Men's Health Behaviors Research Articles

Positive masculinity programmes and sexual and reproductive health behaviours among boys and men in poor urban settlements in Democratic Republic of Congo, Nigeria, and Rwanda.

As Positive Masculinity (PM) Programmes continue to develop globally, it is important to examine their role in Sexual and Reproductive Health and Rights (SRHR) outcomes. This multi-country qualitative study was conducted using in-depth interviews (IDI) and focus group discussions (FGDs) with community members, beneficiaries and implementers of PM programmes. The findings show that PM programmes are designed using a gender lens to make boys and men more aware and conscious of harmful masculinity traits and their effect on SRHR. The beneficiaries of the interventions report imbibing positive SRHR behaviours by being sexually responsible - upholding sexual rights, taking precautions against sexually transmitted Infections (STIs) and learning proper communication with their partners. They also report acting as vanguards of positive gender norms to their families and peers. Although there are challenges in implementing PM programmes, the results of the study suggest that interventions targeting boys and men hold promise for improving boys' and men's health behaviours and promoting gender equality in poor urban settings.

MANifest Health Theory: A Holistic Approach to Cis-Gender Men's Health.

Men's health has often been overlooked in health care, with traditional gender norms and societal expectations significantly shaping men's health behaviors and attitudes. The MANifest Health Theory (MHT) offers a comprehensive framework to address cis-gender men's unique health needs by considering the complex interplay of biological, psychological, and social factors. Rooted in four interconnected core concepts-Biopsychosocial Model, Health Optimization, Health Synchronicity, and Ethnocultural Expression-MHT provides a holistic understanding of men's health. This article explores how MHT integrates inductive and deductive reasoning, describing, explaining, predicting, and controlling aspects of men's health. Key components such as Gender-Sensitive Care, Health Empowerment, Supportive Environments, and Interdisciplinary Collaboration are discussed in relation to practical strategies for health care delivery. The limitations of MHT, including its developmental status, cultural applicability, and inclusivity of diverse gender identities, are acknowledged. Future steps for validating and refining the theory through empirical research, cultural adaptation, and inclusion of diverse gender experiences are outlined. By applying MHT, health care professionals can deliver more holistic and culturally competent care, promoting healthier lifestyles and reducing health care disparities among men.

Suitability of Middle Eastern and North African immigrant minimal reporting category for Arab immigrant health research in the national health interview survey

Studies of Middle Eastern immigrants using national data, with and without African immigrants, have provided important discoveries on the health of this group. However, they do not directly measure health among Arab immigrants. It is yet to be determined whether using a Middle Eastern and North African (MENA) classification can represent the health needs of Arab immigrants. The objective of this study was to assess if MENA immigrant health reflects the same patterns found in previous research focusing on Arab immigrant health. We used multiple years of data from the National Health Interview Survey in alignment with each former study methodology to compare our findings with four previous research studies. The independent variable was region of birth among non-Hispanic Whites. The dependent variables were chronic diseases, women's preventive health behaviors, men's preventive health behaviors, and cigarette smoking. Logistic regression was conducted to determine the odds of each outcome for MENA immigrants compared to US-born Whites. Then, adjusted 95% confidence intervals representing the more inclusive MENA immigrant categorization were compared to previous studies among Arab immigrants. Chronic conditions, women's and men's preventive health behaviors and cigarette smoking did not differ whether the MENA or Arab definition was used. However, statistically significant differences were observed between MENA and Arab immigrants regarding bachelor's degree or higher, not employed and years in the US. The MENA category reflects the Arab immigrant experience, even though it includes a wider set of origins, some of which are not Arab. Including a MENA identifier on future data collections will both represent Arab Americans, as well as identify this population as distinct from Whites to better represent and track health disparities.

Coping with Community Violence: Perspectives of African American Young Adult Men and Hispanic/Latino Young Adult Men.

Further study is needed regarding the intersection of community violence exposure, coping strategies, and health behaviors among young adult African American men and Hispanic/Latino men. This study did so in Lake County, Indiana, which contains multiple areas with disproportionate prevalence of violence relative to population size. Approximately 22 miles from Chicago, Lake County includes noteworthy mid-sized cities such as Gary, Hammond, and East Chicago. This study explored the perceptions of African American men and Hispanic/Latino men ages 18 to 25 regarding coping strategies and both healthy and health risk behaviors after directly witnessing or indirectly experiencing a violent act or event. We used aspects of social cognitive theory to design this community-based participatory research study. Thirteen males who self-identified as African American, Hispanic/Latino, or both, completed 34- to 80-minute, audio-recorded phone interviews. Audio recordings were transcribed, and NVivo 12 Windows was used by the research team (primary researchers and two coders) to complete transcript analysis. Findings from this study provided insight around African American men and Hispanic/Latino men regarding (a) witnessing violence directly or indirectly experiencing violence; (b) changes in everyday life experiences; (c) coping strategies that involved socio-emotional health, spiritual health, social health, and risky health behaviors; (d) rationales for not asking for help; (e) observations of significant others' coping; (f) what to do differently in the future; (g) beliefs about mentors; and (h) beliefs about mental health providers. Delving into participants' experiences revealed that African American men and Hispanic/Latino men in Lake County, Indiana chose to adopt a range of health risk and health positive strategies after directly witnessing or indirectly experiencing violence. Becoming knowledgeable about African American men's and Hispanic/Latino men's diverse coping strategies and health behaviors may help inform the community about how best to cocreate spaces that aim to alleviate the traumatic experience of having directly or indirectly experienced community violence.

Impact of Expectant Father’s Depression on Health-Promoting Behaviors and Marital Adjustment

This study aimed to investigate the prevalence of depression in expectant fathers, its association with marital adjustment and health-promoting behaviors, as well as the mediating role of depression in the association between marital adjustment and health behaviors in men. In the summer of 2022, 200 expectant fathers were selected. The participants completed the questionnaires included demographic information, dyadic adjustment, depression, and health-promoting behaviors. The results showed that depression had a high prevalence (25%) in expectant fathers. Also, marital adjustment predicted 73% of health-promoting behaviors of the expectant fathers, both directly (58%) and indirectly through depression (15%).

Ecological model of health behaviour of hypertensive stroke patients at the end of recovery period.

This study aimed to construct a structural equation model guided by the ecological model to explore the factors influencing health behaviour among hypertensive stroke patients 6 months post-stroke. Health behaviour is important for recurrence prevention in hypertensive stroke patients. Moreover, previous studies have indicated that health behaviour at the end of the recovery period is of particular concern. The ecological model provides an integrated perspective for explaining the factors influencing health behaviour. A cross-sectional study guided by the STROBE. A total of 121 hypertensive stroke patients were included to assess stroke knowledge, health belief, depression, family function, chronic illness resource and health behaviour. A structural equation model was used to explore the health behaviour's factors and pathways. In the final ecological model, sex, education level, depression and chronic illness resource directly affected health behaviour. Stroke knowledge directly affected health behaviour and indirectly affected health behaviour through health belief and chronic illness resource. Family function indirectly affected health behaviour through health belief, depression and chronic illness resource. Health belief affected health behaviour indirectly through depression and chronic illness resource. Hypertensive stroke patients' health behaviour is jointly and interactively influenced by stroke knowledge, health belief, depression, family function and chronic illness resource. In particular, chronic illness resource is an important mediator of health behaviour. For clinical practitioners, health behaviour of men and patients with low educational levels should be specifically focused on. Additionally, it is necessary to provide stroke knowledge, establish health beliefs, control depression emotion and improve family function. Furthermore, chronic illness resources should be improved particularly due to its important mediating role. Participants completed demographic and disease-related questionnaires during hospitalisation and completed other questionnaires when returning to hospital at 6 months follow-up.

Men's preconception health and the social determinants of health: What are we missing?

BackgroundLife course perspectives suggest that optimizing men's health before conception is requisite to equitably improve population health, an area of increasing public health focus. Although scholarship on the social determinants of health (SDOH) suggests that men's health and health behaviors do not occur in a vacuum, preconception health studies have not explicitly examined how these factors influence men's preconception health.ObjectiveTo identify latent classes of men's preconception health and the role of the SDOHs in predicting class membership.MethodsPooled data from the 2011–2019 male file of the National Survey of Family Growth were analyzed (n = 10,223). Latent class analysis (LCA) was used to identify distinct classes of men's preconception health. Eight manifest variables were used to fit latent class models. A classify-analyze approach was subsequently used to create a preconception health phenotype (PhP) outcome variable. SDOHs (exposure variable) were assessed in four domains (rural/urban residence, health access, socioeconomic status, and minority/immigrant status) to predict class membership. Survey-weighted multinomial regression models were fitted to examine the association between the exposure and the outcome.ResultsThree unique PhPs were identified (lowest risk (69%), substance users (22.9%), and sexual risk-takers (8.1%) from the LCA model. Health access, socioeconomic status, and minority/immigrant status were significant predictors of class membership but not rural/urban residence. Sexual risk takers were more likely to be uninsured (aOR: 1.25, 95% CI 1.02, 1.52), college-educated (aOR: 1.94 95% CI: 1.34, 2.79), and non-Hispanic Black (aOR: 1.99 95% CI: 1.55, 2.54) while substance users were more likely to have unstable employment (aOR: 1.23 95% CI:1.04, 1.45) and have a high school degree or higher (aOR 1.48 95% CI: 1.15, 1.90) than men in the lowest risk category.ConclusionSocial determinants may impact men's preconception health in ways that are not conventionally understood. These findings raise important questions about how preconception health interventions should be created, tailored, and/or retooled. Specifically, studies that examine the sociocultural and political contexts underpinning the relationship between social class, masculinity, and men's preconception health are needed to provide nuanced insights on factors that shape these outcomes.

The Sense of Coherence and Health Behavior of Men with Alcohol Addiction.

Introduction: Alcohol dependence is one of the world’s major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism. Objective: The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol. Materials and methods: The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky’s “SOC-29 Life Orientation Questionnaire” and Juczyński’s “Health Behaviour Inventory”, were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson’s r test. Results: A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43–65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors. Conclusions: Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.

Relationships between Women's and Men's Modifiable Preconception Risks and Health Behaviors and Maternal and Offspring Health Outcomes: An Umbrella Review.

Parental health before conception effects maternal and offspring health outcomes. Preconception care provides healthcare to prospective parents addressing modifiable preconception risks and health behaviors. This umbrella review aimed to consolidate evidence on women's and men's modifiable preconception risks or health behaviors associated with maternal and offspring health outcomes. MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, and PsycINFO were searched from March 4, 2010, to March 4, 2020. Eligible studies were systematic reviews or meta-analyses of observational studies examining associations between modifiable preconception risks or health behaviors and maternal and offspring health outcomes. Screening, data extraction, and methodological quality assessment (AMSTAR 2) occurred independently by two reviewers. Degree of overlap was examined. Findings were summarized for evidence synthesis. Twenty-seven systematic reviews were included. Modifiable preconception risks and health behaviors were identified across categories: body composition (e.g., overweight, obesity), lifestyle behaviors (e.g., caffeine, smoking), nutrition (e.g., micronutrients), environmental exposures (e.g., radiation), and birth spacing (e.g., short interpregnancy intervals). Outcomes associated with exposures affected embryo (e.g., embryonic growth), maternal (e.g., gestational diabetes mellitus), fetal/neonate (e.g., preterm birth), and child (e.g., neurocognitive disorders) health. For real-world practice and policy relevance, evidence-based indicators for preconception care should include body composition, lifestyle, nutrition, environmental, and birth spacing.

PD25-05 CHANGES IN HEALTH BEHAVIORS AMONG LOW-INCOME UNINSURED MEN WITH PROSTATE CANCER

You have accessJournal of UrologyCME1 May 2022PD25-05 CHANGES IN HEALTH BEHAVIORS AMONG LOW-INCOME UNINSURED MEN WITH PROSTATE CANCER Allen E. D. Siapno, Megha D. Tandel, Lorna Kwan, and Mark S. Litwin Allen E. D. SiapnoAllen E. D. Siapno More articles by this author , Megha D. TandelMegha D. Tandel More articles by this author , Lorna KwanLorna Kwan More articles by this author , and Mark S. LitwinMark S. Litwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002567.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with prostate cancer from low-income and uninsured backgrounds have poorer health outcomes partly due to higher risk of chronic disease and lower rates of healthy behaviors. We sought to describe the changes in health behaviors of men with prostate cancer participating in a disease-focused treatment program providing free medical care and navigation services. METHODS: We retrospectively reviewed survey data from the UCLA Men’s Health Study, a cohort quantifying patient-reported outcomes, and compared baseline surveys collected at program enrollment to 12–18-month follow-up surveys. Five health behavior domains from the California Health Interview Survey were individually and compositely scored based on adherence to the 2014 American Cancer Society Prostate Cancer Survivorship Care (ACS-PCSC) Guidelines. The scores were categorized into three adherence levels: Low, Moderate, and High. Subjects were grouped by change in adherence levels from baseline to follow-up as Worsened, No Change, or Improved. We compared patient demographics, clinical characteristics, health-related quality of life, and adherence to the five domains at baseline between the three groups. RESULTS: Of the 256 subjects eligible for analysis, 17% worsened, 52% had no change, and 31% improved in overall adherence. Most subjects identified as Hispanic (72%), were foreign born (79%), and had a partner (71%). There were no differences in clinical characteristics among the three adherence change groups. Baseline general and physical health scores were similar, but baseline mental health scores were lower in the worsened group compared to the no change and improved groups (44.3 vs 50.1 vs 47.6, respectively, p=0.0320). Those in the worsened group already had low adherence to physical activity at baseline compared to the no change and improved groups (p=0.0019) (Table 1). CONCLUSIONS: In this cohort of low-income men participating in a free navigation-based prostate cancer treatment program, 31% had improvement in overall adherence to the ACS-PCSC Guidelines for health behaviors. Worsening adherence was associated with lower baseline mental health score and physical activity adherence. Interventions aimed at physical activity may improve overall health behaviors. Source of Funding: Department of Urology, David Geffen School of Medicine, University of California Los Angeles © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e422 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allen E. D. Siapno More articles by this author Megha D. Tandel More articles by this author Lorna Kwan More articles by this author Mark S. Litwin More articles by this author Expand All Advertisement PDF DownloadLoading ...

Effects of Conformity to Masculine Norms and Coping on Health Behaviors in Men With Multiple Sclerosis.

The role of conformity to masculine gender norms in health behaviors in men with multiple sclerosis (MS) has not received attention. This cross-sectional study explores these issues and their relationship to coping and health behaviors. Eighty-one men with MS completed the Conformity to Masculine Norms Inventory-46 and the Ways of Coping Questionnaire and provided demographic and clinical variables. These results were used to predict subscale scores of the Health Behavior Inventory-20 in multivariable regression models. Models for the Preventive Self-care and Avoiding Anger and Stress subscales were successfully fit. For the former, respondents endorsing lower levels of masculine conformity related to Emotional Control and higher levels of Heterosexual Self-presentation predicted greater self-care, as did higher use of Positive Reappraisal as a coping strategy. For men reporting low levels of Positive Reappraisal as a coping strategy, increasing Heterosexual Self-presentation was associated with higher levels of self-care. For those with high levels of coping with Positive Reappraisals, increased Heterosexual Self-presentation was associated with modest declines in self-care. For the Avoiding Anger and Stress subscale score, men endorsing Violence or Heterosexual Self-presentation as important aspects of masculinity also reported less efforts in controlling stress and anger. Masculinity adherence to traditional gender norms was a significant predictor of how men engaged in health behaviors and, in the case of Preventive Self-care, was found to interact with Positive Reappraisal as a coping strategy. Such information is novel and important to providers serving male patients with MS and can improve provider awareness/conceptualization of male patient needs.

Masculinity and men's health service use across four social generations: Findings from Australia's Ten to Men study

There is a perception that traditional masculine ideals, usually thought deleterious for men's health outcomes, are no longer as relevant for younger social generations such as Millennials as they are for older social generations such as Baby Boomers. Yet, in Australia, there remains a disparity between younger men's and women's health outcomes and use of health services. Conformity to traditional masculinity is often cited as a barrier to men's positive health behaviours but conceptualisation of the construct is contested. We analysed a selected secondary dataset (n = 14,917) of Australian males aged between 15 and 55 years from Ten to Men: The Australian Longitudinal Study on Male Health. We examined the role of conformity to traditional masculine norms in predicting likelihood of regular primary and preventative health services use for different social generations. Analyses included mediated regression and adjusted logistic regression. Conformity to ten of the eleven specific traditional masculine norms predicted likelihood of increased or decreased regular health service use depending on the generation and health service type. Specific traditional masculine norms play a complex role in men's use of distinct health service types for different generations of Australian males. Practitioners wishing to increase men's engagement with health services should consider gender-sensitive approaches that leverage specific masculine norms relevant to the age cohort to drive positive outcomes in men's health.

Exploring Health Professionals’ Perceptions of Husbands’ Responsibilities in Muslim Women’s Health

Background: The husband has an important role in women's health. However, the information related to their roles is limited, including from the perspectives of health professionals. The health professionals' support and behavior have influenced men's and women's health behavior. Purpose: This study aimed to determine the health professionals’ perceptions of husbands’ roles and behavior in women's health, especially in the Muslim community.Methods: A qualitative descriptive approach applied in this study. Data were collected using the interview method. Ten clinicians from rural and urban areas of West Java, Indonesia, with a range of experience engaging with Muslim husbands involved in this study. Semi-structured interviews were recorded and then transcribed by the researchers. The transcribed data were analyzed using the comparative analysis for the interview technique.Results: Four main themes were identified: (1) Contextual factors impact husbands' roles in women's health; (2) Extensive roles of Muslim husbands in women's health; (3) Husbands and others involved in decisions about women's health; and (4) Level of health literacy affects husband's actions in women's health and cancer.Conclusion: Health professionals perceived that husbands' roles in Muslim women's health are pivotal, especially in supporting health treatments in health services. Little information was obtained about husbands' support in cancer prevention and early detection. Nurses can take the lead in improving Muslim husbands' understanding of women's health and cancer and raising their awareness of cancer screening for their wives.

A thematic analysis of men's help-seeking on an Australian health helpline.

The current study aimed to qualitatively explore men's help-seeking behaviours by analysing male callers' talk on an Australian health helpline. Analysis focused on identifying the ways in which men positioned themselves as help-seekers and the extent to which help-seeking behaviours deviated or conformed to the narrative commonly reported on in men's health literature which, generally speaking, positions men as reluctant help-seekers and health service users. The present study utilised naturally occurring instances of men's help-seeking during 196 calls to the helpline, Healthdirect Australia. Thematic analysis was used to explore recurrent themes in help-seeking interactions. The analysis yielded three broad themes, which were formulated as caller archetypes. These themes included the 'reluctant caller', the 'unwell patient' and the 'concerned carer', as well as a number of associated sub-themes within these broad categories. The findings demonstrated that male callers sought help in a variety of different ways, rather than prescribing to a homogenous pattern of help-seeking. However, it was acknowledged that some data did align with help-seeking behaviour which indicated men's reluctance to engage with their own health. SO WHAT?: The present study contributes to men's health promotion by identifying the various social devices used by men to facilitate help-seeking. The findings highlight the changing and flexible landscape of contemporary masculinity and its impact on health engagement. Recognising the versatility in men's health behaviour is important for ensuring that men have positive experiences during healthcare encounters which, in turn, may facilitate future health service uptake and engagement.

Increasing access to erectile dysfunction treatment via pharmacies to improve healthcare provider visits and quality of life: Results from a prospective real-world observational study in the United Kingdom.

ObjectivesThe Medicines and Healthcare Products Regulatory Agency in the United Kingdom (UK) formally reclassified sildenafil citrate 50 mg tablets as a pharmacy medicine (sildenafil‐P) in 2017 for adult men with erectile dysfunction (ED). A 1‐year prospective real‐world observational study was conducted to track men's health behaviour, particularly their healthcare resource utilisation (HCRU) and quality of life (QoL) before and after the availability of sildenafil‐P.MethodsAdult men with ED aged ≥18 years provided data at baseline (prior to launch of sildenafil‐P) and every 3 months after the launch. Demographics, health characteristics, treatments at baseline and HCRU, including number of pharmacist and physician/nurse practitioner visits over time are reported. QoL‐related outcomes were assessed via the Self‐Esteem and Relationship Questionnaire (SEAR), 2‐Item Patient Health Questionnaire and ratings of sexual satisfaction. Generalised linear models were used to assess the association of sildenafil‐P use with total physician/nurse practitioner and pharmacist visits and QoL‐related outcomes at 12 months.ResultsOverall, 1162 men completed the survey at all 5 time points. The mean ± SD age was 59.02 ± 12.06 years; 55.42% reported having a moderate‐to‐severe ED. Hypertension (37.52%) and hypercholesterolaemia (31.50%) were the most common risk factors for ED. At baseline, 62.99% were not using any ED treatment. After adjusting for baseline visits/other covariates, mean physician/nurse practitioner (3.68 vs 2.87; P = .003) and pharmacist visits for any reason (2.10 vs 1.34; P < .001) at 12 months were significantly higher among sildenafil‐P users than those who never used sildenafil‐P. Sildenafil‐P users also had significantly higher SEAR total and domain (sexual relationship and self‐esteem) scores at 12 months.ConclusionFollowing the reclassification to a pharmacy medicine in the UK, sildenafil‐P was associated with a higher number of physician/nurse practitioner and pharmacist visits for any reason. Sildenafil‐P use was also associated with better QoL, although group differences were small in magnitude.

Gender responsive health promotion and NCD prevention – challenges and solutions in Kyrgyzstan

Abstract Reaching men is one of the challenges related to targeted health promotion. Societal factors, concepts of masculinities, and gender norms have a strong influence on preventive and health behavior of men. Targeted health promotion and prevention has to consider gender-specific differences in language and information sources to spread preventive messages but often fail to be effective. In Kyrgyzstan, non-communicable diseases account for 80% of mortality, including cardiovascular diseases, and raised blood pressure is the second most common disease for men. The NCD prevention and control project in Kyrgyzstan, funded by the Swiss Agency for Development and Cooperation (SDC), aims to facilitate behavioral change towards healthier lifestyles by taking a gender-responsive approach to support the utilization of NCD related primary health care services for men. The gender-responsive intervention considers gender roles, norms, and inequalities, understands men's health needs, and pattern of preventive behavior to develop interventions. Data from project studies yielded that for men family members were the primary source of information about NCDs, risk factors and prevention. An assets-based approach is taken, building on the male role in a life-course perspective and a positive approach to the role of men as fathers. In 2019, an intervention, combining a school competition for children with a voucher system for preventive services for fathers and male relatives was conducted. In total, 80,416 males were reached and visited primary health facilities for preventive services (which averaged 20% of the male population over 18 years old); 18,364 (23%) men were newly detected with high blood pressure. Medical workers were made available during special hours to provide men with a consultation. During their visits, all men were screened for risk factors and received a consultation based on PEN protocol 1 and 2. Lessons on gender sensitivity have been learned from this experience.

A gender framework for understanding health lifestyles.

A health lifestyles approach holds promise for understanding change in women's and men's health behaviors and reducing gendered health disparities. The emerging theoretical and empirical literature on health lifestyles (individuals' bundled health behaviors that are shaped by group-based identities and norms) helps elucidate complex disparities in health behaviors, but research is needed on how gender shapes the development of health lifestyles. This study proposed and assessed a dynamic multilevel framework for understanding health lifestyles that draws on insights from contemporary gender and life course scholarship. Using the transition from adolescence into adulthood as an empirical case, we analyzed US data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N=6605), which followed adolescents through young adulthood, collecting information on their health behaviors and social contexts. Latent class analyses showed that health lifestyles differed significantly by gender. Results supported the dynamic multilevel framework, finding more variation in health lifestyle behaviors within genders than between, high levels of change across ages, intersections of gender with age, and socioeconomic status as a structural pathway for gender's influence. Taken together, these findings suggest that conceptualizing gender as a dynamic multilevel system intersecting with other social statuses is fruitful for understanding how health lifestyles form and change. These findings can inform more effective policies to change health behaviors.

Food and heart-the nutritional jungle: Patients' experiences of dietary habits and nutritional counselling after coronary artery bypass grafting.

The aim of the study was to examine patients' experience of dietary habits and nutritional counselling in the early period during hospitalisation after coronary artery bypass surgery (CABG). Undergoing CABG, patients have two different nutritional needs, extra proteins and calories for the first period after surgery and a heart-healthy diet when the recovery period is over. These needs can be difficult to manage for the patients. Qualitative study. Interviews were conducted and analysed within a phenomenological-hermeneutic frame inspired by the French philosopher Paul Ricoeur. Patients undergoing CABG were interviewed 4-5days after surgery at Odense University Hospital from March to May, 2017. The study adhered to the COREQ guidelines. In total, 15 patients were interviewed (mean age 65years, 87% men). After analysing the interviews following themes emerged, "Different needs-the nutritional jungle", "Food and heart-the lacking attention," and "The force of habits-being under the influence from spouses on dietary habits". The interviewed patients had no or only a little knowledge about how to eat after heart surgery. In general, they experienced a lack of attention to nutritional counselling by the nursing staff during hospitalisation. Furthermore, the health behaviour of men seems to be different from women's, and therefore, interventions aiming at optimising men's health might be prioritised. Finally, spouses have a great influence on eating habits, why they should be involved in nutritional counselling. This study provides important and relevant knowledge about patients' lacking knowledge about nutrition. When planning nutritional measures, whether it is promoting healing after heart surgery or preventing progression of arteriosclerosis, the study contributes with suggestions as to which factors should be considered in this process-men's health behaviour and spouses' influence on dietary habits in the household.

Men’s knowledge and beliefs about their care for health – results of in-depth interviews

Men's health behaviors and care for health are getting more explored, due to adverse statistics on morbidity, mortality and chronic diseases for this group. Men generally assess their health well, declare that they care about it, and yet, what more often they fall ill, which they could avoid by following the principles of a healthy lifestyle, including, above all, rational nutrition and physical activity. This article presents data from direct interviews with 51 men, which show that they have a lot of knowledge about health and care for it, but unfortunately it does not always transform into their health behaviors. Men are happy to talk about their health and show interest in this subject, which allows to conclude that a properly planned health education program for them would bring the desired effects in the form of greater health care.

Gender and health literacy: men's health beliefs and behaviour in Trinidad.

Gender variations in health literacy have implications for engagement in preventive behaviours and the uptake of health services, especially in areas such as the Caribbean where there are marked disparities in life expectancy and health service utilization. A self-reported questionnaire was used to examine men's concepts of health, their help-seeking behaviours and their functional and interactive health literacy. Two hundred and forty-eight men across the life course participated at three sites in Trinidad. Data were analysed using descriptive statistics, with free-text responses analysed thematically. Men were concerned about, and accepted responsibility for their own health but social norms concerning sickness and masculinity were barriers to accessing health services. Almost one-third (31.5%) sought advice from a healthcare service when they were last sick because they were prompted to do so by their wife/partner or family. Levels of functional and interactive health literacy were not high among older men, who were reliant on healthcare professionals to communicate health messages. There was an age divide in e-health literacy. There is little published evidence on men's health literacy, particularly from Caribbean countries such as Trinidad and Tobago. This study highlights the importance of the design and implementation of specific policies focusing on men's health. A major challenge is to engage with men who do not access health services.