Identifying barriers and strategies to increase older male participation in evidence-based health promotion programs

Background: Evidence-based health promotion programs are effective at helping older adults to prevent and manage chronic health conditions and to improve their quality of life, but participation by males is suboptimal. The Healthy Aging Regional Collaborative (HARC) offers evidence-based programs in physical fitness, disease management, and fall prevention to older adults in south Florida. Males represent 44% of the population age 60 and older in counties where HARC offers programs, but males represent only 19% of HARC participants.

Methods: Formative research was conducted to identify barriers to male participation and strategies to increase male participation. A survey was sent to HARC coordinators and to instructors who taught HARC workshops between October 2008 and November 2013 (n=281). Response percentages were calculated for fixed-choice questions and qualitative analysis was used for open-ended questions. 

Results: The majority of respondents agreed that machismo or cultural beliefs (75%) and the perception of exercise programs as feminine (80%) were barriers to participation. Themes from qualitative data on barriers included 1) feeling outnumbered by women, 2) preference for other activities, 3) gender roles, and 4) negative perceptions of health promotion programs. The strategies perceived as most likely to increase participation included advertisements highlighting male participation (95%) and endorsement of programs by male community leaders (91%).

Conclusions: To increase male participation in evidence-based health promotion programs, it may be necessary to address men's perceptions regarding health promotion, match health promotion activities with the preferences of men, and improve advertising efforts.