Sheds for life: health and wellbeing outcomes of a tailored community-based health promotion initiative for men’s sheds in Ireland

Abstract

Background Gender is increasingly recognised as a critical factor in designing community-based health promotion programmes. Men’s Sheds (‘Sheds’) are community-based informal environments that represent a safe space in which to engage cohorts of hard-to-reach (HTR) men in health promotion. Sheds for Life (SFL), the first structured health promotion initiative evaluated globally in Sheds, is a 10-week initiative co-designed with Shed Members (Shedders) and delivered directly in the Shed setting in Ireland. This research describes the health and wellbeing outcomes experienced by SFL participants. Methods Purposive sampling was used to recruit a diverse representation of Shedders (n = 421) participating in SFL alongside a wait list control (n = 86). Questionnaires assessing constructs of health and wellbeing were administered one-to-one in Sheds at baseline, 3, 6 and 12 months. Descriptive data for health outcomes were generated for each time point and assessed for significant changes using inferential testing, while considering COVID-19 impact. Results Outcomes related to subjective wellbeing, mental wellbeing, physical activity, social capital and healthy eating significantly increased post SFL (p < 0.05). Mental wellbeing scores (SWEMWBS) post SFL remained significantly higher than baseline despite COVID-19 impact (p < 0.05). Binary logistic regression indicated that the odds of a meaningful SWEMWBS change was significantly higher for shedders that had lower SWEMWBS (OR 0.804), less loneliness (OR 0.638) and lived alone (OR 0.456) at baseline. Shedders with lower SWEMBWS had higher odds of experiencing positive changes in life satisfaction (OR 0.911) and trust (OR 0.928), while Shedders who lived alone had also higher odds of experience positive changes in healthy eating (OR 0.481). Finally, inactive Shedders at baseline had higher odds of experiencing increased levels of physical activity (OR 0.582). Conclusions Findings suggest that the inclusive, community-based SFL model is effective in engaging Shedders and facilitating positive and sustained changes in health and wellbeing outcomes. Using gender-specific approaches in the informal and safe environment of the Shed are effective in engaging men in structured health and wellbeing initiatives, particularly those who may be more vulnerable, isolated or lonely. Trial registration This study has been retrospectively registered with the ‘International Standard Randomised Controlled Trial Number’ registry (ISRCTN79921361) as of 05/03/2021.

Strategies for effective implementation and scale-up of a multi-level co-designed men's health initiative “Sheds for Life” in Irish Men's Sheds

“…Participants (n = 421) were followed at baseline, 3, 6, and 12 months. These results are described in detail elsewhere and highlight both the efficacy of the SFL initiative in encouraging positive and sustained changes in health and wellbeing outcomes for Shedders (31), as well as supporting the case for scale-up (29). Baseline characteristics of participants also highlight that SFL was effective in engaging a cohort of HTR men (12).…”

“…An important question for SFL is ultimately what fidelity of the initiative looks like, particularly post pandemic. Indeed, while SFL is currently structured as 10-week intervention with multiple program offerings, this implementation science study highlights that while there should be fidelity to core components of SFL in terms of content to retain effect (31), the process of implementation and key implementation strategies are perhaps more critical to SFL fidelity than strict adherence to program content. In fact the inherent nature of Sheds means a constantly changing practice environment which is a key challenge for implementation research (51).…”

“…That's men for you." -SFL participant Overall at Shed and Shedder level, the implementation of SFL demonstrated feasibility and impact in terms of positive and sustained health and wellbeing outcomes among participants as outlined in a SFL outcomes paper (31). Moreover, SFL successfully transferred across Shed settings demonstrating its transferability and feasibility for scale-up in this regard.…”

“…Therefore, persistent barriers to sustainability and subsequent scale-up of SFL at organizational level are leadership and staff resources: "I think the fact that the program has grown significantly the whole SFL umbrella over the last four years and it was very clear from the beginning there would need to be more staff in order to upscale it and further develop it. So trying to make the case that, that you can't run a national program with one person was something that was challenging" -Organization stakeholder Nevertheless, the evaluation of SFL which demonstrated that the program is cost effective (35), reaches HTR groups (46) and provides important benefits in terms of health and wellbeing for Shedders (31), meant that it was possible to leverage financial support for SFL at a systems level. This meant that the Irish Men's Sheds Association was awarded ongoing funding for delivery costs of SFL under "Sláintecare"-a framework for health service reform in Ireland which focuses on preventative strategies within the community setting (47) which was integrated into a sustainable funding model under the public health framework, Healthy Ireland (42).…”

“…It aimed to investigate both the process and effectiveness of the SFL intervention with a focus on the key strategies involved in implementation and future scale-up to maximize reach to HTR men within the non-conventional settings of Sheds and the wider implementation environment. A detailed protocol which outlines the effectiveness-implementation design is available (19) as well as work which describes effectiveness outcomes (31). This study discusses the implementation research of SFL in terms of the process of implementation, identification of barriers, facilitators and strategies that impact on implementation outcomes, guided by established implementation frameworks (24,32,33).…”