First Nations Men Experiencing Fatherhood

BackgroundEvidence suggests that positive parenting can impact men’s mental wellbeing and child development, and male parents have a unique and critically important role as parents. Unfortunately, limited literature is available regarding the First Nations male parenting and the challenges they encounter raising children. Furthermore, the qualitative studies examining First Nations male parents do not appear effective for translating policy and practice. In effect, important knowledge from these qualitative studies is not informing or shaping First Nations male parenting programs. A systematic collation and meta-synthesis of existing qualitative studies may strengthen the evidence base and assist with the integrative knowledge into policy and practice. MethodsA meta-synthesis of qualitative studies were performed to explore the experiences, barriers and facilitators to parenting among First Nations males. A systematic search in Social Sciences Citation Index, CINAHL, ProQuest, Informit Databases, Expanded Academic, Scopus and Google scholar for e-journals was conducted to identify studies that explored First Nations male parenting, barriers and facilitators. Thematic synthesis was performed to identify the key elements influencing (challenging or facilitating) them. ResultsNine qualitative studies were identified in the review, including eight peer-reviewed articles and one dissertation. Four themes emerged: (1) the complexity of roles and relationships; (2) poverty and exclusion; (3) sharing and receiving knowledge and (4) keeping strong. Elements across studies were identified as a barrier, facilitator or both to male parenting. Conclusions There is compelling evidence demonstrating the critical role of male parents to their own and their children’s development and wellbeing. This meta-synthesis generates a much-needed empirical foundation to guide further research, policy and practice for First Nations male parents. The meta-synthesis and the resulting explanatory theory can be used by communities, practitioners and policymakers to identify the barriers and facilitators that support and promote First Nations male parenting from an indigenous understanding of history and contemporary society.

How American Attitudes about Race, Ethnicity, and Gender affect the Health and Wellbeing of Black-African Refugee Men in the United States

More than half of all refugees currently resettled in the United States are racial-ethnic-minority men. Yetrefugee health scholarship has not fully explored racial ethnic minority refugee men's encounters with resettlement environment norms about race, ethnicity and gender. This paper describes an intersectional-informed qualitative study of the daily stressors experienced by Black-African refugee men in the United States to explain how such experiences impact their health and wellbeing. These men’s life narratives illumi-nate how stigma and discrimination associated with race, ethnicity, gender affect their health and wellbeing during resettlement. These findings offer evidence that the realities of ethnic minority refugee men in the United States, while unique, can contribute to broader discourses about minority men’s health inequities.

The Meanings of Mental Health Recovery for African and Caribbean Men in the UK

Racial disparities for African and Caribbean men are nowhere as stark as in mental health services and outcomes. Men from these communities who have been in contact with mental health services seemed to be stuck in a stalled cycle of recovery. This paper reports the findings from a study that aimed to explore how African and Caribbean men and their supporters conceptualise mental health recovery at the intersections of masculinity, racialised identities and mental distress. It illuminates the perspectives of service users,family, carers and practitioners on recovery in relation to ethnicity and culture.Owing to the exploratory nature of this study, a qualitative design using a phenomenological approach was adopted to capture the dynamics of recovery processes and outcomes for African and Caribbean men across two study sites. Interviews were conducted with African and Caribbean men, their supporters and service providers. Interpretive Phenomenology Analysis (IPA; Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory method and research. London: SAGE; 2009) was used to offer insights into how recovery was understood and experienced by study participants.Seven overarching themes emerged from the data in relation to the meanings of recovery: recovering from social suffering, leading a normal life, (re)gaining control and agency, a sense of hope, (re)gaining identity, reduced medical involvement, and recovery being a healing journey. The paper concludes that recovery is an ongoing process, not merely a narrow outcome to be achieved for men. The paper advances previous understandings by conceptualising mental health recovery for African and Caribbean men as a journey towards addressing individual and collective “social suffering” that occurs at the intersections of masculinity, “race” and mental distress, and moving to a better social location.

"Just Shave It Off"

IntroductionHead hair comprises a critical part of the male appearance ideal, which itself is a crucial signifier of a man’s masculinity. However, difficulties in recruitment have meant that research has not yet fully explored how men construct the loss of head hair (baldness), perhaps because it is considered “feminine” to disclose body dissatisfaction experiences to a researcher or other people. Methods and DesignOnline forums provide an opportunity for the anonymous discussion of body dissatisfaction that may overcome this obstacle. The first 260 forums posts from the two most popular baldness forums were thematically analysed. Ethics StatementInstitutional ethics approval was granted. Results and DiscussionWe identified three themes titled: (1) Baldness is an ugly and demasculinising condition, (2) Baldness is stigmatised by a superficial society and superficial women and (3) Resistance to baldness despair. Our findings show baldness distress, and stigma exist though so does resistance, which can be comforting to men experiencing baldness or any form of body dissatisfaction. Conclusion and ImplicationsOnline forums are a salient resource to enhance our understanding of men’s balding concerns and disclosure barriers. Independent, professional and effective baldness support that unpacks baldness masculinised and medicalised framing is recommended.

Men’s Baldness Stigma and Body Dissatisfaction

Introduction: Head hair forms a central component of the sociocultural male appearance ideal (e.g.,mesomorphic, tall, young and not bald) and carries masculine connotations and stigma. Immense pressures to conform to this male appearance ideal gives rise to body dissatisfaction. Previous assessments of body dissatisfaction are too narrow, ignoring dissatisfaction beyond mesomorphy such as baldness dissatisfaction. Our study involved two research questions: (i) Do the facial expressions assigned to images of bald and non-bald men differ? and (ii) What forms of body dissatisfaction, including baldness dissatisfaction, do men have and are these related to men’s wellbeing and muscularity behaviours? Method: Eighty-six male participants aged 18–58 years (mean = 23.62; standard deviation = 7.80) were randomly exposed to 10 images of smiling men (half balding and half not) and were asked to rate the facial expression displayed. Participants also rated their body dissatisfaction and wellbeing. Ethics statement: Institutional ethics approval was granted. Results: We found that participants interpreted the facial expressions of images of bald men slightly more negatively than non-bald men. Most participants reported some form of body dissatisfaction correlated with wellbeing and muscularity enhancing behaviours, albeit weakly. Participants also disclosed a range of body dissatisfaction aspects (including surrounding muscularity, body fat, teeth alignment, skin tone and facial hair amount) though generally were not impacted heavily nor highly dissatisfied. Conclusion: These findings underscore the complex challenge in producing a complete assessment of men’s body dissatisfaction and the general resilience men experience with extant appearance pressures around their bodies and head hair.

A Mixed-Methods Evaluation of a Gender-Sensitive Rite of Passage Program for Adolescent Males

IntroductionCurrent gendered health disparities impacting the wellbeing of boys and young men require new early intervention-focussed approaches. Health promotion programs developed with young men’s health needs and preferences in mind commonly report positive outcomes. Male-specific rite of passage programs aim to formally acknowledge the life-stage transition from boyhood to manhood through a holistic focus on identity, community, and social responsibility. While these programs are growing in popularity, there is limited data available on their effectiveness. MethodsThis study undertook a pilot evaluation of the Making of Men rite of passage program in a sample of second-ary school boys (n=61, age M=16.0, SD=0.5) and their accompanying fathers or male mentors (n=47, age M=52.1, SD=5.8 years) providing non-matched pre-test, post-test, alongside follow-up data for participating boys. Qualitative interviews were also undertaken with 15 individuals (5 mothers, 6 staff members, 4 fathers). ResultsQuantitative program feedback indicated acceptability, with most respondents providing positive feedback, particularly from participating fathers. Exploratory quantitative effects indicated potential improvements in subjective social support and open communication among boys. Fathers appeared to report lower confor-mity to traditional masculine norms post-program, in addition to more open communication. Qualitative interviews identified three main themes: enabling relational bonds, creating a men-specific context, and supporting developmental transitions. ConclusionsPositive program acceptability and promising outcome effects highlighted the present rite of passage program as a promising mechanism for supporting healthy masculine identity development among adolescent males.

Understanding the Nexus between Alcohol Consumption, Social and Emotional Wellbeing, and higher Education Outcomes among Aboriginal and Torres Strait Islander Males in Australia

Education is a critical social determinant of health, particularly in the context of Aboriginal and Torres StraitIslander health and well-being. There is also a broad array of other health risk factors that intersect with these social and cultural determinants of health. Overall, an in-depth examination of the complex health–education nexus is needed. This paper provides a commentary on interrelationships between health risk factors, their impact on education trajectories, and their implications for Aboriginal and Torres Strait Islander males.

Men's Health Promotion in Waiting Rooms: An Observational Study

Issue addressedCurrently, in Australia, male health outcomes are poorer than that of females, with males experiencing a lower life expectancy, accounting for 62% of the premature deaths. Exploring male-specific health promotional material in health facility waiting rooms provides an opportunity to examine available health information. There are few studies on health-related education for patients, families and carers in general practitioner (GP) waiting rooms, and no studies on male-specific health material content in waiting rooms. MethodsThis prospective observational study audited all printed health promotional materials in all health facility waiting rooms within a single local government area. A total of 24 sites were surveyed, which included general practice centres, community health centres and hospitals. The surveyed health literature included posters, brochures and booklets. ResultsThere were 1143 health materials audited across the sites. Of these, 3.15% (n = 36) were male-specific literature, 15.31% (n = 175) were female-specific health literature and 81.54% (n = 932) were neutral/others. Overwhelmingly, the audited health literature evidenced a 5:1 ratio favouring female-specific literature versus male-specific literature. ConclusionsThis research highlighted that despite the known outcomes of lower male life expectancy and higher burden of disease, male-specific literature was observed to be significantly under-represented within the audited health facility waiting room spaces. There remains potential for health clinicians to provide targeted male health education and thereby improve male health literacy.

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

Inconsistent access to a healthcare provider (HCP), which can lead to advanced morbidity, is an oft-cited barrier to advancing health. Extensive review of the literature consistently suggests men are far less likely to engage within the healthcare system. This is particularly problematic pertaining to preventive services. As many health conditions are preventable and/or treatable in earlier stages, delay in screening and treatment often leads to long-term negative health outcomes. Lack of early and frequent preventive healthcare (e.g. primordial, primary, and secondary prevention) may even be perceived as “normative” where poorer health outcomes in males are expected.1 In fact, some evidence demonstrates a clear connection that seeking help via healthcare runs contrary to masculinity and dominant masculine principles, such as being strong/sturdy, working through pain, avoiding weakness or anything perceived as feminine, among other psychosocial phenomena.2,3 Changing healthcare “culture” concerning the care of men (i.e. gender-sensitive care) may provide a salient avenue to encourage more consistent and preventive contact or “touch points” in the patient-provider dynamic. There is a need to understand how social norms and practices in healthcare and medical settings can be effectively leveraged to address life-long male health outcomes versus focusing on late(r)-stage palliative care. The purpose of this article is to advance dialogue concerning practical considerations, such as resources (e.g. time, money) and methods (e.g. practitioners considering whether men respond best to immediate efforts to establish rapport versus a traditional power-based dynamic during the medical interaction) so as to inform gender-sensitive touchpoints in the healthcare of men. Location and types of facilities where men are willing to seek care (preventative or palliative) also need to be considered in a holistic, gender-sensitive patient-provider model of healthcare. Implications, policies, and evidence-based practical strategies for leveraging medical education, prevention programming, proper and improper recognition and management, and long-term treatment are presented and discussed with the practitioner in mind.

Strengthening Policy Commitments to Equity and Men’s Health

Commentary