Hoddinott P, van Teijlingen E, Stewart F, Robertson C, Boyers D, Avenell A. A qualitative evidence synthesis on the management of male obesity. BMJ Open 2015; 5:e008372. [PMID: 26459486 PMCID: PMC4606385 DOI: 10.1136/bmjopen-2015-008372] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To investigate what weight management interventions work for men, with which men, and under what circumstances. DESIGN Realist synthesis of qualitative studies. DATA SOURCES Sensitive searches of 11 electronic databases from 1990 to 2012 supplemented by grey literature searches. STUDY SELECTION Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m(2) in all settings. RESULTS 22 studies were identified, including 5 qualitative studies linked to randomised controlled trials of weight maintenance interventions and 8 qualitative studies linked to non-randomised intervention studies, and 9 relevant UK-based qualitative studies not linked to any intervention. Health concerns and the perception that certain programmes had 'worked' for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled 'obese'; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design. CONCLUSIONS Men's perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition.
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Affiliation(s)
- Daryll Archibald
- Scottish Collaboration for Public Health Research & Policy (SCPHRP), University of Edinburgh, Edinburgh, Lothian, UK
| | - Flora Douglas
- Rowett Institute of Health and Nutrition, University of Aberdeen, Medical School, Aberdeen, UK
| | - Pat Hoddinott
- NMAHP Research Unit, Unit 13 Scion House, University of Stirling, Stirling University Innovation Park, Stirling, UK
| | - Edwin van Teijlingen
- Maternal & Perinatal Health Faculty of Health & Social Sciences, Centre for Midwifery, Christchurch Road Bournemouth University, Bournemouth, UK
| | - Fiona Stewart
- Cochrane Incontinence Review Group, University of Aberdeen, Aberdeen, UK
| | - Clare Robertson
- Health Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK
| | - Dwayne Boyers
- Health Economics Research Unit (HERU) and Health Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK
| | - Alison Avenell
- Health Services Research Unit (HSRU), University of Aberdeen, Aberdeen, UK
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Abstract
People with a big body are tainted in western societies. Although most research on obesity occurs in the medical context, few studies investigate characteristics and effects of feelings and fears related to the fat stigma in the absence of overt discrimination. By linking Norbert Elias's and George H. Mead's theoretical frameworks, this paper offers a different approach to understanding and investigating felt stigma. The study is based on secondary data (25 semistructured interviews with children and adolescents). It explores internalized societal perspectives on overweight and obesity and inquires into the way in which interviewees handle the blame frame of personal responsibility during their interview. The preliminary findings suggest that specific forms of managing one's self-presentation in interviews indicate felt stigma. Consequently, the paper argues for an analytical approach that extends the focus on the content of interviews to include its dynamics.
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Relton C, Li J, Strong M, Holdsworth M, Cooper R, Green M, Bissell P. Deprivation, clubs and drugs: results of a UK regional population-based cross-sectional study of weight management strategies. BMC Public Health 2014; 14:444. [PMID: 24884639 PMCID: PMC4046155 DOI: 10.1186/1471-2458-14-444] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 04/23/2014] [Indexed: 12/03/2022] Open
Abstract
Background Despite rising levels of obesity in England, little is known about slimming club and weight loss drug (medication) use or users. In order to inform future commissioning, we report the prevalence of various weight management strategies and examine the associations between slimming club and medication use and age, gender, deprivation and body mass index. Methods A population based cross-sectional survey of 26,113 adults was conducted in South Yorkshire using a self-completed health questionnaire. Participants were asked whether they had ever used the following interventions to manage their weight: increasing exercise, healthy eating, controlling portion size, slimming club, over the counter weight loss medication, or meal replacements. Factors associated with slimming club and weight-loss medication use were explored using logistic regression. Results Over half of the sample was either overweight (36.6%) or obese (19.6%). Obesity was more common in the most deprived areas compared to the least deprived (26.3% vs. 12.0%). Healthy eating (49.0%), controlling portion size (43.4%), and increasing exercise (43.0%) were the most commonly reported weight management strategies. Less common strategies were attending a slimming club (17.2%), meal replacements (3.4%) and weight-loss medication (3.2%). Adjusting for BMI, age, deprivation and long standing health conditions, women were significantly more likely to report ever using a slimming club (adjusted OR = 18.63, 95% CI = 16.52–21.00) and more likely to report ever using over the counter weight-loss medications (AOR = 3.73, 95% CI = 3.10-4.48), while respondents from the most deprived areas were less likely to report using slimming clubs (AOR = 0.60, 95% CI = 0.53-0.68), and more likely to reporting using weight loss medications (AOR =1.38, 95% CI = 1.05-1.82). Conclusion A large proportion of individuals report having used weight management strategies. Slimming clubs and over-the-counter weight loss medication account for a smaller proportion of the overall uptake. Those from less deprived areas were more likely to use slimming clubs while those from more deprived areas were more likely to use weight-loss medications. Future NHS and Local Authority commissioning of weight management services must be aware of this varying social gradient in weight management strategies.
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Affiliation(s)
- Clare Relton
- Public Health Section, ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
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Hunt K, Gray CM, Maclean A, Smillie S, Bunn C, Wyke S. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study. BMC Public Health 2014; 14:50. [PMID: 24443845 PMCID: PMC4028855 DOI: 10.1186/1471-2458-14-50] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 11/26/2013] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. METHODS A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. RESULTS Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. CONCLUSIONS The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt 'right' rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.
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Affiliation(s)
- Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ, UK.
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Wirth CK, James DCS, Fafard M, Ochipa K. Developing Weight Management Messages and Interventions for Baby Boomer Men. Am J Mens Health 2013; 8:258-66. [DOI: 10.1177/1557988313510731] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The goal of this study was to explore the weight management experiences of Baby Boomer men (born between 1946 and 1964) and to use the information to develop targeted messages and interventions. Twenty men were interviewed. The Health Belief Model was used as the study’s theoretical framework. Men correctly identified health risks of being obese. However, most believed that body mass index and weight charts were unrealistic, and a few felt that they would be too “skinny” at the recommended weight. Wives were sources of nutrition information and social support. Perceived benefits of losing weight included reduced risk for health problems and looking good. Perceived barriers included apathy and weight loss programs being “too feminine.” Motivators for losing weight included being diagnosed with a health problem, health requirements for work, and financial incentives. The data themes suggest ways to develop male-specific messages and interventions that consider the aging body.
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Lindvall K, Jenkins P, Emmelin M, Scribani M, Norberg M, Larsson C, Weinehall L. Primary weight maintenance: an observational study exploring candidate variables for intervention. Nutr J 2013; 12:97. [PMID: 23855935 PMCID: PMC3717287 DOI: 10.1186/1475-2891-12-97] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 07/08/2013] [Indexed: 11/11/2022] Open
Abstract
Background Previous studies have focused on weight maintenance following weight loss, i.e. secondary weight maintenance (SWM). The long-term results of SWM have been rather modest and it has been suggested that preventing initial weight gain, i.e. primary weight maintenance (PWM), may be more successful. Therefore, developing a prevention strategy focused on PWM, enabling normal weight or overweight individuals to maintain their weight, would be of great interest. The aim of this study was to identify attitudes, strategies, and behaviors that are predictive of PWM in different age, sex and BMI groups in Northern Sweden. Methods A questionnaire was mailed to 3497 individuals in a Swedish population that had two measured weights taken ten years apart, as participants in the Västerbotten Intervention Programme. Subjects were between 41–63 years of age at the time of the survey, had a baseline BMI of 20–30, and a ten year percent change in BMI greater than -3%. The respondents were divided into twelve subgroups based on baseline age (30, 40 and 50), sex and BMI (normal weight and overweight). Analysis of variance (ANOVA), correlation, and linear regression were performed to identify independent predictors of PWM. Results Of the 166 predictors tested, 152 (91.6%) were predictive of PWM in at least one subgroup. However, only 7 of these 152 variables (4.6%) were significant in 6 subgroups or more. The number of significant predictors of PWM was higher for male (35.8) than female (27.5) subgroups (p=0.044). There was a tendency (non significant) for normal weight subgroups to have a higher number of predictors (35.3) than overweight subgroups (28.0). Adjusted R-squared values ranged from 0.1 to 0.420. Conclusions The large number of PWM predictors identified, and accompanying high R-squared values, provide a promising first step towards the development of PWM interventions. The large disparity in the pattern of significant variables between subgroups suggests that these interventions should be tailored to the person’s demographic (age, sex and BMI). The next steps should be directed towards evaluation of these predictors for causal potential.
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Affiliation(s)
- Kristina Lindvall
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, S-901 87 Umeå, Sweden.
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Douglas FCG, Greener J, van Teijlingen E, Ludbrook A. Services just for men? Insights from a national study of the Well Men Services Pilots. BMC Public Health 2013; 13:425. [PMID: 23634701 PMCID: PMC3651411 DOI: 10.1186/1471-2458-13-425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 04/23/2013] [Indexed: 11/10/2022] Open
Abstract
Background Men continue to have a lower life expectancy in most countries compared to women. Explanations of this gendered health inequality tend to focus on male risk taking, unhealthy lifestyle choices and resistance to seeking help from health services. In the period 2005–2008 the Scottish Government funded a nationwide community health promotion programme aimed at improving men’s health, called Well Men Service Pilots (henceforth WMS). Method This paper explores WMS programme users’ perspectives and experiences of health help-seeking against theories of hegemonic masculinity as explanatory frameworks for men’s behaviour around health and illness, and their views on a male-specific focus of the programme. It is based on a secondary analysis of 43 semi-structured interviews with men who engaged with this programme. Results We challenge the commonly held notion of men as being disinterested in their health, and point to their heterogeneity in relation to their views about health and notions of health seeking. Moreover, men in our study were largely ambivalent about the need for gender specific services, despite their positive reactions to the programme in general. Conclusions Our findings question the utility of some theories of masculinity that posit somewhat simplistic explanations for men’s reluctance to seek help from formal healthcare services. They also suggest that providing male-specific health services may not significantly address men’s supposed reluctance to seek help from formal health services. Essentially, age seemed to be more important than gender. All encompassing health programmes are likely to fail to meet their health improvement objectives if they attempt to engage with men on the simple basis that they are male.
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Affiliation(s)
- Flora C G Douglas
- The Rowett Institute of Health and Nutrition, University of Aberdeen, Aberdeen, UK.
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Mao A, Bristow K, Robinson J. Caught in a dilemma: why do non-smoking women in China support the smoking behaviors of men in their families? HEALTH EDUCATION RESEARCH 2013; 28:153-164. [PMID: 22843329 DOI: 10.1093/her/cys078] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Intimate relationships influence family members' health practices. Although cigarette smoking in China is predominantly a male behavior, (non-smoking) women's roles should be taken into account for the development of home-smoking interventions. Drawing on ethnographic interviews with 22 families in a rural area of China, this article explores non-smoking women's attitudes towards male smoking. The findings suggest that women's ability to influence male behavior is largely determined by culturally defined gender roles, underpinned by ideologies of familism and collectivism. Despite concerns about the adverse results of smoking to their family members and households, non-smoking women ultimately maintain the (male) smokers' argument that smoking plays an important role in construction and maintenance of intra- and extra-family relationships. By accepting male smoking and men's engagement in the social practice of smoking and cigarette exchanges, women maintain their identities as supportive wives, filial daughters/in-law and responsible family members who pursue family collective interests at the expense of their own personal beliefs. Future smoking control initiatives that target non-smoking women to influence male smoking should take into account the women's overarching need to maintain the status and harmony of their families.
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Affiliation(s)
- Aimei Mao
- School of Law and Social Justice, University of Liverpool, Liverpool L69 7WW, UK.
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Bennett E, Gough B. In pursuit of leanness: The management of appearance, affect and masculinities within a men’s weight loss forum. Health (London) 2012; 17:284-99. [DOI: 10.1177/1363459312454149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In a somatic society which promotes visible, idealized forms of embodiment, men are increasingly being interpellated as image-conscious body-subjects. Some research suggests that men negotiate appearance issues in complex and varied ways, partly because image concerns are conventionally feminized. However, little research has considered how overweight men construct body projects in the context of weight loss, or how men talk to each other about weight management efforts. Since sources of information and support for overweight men are now provided online, including dedicated weight loss discussion forums, our analysis focuses on one such forum, linked to a popular male-targeted magazine. We conducted a thematic analysis of selected extracts from seven threads on the forum. Our analysis suggests a widespread focus on appearance, as well as the use of emotion categories when describing difficult bodily experiences. Invariably, however, such talk was carefully constructed and constrained by hegemonic masculinities founded on discipline, work-orientation, pragmatism and self-reliance. The findings are discussed in relation to magazine masculinities and aesthetics, as well as literature on male embodiment.
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Bisogni CA, Jastran M, Seligson M, Thompson A. How people interpret healthy eating: contributions of qualitative research. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:282-301. [PMID: 22732708 DOI: 10.1016/j.jneb.2011.11.009] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 11/22/2011] [Accepted: 11/26/2011] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To identify how qualitative research has contributed to understanding the ways people in developed countries interpret healthy eating. DESIGN Bibliographic database searches identified reports of qualitative, empirical studies published in English, peer-reviewed journals since 1995. DATA ANALYSIS Authors coded, discussed, recoded, and analyzed papers reporting qualitative research studies related to participants' interpretations of healthy eating. RESULTS Studies emphasized a social constructionist approach, and most used focus groups and/or individual, in-depth interviews to collect data. Study participants explained healthy eating in terms of food, food components, food production methods, physical outcomes, psychosocial outcomes, standards, personal goals, and as requiring restriction. Researchers described meanings as specific to life stages and different life experiences, such as parenting and disease onset. Identity (self-concept), social settings, resources, food availability, and conflicting considerations were themes in participants' explanations for not eating according to their ideals for healthy eating. IMPLICATIONS People interpret healthy eating in complex and diverse ways that reflect their personal, social, and cultural experiences, as well as their environments. Their meanings include but are broader than the food composition and health outcomes considered by scientists. The rich descriptions and concepts generated by qualitative research can help practitioners and researchers think beyond their own experiences and be open to audience members' perspectives as they seek to promote healthy ways of eating.
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Affiliation(s)
- Carole A Bisogni
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
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Bove CF, Sobal J. Body weight relationships in early marriage. Weight relevance, weight comparisons, and weight talk. Appetite 2011; 57:729-42. [PMID: 21864601 PMCID: PMC3229225 DOI: 10.1016/j.appet.2011.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 08/08/2011] [Indexed: 01/04/2023]
Abstract
This investigation uncovered processes underlying the dynamics of body weight and body image among individuals involved in nascent heterosexual marital relationships in Upstate New York. In-depth, semi-structured qualitative interviews conducted with 34 informants, 20 women and 14 men, just prior to marriage and again one year later were used to explore continuity and change in cognitive, affective, and behavioral factors relating to body weight and body image at the time of marriage, an important transition in the life course. Three major conceptual themes operated in the process of developing and enacting informants' body weight relationships with their partner: weight relevance, weight comparisons, and weight talk. Weight relevance encompassed the changing significance of weight during early marriage and included attracting and capturing a mate, relaxing about weight, living healthily, and concentrating on weight. Weight comparisons between partners involved weight relativism, weight competition, weight envy, and weight role models. Weight talk employed pragmatic talk, active and passive reassurance, and complaining and critiquing criticism. Concepts emerging from this investigation may be useful in designing future studies of and approaches to managing body weight in adulthood.
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Affiliation(s)
- Caron F Bove
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
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Abstract
In this article, we examine the existing sociocultural research and theory concerned with the aging body. In particular, we review the body image and embodiment literatures and discuss what is known about how older adults perceive and experience their aging bodies. We analyse how body image is shaped by age, culture, ethnicity, gender, health status, sexual preference, and social class. Additionally, we critically elucidate the embodiment literature as it pertains to illness experiences, sexuality, the everyday management of the aging body, appearance work, and embodied identity. By outlining the key findings, theoretical debates, and substantive discrepancies within the body image and embodiment research and theory, we identify gaps in the literature and forecast future, much-needed avenues of investigation.
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Woolhouse M, Day K, Rickett B, Milnes K. ‘Cos girls aren’t supposed to eat like pigs are they?’ Young women negotiating gendered discursive constructions of food and eating. J Health Psychol 2011; 17:46-56. [DOI: 10.1177/1359105311406151] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
While psycho-medical understandings of ‘eating disorders’ draw distinctions between those who ‘have’/‘do not have’ eating disorders, feminist poststructuralist researchers argue that these detract from political/socio-cultural conditions that invoke problematic eating and embodied subjectivities. Using poststructuralist discourse analysis, we examine young women’s talk around food and eating, in particular, the negotiation of tensions arising from derogating aspects of hetero-normative femininities, while accounting for own ‘feminine’ practices (e.g. ‘dieting’) and subjectivities. Analysis suggested that eating/dieting was accounted for by drawing upon neo-liberalist discourses around individual choice; however, these may obscure gendered, classed and racialized power relations operating in local and wider contexts.
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Allan K, Hoddinott P, Avenell A. A qualitative study comparing commercial and health service weight loss groups, classes and clubs. J Hum Nutr Diet 2010; 24:23-31. [DOI: 10.1111/j.1365-277x.2010.01110.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Oliffe JL, Grewal S, Bottorff JL, Dhesi J, Bindy H, Kang K, Ward A, Hislop TG. Masculinities, diet and senior Punjabi Sikh immigrant men: food for Western thought? SOCIOLOGY OF HEALTH & ILLNESS 2010; 32:761-776. [PMID: 20646249 DOI: 10.1111/j.1467-9566.2010.01252.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The high rates of diabetes and cardiovascular disease among Punjabi Sikh (PS) men are often linked to diet. Although some high fat and sugar foods in both traditional and Western foods negatively influence these illnesses, little is known about what underpins PS immigrant men's dietary practices. This article details the connections between masculinities and diet to reveal how varying gendered ideals can inform and influence the practices of senior PS Canadian immigrant men who attended community-based men's groups. Participants' masculine ideals and their alignment to those ideals were deeply rooted in spirituality and traditional cultures, which shaped the use of specific foods and beverages, yet there was also evidence that the availability and affordability of dairy products and alcohol in Canada strongly influenced men's diets. While the men's group leaders educated attendees about diet, ideologies reinforcing ties between femininities and the cooking of meals often prevailed. Linkages between participants' masculine ideals and dietary practices were both similar and discordant with the findings reported in studies of Western men. The findings drawn from this study may direct what, how and where dietary messages are targeted to senior PS Canadian immigrant men.
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Affiliation(s)
- John L Oliffe
- School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver BC, V6T 1Z3 Canada.
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Lindvall K, Larsson C, Weinehall L, Emmelin M. Weight maintenance as a tight rope walk - a Grounded Theory study. BMC Public Health 2010; 10:51. [PMID: 20122140 PMCID: PMC2835685 DOI: 10.1186/1471-2458-10-51] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 02/01/2010] [Indexed: 11/12/2022] Open
Abstract
Background Overweight and obesity are considerable public health problems internationally as well as in Sweden. The long-term results of obesity treatment are modest as reported by other studies. The importance of extending the focus to not only comprise obesity treatment but also prevention of weight gain is therefore being emphasized. However, despite the suggested change in focus there is still no consensus on how to prevent obesity or maintain weight. This study reports findings from a qualitative study focusing on attitudes, behaviors and strategies important for primary weight maintenance in a middle-aged population. Methods In depth interviews were conducted with 23 maintainers and four slight gainers in Sweden. The interviews were transcribed and an analysis of weight maintenance was performed using Grounded Theory. Results Based on the informants' stories, describing attitudes, behaviors and strategies of importance for primary weight maintenance, a model illustrating the main findings, was constructed. Weight maintenance was seen as "a tightrope walk" and four strategies of significance for this "tightrope walk" were described as "to rely on heritage", "to find the joy", "to find the routine" and "to be in control". Eleven "ideal types" were included in the model to illustrate different ways of relating to the main strategies. These "ideal types" described more specific attitudes and behaviors such as; eating food that is both tasteful and nutritious, and choosing exercise that provides joy. However, other somewhat contradictory behaviors were also found such as; only eating nutritious food regardless of taste, and being physically active to control stress and emotions. Conclusion This study show great variety with regards to attitudes, strategies and behaviors important for weight maintenance, and considerations need to be taken before putting the model into practice. However, the results from this study can be used within primary health care by enhancing the understanding of how people differ in their relation to food and physical activity. It informs health personnel about the need to differentiate advices related to body weight, not only to different sub-groups of individuals aiming at losing weight but also to sub-groups of primary weight maintainers aiming at maintaining weight.
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Affiliation(s)
- Kristina Lindvall
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Medical Faculty, Umeå University, Umeå, Sweden.
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De Visser RO, Smith JA, McDonnell EJ. 'That's not masculine': masculine capital and health-related behaviour. J Health Psychol 2010; 14:1047-58. [PMID: 19786531 DOI: 10.1177/1359105309342299] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In recent years increasing attention has been given to how different masculinities are expressed in young men's health behaviour. To examine whether men can use competence in key health-related masculine domains to compensate for other non-masculine behaviour, group discussions were conducted with men aged 18-21 living in London, England. The analysis revealed the ways in which competence in traditionally masculine health-related domains produces masculine 'capital', which can be used to compensate for non-masculine behaviour in other domains. However, the capacity to trade this capital is limited because different masculine and non-masculine behaviours have different values.
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Daniel S, Bridges SK. The drive for muscularity in men: media influences and objectification theory. Body Image 2010; 7:32-8. [PMID: 19815476 DOI: 10.1016/j.bodyim.2009.08.003] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 08/24/2009] [Accepted: 08/28/2009] [Indexed: 10/20/2022]
Abstract
Presently, objectification theory has yielded mixed results when utilized to explain body image concerns in men. An online survey assessing internalization of media ideals, self-objectification, body surveillance, body shame, the drive for muscularity, and body mass index (BMI) was completed by 244 predominantly college-aged males. Path analyses were used to investigate relationships among these variables where it was hypothesized that objectification variables would mediate the relationship between internalization of media ideals and the drive for muscularity. Internalization of media ideals was the strongest predictor of the drive for muscularity, followed by BMI, though variables of objectification theory had no impact on the drive for muscularity contrary to hypotheses. The results suggest that objectification theory may not be applicable to men as it is currently measured.
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Affiliation(s)
- Samantha Daniel
- The University of Memphis, Memphis, Tennessee 38152, United States
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Green A, Larkin M, Sullivan V. Oh Stuff It! The Experience and Explanation of Diet Failure. J Health Psychol 2009; 14:997-1008. [DOI: 10.1177/1359105309342293] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Successful long-term weight-loss is exceptional, even with the best dietary and psychological interventions. Nomothetic accounts of diet failure focus on cognitive processes and emotional regulation. However, qualitative research suggests that successful dieters draw on wider understandings in explaining their success; this study extends this literature to address diet failure. Individual interviews with 10 self-selected UK dieters are analysed using IPA. Understandings of diet failure are explored and situated within wider cultural discourses. Five themes are identified: ‘Dieting mode’; ‘Multime’; ‘Not me’; ‘Modern life’; and ‘Challenges of emotional and social eating’. Implications for weight-loss interventions are explored.
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Pietilä I, Rytkönen M. 'Health is not a man's domain': lay accounts of gender difference in life-expectancy in Russia. SOCIOLOGY OF HEALTH & ILLNESS 2008; 30:1070-1085. [PMID: 18564970 DOI: 10.1111/j.1467-9566.2008.01106.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The substantial gender difference in life-expectancy is among the key characteristics of current health crisis in Russia. Despite a relatively large body of epidemiological literature on gender difference, there is little empirical research on the gendered meanings of health among Russian lay people. This study aims to enhance understanding of gendered meanings of health by analysing lay accounts of the gender gap in life-expectancy on the basis of 29 interviews with Russians aged 15-81. The analysis showed that gender difference was largely attributed to structural conditions and changes in Russian society and, to a lesser extent, to behavioural factors. Another important conclusion drawn from the analysis was that talk about gender included very few alternatives to conventional gender relations, or negotiation of their effects on health and illness. We interpret these findings to reflect, first, the culturally weak role of the individual in Russian discourses of health that are still largely focused on the role of government as primarily responsible for public health. Secondly, it seems that there are few alternatives to conventional discourses of gender in post-Soviet Russia; the gender relations in people's understanding appear to be static and persistent despite recent profound social changes.
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Affiliation(s)
- Ilkka Pietilä
- School of Public Health, University of Tampere, Tampere, Finland
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Bas M, Donmez S. Self-efficacy and restrained eating in relation to weight loss among overweight men and women in Turkey. Appetite 2008; 52:209-16. [PMID: 18929608 DOI: 10.1016/j.appet.2008.09.017] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Revised: 09/11/2008] [Accepted: 09/22/2008] [Indexed: 01/18/2023]
Abstract
The purpose of this study was to examine the potential improvements in eating self-efficacy, eating behavior and other psychological factors in obese subjects participating in a weight management program. The participants in this study consisted of 96 persons (76 women and 20 men) who were attending the first session of a commercially run 20-week treatment program for weight reduction. Self-efficacy in relation to eating was assessed by the Weight Efficacy Lifestyle Questionnaire. The participants also completed the Three Factor Eating Questionnaire (TFEQ), Rosenberg Self-esteem Scale, Social Physique Anxiety Scale, State Trait Anxiety Inventory and Body Parts Satisfaction Scale prior to weight management program and again 20 weeks after the program. High self-efficacy score was significantly associated with high weight loss among all participants. Also, high negative emotions and physical discomfort scores were significantly associated with high weight loss among all participants. Results indicated that there was a significant decrease in the TFEQ hunger and disinhibition scores during the study. As a conclusion, our findings suggest that the role of self-efficacy has an important role in obesity treatment regarding to weight control behavior.
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Affiliation(s)
- Murat Bas
- Baskent University, Health Sciences Faculty, Department of Nutrition and Dietetics, Eskisehir Yolu 20 Km, Baglica Campus, 06530 Ankara, Turkey.
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46
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Abstract
Research has demonstrated that gender is a barrier to men's participation in self-help groups. In this article I analyse how four men and seven women negotiate their identities as members of cancer self-help groups. Their accounts were transcribed and analysed using a synthetic approach to discursive psychology. Women's accounts were organized around the notion of receiving help whereas men appeared to resist this type of identity. I explore how men attended to the presentation of a masculine identity and focus on how men negotiated `legitimately masculine' reasons to be engaged in self-help groups.
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47
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Wharton CM, Adams T, Hampl JS. Weight loss practices and body weight perceptions among US college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2008; 56:579-584. [PMID: 18400672 DOI: 10.3200/jach.56.5.579-584] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The authors assessed associations between body weight perception and weight loss strategies. PARTICIPANTS They randomly selected male and female college students (N = 38,204). METHODS The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the National College Health Assessment survey. RESULTS Half of respondents (50%) were trying to lose weight, although only 28% of students were overweight or obese. Also, 12% of respondents had inaccurate body weight perception. Women and men with inaccurate body weight perception were significantly more likely to engage in inappropriate weight loss strategies than were those with accurate body weight perception. Of all students attempting to lose weight, 38% used both diet and exercise. CONCLUSIONS These data show that college students are interested in weight loss and that body weight perception plays an important role in the desire to lose weight.
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Gough B. 'Real men don't diet': an analysis of contemporary newspaper representations of men, food and health. Soc Sci Med 2006; 64:326-37. [PMID: 17070972 DOI: 10.1016/j.socscimed.2006.09.011] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Indexed: 11/16/2022]
Abstract
Little research to date has focused on the meanings men attach to food and the relationship between diet and health. This is an important topic in light of the current 'crisis' in men's health and the role of lifestyle factors such as diet in illness prevention. Since the mass media is a powerful source of information about health matters generally, media representations bear critical examination. The present paper reports on an in-depth qualitative analysis of contemporary UK newspaper articles on the topic of men and diet (N=44). The findings indicate a persistent adherence to hegemonic masculinities predicated on health-defeating diets, special occasion cooking of hearty meals, and a general distancing from the feminised realm of dieting. At the same time, men are constructed as naïve and vulnerable when it comes to diet and health, while women are viewed as experts. The implications for health promotion with men are discussed.
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