1. 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

2. 2 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”?

3. 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)

4. The Turning point  Men’s Friendships  Social isolation  Unemployment  Social Exclusion  Stress Macdonald, 2005; 2011; WHO, 2003; Wilkinson & Marmot, 2003

5. 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

6. 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.

7. Social Inclusion In 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) Men report enjoyment from participation, camaraderie, socialisation and skill development at Men’s Sheds.

8. 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 well- being.

9. 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

10. Metatheoretical Map. Person Group Experience Interpretation Measurement s Philosophy Hermeneutics Endocrinology Biology Cardiology Physiology Somatic biofeedback Phenomenology Psychoanalysis Character Psychology Relational Psychology

11. Research Design and Methods 11 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 health- related outcome measures in individuals involved. Serve as an explorative study and an initial effort to produce biological evidence for the advancement of men’s sheds

12. Methods of data collection Indepth interview Saliva samples Heart rate monitor Blood Pressure monitor Questionnaires

13. Conceptual Framework Hermeneutics (Qualitative Study) StagesDesignCollectionConversionAnalysisInterpreta tion Integr ation TheoryOpen- Ended Questio ns (n=15) Recording Written Audio Transcription Translation Generating Thematic Categories Thematic Analysis Narrative Analysis Analysis of quotation s, Story lines Integrati ve Analysis, Drawing Conclusi ons Items and Scales (n=46) Salivary Cortisol, RHRV, SF36 & STAI Ques Codes Scale Descr & Multivaria te Analyses Model Interpreta tion One Group Pre-test-Post Test (Quantitative Study) SDH Salutogenesis Transaction theory Coping and Hormones Axial Coding Item Analysis  

14. 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

15. 15 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)

16. Interested in taking part in this Study? Luckman Hlambelo –Mobile 0408934032 –Email: 16269965@student.uws.edu.au OR Professor John Macdonald -Mobile 0404008760 -Email: J.Macdonald@uws.edu.au

17. 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 Men’s Health 17

19. 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. 8.Wilkinson, R., & Marmot, M. (2003). Social determinants of health: the solid facts: World Health Organization. 19