Bridging the Gap: Harnessing Community Health Workers to Boost Men's Health

by Kaylyn A. Garcia

Men have shorter life spans and higher rates of preventable illnesses and diseases than women. Despite these concerns, men are less likely to seek preventive healthcare and engage in health promotion efforts – things that have led them to be called a “hard to reach” group. However, research among men has shown that men really do care about their health. This represents a significant contradiction. On one hand, you have men not engaging in healthcare or health promotion and on the other hand, you have research indicating that men do care about their health. This contradiction highlights the need to improve health promotion efforts among men.

Existing research can help inform efforts to improve health promotion among men. For example, there is widespread support in existing research that shows that men are more likely to engage in health promotion efforts that are tailored (e.g., recognize the unique barriers to engaging in health among men and the unique strengths and sources of motivation of men) for men and that include large numbers of other participating men. Because of this existing research, it is likely that Community Health Worker (CHW)-led health promotion programs may be uniquely positioned to promote health among men. This is because CHWs are health promotion specialists who are trusted members of the community that are being served. Because they are trusted members of the community, and share many experiences with the community, they have a close understanding of the community’s needs and values.

Therefore, this scoping review (i.e., a review of available research articles to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct) focuses on health promotion efforts conducted by CHWs to improve men’s health. This scoping review is the first of its kind. This review identified only 24 CHW-led health promotion programs that focused on men’s health. Research articles summarized in this review were compiled and assessed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework, a framework that is used to gather useful information about health promotion efforts. Findings from this review revealed that of the 24 programs, most of the CHW-led programs focused on underserved men (e.g., Hispanic men, Black men, inmates, men who have sex with men).

Additionally, it was found that the programs were able to recruit men and keep them engaged. Most of the health promotion efforts resulted in an ability to improve the health among men. Commonly targeted outcomes included colorectal cancer screening and sexual health practices among others. The results also found that most programs took place in a community-based setting (e.g., community center) and were developed in partnership with the men from the target community. This aligns with prior research indicating that men prefer community-based health programming rather than programming that takes place in traditional healthcare systems (e.g., doctor’s offices).

Although this review confirmed that CHW-led men’s health promotion programs are uniquely positioned to improve men’s health, the review found some significant gaps that should be addressed by future CHW-led health promotion efforts among men. For example, of the 24 programs, few focused on mental health and few focused on prosocial aspects of masculinity and gender ideals to promote health. Research indicates that men report high rates of mental health concerns such as stress and depression, but given the rates of men dying by suicide and using abusing substances it appears that those issues are often underdiagnosed in men. Research also indicates that traditional forms of masculinity, such as “being a man” and a “tough guy”, can get in the way of designing and implementing health promotion interventions for men.

The results of the present review conclude with suggestions for future CHW-led health promotion efforts among men. First, carrying out CHW-led programs may be a reasonable strategy to promote health and prevent health concerns among men – a group that has been underserved by health promotion programs in the past. Such programs would benefit from tailoring the program to the needs of men and incorporating the voices of men in the target group as early as possible.

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Article Details
Community Health Worker Interventions for Men: A Scoping Review Using the RE-AIM Framework
Guillermo M. Wippold, Kaylyn A. Garcia, Sarah Grace Frary, Derek M. Griffith
First Published June 23, 2023 Review Article
DOI: 10.1177/10901981231179498
Health Education & Behavior

About the Author

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Kaylyn A. Garcia (she/her) is a doctoral student in the Clinical-Community Psychology program at the University of South Carolina. As a community-engaged researcher, she is passionate about partnering with communities to promote collective well-being. Her work is centered on the theories and principles of Community Psychology and implemented utilizing a Community-Based Participatory Research (CBPR) framework to address health disparities and promote systems-change. Prior to her doctoral program, she worked for two years as a Senior Research Assistant at The Consultation Center at Yale University, completed her Master’s degree in Community Psychology at the University of New Haven, and her Bachelor’s degree in Psychology at Western Oregon University.