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Gender and health class 2nd feb 2016

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Gender and health class 2nd feb 2016

  1. 1. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Gender and Health 2nd Feb 2016 Dr Matt Maycock MRC|CSO Social and Public Health Sciences Unit, University of Glasgow matthew.maycock@glasgow.ac.uk
  2. 2. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Session overview • Theories of gender and health • Theories of masculinity • Theories of masculinity applied to a health promotion intervention - Fit for Life • Practical application of theories of masculinity to a health promotion resource
  3. 3. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. DEFINITIONS • Sex – biological or genetic differences between men and women. Largely universal. • Gender – socially/culturally constructed differences between men and women. Variable. • Sexism – the personal and institutional differentiation of power and status between the sexes which limit opportunities for girls and women. • Gender/sex role – pattern of behaviour a particular society expects from individuals of either sex. Learned through socialisation.
  4. 4. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Recognising the Social Construction of Gender ‘Gender refers to women’s and men’s roles and responsibilities that are socially determined. Gender is related to how we are perceived and expected to think and act as women and men because of the way society is organised, not because of our biological differences’. Gender and Health, WHO (1998:5)
  5. 5. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. THE SECOND SEX ‘In truth, to go for a walk with one’s eye open is enough to demonstrate that humanity is divided into two classes of individuals whose clothes, faces, bodies, smiles, gaits, interests and occupations are manifestly different. Perhaps these differences are superficial, perhaps they are destined to disappear. What is most certain is that they do most obviously exist.’ Simone De Beauvoir – 1953
  6. 6. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Social explanations of gender differences • Feminine traits are de-valued and under- valued by society. • Women as relative beings – ‘woman as other’. • Men are the ‘unmarked’ or norm
  7. 7. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Explanations Cont. • The process of socialisation places men in a different position to women: a masculine (hegemonic) archetype • Traditional notions of masculinity position men as ‘breadwinners’, risk takers (in terms of hazardous work – industrial accidents, contact with harmful substances, and other pursuits such as sport, sex, violence and health damaging behaviours – smoking and excessive alcohol intake) See Doyal, L. (2002) in Bendelow, G. et al (eds) Gender, Health and Healing. London:Routledge.
  8. 8. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Social or Biological? ‘Men’s health is not a medical issue, it is societal’ argues White (2001:3) Equally, argues Doyal (2002), this is the case for women also – both nationally and globally.
  9. 9. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Difference/sameness debate • Why should any difference – if it exists, or we believe it to – be constructed as disadvantage, particularly for women? • If we are the same – the problem of women's relative disadvantage and lack of power remains unresolved. • What needs to be addressed is not are we the same or different, but what structures exist which convert this into disadvantage?
  10. 10. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Gender & health inequalities ‘Women get sicker but men die quicker’ (Miers, 2000) Morbidity rates are higher for women Mortality rates are higher for men
  11. 11. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Statistically Speaking… • Life expectancy is higher for women than men: in 2001 life expectancy at birth for women was 80.4 years compared with 75.7 for men. • Life expectancy for men has been increasing faster than for women: an increase of 4.8 years for men, and 3.6 years for women between 1981 and 2001.
  12. 12. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. More stats… • In 2001 obesity levels were similar for both sexes: nearly half of men were considered overweight, compared with a third of women • Underweight: men 4%, women 6% • Men twice as likely to exceed recommended daily benchmarks for alcohol consumption (3-4 units daily for men, 2-3 for women) • Young men more likely to binge drink • Student drinking levels/behaviours revealed no significant differences between the sexes!
  13. 13. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. CRITIQUE THE PICTURE IS MORE COMPLEX • Age ranges are significant. • Men have higher rates of serious illness than women • Women have higher consultancy rates than men – particularly GP contact
  14. 14. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Impact on Health Women may still (just) have some advantage over men in life expectancy, may seem to get ‘sicker’ (higher rates of morbidity), may be protected to some extent from CHD due to oestrogen levels – but their changing patterns of behaviour are giving cause for interest and concern: women are becoming more like men, and thus experiencing similar health problems.
  15. 15. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. • To examine gender differences in consulting in primary care in the UK population using routinely collected general practice data. ▪ • To explore whether gender differences remain when consultation for reproductive reasons or treatment for common underlying morbidities are accounted for.
  16. 16. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.
  17. 17. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. • The crude consultation rate was 32% lower in men than women. • The magnitude of gender difference varied across the life course, and there was no ‘excess’ female consulting in early and later life. • The greatest gender gap in primary care consultations was seen among those aged between 16 and 60 years. • Gender differences in consulting were higher in people from more deprived areas than among those from more affluent areas. • Accounting for reproductive-related consultations diminished but did not eradicate the gender gap. • However, consultation rates in men and women who had comparable underlying morbidities (as assessed by receipt of medication) were similar
  18. 18. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. • Conclusion: Overall gender differences in consulting are most marked between the ages of 16 and 60 years; these differences are only partially accounted for by consultations for reproductive reasons. • On average, men consulted less than women between the ages of 16 and 60 years, but not at younger and older ages. • After controlling for medication for common underlying morbidities (depression and cardiovascular disease), gender differences in the use of primary healthcare services reduce substantially and are modest.
  19. 19. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Why are women the main consumers of health care? • Women assume main responsibility for contraception • Women encounter medical profession during pregnancy and childbirth • Women assume prime responsibility for well and sick children • Women’s anatomy is seen to be more complex than men’s and appears to be more likely to succumb to health problems and illness • Traditionally women have been seen to be frail – medicine has capitalised on women’s perceived weaknesses ( from the vapours to pms) • Women see themselves as ill more often than men
  20. 20. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Hegemonic Masculinity, Raewyn Connell (2005)
  21. 21. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Hegemonic Masculinity • “hegemonic masculinity” - a form of masculinity that is dominant in society, establishes the cultural ideal for what it is to be a man, silences other masculinities, and combats alternative visions of masculinity. • Hegemonic masculinity’ is a concept that draws upon the ideas of Gramsci. It refers to the dynamic cultural process which guarantees (or is taken to guarantee) the dominant position of men and the subordination of women. • hegemonic masculinity - rejection of the idea that all men are the same
  22. 22. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Hegemonic Masculinity Cont… • a change from the concept of masculinity to the concept of masculinities • allows meaningful distinction between different collective constructions of masculinity and identification of power inequalities among these constructions. Masculinities: • Are actively constructed (not biologically determined) • Are dynamic- change over time • Have negative impacts- be tough don’t cry, can lead to disengagement, health problems, aggression, overwork and lack of emotional responsiveness.
  23. 23. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Criticisms (V. Seidler) • Leaves gender roles, and in particular patriarchy unchallenged • Leaves out personal and emotional perspectives- emotional lives of men ignored. • “There is a danger of creating a fixed category of ‘abusing men,’ rather than learning how pregnancy invokes unresolved emotional feelings in men” • Is often applied to research quite uncritically
  24. 24. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Inclusive Masculinity, Eric Anderson (2009)
  25. 25. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. • Eric Anderson’s theory of Inclusive Masculinity describes changes in the ways some men conceive of and enact their masculinity. Employing ethnographic methods and “social- feminist thinking” (14) • Inclusive masculinity, like hegemonic masculinity, frames gender (partially) in terms of power relations. However, it suggests a shift toward a more egalitarian conception of masculinity and a less rigidly vertical notion of hierarchy • Anderson claims that “university-attending men are rapidly running from the hegemonic type of masculinity that scholars have been describing for the past 25 years” (4). Inclusive Masculinity (2009)
  26. 26. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. • Connell’s definition of “hegemonic masculinity”—emerges as insufficient for describing “the complexity of what occurs as cultural homohysteria diminishes.” To rectify this shortfall, Anderson proposes “inclusive masculinity theory,” his own “new social theory” (7). • homohysteria “describes the fear of being homosexualized,” • diminishing “homohysteria,” which Anderson defines as combining “a culture of homophobia, femphobia, and compulsory heterosexuality” (7). Inclusive Masculinity
  27. 27. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Criticisms (de Boise, 2014) • Misread hegemonic masculinity to be a type of person as opposed to a web or matrix of configuration • Assumes that hegemonic masculinity is inflexible and doesn’t adapt to periods of low homohysteria • Assumes a singular dominant ideal, but Connell uses a multidimensional understanding of gender • Claims of a ‘decline’ homophobia and homohysteria are questioned; can levels of prejudice be objectively established; are acts like same-sex kissing indicative of attitudes, is homophobia is really as insignificant as inclusive masculinity claims.
  28. 28. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Prison masculinities and health in Scotland (post-doc)
  29. 29. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Can FFIT be adapted to attract men to positive lifestyle change in a prison? Football Fans in Training (FFIT) has helped overweight and obese men lose weight, improve diet, and increase physical activity (Hunt et al, The Lancet, 2014)
  30. 30. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Context Prisons are largely all-male environments p-FFIT delivered to men-only groups Content Info about science of weight-loss presented simply Role of alcohol in weight management FFIT logo branding Delivery notes adapted to take account of prison context Style of delivery PEIs have detailed knowledge of prison context Participative and peer-supported learning Encouraged male banter to facilitate discussion of sensitive topics Testing feasibility of delivering an adapted version of FFIT, Fit for Life was delivered in two prison gyms over course of 10 weeks
  31. 31. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Methods Prison A Delivered to 18 prisoners by prison Physical Education Instructors (PEIs) Data collection Observations of all 15 sessions Interviews with participants who completed programme (n=9) Interviews with participants who did not complete (n=3) Focus group with PEIs (n = 1) Delivered to 21 prisoners by community coaches from a professional football club Data collection Observations of all 12 sessions Interviews with participants who completed programme (n=9) Interviews with PEIs and staff (n=3) Prison B
  32. 32. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Health in prison contexts Context-specific challenges to prisoners’ mental and physical well-being The prevalence of overweight and obesity among male prisoners in the UK is ‘unacceptably high’ (Herbert et al, 2012) Many prisoners do not take given opportunities to eat healthily and exercise regularly and are less likely to achieve recommended minimum PA guidelines (Herbert et al, 2012)
  33. 33. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Prison masculinities In (largely male) prisons environments, there are performances of masculinity that are structured in hierarchical ways in reference to both orthodox/hegemonic' and 'inclusive' masculinities Orthodox/ hegemonic masculinity " inclusive form of masculinity based on social equality for gay men, respect for women, and racial parity and one in which... men bond over emotional intimacy" (Anderson, 2008, 604) "masculine performance labeled as orthodox attempts to approximate the hegemonic form of masculinity, largely by devaluing women and gay men." (Anderson, 2005, 338) (Bourdieu, 1998) (Connell, 1995) Inclusive masculinity
  34. 34. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Prison is an ultramasculine world where nobody talks about masculinity. (Sabo et al 2001, 3) …a hegemonically defined hypermasculine and heteronormative environment with an abundance of alpha males, sexism, and violence. (Jenness and Fenstermaker, 2013, 13) …prison facilities are a particular kind of institutional setting, one that actively resists the diversity of masculine practices and identities. (Curtis, 2014, 121) …places of great humour and playfulness, of friendship and camaraderie, of educational enlightenment, of successful therapeutic intervention. (Jewkes, 2013, 14). in their mutual support and encouragement, it was also possible to discern sublimated forms of intimacy. Certainly, the vivid and joyful ways in which prisoners engaged in collective exercise, and the sheer amount of physical horseplay among younger prisoners, pointed to submerged emotional sentiments. (Crewe et al, 2013, 11) Orthodox/ hegemonic prison masculinities Inclusive Prison masculinities
  35. 35. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Orthodox masculinities in the context of the Fit for Life programme I can understand aboot guys being apprehensive an’ that, ken I think when, especially wi’ everybody else in the hall, ken, an’ you’re goin’ and they’re goin’ “aye, goin’ tae fat club,” an’ a’ this carry on, ken whit I mean? So I could imagine people being apprehensive aboot it, eh. (Prison A - P2) I was hammering everybody fae the word go. I'm the sort o' person, see once I get up there I don't like anybody beating me, you know? Determined an' that, you know? (Prison B - P11) Ken what I mean? I’ll par—ken, I’ll... I’ll take—I’ll partake in anythin’ eh? And as I say when, ken when I got there I was like that, ‘right, fair enough.’ I mean you’re only putting your view forward. I mean we’re in a hostile situation here, eh? And people dinnae want tae speak forward in case the boy, “he’s a fucking idiot,” excuse my French. (Prison A - P11)
  36. 36. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Inclusive masculinity within the context of the Fit for Life programme I think it was a part of—it was being a part of a group. On the outside I’m a lone person. I’m no’ part of any group. So see learning in a group, and interacting wi’ people, and speaking to people in the group that kept me motivated as well. (Prison A - P11) it was important for me tae, for me tae do my thing and for me tae tell people that they was doing good at their thing, and encouraging them and pushing them and stuff like that. (Prison A - P3) Well you’re having a laugh wi’ people and it’s like yous are losing a wee bit o’ weight an’ you’re kinda like, it’s just you’re no’ coming an’ you’re no’ like if you’re coming tae the gym, it’s like you’re no’ the fattest person in the gym. So you’re here and yous are all kinda fat, yous are all here for the same reason. (Prison B - P3)
  37. 37. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Embodied masculinity - The gym, muscularity and weight You’ve gottae get big, aye, you’ve got a group, your group o’ guys, that’s what they’re intae, their bodybuilding an’ they’re strength things like that. (Prison A - P8) You want everybody tae go intae a prison an' they all want tae dae the weights, they a’ want tae get big an' strong. That's what they all want tae dae. (Prison B P11) I actually get people that go like that, “oh how long did it take you to get that [large] size?” And this is the first time I’ve ever trained in my life! Know what I mean? And I’ve just worked hard at it, and worked hard, and I explain that to guys. I just, know what I mean? Guys were all wanting to get like me, and like as big as me kinda thing. (Prison B-P1)
  38. 38. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Changes to bodies and appearance I think people in general do take a lot more care of themselves nowadays and it happens more in prison. So you're not automatically in inverted commas 'a poof' if you use face cream and keep yourself clean and... yeah. (Prison A - P4) When I lost weight I kind o'... I like tae keep my strength up an’ I felt as if when I was losing my weight that I was losing my strength as well, that my strength was falling away. (Prison B - P11) Some people don't care aboot themselves 'cause they're in the jail, they've hit rock bottom. (Prison A - P7)
  39. 39. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Orthodox to Inclusive masculinity - Group dynamics I think it was a part of—it was being a part of a group. On the outside I’m a lone person. I’m no’ part of any group. So see learning in a group, and interacting wi’ people, and speaking to people in the group that kept me motivated as well. I mean I enjoyed the group. It’s one of the biggest things I’ll take away fae it has been involved in the group. (Prison A - P11) ...you dinnae want tae be yourself, ‘cause you just single yoursel’ oot, ken whit I mean? As I say you can put yourself the gither as a team an’ you take it on as a team, ken whit I mean? An’ you support each other through it. (Prison A - P2) Yeah, there was two lads in particular that were like really taking the piss an’ I didn’t enjoy that bit. No-one had control over them. D’you know what I mean? But other than that everything went really, really well. (Prison B - P5)
  40. 40. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Results - ActiGraph data – Total Moderate to Vigorous Physical Activity (MVPA) (HMP Perth and Kilmarnock, Phase three) Mean 54.70956504 Mean 81.0760771 0 20 40 60 80 100 120 140 Basline 12 week M i n u t e s
  41. 41. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Results - ActiGraph data: Sedentary time (HMP Perth and Kilmarnock, Phase three) Mean 473.475067 Mean 427.5057823 0 100 200 300 400 500 600 700 Basline 12 week M i n u t e s
  42. 42. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Results - ActiGraph data: Step counts (HMP Perth and Kilmarnock, Phase three) Mean 8817.266193 Mean 12522.58197 0 2000 4000 6000 8000 10000 12000 14000 16000 18000 20000 Basline 12 week S t e p s
  43. 43. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Results - Self reported - Portion sizes (HMP Perth and Kilmarnock, Phase three (14 participants)) 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Cheese Pasta Meat Chips Baseline 12 weeks
  44. 44. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Results - Self reported – Self-Esteem (HMP Perth and Kilmarnock, Phase three (14 participants)) Mean 14.54545455 Mean 15.22727273 8 10 12 14 16 18 20 baseline 12 weeks
  45. 45. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Fit for Life - Conclusions • Masculinity has shaped the planning and the experience of engagement in the Fit for Life programme. • An approach to men's health similar to that taken by FFIT has the potential to be successfully adapted for secure settings. • A gender and context sensitised health promotion intervention has the potential to facilitate engagement with a cohort of hard to reach and disadvantaged men in a secure setting. • Performances of both hegemonic/orthodox and inclusive forms of masculinity were evident amongst men who took part in the Fit for Life programme. • Programmes such as Fit for Life have the potential to enhance more inclusive forms of masculinity. • There are many, often contradictory implications for masculinities in taking part in programmes to enhance health and wellbeing.
  46. 46. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Practical exercise In groups think about a health promotion resource in the form of a leaflet that will communicate men or boys about health. • Consider how the theory/s of gender/ masculinity will shape the resource • Consider how you will design the leaflet in a gendered way • Consider about what subjects/issues you will cover
  47. 47. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Masculinity and health – the Haynes Man Manuals Men&Work Warning: Reading this may seriously improve your health
  48. 48. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Masculinity and health – the Haynes Man Manuals
  49. 49. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Questions/ Comments

Hinweis der Redaktion

  • The Football Fans in Training (FFIT) programme is a group-based, gender-sensitised weight management, physical activity and healthy lifestyle programme which is delivered through Scottish Professional Football League football clubs. In this community setting, FFIT has attracted overweight and obese men and helped them to lose weight, improve their diet and increase physical activity. Following expressions of interest from other stakeholders, we wanted to see if a) FFIT could be translated to other settings, without compromising the integrity of the programme, and b) could engage different target groups within these novel settings. In this paper, we’re asking whether FFIT can be adapted to attract men to positive lifestyle change in a prison?
  • These borrow heavily on the main FFIT adaptations.

    Adapting FFIT for prisoners (p-FFIT) capitalises on the known appeal of football to this disadvantaged and excluded population,

    Context –

    Content – mention literacy issues
    This is quite different to the main FFIT study given that the p-FFIT participants supported quite a wide range of football clubs.

    Delivery – stress the impressive work of the PEIs

  • 18 men were recruited to p-FFIT, a pilot version of FFIT adapted for the prison setting, by prison physical exercise instructors. P-FFIT was delivered in the prison gym by PEIs over the course of 15 weeks (including baseline measures and a graduation week).
    We evaluated p-FFIT to assess the programme’s potential to recruit prisoners to lose weight and become more active, improve health behaviours and deliver physical and mental health benefits.

    Data collection included:
    Collection of a number of objective, self-report and biomarker measures (at baseline, post-programme, and at 6, 9, and 12 months)
    Observations of all 15 sessions
    Interviews with participants who completed the programme
    Interviews with men who do not complete the programme
    A focus group with the PEIs
    There is significant movement of prisoners within the prison system, which makes
    measuring participants challenging.

    Ethical approval was gained from the College of Social Science, Glasgow University and NHS Greater Glasgow and Clyde West of Scotland Research Ethics Board.

    Due to time restrictions, we won’t be reporting the results of the quantitative data or PEI focus group in this presentation.
  • Men living within prisons experience many context-specific challenges to their mental and physical well-being, which are often compounded by lifetime disadvantage that makes the adoption of healthier practices particularly difficult.

    The prevalence of overweight/obesity among male prisoners in the UK is ‘unacceptably high’ (even though previous substance misuse can lower BMI for some prisoners).

    Despite being given opportunities to eat healthily and take part in PA, many prisoners choose not to do so, and they are less likely to achieve recommended minimum PA guidelines than non-incarcerated men.

    National recommendations suggest using prison settings to promote PA, healthy eating and wellbeing.

  • *Towards the end of the programme fidelity declined noticeably (I have removed this as a bullet on slide but you could just say it instead)

    I have also taken out coaches from the 4th bullet as we haven’t mentioned anything about external coaches before this.

  • *Towards the end of the programme fidelity declined noticeably (I have removed this as a bullet on slide but you could just say it instead)

    I have also taken out coaches from the 4th bullet as we haven’t mentioned anything about external coaches before this.

  • Read through inclusion and exclusion criteria.

    Elevated BP = systolic≥160mmHg and/or diastolic≥100mmHg (I’ve taken off slide)

    This give a sense of the sorts of prisoners we were trying to attract to the programme, although participants did not have to meet all three inclusion criteria.
  • Read through inclusion and exclusion criteria.

    Elevated BP = systolic≥160mmHg and/or diastolic≥100mmHg (I’ve taken off slide)

    This give a sense of the sorts of prisoners we were trying to attract to the programme, although participants did not have to meet all three inclusion criteria.
  • Read through inclusion and exclusion criteria.

    Elevated BP = systolic≥160mmHg and/or diastolic≥100mmHg (I’ve taken off slide)

    This give a sense of the sorts of prisoners we were trying to attract to the programme, although participants did not have to meet all three inclusion criteria.
  • Read through inclusion and exclusion criteria.

    Elevated BP = systolic≥160mmHg and/or diastolic≥100mmHg (I’ve taken off slide)

    This give a sense of the sorts of prisoners we were trying to attract to the programme, although participants did not have to meet all three inclusion criteria.
  • Read through inclusion and exclusion criteria.

    Elevated BP = systolic≥160mmHg and/or diastolic≥100mmHg (I’ve taken off slide)

    This give a sense of the sorts of prisoners we were trying to attract to the programme, although participants did not have to meet all three inclusion criteria.
  • For more on FFIT, please see (cf. Hunt et al (2014), A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet, April)

    We will present findings on the acceptability of the programme to prisoners and staff, and on the potential for such approaches to improve the health of a vulnerable group of men.
  • For more on FFIT, please see (cf. Hunt et al (2014), A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet, April)

    We will present findings on the acceptability of the programme to prisoners and staff, and on the potential for such approaches to improve the health of a vulnerable group of men.
  • For more on FFIT, please see (cf. Hunt et al (2014), A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet, April)

    We will present findings on the acceptability of the programme to prisoners and staff, and on the potential for such approaches to improve the health of a vulnerable group of men.
  • For more on FFIT, please see (cf. Hunt et al (2014), A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet, April)

    We will present findings on the acceptability of the programme to prisoners and staff, and on the potential for such approaches to improve the health of a vulnerable group of men.
  • For more on FFIT, please see (cf. Hunt et al (2014), A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. Lancet, April)

    We will present findings on the acceptability of the programme to prisoners and staff, and on the potential for such approaches to improve the health of a vulnerable group of men.
  • *Towards the end of the programme fidelity declined noticeably (I have removed this as a bullet on slide but you could just say it instead)

    I have also taken out coaches from the 4th bullet as we haven’t mentioned anything about external coaches before this.

  • with the majority of participants having maintained or put on weight between enrolment and session five
  • with the majority of participants having maintained or put on weight between enrolment and session five

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