Men's Health Research

Overview

The Shape the Path research program, funded by the Canadian Institutes of Health Research (2015-2019), aims to generate comprehensive and action oriented information to improve the health of older men.

The Issue

The World Health Organization tells us that “mobility…is the best guarantee of retaining independence and being able to cope” – especially as we age. We broadly refer to mobility as the physical capacity of individuals to move. Mobility is a key factor to one’s health and is embedded into the activities we perform every day.

Limited mobility is a significant risk factor for further physical disability and brain health impairments – and is associated with an increased risk of early death. Therefore, maintaining mobility is fundamental to healthy aging and to retaining one’s independence for as long as possible. This is particularly true for men who are at high risk for diseases often born of inactivity (e.g., cardiovascular disease, diabetes).

However, currently in Canada little research evidence exists about the factors that influence older men’s mobility in their homes and neighbourhoods.

Our Research Questions

  1. What are older men’s understandings and experiences of mobility, including its relationship to their health?
  2. What are the determinants (barriers and facilitators) and outcomes of older men’s mobility in three distinct settings (community, home, residential care)?
  3. What are effective practices in optimizing mobility for older men?
  4. What factors influence individual and community based agency and government stakeholders’ implementation of best practices related to mobility and health?

To address these questions, the Shape the Path program includes five central projects, each with distinct and overlapping parts:

Jump to:
Seek to understand
Men on the move
Mobile at home
Safe mobility
Definition of terms

1. Characterizing mobility trends in Canadian men, across life stages: What can we learn from national survey data?

A more in-depth understanding of older men’s behaviour across the population at large is crucial to help direct targeted attention to increase health promoting behaviour.   At different life stages, certain individual- and neighborhood-level factors may carry stronger influences. For example, life changes such as giving up a drivers’ license, may change the destinations one can access, their use of public transit, or engagement in social activities. This project is an in-depth examination of data from national surveys (e.g., Canadian Community Health Survey-Healthy Aging Survey in the Statistics Canada Research Data Centre) to help us learn more about activity (or inactivity) behaviours, how this differs for men and women, and across time and geographical location.

2. Seek to Understand

The purpose of this study is to better understand older men’s experiences of their mobility, and to hear their views on what helps them be more able, and what makes them less able to move about their homes and neighbourhoods, and the importance of this in their daily lives. We will gather this information primarily by using qualitative methods. This includes spending time with the men and asking questions as they go about their usual activities. To hear a range of perspectives we will talk to 25-30 men over the age of 60 from different cultural backgrounds and living situations in the Greater Vancouver area. This will include men living at home with or without home care services, and men who live in residential care.

3. Men on the Move

Men on the Move is an intervention study designed to promote mobility for men through the uptake of physical activity among men over the age of 60 who are physically inactive. Specifically, Men on the Move is evaluating the effects of a choice-based physical activity model paired with an active transportation model. The choice-based physical activity model encourages older men to use existing community-based resources to create and implement actions plans for physical activity. It also provides ongoing face-to-face and telephone-based support. The active transportation model provides transit passes and personal travel planning to promote use of transit and walking to destinations of interest. The Men on the Move study team uses cutting-edge tools, such as accelerometry and travel diaries, to measure the effects of these intervention strategies on physical activity. 

4. Mobile @ Home

More than 1.4 million Canadians receive publicly-funded home care services annually and this number is expected to increase.  Home care clients often have limited mobility, compounded by physical inactivity. This renders them at risk for falls and fractures which lead to mobility-disability. Older people who sustain a fall-related injury often require more home care support.

Physical activity and functional re-training reduces the risk of mobility-disability.

The core focus of Mobile @ Home is to:

  1. Determine the characteristics of older people in receipt of home care with specific attention to their mobility (‘who are these people?’).
  2. Identify the key features and feasibility of a physical activity intervention for older people receiving home care using a (re)ablement approach (‘what do they need/want to aid mobility?’).
  3. Apply this research knowledge and intervene with this targeted physical activity program. 

5. Safe Mobility for Men in Residential Care

For older men in residential care (RC), mobility is often challenging due to the associated risk for falls and injuries. This project seeks to develop best practices for care providers in promoting safe mobility in RC. Our objectives are to:

  1. Analyze the biomechanics of safe mobility in men in RC, by measuring real-life movement patterns (walking, transferring, falls, and near falls) with video and wearable sensors. Tracking men over time, we will compare tasks performed successfully versus unsuccessfully (leading to imbalance and/or falling). We will also examine balance recovery and injury avoidance strategies in falls and how clinical, environmental, and behavioural variables associate with safe mobility and falls.

  2. Develop a physical activity (PA) handbook for men in RC. The handbook will be informed by: (i) literature synthesis; (ii) evidence on how falls occur in RC; and (iii) surveys with care providers on the PA programs available to men in RC, and how the success of these programs depends on demographic and clinical characteristics. 

Terms and Definitions

PHYSICAL ACTIVITY

Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. World Health Organization

MOBILITY

Mobility is the physical capacity of humans to walk or move themselves within their homes and communities. Mobility includes modes of transport (walking, biking and motorized), and policies that facilitate and encourage Canadians to move (such as community design). Canadian Institutes of Health Research

How do ‘mobility’ and ‘mobility-disability’ relate to physical activity-physical inactivity?

Mobility is a ‘capacity’ whereas physical activity is something that a person does or does not do. By analogy, a person is either ‘able to read’ or ‘unable to read’ (i.e., mobility or mobility-disability). A person capable of reading may choose to read or not (i.e. physically active/inactive). A person unable to read may take steps to be able to read (i.e. undertake physical activity despite mobility-disability).

BUILT ENVIRONMENT

The built environment consists of: the design of and elements within cities (e.g., urban design); land use patterns (e.g. location of buildings, amenities and services) and the transportation network (e.g. roads, sidewalks and transportation services) (Handy, 2002).

SOCIAL ENVIRONMENT

The social environment refers to the immediate physical and social settings where people live and/or where daily and special events and interactions occur. It includes the culture that the individual was educated or lives in, and the people and institutions with whom they interact. Social environments can be experienced at multiple scales, often simultaneously, including households, kin networks, neighborhoods, towns and cities, and regions (Barnett and Casper, 2002).

HOME CARE

The term home care generally refers to services provided in the home or in the community to individuals (and families) with functional disabilities. These services can range from home support, such as a few hours a week of simple housekeeping, to full nursing and medical care, such as administering intravenous medications which were previously done only in hospitals. Home care is also provided on a short-term basis to assist people who are discharged from acute care hospitals. In addition, home care can provide palliative care, respite care and other related services to those in need. (National Evaluation of the Cost Effectiveness of Home Care)

(LONG TERM) RESIDENTIAL CARE

Long-term residential care services provide 24-hour professional supervision and care in a protective, supportive environment for people who have complex care needs and can no longer be cared for in their own homes or in an assisted living residence. Long-term residential care services include:

  • Basic daily living (accommodation, food etc);

  • Development and maintenance of a care plan;

  • Clinical support services (e.g., rehabilitation and social work services) as identified in the care plan;

  • Ongoing, planned physical, social and recreational activities (e.g., exercise, music programs, crafts, games). (Government of British Columbia)

SEX

Refers to a set of biological attributes in humans and animals. It is primarily associated with physical and physiological features including chromosomes, gene expression, hormone levels and function, and reproductive/sexual anatomy. Sex is usually categorized as female or male but there is variation in the biological attributes that comprise sex and how those attributes are expressed. (Canadian Institute for Health Research)

GENDER

Refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men, and gender diverse people. It influences how people perceive themselves and each other, how they act and interact, and the distribution of power and resources in society. Gender is usually conceptualized as a binary (girl/woman and boy/man) yet there is considerable diversity in how individuals and groups understand, experience, and express it.

Gender and sex are interrelated. There is no simple "recipe" for integrating gender and sex in health research (or for accounting for the complex interrelationships between them and other factors or determinants of health). (Canadian Institute for Health Research)

Press kit

Shape the Path program overview (pdf)

Definition of terms (pdf)

Logos

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