michael j. rovito, ph.d., ches, fmhi kenyatta rivers, phd kathy e. rovito, mph, ches social...

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Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS: WHAT’S THE CONNECTION?

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Page 1: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

Michael J. Rovito, Ph.D., CHES, FMHI

Kenyatta Rivers, PhD

Kathy E. Rovito, MPH, CHES

SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT

MALE HEALTH BEHAVIORS:

WHAT’S THE CONNECTION?

Page 2: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

A LITTLE BACKGROUND….

My science?

Male health behavioral sciences

Faculty in the Department of Health Professions

Founder and Chairman of Men’s Health Initiative, Inc.

Page 3: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

PURPOSE OF THIS DISCUSSION….

To discuss a few things about young adult and adolescent males

(YAAM) that you may not know

To discuss different ways to outreach to this population

To discuss different methods in research

within this population

But first, let’s discuss some general concepts

of male health

Page 4: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:
Page 5: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:
Page 6: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:
Page 7: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:
Page 8: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:
Page 9: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

Male health community

consolidation

Policy agendas and statement

pieces

Expanding body of

research

•Men’s Health Initiative•Men’s Health Collaborative

•Men’s Health Network

•APHA’s Men’s Health Caucus

•National Policy•Fatherhood Policy

•Epidemiological assessment

•Behavioral interventions

WHAT ARE SOME TRENDING

EFFORTS IN MALE HEALTH?

Page 10: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

OVERVIEW OF YAAM PERIOD (AGES ~13-26)Review of the ‘young adult and adolescent male’ period Staging point in life

Influenced by: social indicators, pop culture, peers (subjective norms)

Influenced by: desire for independence (thought and directive control)

Dynamic life: physiologically, socially

This dynamism can influence health behaviors

Significant differences is mortality/morbidity gender and age differences

YAAM’s are 10x more likely to engage in delinquent behaviors as children and 5x maturing into adolescence

~200% increased mortality risk, more prone to injury than YAAF’s

Higher likelihood of risky behaviors (smoking, binge drinking, illicit drug use, social isolation, sexual promiscuity, thrill-seeking) than males 26+

A need presents itself

Page 11: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN MALE HEALTH?

The BIG C’s:

Prostate cancer

Testicular cancer

Being male:

Masculinity

Gender norms

Risk-taking behaviors:

Suicides/accidents

Homicides/accidents

Receptive male sexual assault

Raising awareness:

IDM

Promotions

Communication-improvement

Well, what about issues related specifically to

YAAM’s?

Page 12: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN YAAM HEALTH?

Performance-enhancing substancesPressure to excel

Pressure from peers

Ease of access/Ubiquity of it all

(Buckman et al, 2009)

Page 13: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN YAAM HEALTH?

Main points

1. PES use associated with severe adverse health behaviors more so

than non-PES users

2. Many new forms of PES available (non-prescription meds)

3. The behaviors associated with PES use decreases athletic performance

(Buckman et al, 2009)

Page 14: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN YAAM HEALTH?

Masculinity and Energy Drink Consumption

Pressure to excel during competition

Pressure from team to compete

Perceived weakness if fatigue is shown

Ease of access/Ubiquity of it all

(Wilmer and Levant, 2013)

Page 15: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN YAAM HEALTH?

Main points

1. Health risks (p. 318 excerpt)

2. Toxic jocks (p. 319 excerpt)

3. Theory: “Jocks” consume more energy drinks than “athletes”

(Wilmer and Levant, 2013)

Page 16: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN YAAM HEALTH?

Masculinity and InjuriesPressure to excel (professional

sports)

Pressure from team

Perceived weakness

(Rovito and Alfonso, 2014)

Multiple Comparisons

Tukey Post-hoc Analysis

Dependent

Variable

(I)

Mascul_Categ

ory

(J)

Mascul_Categ

ory

Mean

Differenc

e (I-J)

Std.

Error

Sig. 95% Confidence

Interval

Lower

Bound

Upper

Bound

Conceal

1.00

2.00-1.76505* .5143

2

.003 -2.9922 -.5379

3.00-2.91792* .5016

6

.000 -4.1149 -1.7210

2.00

1.001.76505* .5143

2

.003 .5379 2.9922

3.00-1.15287* .4214

2

.021 -2.1584 -.1474

3.00

1.002.91792* .5016

6

.000 1.7210 4.1149

2.001.15287* .4214

2

.021 .1474 2.1584

Team

1.00

2.00-1.96296* .3667

7

.000 -2.8384 -1.0875

3.00-3.13488* .3535

2

.000 -3.9787 -2.2910

2.00

1.001.96296* .3667

7

.000 1.0875 2.8384

3.00-1.17192* .3022

4

.001 -1.8934 -.4505

3.00

1.003.13488* .3535

2

.000 2.2910 3.9787

2.001.17192* .3022

4

.001 .4505 1.8934

*. The mean difference is significant at the 0.05 level.

High fear of losing spot on team and concealing an injury was also predicted by high masculinity scores

Page 17: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

WHAT ARE SOME SPECIFIC TRENDING TOPICS IN YAAM HEALTH?

Multiple Comparisons

Tukey Post-hoc Analysis

Dependent

Variable

(I)

Mascul_Categ

ory

(J)

Mascul_Categ

ory

Mean

Differenc

e (I-J)

Std.

Error

Sig. 95% Confidence

Interval

Lower

Bound

Upper

Bound

Conceal

1.00

2.00-1.76505* .5143

2

.003 -2.9922 -.5379

3.00-2.91792* .5016

6

.000 -4.1149 -1.7210

2.00

1.001.76505* .5143

2

.003 .5379 2.9922

3.00-1.15287* .4214

2

.021 -2.1584 -.1474

3.00

1.002.91792* .5016

6

.000 1.7210 4.1149

2.001.15287* .4214

2

.021 .1474 2.1584

Team

1.00

2.00-1.96296* .3667

7

.000 -2.8384 -1.0875

3.00-3.13488* .3535

2

.000 -3.9787 -2.2910

2.00

1.001.96296* .3667

7

.000 1.0875 2.8384

3.00-1.17192* .3022

4

.001 -1.8934 -.4505

3.00

1.003.13488* .3535

2

.000 2.2910 3.9787

2.001.17192* .3022

4

.001 .4505 1.8934

*. The mean difference is significant at the 0.05 level.

Main points

1. Athletes with higher reported perceived masculinity scores will conceal their injuries more often than those with lower reported

scores.

2. Those with higher masculinity scores indicated that they feel a stronger sense of

commitment to their teammates

3. Those with higher masculinity scores indicated that more fearful of an athletic

injury than those having a lower masculinity score.

(Rovito and Alfonso, 2014)

Page 18: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

OVERVIEW OF YAAM PERIOD (AGES ~13-26)

Methodological and Topical Gaps Descriptive evidence abounds

But…..

Narrow focus on major health concerns

Sexual activity

Drug use

Violence

Masculinity (but only recently has this seen an upsurge in focus)

TCa ONLY just started receiving any comprehensive focus

Page 19: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

ARE WE MISSING ANYTHING?

Perhaps….

….Therefore, we need to “groundtruth” the issues

We need….

….An inductionist perspective; qualitative; ground-up approach

We need to determine….

….What are the salient factors predicting how YAAM make decisions?

Page 20: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

YAAMHBIS

Young Adult and Adolescent Males Health Behavior Indicators Scale Phenomenological design

Introspection

Journaling and Focus Group activities

Being a man is harmful to one’s health?

Why would this off-color comment be relevant here?

Sometimes, it may be true….

How does it tie in here?

Privacy….reflection…..breaking the dam

Would you feel comfortable talking about your testicles, sexual activity, or if your father was a good/bad father to other males?

Page 21: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

YAAMHBISYoung Adult and Adolescent Males Health Behavior Indicators Scale Phenomenological design

We need to assess at the individual level these individual perceptions, try to assess the “true” variance in perceptions

Only when we get this groundtruth can we begin to start compiling evidence to create codes/topics/general ideas shared across males

Too many times these types of tools, studies, outreach programs, etc. are created from a top-down approach

Issues with validity abound

How do you know if your ideas of what is important to males really is important?

Page 22: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

YAAMHBISYoung Adult and Adolescent Males Health Behavior Indicators Scale Phenomenological design

This approach attempts to get at the intentionality of different objects, events, or topics for each individual male

What one male thinks is a violent situation is not the same across all males……

What about ideas of what “man” is, what they think a good family or father looks like, a bad family or bad father, or even risky sexual activity?

IT ALL DIFFERS

What if my green is your blue?

What if my idea of a good family differs from yours?

What if I think competition and violence in society is a positive thing and your negative?

Page 23: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

YAAMHBISYoung Adult and Adolescent Males Health Behavior Indicators Scale Purpose

Determine the role of popular social and health indicators in the decision-making process of YAAM behaviors

Sometimes what is reported as an indicator in AYM lives may not actually be a true indicator of total wellness

Comprehensive assessment tool to measure what the true indicators are for AYM

Implications

Getting a truer sense of behavioral predictors and influence

We need to figure out how AYM truly think about these supposed influential topics in their lives….maybe what we think is their blue really is their red?

Improving the lives of YAAM to help foster a true public health contribute to the goals and objectives of HP2020 and ACA

Page 24: Michael J. Rovito, Ph.D., CHES, FMHI Kenyatta Rivers, PhD Kathy E. Rovito, MPH, CHES SOCIAL INDICATORS AND YOUNG ADULT AND ADOLESCENT MALE HEALTH BEHAVIORS:

THANK YOU FOR YOUR TIME

Contact information:

[email protected]

(407) 823-3888

@RovitoMJ

www.MHInitiative.org