Australian men’s help-seeking & engagement with general practice

<p dir="ltr"><b>Background:</b> Males have a lower life expectancy than females. Modifiable lifestyle risk factors such as being overweight, smoking, having a poor diet, harmful alcohol intake, and physical inactivity increase men’s risk of developing chronic health conditions. General practice is a key health setting for the delivery of preventive care. However, when males present to general practice, they often do so when a condition is more advanced, reducing the potential for preventive care and early intervention. This significantly impacts illness trajectory and prognosis.</p><p dir="ltr"><b>Aim: </b>This Doctoral Project explored Australian men’s engagement with general practice for preventive healthcare.</p><p dir="ltr"><b>Methods:</b> A sequential explanatory mixed methods Project was undertaken, underpinned by pragmatism. To provide a group of men with varying socioeconomic, geographical and educational characteristics, this study recruited males who were employed by or volunteered for the New South Wales Rural Fire Service.</p><p dir="ltr">The first phase used an online survey to explore health literacy, understand their current lifestyle risks and investigate their engagement with preventive care. The survey tool comprised three sections. The first section sought participants demographics, the second consisted of health-related questions, lifestyle risk factors and engagement with healthcare. The final section comprised the validated Health Literacy Questionnaire. Data were analysed using descriptive and inferential statistics.</p><p dir="ltr">In the next phase, semi-structured interviews were undertaken using a qualitative descriptive approach to understand the men’s experiences engaging with general practice and in accessing and receiving preventive care. Data were analysed using the thematic analysis approach described by Braun and Clarke.</p><p dir="ltr"><b>Findings: </b>The survey received 431 responses, with 52.9% (n=228) coming from men living in rural areas. Findings revealed that some 18.6% (n=80) of respondents were in the healthy range based on body mass index calculations, yet just 29.9% (n=129) had been told by their doctor that they were overweight/obese. Only 11.1% (n=48) of respondents consumed the recommended vegetable serves per day, and a third (n=92; 33.3%) of those aged under 64 years met physical activity guidelines. Most (n=344;79.8%) respondents had a regular General Practitioner (GP)/general practice. Having a regular GP/general practice was significantly associated with participants engaging in all preventive and screening activities (p<0.05), except having a dental check-up. Health literacy was significantly related to participants’ age, income and urban/rural location (p<0.05).</p><p dir="ltr">Seventeen semi-structured interviews were conducted via video conferencing. Five sub-themes emerged about men’s engagement with general practice. ‘Reasons for engagement’ highlighted men’s motivation to help-seeking. ‘Seeking validation’ explained how social influences impacted healthcare engagement. Whilst ‘importance of relationships’ identified the value that men have with the healthcare team and the impact this has on healthcare engagement. ‘Interpersonal communication’ highlighted the need for authentic communication. Finally, ‘barriers to engagement’ identified the challenges in accessing care in general practice.</p><p dir="ltr">Two sub-themes were identified relating to men’s engagement in preventive healthcare. ‘The scope of general practice services’ highlighted men’s varied perceptions of the role and value of preventive care. ‘Addressing lifestyle risk factors’ revealed the communication and advice provided about lifestyle risks and behavioural change.</p><p dir="ltr"><b>Conclusion: </b>The Project has generated new knowledge about men’s engagement with general practice for preventive care. Findings have established that many men have existing connections with a GP/general practice, do not always see general practices’ role in prevention, and that there are missed opportunities to address lifestyle risk factors. Even though our findings indicated that men attend general practice, their engagement is not optimised to support and promote their health and well-being. To provide the care that men want and need from general practice, health professionals must prioritise preventive care and support men to make informed decisions about their health and lifestyle choices and reduce the impact of chronic health conditions. Organisational, educational and ongoing funding support for general practice is crucial to ensure person-centered quality healthcare is provided to all.</p>