Impact of Social Inclusion Provided By Men’s Sheds on Health & Wellbeing Luckman Hlambelo (RN, BN,MN,MPH,MBA) University of Western Sydney, Australian Men's Shed Association 5th National Conference, Victoria. 29 October 2013 Outline • Why bother about men’s health? • Why social inclusion is an important determinant of men’s health? • What do we know about the impact of social inclusion on cardiovascular, endocrine and neurological systems? • What we are researching? • Why we need the support of the ‘Shedders”? 2 What does the literature say? • Outcomes: Morbidity & Mortality rates higher in men than women • Behaviour: Cultural Constructions of men • Policy: Clinical Concern & andrology • Health Services: Lack of engagement • Socio-economic environment: 1/3 of men are not in work (Macdonald, 2006, Lattimore 2007) The Turning point Men’s Friendships Social isolation Unemployment Social Exclusion Stress Macdonald, 2005; 2011; WHO, 2003; Wilkinson & Marmot, 2003 Impact of Stress on Health(HPA-Axis) Prolonged Cortisol Secretion • Abdominal fat (heart attacks, strokes) • Metabolic syndrome ( levels of “bad” cholesterol (LDL) and levels of “good” cholesterol (HDL) • Immune deficiency (colds, delayed wound healing) • Decreased sexual interest • Blood sugar imbalances • Cancer Social Support & Health • Effect on neuroendocrine pathways - stress reduction • “buffers” or protect health during times of high stress. • A study conducted by Cohen and Wills found a relationship between social support and psychological well-being in the presence of stress. • It is believed that social support increases one’s level of psychological well-being by allowing individuals to feel like that have better control over their stress. • Social support may be a primary coping mechanism. Social Inclusion In Men’s Sheds Men report enjoyment from participation, camaraderie, socialisation and skill development at Men’s Sheds. Theoretical and descriptive case studies/literature (e.g. , Golding et al, 2007; Ballinger et al .2009; Wilson & Cordier, 2013; Golding et al. 2006; 2007, DoHA, 2010; Macdonald, 2013) Research Aims 1) To examine the impact of Men’s sheds on the health of the men involved; and 2) To determine whether participation in the Men’s Shed can improve measures of stress, cardiovascular health and wellbeing. Research Objectives • Understand men’s experiences of social inclusion provided by the Men’s Shed • H1:Men involved in Men’s Sheds will show an increase in resting HRV and a decrease in the basal levels of cortisol. • H2: Increased HRV will be associated with reduced resting HR and BP and improved psychological health status Metatheoretical Map Person Somatic biofeedback . Psychoanalysis Character Psychology Physiology Biology Phenomenology Experience Interpretation Measurement s Endocrinology Philosophy Hermeneutics Relational Psychology Group Cardiology Research Design and Methods QUANTITATIVE -Data + QUALITATIVE -Data Interpretation • Philosophical Hermeneutics (Gadamer 1900-2002) framed in the context of narrative • One-Group-Pre & Post Test to evaluate the effect of Men’s shed on HRV, cortisol level and additional healthrelated outcome measures in individuals involved. • Serve as an explorative study and an initial effort to produce biological evidence for the advancement of 11 men’s sheds Methods of data collection Indepth interview • Saliva samples • Heart rate monitor Blood Pressure monitor • Questionnaires Conceptual Framework Hermeneutics (Qualitative Study) Stages Design Collection Conversion Analysis Interpreta Integr tion ation Theory OpenEnded Questio ns (n=15) Recording Written Audio Transcription Translation Generating Thematic Categories Thematic Analysis Narrative Analysis Analysis of quotation s, Story lines • SDH • Salutogenesis • Transaction theory • Coping and Hormones Axial Coding Items and Scales (n=46) Item Analysis Salivary Codes Cortisol, Scale RHRV, SF36 & STAI Ques Descr & Multivaria te Analyses Model Interpreta tion One Group Pre-test-Post Test (Quantitative Study) Integrati ve Analysis , Drawing Conclusi ons Sample Size and Power Calculation • Qualitative Study (n=15) –Saturation not sought • Quantitative Study (n=46) –Paired t-test (two-sided, alpha=0.05, power=0.8, effect size=0.75) test of significance, approximately 42 subjects In closing…..what they are saying • “Surely attending has been of great benefit to my health, and if it wasn’t for the supportive mates, I would have died long back.” (D5) • “I went through hard times and lost everything…I am beginning to find meaning and coming here has confirmed there is a lot to live for” (D3) • “Companionship reduced my stress levels” (D2) 15 Interested in taking part in this Study? Luckman Hlambelo – Mobile 0408934032 – Email: firstname.lastname@example.org OR Professor John Macdonald - Mobile 0404008760 - Email: J.Macdonald@uws.edu.au Take Home Message • Not all diseases can be cured in the hospital • Think about Social Determinants of Men’s Health • The National Male Health Policy endorses a SDH approach to men’s health • Social inclusion is an important SD of 17 Men’s Health References 1. Ballinger M.L., Talbot L.A. & Verrinder G.K. (2009) More than a place to do woodwork: a case study of a community-based Men’s Shed. Journal of Men’s Health 6 (1), 20– 27. 2. Department of Health and Ageing (2010) National Male Health Policy: Building on the Strength of Australian Males. Department of Health and Ageing, Canberra, 3. Golding B. (2011) Older men’s wellbeing through community participation in Australia. International Journal of Men’s Health 10 (1), 26–44. identity and gender in Australia. Social Policy and Society, 6(2), 151-163. 4. Golding B. & Harvey J. (2006) Final report on a Survey of Men’s Sheds Participants in Victoria: Report to Adult, Com- munity and Further Education Board. Adult, Community and Further Education Board of Victoria, Melbourne, FL. 5. Golding B., Brown M., Foley A., Harvey J. & Gleeson L. (2007a) Men’s Sheds in Australia: Learning Through Community Contexts. National Centre for Vocational and Educational Research (NCVER), Adelaide, SA. 6. Macdonald, J. J. (2006). Shifting paradigms: a social-determinants approach to solving problems in men's health policy and practice. 7. Macdonald, J. J. (2011). Building on the Strengths of Australian Males. International Journal of Men's Health, 10(1), 82-96. 19 8. Wilkinson, R., & Marmot, M. (2003). Social determinants of health: the solid facts: World Health Organization.