Older men and social activity: a scoping review of Men s ... · and other gendered interventions...

Older men and social activity: a scopingreview of Men’s Sheds and othergendered interventions

CHRISTINE MILLIGAN*, DAVID NEARY†, SHEILA PAYNE‡,BARBARA HANRATTY§, PAMELA IRWIN* andCHRISTOPHER DOWRICK||

ABSTRACTFinding ways of improving the health and wellbeing of older men is an importantchallenge for public health. This review aimed to assess evidence for the effects ofMen’s Sheds and other gendered social activities on the health and wellbeing ofolder men, and to consider their effective components and theoretical frameworks.A scoping review using standardised search criteria and terms identified relevantpapers of sufficient quality for inclusion. Analysis was informed by guidance on inter-pretative and narrative synthesis and a quality assessment tool designed for reviewingdisparate data from different disciplines and research paradigms applied. The reviewfound some limited evidence that Men’s Sheds and other gendered social activitiesmay have impact on the mental health and wellbeing of older men, but little evi-dence of the impact on physical health. Qualitative data provided valuable insightsinto how and why complex psycho-social activities can affect participants, butthere was a lack of longitudinal evidence drawing on validated health and wellbeingmeasures. Key components of successful interventions included accessibility, rangeof activities, local support and skilled co-ordination. A variety of theoretical frame-works were employed. As yet, there is no conclusive evidence that Men’s Shedsand other gendered interventions confer health and wellbeing benefits on oldermen. Studies in this field to date are few and of variable quality. Larger and morerobust mixed-methods studies, including randomised designs, are needed.

KEY WORDS – older men, social isolation, wellbeing, interventions, scoping review.

* Centre for Ageing Research, Faculty of Health and Medicine, LancasterUniversity, UK.

† Public Health and Public Policy, Liverpool University, UK.‡ Division of Health Research, Lancaster University, UK.§ Health Sciences, University of York, UK.|| Psychological Sciences, Liverpool University, UK.

Ageing & Society , , –. © Cambridge University Press doi:./SX

terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0144686X14001524Downloaded from https://www.cambridge.org/core. IP address: 54.39.106.173, on 07 Oct 2020 at 17:06:35, subject to the Cambridge Core

https://www.cambridge.org/core/terms

https://doi.org/10.1017/S0144686X14001524

https://www.cambridge.org/core

Introduction

Whilst population ageing is an almost universal phenomenon, women, onaverage, outlive men across all population groups and cultures (Salomonet al. ; Wang et al. ). Yet recent data for both the UnitedKingdom (UK) and the European Union more widely demonstrate thatthis gap in gendered life expectancy is closing (Davidson ; Eurostat). Despite this shift, much of the literature on men’s health is domi-nated by negative portrayals of men’s life expectancy, in which men are con-structed as being more likely to lead riskier lifestyles than women and lesslikely to make optimal use of health-care services (White et al. : ).Premature mortality amongst men is often attributed to unhealthy lifestylechoices, including those related to alcohol and tobacco. Finding ways ofimproving the health and wellbeing of older men thus presents an impor-tant challenge for public health.Linked to debates about health and gender in later life is a growing

concern about the health impacts of loneliness and social isolation. At itssimplest, social isolation can be defined as an absence of other individuals(Hawton et al. ; Victor, Scambler and Bond ), whilst lonelinessis viewed as the psychological counterpart of social isolation (Shankaret al. ). Social isolation, loneliness and stressful social ties are associatedwith poor physical and mental health, higher risk of disability, poor recoveryfrom illness and early death (Cacioppo et al. ; Luanaigh and Lawlor; Masi et al. ). Indeed, amongst older adults, the effect of social iso-lation and loneliness on mortality is believed to be of similar size to that ofcigarette smoking (Holt-Lunstad, Smith and Layton ). Whilst loneli-ness is not an inevitable consequence of lone dwelling, those who do livealone are at greater risk of social isolation. In the UK alone, between

and per cent of middle-aged and older people experience severe or per-sistent loneliness, with the number of older men who live alone reachingaround one million for the first time (Steffick ; Victor, Scambler andBond ).Older women have tended to attract more scholarly attention than older

men, hence there is still something of an academic ‘blind spot’ in researcharound older men in comparison to their female counterparts (Arber et al.; Fennell and Davidson ; Fleming ). Yet social isolation iscommon amongst older men, particularly those who live alone or experi-ence mood or cognitive problems (Illiffe et al. ). Finding activitiesand interventions that can successfully address the problems of social iso-lation amongst older men is thus an important health challenge. Oldermen not only find it harder than women to make friends late in life, they

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


are also less likely to join community-based social groups that tend to bedominated by women. They are known to use fewer community health ser-vices than women, and are less likely to participate in preventive healthactivities (Suominen-Taipale et al. ; White et al. ). This combi-nation of need and lower rates of engagement with services has promptedthe public and voluntary sectors to look to develop a range of social activityinterventions specifically targeted at older men.Social activity in a variety of forms has long been recognised as beneficial

to health, particularly among older people. House, Landis and Umberson(), for example, highlighted the increased risk of death among thosepeople with a low quantity, and sometimes low quality, of social relation-ships. Work underpinned by social activity theory for older people hasthus hypothesised that health and wellbeing is promoted by high levels ofparticipation in social and leisure activities and role replacement (BettsAdams, Leibbrandt and Moon ). A number of reviews have thussought to consolidate knowledge on the links between social activity,health and wellbeing (e.g. Cattan et al. ; Dickens et al. ; Findlay). Betts Adams, Leibbrandt and Moon (), in particular, found adiverse literature around studies that showed positive associationsbetween social activity and health and wellbeing. A systematic review byCattan et al. () further found that group activities with an educationalor support input were most likely to be effective in alleviating social isolationamongst older people. Indeed, such is the impact of social activity on healthand wellbeing, that a meta-analysis of studies undertaken by Holt-Lunstad, Smith and Layton () found a per cent increase in theoverall odds of survival as a function of social relationships. Drawing onthe outcomes of a large-scale study of nearly , adults in NorthAmerica, Pantell et al. () were also led to conclude that as a predictorof mortality, the strength of social isolation is similar to that of well-docu-mented clinical risk factors (although it is worth noting that the data didnot allow the authors to account for the effect of social position onmortality).Developing interventions to promote social activity among older men,

particularly those who are lonely or socially isolated, has proven to be adifficult task (Greenfield and Marks ; Milligan et al. ). Onerecent and rapidly developing social activity intervention for older men isthat of the Men’s Sheds movement. This has spread from Australia toseveral parts of the Anglophone world including the UK and Ireland(Wilson and Cordier ). Sheds provide a communal space for oldermen to meet, socialise, learn new skills and voluntarily take part in practicalactivities with other men. Much of this activity is focused around woodworkbut Sheds can cover a wide range of activities, stretching from engineering

Older men and social activity



https://doi.org/10.1017/S0144686X14001524


to model railways and the making of musical instruments. They can engagemen in informal adult learning activity, or provide health-related infor-mation or signposting to relevant services (Milligan et al. ). Shedsmay also have a wider benefit to the local community in terms of engagingwith, and providing services for, individuals and groups within that commu-nity (Carragher ). Many of the Sheds are member led or are supportedby voluntary-sector organisations, a few are supported by charitabledonations from the business sector. All, however, are tailored to theirlocal context and, hence, are not standardised. Whilst Shed members maynot necessarily recognise or welcome the notion of Sheds as an intervention,we suggest that given their broad aims to improve physical, emotional, socialand spiritual health and wellbeing, and the increasing recognition andsupport of Sheds within public health initiatives, Sheds can be considereda complex intervention.Sheds have captured the public imagination. Over Men’s Sheds now

exist across Australia (Cordier and Wilson ), with more than ,older men attending on a regular basis. Men’s Sheds have attracted atleast Aus dollars , between - from the Australian StateGovernment with further support from local sources (AustralianGovernment ). A similar, but more modest, pattern of growth andfunding has developed across the UK (Milligan et al. ) and Ireland(Carragher ).However, before advocating gender-based activity interventions for older

men, several issues need to be clarified. Firstly, we need a better understand-ing of what the literature tells us about conceptual and measurement differ-ences, reflecting the various academic disciplines that have conductedresearch in this area. Importantly, to what extent does this enable us tocompare and synthesise across studies? Secondly, to what extent does the lit-erature enable us to determine the direction of causality between activityand health? Are older men more likely to be healthy because of the activitiesthey participate in, or are they more active due to the good health theyenjoy? Thirdly, there are unresolved questions around various types of activi-ties and gender, with older men appearing to benefit from physical activitiesand solitary hobbies much more than older women (Betts Adams,Leibbrandt and Moon ).In the light of these issues, it is important to have a clear understanding of

what the evidence base tells us about the role and impact of gender-basedactivity interventions on the health and wellbeing of older men. WhilstSheds are perhaps the fastest growing social activity interventions forolder men, we have also seen the emergence of a number of other socialactivity interventions designed for older men in recent years. In terms oftheir descriptive features, these other gendered interventions are clearly

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


more diverse thanMen’s Sheds. A cooking club for older men, a communityallotment and a ‘Gentleman’s Club’ in a residential care setting are clearlydifferent forms of social activity intervention but, importantly, they are alldefined by having older men as participants in voluntary social activitythat is theoretically intended to improve their health and wellbeing.Furthermore, as they share this essential characteristic, some inferences onadequate causal links can be made (Buss ). In this paper, we thusdraw on the outcomes of a high-quality scoping review of the existing pub-lished literature on Men’s Sheds and other gendered interventions that wasdesigned to address the following questions:

. What are the effects on the physical health of older men?

. What are the effects on the mental health of older men?

. What are the effects on the wellbeing of older men?

. What are the effective components of interventions?

. What theoretical frameworks were employed?

Methods

The scoping review of the available studies on Men’s Sheds and on otherforms of gendered interventions for older men aimed to compare and con-trast the evidence of effects on the health and wellbeing of older men.Our search strategy, incorporating electronic and hand searches of pub-

lications from to , is set out in Table . Grey literature searchesincluded the websites of a number of age-related andmale-orientated volun-tary organisations in the UK, Australia, New Zealand, Ireland, Canada andthe United States of America (USA). The websites of appropriateGovernment departments in these countries were also searched alongwith the OpenGrey Repository (formerly OpenSIGLE) for relevant litera-ture. The first results from combinations of older men and interventions

T A B L E . Search strategy and actions

Electronic search of databases:ASSIA, British Nursing Index, CINAHL, Cochrane Library, DARE, Embase, Ingenta, King’sFund, MEDLINE, Proquest, PsycINFO, PubMed, Scopus, Social Sciences Citation Index,Social Care Online, Web of Science

Electronic and hand search of:Grey literature including that held by third sector, Shed organisations and research centresKey journals, including: Health and Place, Ageing & Society, Social Science and Medicine,International Journal of Men’s Health, Men’s Health, The Journal of Men’s Health and Gender,American Journal of Men’s Health, Journal of Public Health, Health and Social Care in the Community




https://doi.org/10.1017/S0144686X14001524


were also screened for possible inclusion. Initial screening and searchesdemonstrated a declining relevance to the review topic beyond the first results, hence a pragmatic decision was made to limit screening to thefirst .The following search terms and all their variations, as set out in Table ,

were incorporated into a search strategy tailored to each database, drawingon specialist librarian support.A clear set of inclusion and exclusion criteria was discussed and agreed by

the research team prior to undertaking the searches. Inclusion criteriaincluded all forms of publications containing original empirical data oninterventions that provided an opportunity for older men to meet togetherface to face in a specified place for social activities, learning and teaching, orthe receipt of advice. Included studies needed to contain some measure ofhow the intervention impacted on health, quality of life or wellbeing of par-ticipants or their families. No study design was excluded.Exclusion criteria included studies that solely considered interventions or

activities where the primary focus is sport or leisure activities in clubs or reli-gious activity, formal education, paid work or volunteering, or part of statu-tory service provision (such as local authority day centres) or disease-specificsupport groups. Studies that reviewed interventions not specificallydesigned for older people were also excluded.The search strategy aimed to include all relevant studies of Men’s Sheds

and other gendered activity interventions that were exclusively or predomi-nantly focused on older men. In line with current provider policy, an olderman was defined as someone over the age of years. Initially, a predomi-nant focus was interpreted as a study with a sample that contained three-quarters of the total being older men, but at an early stage it was evident

T A B L E . Search terms

Older people:Older men, aged, ageing, geriatric(s), middle aged, retirement, retired, elder(s), senior(s),old age, old person, older people, senior citizen(s)

Men:Male(s), men, gender, gender identity

Activity:Men’s Sheds, men in sheds, shed(s), hut(s), hutters, intervention, intervention studies,programme evaluation, social activity, social contact, social engagement, social environment,social integration, social participation, social networks, community participation, communitysupport, community involvement, community engagement, friendships, mentors, self-help,befriending, peer(s), promotion, prevention, education

Health and wellbeing:Health, health status, physical health, mental health, quality of life, wellbeing, self-esteem,self efficacy, loneliness, social isolation, social alienation, dementia, Alzheimer’s, disability

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


that such a stringent approach would limit the number of studies includedin the review with the loss of potentially valuable insights. A pragmaticdecision was taken to include studies where older men formed the majorityof the sample. This was defined as per cent plus one of participants in thesample population, regardless of its size, and where there was clear datafrom only older males. Figures and detail the search and screeningprocess used for both the Men in Sheds literature and the literature focus-ing on other gendered activity interventions for older men.Our search included electronic and manual searches, including the

checking of bibliographies of papers as well as relevant conference papersand presentations. In addition, individual contact was made with allMen’s Sheds projects in the UK as well as experts in Australia to identifyfurther potential sources. The relatively small number of Men in Shedsources (N = ) meant it was possible for all of these sources to be screenedby two reviewers. Electronic searches for the ‘other gendered activity inter-vention’ sources however revealed , records, hence all of these records

Figure . Search process for Men’s Sheds literature.

Figure . Search process for other gendered activity interventions literature.




https://doi.org/10.1017/S0144686X14001524


were screened by one reviewer (DN) and a per cent randomised sample(N = ,) was screened by a second reviewer (PI) to ensure accuracy andconsistency in the application of the inclusion and exclusion criteria. PItook the lead for work around Men’s Sheds, with DN taking the lead forwork around other gendered interventions. Where uncertainty or disagree-ment around inclusion/exclusion occurred, a final decision was made bythe whole research team. The whole research team also reviewed andagreed the final set of papers for inclusion.

Quality assessment and data extraction

We used the tool developed by Hawker et al. () to appraise the qualityof the studies in this scoping review. The tool uses a scale of to acrossnine domains to assess methodological rigour and clarity of reporting andwas independently applied to the studies by both reviewers. The qualityscores ranged from to out of a possible total of , with a medianscore of , with a high degree of agreement between the reviewers andthe wider research team on the aggregate scores for the studies includedin both reviews. These scores are included in Table to inform thereader, but they played no part in any decisions to include or exclude indi-vidual studies. Our review encompassed qualitative and quantitative studies,and there are very few quality assessment tools that are applicable to such awide range of methods. This tool has been widely used in UK research,though we do acknowledge that it has not undergone extensive validation.A common data extraction tool, covering substantive domains ranging

from location and methodology through intervention and sample descrip-tion to findings and limitations, was developed and tested by both reviewerson three studies from each review. This was independently applied to thestudies of Men’s Sheds and gendered interventions. Minor differenceswere reconciled through discussions during and after data extraction.

Data analysis and synthesis

Reviews were informed by the Medical Research Council guidance on thedevelopment and evaluation of complex interventions (Craig et al. ;Medical Research Council ) and the Cochrane Collaboration guide-lines for reviews on health promotion and public health interventions(Armstrong et al. ). The majority of the studies included were eitherqualitative studies, cross-sectional surveys or used a combination of thesemethods. There were no intervention studies, and only three of theMen’s Sheds studies included collected data at more than one point intime. This means that all the research discussed in this paper falls into

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


T A B L E . Summary and quality (QA) scores of included studies

Author Year Country Study aim Design and sample Strengths Limitations QA score

Men’s Sheds:Ballinger, Talbotand Verrinder

Australia To explore men’s experi-ences of participatingin a Men’s Shed pro-gramme and impact ontheir health and well-being in small ruraltown in Australia.

Observational case study of one Shedconducted between and. Eight men participated inthe research, mostly over yearsof age, ex-tradesmen, lived alone,retired, on pensions or benefits.

Focus group questionsprovided in appen-dix adds to credibilityand potential forreplication and/orcomparison.

Convenience sample of unstatedrepresentativeness, especiallyconsidering selection criteriaaimed to obtain maximumvariation in age, length oftime at Shed and attendance.Authors maintain Shed is‘typical’ of most AustralianMen’s Sheds, but do not raiseissues of relationship to urbanSheds, ethnicity and mixedability/background groups,so limiting utility, generalisa-bility and transferability.

/

Cass, Fildes andMarshall

Australia Not specifically stated, buta project/programmeevaluation inWollongong, NewSouth Wales, Australia.

Prospective study capturing pre-,mid- and post-intervention longi-tudinal data through semi-struc-tured interviews with participantsand next of kin and journalscompleted by Shed facilitators.Also used participatory actionresearch, observation, and ques-tionnaires with nine men fromone Shed. Average age yearsfrom ethnic minority groups, pre-dominantly the Portuguese com-munity. All of the menexperienced health conditionsand social issues, took medicationand consulted a doctor orspecialist on a regular basis.

Thorough descriptionof evaluation ‘tools’and methodology.

Convenience sample (ninemen) in a single site, butcommendable focus on menfrom minority and ethnicbackgrounds. Poor overallreporting of data collectionlimits credibility and transfer-ability to other sites, contextsand ethnic groups.

/

Older

men

andsocialactivity

terms of use, available at https://w

ww

.cambridge.org/core/term

s. https://doi.org/10.1017/S0144686X14001524D

ownloaded from

https://ww

w.cam

bridge.org/core. IP address: 54.39.106.173, on 07 Oct 2020 at 17:06:35, subject to the Cam

bridge Core


https://doi.org/10.1017/S0144686X14001524


T A B L E . (Cont.)Author Year Country Study aim Design and sample Strengths Limitations QA score

Golding et al. Australia To conduct (the first)comprehensive surveyof participants inMen’s Sheds inVictoria, Australia

Quantitative survey of active Men’sSheds. Ten surveys sent to active Victorian Men’s Sheds; surveys returned from Sheds;% of participants attended aShed managed by an education-type organisation; % of partici-pants were located in health-typeorganisations; % of participantsattended metropolitan Sheds;% attended non-metropolitanSheds.

First attempt to capturebroad demographicprofile of menattending a Men’sShed in Australia,with quantitative andsome qualitativedata.

Authors note that though thesurvey response was high andthe survey was inclusive ofmost active Men’s Sheds inVictoria, respondentnumbers relatively small,impacting on accuracy andconfidence levels when dataare broken into several cat-egories. Survey deliberatelyexcluded the relatively smallnumber of female partici-pants who are active membersof some men’s and particu-larly ‘community’ Sheds. Nodetails of selection/stratifica-tion of specific Sheds insample, and though vari-ables exist, power calcu-lations/confidence levels arenot noted.

/

Golding, Brownand Foley

Australia To illustrate some theor-etical and practicalimplications andbenefits of reciprocalworkshop-based men-toring relationshipsinvolving men ofdifferent ages

Mixed-methods study (on-site inter-views and survey) in sample of Sheds providing a social andtherapeutic function across fiveAustralian states. Sample centredon young people, war veteransand men in aged residential care.Focus is on theoretical and prac-tical implications and benefits ofreciprocal workshop-based men-toring relationships involving menof different ages.

Provides qualitativeinsights into how theShed model canaccommodatespecial groups withvarying needs.

Sub-samples from large Goldinget al. () survey. Much ofintroduction and backgroundrelates to older participants,but primary focus is utility ofthe Men’s Shed model foryoung people (male andfemale) and war veterans,rather than those aged over years. Though emphasison direct effects of Sheds tohealth and wellbeing for ex-military and older care reci-pients, no objective healthmeasures used.

/

Christine

Milligan


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524


Golding et al. Australia To investigate the learn-ing styles employed inMen’s Sheds, as well asthe motivations andexperiences of themainly older men whofrequent them.

Mixed-methods study (on-site inter-views and survey) in sample of Sheds providing a social andtherapeutic function across fiveAustralian states. Sample centredon young people, war veteransand men in aged residential care.Focus on learning styles employedin Men’s Sheds, motivations andexperiences of the mainly oldermen who frequent them.

First comprehensiveinvestigation ofMen’s Sheds inAustralia, with aspecific focus onmen’s learning andadult education.

Shed selection was based onconvenience (not randomis-ation) and skewed towardsthe ‘early adopter’ states andlocations closer to cities forease of researcher access.Respondent selection waspossibly biased by key infor-mants choosing surveyparticipants.

/

Golding and Foley Australia To explore the genderedroles associated withmen’s informal learn-ing, in particular therole of women as co-ordinators and partici-pants in communityorganisations wheremen comprise the sig-nificant majority ofparticipants.

Mixed-methods study (on-site inter-views and survey) in sample of Sheds providing a social andtherapeutic function across fiveAustralian states. Sample centredon young people, war veteransand men in aged residential care.Focus is on interview data toidentify the status of womenengaged in Men’s Sheds.

Provides qualitativeinsights intowomen’s roles inmen’s organisationsand helps identifywhat it is about theway some womenparticipate in Men’sSheds that is effectiveand ineffective forthe older maleparticipants.

As the research question ispotentially sensitive and con-troversial, the study does notprovide adequate detailsabout: (a) theoretical base,some background but notfully contextualised – effort toground in (limited) theoryare not well related toresearch question; (b) ethicalprecautions; (c) findings,results lack clear presentationand explanation and do notprogress logically from thefindings.

/

Golding et al. a Australia To assess links betweenparticipation andlearning with healthand wellbeing in arange of age- and dis-ability-related commu-nity organisationsdirectly comparablewith Men’s Sheds.

Mixed-methods study with age-and disability-related communityorganisations directly comparablewith Men’s Sheds including adultand community education, sport-ing, religious, indigenous andcultural, fire and emergency ser-vices, in six sites across WesternAustralia. Survey followed bygroup interviews with focus onlinks between participation andlearning with health andwellbeing.

Mixed-methods studyincorporating aquantitative surveyand qualitativeinterviews.

Men’s Sheds were minor sub-sample of other genderedinterventions – the only Shedincluded in the study wasgrouped with a MasonicLodge with concomitantdifficulty in differentiatingintervention-specific findings.

/

Older

men

andsocialactivity


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524



Golding et al. b Australia To assess links betweenparticipation andlearning with healthand wellbeing in arange of age- and dis-ability-related commu-nity organisationsdirectly comparablewith Men’s Sheds.

Mixed-methods study with surveydistributed to participants, fol-lowed by group interviews witholder men who attended range ofage- and disability-related com-munity organisations directlycomparable with Men’s Sheds, e.g.adult and community education,sport, religious, indigenous andcultural, fire and emergency ser-vices. Designed to assess linksbetween participation and learn-ing with health and wellbeing.

Mixed-methods studyincorporating aquantitative surveyand qualitativeinterviews.

Men’s Sheds were a minor sub-sample of other genderedinterventions. Only two Shedswere clearly identified asMen’s Sheds and a third wasclassified as a communitywork-shed.

/

Graves Australia To determine ‘the magicof the Shed’ – why mengo to the Shed, barriersto attendance, whathappens at the Shedand the benefits for theparticipants.

Mixed-methods evaluation of anearly Shed in Australia with menaged – using focus groups,questionnaires and the PRECEDEframework to assess health edu-cation needs in a communitysetting. Aimed at exploring whymen go to the Shed, barriers toattendance, what happens and thebenefits for the participants.

Possibly the first evalu-ation of a Men’sShed and, as such,tried to establish abaseline of organis-ational successfactors.

– /

Christine

Milligan


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524


Healthbox CIC UK To evaluate effectivenessof four Men’s Shedsestablished by Age UKfor inclusion of oldermen.

Evaluation of four Men’s Sheds inthe UK consisting of observationand surveys (RAND health ques-tionnaire) on use of health ser-vices – some qualitative responsesin surveys.

– Most limitations centre around:(a) self-report and relatedissues such as not controllingfor memory loss, and poorlydelimited perceptions ofhealth; (b) composite use ofthe RAND scores and accessto health care to make claimsthat lacked robustness(although raw data wereavailable if requested); (c)limited information aboutbackground, research ques-tions and aims, participantprofiles, data analysis andlimited interpretation offindings.

/

Milligan et al. UK To assess the effectivenessof the Age UK ‘Men inSheds’ pilot pro-gramme in engagingisolated and lonelyolder men on lowincomes and enhan-cing their quality of lifeand wellbeing.

Mixed-methods retrospective evalu-ation of three Men’s Sheds forolder men in the UK using repeatobservation, focus groups andface-to-face interviews with ShedMembers, Shed co-ordinators andmanagers. Designed to assess theeffectiveness of an Age UK ‘Menin Sheds’ pilot programme inengaging isolated and lonely oldermen on low incomes and enhan-cing their quality of life andwellbeing.

Rigorous evaluationutilising mixedmethods and goodsample size.

Limitations noted by authorsprimarily relate to limitationsin some data collection(outside their control) andretrospective evaluation.

/

Older

men

andsocialactivity


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524



Misan Australia To better understand thephenomenon of Men’sSheds and theirinfluence on the socialand other determi-nants of the health ofmen, including that ofindigenous men, andto assess whetherMen’s Sheds offer anopportunity for deliv-ery of targeted healthpromotion pro-grammes for oldermen.

Literature review with eight detailedcase studies involving approxi-mately focus group partici-pants and two (non-comparative)key informant interviews in SouthAustralia. Designed to understandbetter the influence of Sheds onthe social and other determinantsof the health of men, includingindigenous men; and whetherSheds can deliver targeted healthpromotion programmes for oldermen.

Rigorous evaluationutilising mixedmethods, with casestudies provided inappendices.

Extensive and detailed (gener-alised) review with explana-tory rationale for sample andcase study/exemplar selec-tion, but no informationabout how the synthesis andanalysis were conducted.

/

Ormsby, Stanleyand Jaworski

Australia To explore Australianolder men’s percep-tions on participatingin community-basedSheds.

Small qualitative observational studyof two Sheds in Australia with fiveparticipants aged – years,four married with some careneeds from their wife, mixture ofoccupations but all but oneretired for at least years.Designed to explore Australianolder men’s perceptions on parti-cipating in community-basedSheds.

Offers insightful sug-gestions for furtherresearch.

Restricted sample size andsetting with poor generalisa-bility acknowledged but nodiscussion of implications ofself-report in health.

/

Reynolds Canada To develop a theoreticalmodel of the processesof involvement of oldermale adults in Men’sSheds in Manitoba,Canada.

Mixed-methods qualitative research(interviews, field notes, quantitat-ive questionnaire) with oldermen in two Sheds in Canada.Designed to develop a theoreticalmodel of the processes of invol-vement of older male adults inMen’s Sheds.

Rigorous methodologywith interview proto-cols provided inappendices.

– /

Other gendered interventions:

Christine

Milligan


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524


Batt-Rawden andTellnes

Norway To evaluate the impact ofa range of indoor andoutdoor activities as amethod of rehabilita-tion amongst adultsand older adults.

Participatory qualitative observa-tional study in Norway using semi-structured interviews with con-venience sample of people (men) aged – years, most(%) reporting common mentaldisorders or muscular-skeletallimitations and all of whom par-ticipated in a range of health-promoting group activities(hiking, gardening, physicalactivities along with more seden-tary art and crafts) led by pro-fessionals in rehabilitation centre.Study designed to explore socialcharacteristics, frequency andduration of attendance at group,life experiences and subjectiveviews on quality of life.

Provides some usefulinsights into rehabi-litation centre usingsalutogenicapproach.Distinguishesbetween impact ondifferent groups ofpeople.

Observational data only sochanges over time not known.No comparison group toassess interventions against.Potential sample bias/obser-ver effect regarding positiveviews on centre. Limitedsample size and brief report-ing of methods.

/

Drummond, M. J. To assess the impact ofthe physical activity of awalking group and itsassociation with health,competitive masculi-nity with friendshipand camaraderie.

Qualitative study using focus groupsand interviews with conveniencesample of six men aged –years who formed distinct part ofwalking group with trained fitnessco-ordinator. Designed to exploreviews on health, ageing and mas-culinity using interpretative phe-nomenological analysis.

Theoretically informeddiscussion of oldermen and masculi-nity.Phenomenologygives depth to study.

Poorly reported observationaldata from a small sample ofolder men. No comparisongroup to assess interventionagainst.

/

Gleibs et al. UK To assess the effectivenessof men-only socialgroups in care homesettings for addressingsocial isolation onolder men.

Mixed-methods ‘before and after’study with convenience sample of older men aged – yearswho chose to participate in‘Gentlemen’s Club’ interventionin six residential care homes inthe UK. Data captured at weeks and including compositequestionnaire measuring socialidentity, cognitive ability andwellbeing.

Data gathered at twopoints to assesschanges in status.Validated tools tomeasure changes.Theoreticallyinformed with claimsnot made on data perse but on theory theysupport.

Small sample size with verylimited diversity among par-ticipants. No comparisongroup to assess interventionagainst. Short time-frame forduration of intervention.

/

Older

men

andsocialactivity


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524



Gleibs et al. UK To assess the role of col-lective engagement incounteracting feelingsof confinement andlack of autonomy inresidential caresettings.

Qualitative study using short semi-structured interviews with purpo-sive sample of five older men aged– years who had participatedin ‘Gentlemen’s Club’ interven-tion in six residential care homesin Cornwall. Designed to exploretheir views on life in residentialcare and the ‘Club’ intervention.

Provides further quali-tative insights fromoriginal research.Provides furthersupport for claimsmade in earlierpaper regardingcontrol and choice.

Small sample size with verylimited diversity among par-ticipants. No comparisongroup to assess interventionagainst. Short time-frame forduration of intervention.

/

Golding et al. a Australia To assess links betweenparticipation andlearning with healthand wellbeing in arange of age- and dis-ability-related commu-nity organisationsdirectly comparablewith Men’s Sheds.

Mixed-methods study with age-and disability-related communityorganisations directly comparablewith Men’s Sheds including adultand community education, sport-ing, religious, indigenous andcultural, fire and emergency ser-vices, in six sites across WesternAustralia. Survey followed bygroup interviews with focus onlinks between participation andlearning with health andwellbeing.

Mixed-methods studywith survey of and interviews with+ older men.Provides data onmultiple activitiesand sites catering forneeds of older men.Diversity allows simi-larities and differ-ences to emerge.

Observational data with nocomparison group.Insufficient sample size toprovide comprehensivepicture of learning and well-being of older men. Potentialbias from opportunisticallygenerated interview sample.

/

Golding et al. b Australia To assess links betweenparticipation andlearning with healthand wellbeing in arange of age- and dis-ability-related commu-nity organisationsdirectly comparablewith Men’s Sheds.

Mixed-methods study with surveydistributed to participants, fol-lowed by group interviews witholder men who attended range ofage- and disability-related com-munity organisations directlycomparable with Men’s Sheds, e.g.adult and community education,sport, religious, indigenous andcultural, fire and emergency ser-vices. Designed to assess linksbetween participation and learn-ing with health and wellbeing.

Mixed-methods studywith survey of and interviews with older men.Provides data onmultiple activitiesand sites catering forneeds of older men.Diversity of sites andactivities allows simi-larities and differ-ences to emerge.

Observational data with nocomparison group.Insufficient sample size toprovide comprehensivepicture of learning and well-being of older men. Potentialbias from opportunisticallygenerated interview sample.

/

Christine

Milligan


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524


Hayes, Goldingand Harvey

Australia To assess the value of vol-unteer work for olderadult learning throughfire and emergencyservice organisations insmall and remoteAustralian towns.

Mixed-methods study (survey andgroup interviews) with volunteerswho regularly take part in localemergency response units andtraining activities at four sites inAustralia. The core of these unitsis often formed of older men withrelatively limited level of edu-cation. Participants were agedover years and %men. Studydesigned to focus on learning andvoluntary participation.

Mixed-methods studywith survey of and interviews with older men. Linkslearning with healthand wellbeing.

Observational data with nocomparison group.Insufficient sample size toprovide comprehensivepicture of learning and well-being of older men.

/

Keller et al. Canada To assess the health andwellbeing impacts ofmen-only cookinggroups.

Mixed-methods study with conven-ience sample of older men parti-cipating in a monthly cookingclub supported by a dietician inCanada. Design included ques-tionnaire at start and end ofevaluation year and semi-struc-tured interviews. Designed toexplore demographics andcooking/diet of participants,prior cooking experience, andperceived strengths and weaknessof the intervention. Ten themati-cally analysed semi-structuredinterviews lasting – minutesexploring prior cooking experi-ence, strengths and weakness ofthe intervention. Dietician alsokept journal.

Longitudinal mixed-methods study withdata gathered atseveral points.Provides insights intoolder men andmotivations forparticipation.

Qualitative data suggestedhealthy diet changes but noobjective measures. First datacollection not at start ofproject.

/

Older

men

andsocialactivity


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524


T A B L E . (Cont.)

Author Year Country Study aim Design and sample Strengths Limitations QA score

Macdonald,Brownand Buchanan

Australia To assess older men’sviews on the impor-tance of supportingand supportive socialenvironment, difficul-ties of transition frompaid work with loss ofmale identity andlimited opportunitiesfor volunteering.

Qualitative study with conveniencesample of older men attendingOld Men: New Ideas interventionin Australia – an interventiondesigned to address health andwellbeing of older men throughcommunity-based groups thattypically meet on a fortnightlybasis. Study used interviews andfocus groups to explore variousdimensions of health and well-being including work and retire-ment, volunteering, health andsocial services, male culture,relationships and social networks.

Very wide-rangingexploration of oldermen’s views on life,health and well-being. Providesuseful insights onareas and issues thatare not covered inother includedstudies.

Observational data with nocomparison group. Poorlyreported methods andsample description. Limiteddescription of types of activi-ties undertaken at Old Men:New Ideas.

/

Milligan,Gatrelland Bingley

UK To assess the health andwellbeing benefits ofcommunity gardeningfor older people.

Ethnographic study of communitygardening activity with olderpeople supported by qualifiedgardener. Study undertaken inthe UK using focus groups andinterviews with participants at startof project and after nine months.Supplemented with weekly diariesfrom participants along withregular observational data fromproject researcher.

Multiple qualitativemethods give richaccount of replicableintervention. Strongon policy needs andimplications regard-ing healthy ageing.

Relatively small sample size dueto scale of project along withrecruitment and attritionproblems due to poor health.No comparison groupreported to assess impact ofintervention.

/

Pretty et al. UK To examine the effects ofgreen exercise in theUK countryside forhealth and psychologi-cal wellbeing of oldermen.

Quantitative study with conveniencesample of older people (%men) participating in green exer-cise including walking, woodlandconservation and cycling, acrossUK. Study used composite ques-tionnaire with validated measuresdesigned to assess physical andmental health, fitness and lifestyleadministered immediately beforeand after participation inactivities.

Validated tools measur-ing mental healthstatus. Strong onpolicy needs andimplications regard-ing social physicalactivity.

Sample of people who werealready active so no data onthe more typical habituallyinactive. Short time-frame formeasuring effects of greenexercise.

/

Christine

Milligan


ww



ownloaded from

https://ww

w.cam


bridge Core


https://doi.org/10.1017/S0144686X14001524


the lowest categories in hierarchies of research evidence which placegreater weight on systematic reviews, randomised controlled trials andwell-conducted observational studies (Guyatt et al. ).The studies included contained some quantitative data, predominantly

from surveys in mixed-methods papers, but most data were qualitative, offer-ing insights into the perceptions of older men and the processes involved inMen’s Sheds and other gendered interventions. Given the preponderanceof qualitative data, an interpretive synthesis (Noblit and Hare )approach involving both induction and interpretation was used in bothreviews. The four-step guidance on narrative synthesis in reviews(Armstrong et al. ; Popay et al. ) was used to address the researchquestions that were posed prior to the review commencing and provide thestructure for the findings.

Results

Of the studies included in theMen’s Sheds review, came fromAustralia(including three on a single study), reflecting the national origin of this formof intervention, along with two studies from the UK and one from Canada.With the exception of a study by Graves (), who undertook a mixed-methods, longitudinal evaluation, most of the Australian studies tended tobe descriptive and coalesced into either large-scale surveys or small-scalequalitative investigations of particular Sheds. Studies by Milligan et al.(, ) in the UK and Reynolds () in Canada used mixed-methods approaches involving questionnaires, interviews, focus groups andobservations at multiple sites to provide data with richness and depth.In these studies, data collected from older men were supplemented byinformation from family members and key informants such as project co-ordinators and health or social care professionals.Twelve studies were included in the review of other gendered interventions.

Four studies originated in Australia, including two by Golding et al. (a,b) that were also included in the Sheds review, but also provided insightsinto alternative activities in communities where Sheds operated. Four studiesemanated from the UK, including two on a single intervention in residentialcare homes in Cornwall, one study came from Norway, one came fromCanada and one from the USA. One further study was not clearly geographicallylocated. The types of interventions in these studies were more varied than theSheds’ literature, covering a range of alternative social activities including acooking club, a community allotment, walking groups and green exercise inthe natural environment. The profile of participants was also more varied interms of age and capability, with some data from employed active men in their




https://doi.org/10.1017/S0144686X14001524


early fifties who volunteered in their community’s emergency response services,to older men in their eighties in residential care who engaged in more sedateactivities. In terms of study design, there were cross-sectional studies, often includ-ing large-scale surveys supplemented with group interviews; and longitudinalresearch that used mixed methods to assess the impact of an intervention.

What are the effects on the physical health of older men?

There was limited evidence of any positive effects on physical health fromthe studies of Men’s Sheds or those of other gendered interventions. Self-reported improvements from participants suggested that such interventionscould improve physical health through promoting moderate levels of phys-ical activity, but we found no supporting evidence from more longitudinalstudies using objective or validated physical health measures.

What are the effects on the mental health of older men?

There was more extensive evidence of positive effects on the mental healthof those participating in Men’s Sheds, compared to people taking part inother social activities. The consistency and frequency of such reportssuggests that older men find benefits to their mental health from participat-ing in social and physical activities in Sheds, due to a greater sense of belong-ing and purpose in their lives.A similar pattern of self-reported improvements inmental health emerged

from the other gendered intervention studies. Both Pretty et al. () andGleibs et al. () used composite administered research instruments con-taining questions from validated questionnaires, such as the Profile of MoodStates test and the Hospital Anxiety and Depression Scale, to assess mentalhealth status before and after the social activity. Both studies found signifi-cant positive effects in terms of improved mental health and wellbeingamong participants immediately before and after (Pretty et al. ) andover a period of weeks (Gleibs et al. ). It is notable that despite a com-monly held perception that men are reluctant to acknowledgemental healthissues, both reviews drew on studies in which older men talked candidlyabout their own mental health experiences, including feelings of anxiety,depression and even about committing suicide.

What are the effects on the wellbeing of older men?

There is some evidence of the beneficial effects of Men’s Sheds on the socialwellbeing of older men. Men’s Sheds are socially inclusive spaces that provideparticipants with a sense of accomplishment, both personal – through

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


learning and sharing skills, and social – through contributing to their localcommunity. Sheds also provide a sense of purpose for older men throughsocial engagement with their peers, through enjoyment, and fun (Fildeset al. ). Men’s Sheds countered social isolation and loneliness by improv-ing feelings of self-esteem and providing social support through the develop-ment of friendship and a sense of camaraderie with other men.

What are the effective components of interventions?

Successful Men’s Sheds were in a suitable location, provided a wide range ofactivities over extended opening hours, enjoyed strong local support and hada skilled co-ordinator who enabled its smooth operation (Milligan et al. ).Men’s Sheds are a voluntary activity which operate in relatively unstruc-

tured and informal ways that enable older men to choose the activitiesthey will undertake and through this process become ‘more than a placeto do things but also a place of belonging, friendships and purpose’(Ballinger, Talbot and Verrinder : ). It is important to note that‘Shedders’ tend to view themselves as volunteers or members (ratherthan clients or patients) who come together, often to give something backto the community, through enjoyable hands-on activities rather thanbeing the recipients of a complex social intervention designed to improvetheir health and wellbeing.The other gendered interventions studies offered similar explanations for

success in terms of older men coming together and finding a common senseof identity and purpose through shared experiences in volunteer emer-gency services (Golding et al. b; Hayes, Golding and Harvey ) orlearning new skills (Golding et al. a; Keller et al. ; Milligan,Gatrell and Bingley ). The pivotal role of a skilled co-ordinator,usually in a paid position, to provide the organisational skills that enablesolder men to learn and share skills as well as empowering them to act asco-participants in the operation of an intervention was a common findingin both reviews (Milligan et al. ). The friendships and sense ofsupport that can be built over time amongst older men engaged in purpose-ful voluntary social activities are the foundational building blocks for suc-cessful Men’s Sheds and other interventions.

What theoretical frameworks were employed?

A variety of theoretical frameworks were used in the studies to provide anunderpinning for analysis and to develop a deeper understanding of whythese types of gendered interventions may work. Importantly, the differenttheoretical approaches used reflect different aspects of the interventions




https://doi.org/10.1017/S0144686X14001524


that these studies were concerned to draw out, whether that be health,gender, inequalities, identity, learning or a combination of these and/orother issues.In their study of Men’s Sheds, for example, Ballinger, Talbot and

Verrinder () used the World Health Organisation’s (WHO) Fields ofWellbeing model to inform their research. This model of health is derivedfrom cross-cultural research on people’s conceptions and experiences,along with theWHO’s definition of health as physical, mental and social well-being. It contains six elements that capture the interdependency of health:vitality, positive social relationships, a personal sense of control over one’slife and living conditions, enjoyable activities, a sense of purpose and a con-nectedness to community. Other theoretical frameworks employed includeda salutogenic perspective that emphasises factors contributing to health andwellbeing such as a sense of coherence and continuity in life. This theoreticalperspective underpinned the purposeful social activities in the rehabilitationcentre studied by Batt-Rawden and Tellnes (). Gleibs et al. () drewon social identity theory in their studies of older men in residential care. Thisapproach postulates that membership of a social group is critical informing a shared sense of support through which people are able to under-stand who they are, and gain the social support they need to protect andenhance their health and wellbeing. Drummond’s () study of oldermen in walking groups conceptualised issues through the lenses of masculi-nity and phenomenology in order to explore how older men experiencedageing and the steps they took to address it. Finally, (Ballinger, Talbot andVerrinder ) used the WHO’s Determinants of Disadvantage as a theor-etical framework in their studies of Men’s Sheds and other types of genderedintervention aimed at older men. This framework identifies a series of factorsthat underpin the social disadvantages that contribute to health inequalitiessuch as social exclusion, unemployment, difficult experiences earlier in life,the stresses of ageing and the transition from paid work to retirement todevelop an explanatory understanding of the circumstances of older menand the scope for effective interventions.It is worth noting that whilst the variety of theories and frameworks used

can reflect different research priorities, it can also make direct comparisonsdifficult and hinders the identification of the direction of causal pathwaysbetween social activity, health and wellbeing.

Critical reflection on included studies

This review has found evidence to suggest that Men’s Sheds and other gen-dered interventions may have an impact on the mental health and wellbeing

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


of older men, but the evidence is not conclusive. There is limited evidenceof impact on physical health; and what does exist is largely self-report andlimited in scope. Key components of successful interventions includedaccessibility, range of activities, local support and skilled co-ordination.Whilst the Men’s Sheds literature was relatively homogenous, given it was

examining a clearly defined phenomenon, the studies on other genderedinterventions were more heterogeneous, covering a wider range of activitiesstretching from men’s cooking clubs to walking groups. The range of activi-ties within the gendered interventions category meant it was more difficultto make generalisable assessments of the impact of these interventions onthe health and wellbeing of older men.The review also identified a limited number and variable quality of

studies available for synthesis, reflecting the paucity of interventions aimedat older men. This in itself is an important finding. There was also a prepon-derance of qualitative studies, and whilst smaller numbers are to be expectedin qualitative studies, even taking this into account some studies were basedon very small sample sizes. When larger samples were generated, there wasoften a lack of validated measures in survey instruments and the collectionand analysis of qualitative data was not always clearly reported.Despite the widespread availability and acceptance of objective scales,

none of the studies used validated measures to assess physical, or even func-tional, changes in physical health status. This omission is significant giventhat some of the Men’s Sheds literature asserts that one of the primarybenefits of Shed activity is that of participating in physical activities ben-eficial to health (Ormsby, Stanley and Jaworski ). There are self-reported improvements in physical health as a result of the interventionacross both the Shed and the other gendered interventions literatures(Milligan et al. ), but reporting is limited and needs further verification.Hence, while such evidence should not be dismissed, there is a need forlongitudinal and controlled studies that use validated measures of physicalhealth status to provide more reliable evidence to support these self-reported claims that Men’s Sheds and other forms of interventionimprove the physical health of older men.Whilst the evidence of benefits to mental health and wellbeing is more

consistent across the literature, it too is based largely on low-level studiesusing a qualitative research design. The mental health benefits of Men’sSheds would benefit from further investigation using validated measuresspecifically designed to assess mental health status. The methods adoptedwithin some of the research on other gendered interventions (e.g. Gleibset al. ) provide a potentially useful guide for further work.These studies also lacked a control group of older men who did not par-

ticipate in the organised social activities, making it difficult to be confident




https://doi.org/10.1017/S0144686X14001524


that self-reported improvements in physical or mental health and socialwellbeing were directly attributable to the actual interventions. There isalso no evidence about why some older men choose not to participate or,alternatively, initially participated but later withdrew.Finally, it is worth reflecting that to date, most (though not all) of the

Men’s Sheds research has been conducted in Australia, some of whichhas been in rural or remote settings. This raises questions about the needfor a deeper understanding of the cultural context within which Shedshave been developed and the extent to which these may need to beadapted for other parts of the world.

Implications of review

This scoping review has highlighted limitations to the studies on Men’sSheds and other gendered interventions that mean that there is, as yet,no conclusive evidence about their beneficial impact on the health and well-being of older men. Qualitative data from these studies provide valuableinsights into how and why complex psycho-social interventions affect partici-pants. The sense of identity and purpose in life that older men developedthrough building friendships and social networks by learning and participat-ing in organised social activities can be difficult to measure but low-levelevidence does suggest that it exists.The wider social wellbeing benefits may be an important element of

Men’s Sheds, in that they enable older men to share their health concernsand experiences in a supportive environment that is not viewed by partici-pants as being part of the wider health-care system. This more informal‘health by stealth’ approach to health promotion amongst older men(Milligan et al. ) may be one of the key benefits of Men’s Sheds.Misan noted that older men

were less concerned about physical health, and more worried aboutsocial, emotional and mental health and wellbeing, about the effects of retirementand about the changing nature of rural communities … Sheds are importantenvironments in which men offer support to each other on these issues. (: )

The literature on other gendered interventions was, similarly, generally sup-portive of improvements in social wellbeing related to participation in socialactivities that gave older men a ‘sense of balance’ (Macdonald, Brown andBuchanan ) in their lives. This may be important given that older menare at risk of reduced social wellbeing as a result of the transition from paidwork into retirement or into residential care – although again the evidenceis limited and low level. The study of older men in residential care by Gleibset al. (), although modest in scale, provides some evidence of improved

Christine Milligan



https://doi.org/10.1017/S0144686X14001524


social wellbeing and a useful guide for future research. The wider socialwellbeing benefits of interventions that provide spaces where older mencan stand ‘shoulder to shoulder’ (Golding and Foley ) have the poten-tial to be considerable but need to be more thoroughly investigated.The various analytical frameworks used in these studies reflect the variety

of academic disciplines and research traditions deployed, but all tend tosupport the core assumptions of activity theory. They contend that thehealth and wellbeing of older people is promoted by high levels of engage-ment in social and leisure activities and role replacement when an estab-lished role must be relinquished. The frameworks for further researchcould include the WHO’s Determinants of Disadvantage for men approachthat includes domains for social exclusion, unemployment, difficult pastlives, the stresses of ageing and substance abuse issues, as used by Goldinget al. (b). There is also a case for using the WHO’s Fields ofWellbeing approach, as used by Ballinger, Talbot and Verrinder (),which explores six dimensions of health and wellbeing.Further studies of Men’s Sheds and other gendered interventions for older

men are needed, in order to provide more definitive, generalisable and longi-tudinal answers to questions about whether there are any measurable effectsfor physical and mental health that would extend the existing evidence base.Future studies should involve larger samples of participants, consider adopt-ing randomised designs, and deploy mixed methods including standardisedmeasures of health and wellbeing and qualitative approaches.

References

Arber, S., Perren, K., Daly, T. and Davidson, K. . Older Men: Their Social Worldsand Healthy Lifestyles. Economic and Social Research Council, Swindon, UK.

Armstrong, R., Waters, E., Jackson, N., Oliver, S., Popay, J., Shepherd, J.,Petticrew, M., Anderson, L., Bailie, R., Brunton, G., Hawe, P., Kristjansson, E.,Naccarel la, L., Norris, S., Pienaar, E., Roberts, H., Rogers, W., Sowden, A. andThomas, H. . Guidelines for Systematic Reviews of Health Promotion and PublicHealth Interventions. Version , Melbourne University, Melbourne.

Australian Government Department of Health () Australian Government ShedDevelopment Program. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/male-health-programs#sheds [accessed //]

Ballinger, M. L., Talbot, L. A. and Verrinder, G. K. . More than a place to dowoodwork: a case study of a community-based Men’s Shed. Journal of Men’sHealth, , , –.

Batt-Rawden, K. and Tellnes, G. . Nature–culture–health activities as a methodof rehabilitation: an evaluation of participants’ health, quality of life and function.International Journal of Rehabilitation Research, , , –.

Betts Adams, K., Leibbrandt, S. and Moon, H. . A critical review of the literatureon social and leisure activity and wellbeing in later life. Ageing& Society, , , –.



http://www.health.gov.au/internet/main/publishing.nsf/Content/male-health-programs%23sheds

http://www.health.gov.au/internet/main/publishing.nsf/Content/male-health-programs%23sheds


https://doi.org/10.1017/S0144686X14001524


Buss, M. . Evolutionary psychology: The new science of the mind. Allyn and Bacon,Boston, MA: Allyn & Bacon.

Cacioppo, J. T., Hawkley, L. C., Norman, G. J. and Berntson, G. G. . Socialisolation. Annals of the New York Academy of Sciences, , , –.

Carragher, L. . Men’s Sheds in Ireland: Learning Through Community Contexts.Research Report. Available online at http://menssheds.ie/m/wp-content/uploads///Men’s-Sheds-in-Ireland-National-Survey.pdf [Accessed January ].

Cass, Y., Fildes, D. and Marshall, C. . in - Mature men's project evaluationresults. Centre for Health Service Development, South-eastern Sydney Illawarra,Australia. Available online at: http://www.healthyillawarra.org.au/healthypeople/docs/inmen.pdf [Accessed //]

Cattan, M., Newell, C., Bond, J. and White, M. . Alleviating social isolation andloneliness among older people. International Journal of Mental Health Promotion, , ,–.

Cordier, R. and Wilson, N. . Mentoring at Men’s Sheds: an international surveyabout a community approach to health and well-being.Health and Social Care in theCommunity, , , –.

Craig, P., Dieppe, P., Macintyre, S., Mitchie, S., Nazareth, I. and Petticrew, M. .Developing and evaluating complex interventions: the new Medical ResearchCouncil guidance. British Medical Journal, , .

Davidson, K. . Older men in the community: a UK perspective. In Phellas, C.(ed.), Aging in European Societies, International Perspectives on Aging. Book Series ,Springer, New York, –.

Dickens, A. P., Richards, S. H., Greaves, C. J. and Campbell, J. L. . Interventionstargeting social isolation in older people: a systematic review. BMC Public Health,, –.

Drummond, M. J. . Retired men, retired bodies. International Journal of Men’sHealth, , , –.

Eurostat . Mortality and Life Expectancy Statistics. Available online at http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Mortality_and_life_expectancy_statistics#The_gender_gap_is_shrinking [Accessed January ].

Fennell, G. and Davidson, K. . The invisible man? Older men in modern society.Ageing International, , , –.

Fildes, D., Cass, Y., Wallner, F. and Owen, A. . Shedding light on men: theBuilding Healthy Men Project. Journal of Men’s Health, , , –.

Findlay, R. A. . Interventions to reduce social isolation amongst older people:where is the evidence? Ageing & Society, , , –.

Fleming, A. . Older men in contemporary discourses on ageing: absent bodiesand invisible lives. Nursing Inquiry, , , –.

Gleibs, I., Sonneberg, S., Haslam, C., Jones, J., Haslam, A., McNeill, J. andConnolly, H. . No country for old men? The role of a ‘Gentlemen’s Club’in promoting social engagement and psychological well-being in residentialcare. Aging and Mental Health, , , –.

Golding, B. . Older men’s wellbeing through community participation inAustralia. International Journal of Men’s Health, , , –.

Golding, B., Harvey, J., Foley, A., Brown, M. and Darken, S. . Final report on asurvey of men's sheds participants in Victoria. Adult, Community and FurtherEducation Board, Melbourne, Australia.

Golding, B., Brown, M. and Foley, A. . Old dogs new shed tricks. An explorationof innovative workshop-based practice for older men in Australia. AustralianVocational Education and Training Research Association (AVETRA) Conference.

Christine Milligan


http://www.healthyillawarra.org.au/healthypeople/docs/3in1men.pdf

http://www.healthyillawarra.org.au/healthypeople/docs/3in1men.pdf

http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Mortality_and_life_expectancy_statistics%23The_gender_gap_is_shrinking





https://doi.org/10.1017/S0144686X14001524


Melbourne, Australia. Available online at https://avetra.org.au/documents/-Golding.pdf [Accessed //]

Golding, B., Brown, M., Foley, A., Harvey, J. and Gleeson, L. . Men's shedsin Australia. Learning through community contexts. National Centre forVocational Education Research, (NCVER), Adelaide, Australia. Available onlineat http://www.omal.si/userfiles/file/Learning_through_community_contexts.pdf [Accessed //].

Healthbox Community Interest Company . Men in Sheds programme health evalu-ation. Age UK, Cheshire, UK.

Golding, B., Brown, M., Foley, A. and Harvey, J. a. Mens learning and wellbeingthrough community organisations in Western Australia. Report to WesternAustralia Department of Education and Training, School of Education,Federation University, Perth, Australia.

Golding, B. and Foley, A. . ‘How men are worked with’: gender roles in men’sinformal learning. Paper presented to the th Annual SCUTREA Conference, – July, Edinburgh, UK.

Golding, B., Foley, A., Brown, M. and Harvey, J. b. Senior Men’s Learning andWellbeing Through Community Participation in Australia. Report to the NationalSeniors Productive Ageing Centre, School of Education, Federation University,Perth, Australia. Available online at http://www.productiveageing.com.au/site/research.php [Accessed January ].

Graves, K. . Shedding the Light on Men in Sheds: Final Report . CommunityHealth, Bendigo, Australia.

Greenfield, E. and Marks, N. . Formal volunteering as a protective factor forolder adults’ psychological well-being. Journal of Gerontology, , , –.

Guyatt, G. H., Sackett, D. L., Sinclair, J. C., Hayward, R., Cook, D. J. and Cook, R. J.. Users’ guides to the medical literature. IX. A method for grading healthcare recommendations. Evidence-Based Medicine Working Group. JAMA, ,, –.

Hawker, S., Payne, S., Kerr, C., Hardey, M. and Powell, J. . Appraising the evi-dence: reviewing disparate data systematically. (Qualitative Health Research, , ,–. DOI: ./© Sage Publications)

Hawton, A., Green, C., Dickens, A., Richards, S., Taylor, R., Edwards, R., Greaves, C.J. and Campbell, J. L. . The impact of social isolation on the health statusand health-related quality of life of older people. Quality of Life Research, , ,–.

Hayes, C., Golding, B. and Harvey, J. . Adult Learning Through Fire and EmergencyService Organisations in Small and Remote Australian Towns. National Council forVocational Education Research, Adelaide, Australia.

Healthbox Community Interest Company. . Men in Sheds Programme HealthEvaluation. Age UK, Cheshire, UK.

Holt-Lunstad, J., Smith, T. B. and Layton, J. B. . Social relationships and mor-tality risk: a meta-analytic review. PLOS Medicine, , , e. doi:./journal.pmed..

House, J., Landis, K. and Umberson, D. . Social relationships and health. Science,New Series, , , –.

Iliffe, S., Kharicha, K., Harari, D., Swift, C., Gillmann, G. and Stuck, A. E. .Health risk appraisal in older people : the implications for clinicians and commis-sioners of social isolation risk in older people. British Journal of General Practice, ,, –.

Keller, H., Gibbs, A., Wong, S.,Vanderkooy, P. and Hedley, M. . Men can cook!Journal of Nutrition for the Elderly, , , –.



https://avetra.org.au/documents/21-Golding.pdf

https://avetra.org.au/documents/21-Golding.pdf

http://www.omal.si/userfiles/file/Learning_through_community_contexts.pdf

http://www.omal.si/userfiles/file/Learning_through_community_contexts.pdf

http://www.productiveageing.com.au/site/research.php




https://doi.org/10.1017/S0144686X14001524


Luanaigh, C. O. and Lawlor, B. A. . Loneliness and the health of older people.International Journal of Geriatric Psychiatry, , , –.

Macdonald, J., Brown, A. and Buchanan, J. . Keeping the Balance: Older Men andHealthy Ageing. A Framework for Discussion. New South Wales Committee on Ageingand the Men’s Health Information and Resource Centre, University of WesternSydney, Sydney.

Masi, C. M., Chen, H., Hawkley, L. C. and Cacioppo, J. T. . A meta-analysis ofinterventions to reduce loneliness. Journal of Investigative Medicine, , , –.

Medical Research Council . Medical Research Council Guidance on ComplexInterventions. Prepared by Craig, P., Dieppe, P., Macintyre, S., Mitchie, S.,Nazareth, I. and Petticrew, M. Medical Research Council, UK. Availableonline at http://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/[Accessed December ].

Milligan, C., Gatrell, A. and Bingley, A. . Cultivating health: therapeutic land-scapes and older people in northern England. Social Science and Medicine, ,–.

Milligan, C., Payne, S., Bingley, A. and Cockshott, Z. . Evaluation of the men insheds pilot programme. Report for Age UK, London.

Milligan, C., Payne, S., Bingley, A. and Cockshott, Z. . Gender, place andhealth: shedding light on activity interventions for older men. Ageing & Society,, , –.

Misan, G. . Men’s Sheds: a strategy to improve men’s health. Report forMensheds Australia, Spencer Gulf Rural Health School, Adelaide, Australia.

Noblit, G. and Hare, R. . Meta-ethnography: Synthesizing Qualitative Studies. Sage,Beverley Hills, California.

Ormsby, J., Stanley, M. and Jaworski, K. . Oldermen’s participation in community-based men’s sheds programmes. Health and Social Care in the Community, , ,–.

Pantell, M., Rehkopf, D., Jutte, D. S., Syme, L., Balmes, J. and Adler, N. . Socialisolation: a predictor of mortality comparable to traditional clinical risk factors.American Journal of Public Health, , , –.

Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M., Britten, N.,Roen, K. and Duffy, S. . Guidance on conducting narrative synthesis insystematic reviews. Methods Briefing , Cathie Marsh Institute for SocialResearch, Manchester, UK.

Pretty, J., Peacock, J., Hine, R., Sellens, M., South, N. and Griffin, M. . Greenexercise in the UK countryside: effects on health and psychological well-being,and implications for policy and planning. Journal of Environmental Planning andManagement, , , –.

Reynolds, K. A. . Older male adults’ involvement in mens sheds. Master of ArtsThesis, University of Manitoba, Winnipeg, Manitoba, Canada.

Salomon, J., Wang, H., Freeman, T., Flaxman, A., Lopez, A. and Murray, C. .Healthy life expectancy for countries, –: a systematic analysis forthe Global Burden Disease Study . Lancet, , , –.

Shankar, A., McMunn, A., Banks, J. and Steptoe, A. . Loneliness, social isolation, andbehavioralandbiologicalhealth indicators inolderadults.HealthPsychology,,,–.

Steffick, D. E. . Documentation of affective functioning measures in the Healthand Retirement Study. HRS/AHEAD Documentation Report, University ofMichigan, Ann Arbor, Michigan.

Suominen-Taipale, A., Martelin, T., Koskinen, S., Holmen, J. and Johnsen, R. .Gender differences in health care use among the elderly population in areas of

Christine Milligan


http://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/

http://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/


https://doi.org/10.1017/S0144686X14001524


Norway and Finland. A cross-sectional analysis based on the HUNT study and theFINRISK Senior Survey. BMC Health Services Research, , , .

Victor, C. R., Scambler, S. and Bond, J. . The Social World of Older People:Understanding Loneliness and Social Isolation in Later Life. Open University Press/McGraw Hill Education, Maidenhead, UK.

Wang, H., Dwyer-Lindgren, L., Lofgren, K., Knoll Rajaratnam, J., Marcus, J., Levin-Rector, L., Levitz, C., Lopez, A. and Murray, C. . Age-specific and sex-specific mortality in countries, –: a systematic analysis for theGlobal Burden of Disease Study . Lancet, , , –.

White, A., de Sousa, B., de Visser, R., Hogston, R., Aage Madsen, S., Makara, P.,Richardson, N. and Zatonski, W. . The state of men’s health in Europe.Extended Report, European Commission Directorate-General for Health andConsumers, Brussels.

Wilson, N. J. and Cordier, R. . A narrative review of Men’s Sheds literature:reducing social isolation and promoting men’s health and well-being. Healthand Social Care in the Community, , , –.

Accepted December ; first published online March

Address for correspondence:Christine Milligan,Centre for Ageing Research,Faculty of Health and Medicine,Lancaster University,Bailrigg, Lancaster, UK

E-mail: [email protected]



mailto:[email protected]


https://doi.org/10.1017/S0144686X14001524


Older men and social activity: a scoping review of Men s ... · and other gendered interventions...

Documents

Transcript of Older men and social activity: a scoping review of Men s ... · and other gendered interventions...