# Mechanisms of change in a gender-sensitized health intervention: the mediating role of health self-efficacy

## TL;DR

This study explores how a health program for men improves health by helping them challenge traditional masculinity and boosting their confidence in health behaviors.

## Contribution

The study identifies health self-efficacy as a key mediator in the effectiveness of gender-sensitized health interventions for men.

## Key findings

- Health behavior and self-efficacy improved after participating in the program.
- Decreased conformity to masculine norms was linked to better psychological outcomes.
- Changes in health self-efficacy fully mediated the relationship between masculinity norms and health outcomes.

## Abstract

Men’s lower life expectancy has been in part attributed to adherence to masculine stereotypes restricting health promoting behaviors. Health-specific self-efficacy beliefs are theorised to contribute to these outcomes and recent research suggests addressing the link between masculinity and these beliefs is a key pathway to men’s health promotion. Gender-sensitised health interventions show promise for helping men overcome health barriers as the “safe space” provides opportunity to broaden perspectives of masculinity, contributing to increases in health self-efficacy, which then mediates improved health outcomes. This study aimed to address gaps in previous research by examining this mechanism of gender-sensitised health promotion longitudinally in an intervention context.

A sample of 295 men participating in the Sons of the West (SOTW) 2019 program, a 10-week gender-sensitised, community-based health program, were measured pre-program and post-program to longitudinally assess changes in health outcomes. Regression analyses were used to test a mediation model of health behavior change.

Findings showed improvements in health behavior, health self-efficacy, psychological distress, and decreased conformity to masculine norms. Residualized scores of the changes from pre-intervention to post-intervention indicated the changes in health self-efficacy fully mediated the relationship between changes in conformity to masculine norms and changes in health behavior and psychological distress.

Results suggest the key mechanism of change was the provision of opportunities for men to negotiate masculine stereotypes thus increasing health self-efficacy and explaining health improvements. This study utilized data from a real-world, large-scale men’s health program but was limited to two waves of data. Future research and implications are discussed.