By Pat Flanagan

Introduction

International evidence suggests that men, as a group, are frequently under represented at many self-management support services. They have a higher incidence of many of the more disabling long term conditions such as diabetes, CVD, COPD and gout. Men are more likely to engage in risky, unhealthy behaviours such as drinking and smoking and are more reticent to access health services. These behaviours are often associated with traditional masculine ‘she’ll be right’ attitudes. 

Background 

In November 2014 a systematic review was published[1] This review analysed the findings relating to men’s access and acceptability of self management support services and  identified four main themes:  

Need for purpose: getting information, finding out and engaging in physical activity.

Trusted environments: enabling men to talk about ‘taboo subjects’ and open up to different ways of thinking.

Value of peers: people in the same boat, validation of what they are experiencing.

Becoming expert: gaining knowledge and skills, understanding how to navigate the health system, becoming informed consumers, generating a sense of power.

Our understanding and definition of self-management support is evolving as the health system grapples with the increasing burden of chronic disease, the need to reduce health inequalities and deliver person and whanau centred care.

Increasingly we are looking outside of the traditional health paradigm to a more holistic community oriented model of service provision that promotes positive health and social wellbeing.

Background

Earlier this year the Health Foundation produced an evidence review of asset based approaches to health care and wellbeing. The authors suggest that by applying what they describe as ‘the theory of change’ to the development of an initiative; more powerful insights are gained and outcomes realised.
This ‘theory of change’ has four key components.

1. Reframing of thinking, goals and outcomes - An explicit statement of the shift to thinking about assets (not deficits) and how this enables reassessment of current practice and priorities and the ways in which desired changes can be achieved.
2. Recognition of the assets available to achieve the change - Mapping and describing as many as possible of the individual, organisational, economic, cultural and physical resources available to the members of the community.
3. Mobilisation of assets for a purpose - A plan of action for how the identified community assets can be connected, across organisational boundaries and used to achieve the desired goals identified by the community members.
4. Co-production of outcomes – on the pathway to the long-term goal Co-production of services and outcomes by professionals and citizens, coming together as equals, each with assets and strengths, around a common goal or a joint venture.

Read the rest of the case study and what is happening at Counties Manukau in this space.