Prick and a Pint: Growing men’s health literacy, one group at a time

Amanda Lyons

30/11/2018 2:48:11 PM

newsGP looks at an innovative community health program that aims to empower men to take control of their own health.

Dr Rebecca McGowan (left) wants to change the current paradigm of men’s health education.
Dr Rebecca McGowan (left) wants to change the current paradigm of men’s health education.

Although we are witnessing changes that have led to increased opportunities for women in public life, it remains, in many ways, a man’s world.
But there is one particular area in which men still trail women – health.
Men have a lower life expectancy, and tend to have poorer health-related behaviours than women. These differences in health outcomes are also often exacerbated by living in rural and remote areas.
However, Dr Rebecca McGowan, a GP who has worked in rural areas for 20 years, would like to change that. She has developed an innovative, GP-delivered health education program named ‘Prick and a Pint’, or PNAP for short.
‘I strongly feel there needs to be a change from the current paradigm of men’s health education. As in, rolling out an ex rugby or footy star to the local RSL to talk about prostate cancer,’ Dr McGowan told newsGP.
‘The beauty of [PNAP] is that we get men who normally don’t see a GP or, if they do, they bounce from one GP to the next – no continuity of care, no understanding of prevention and their role in it.
‘We feel we are bringing the mountain to Mohammed.’
The ‘pint’ aspect of PNAP refers to the fact the program involves groups of men who meet in the local pub at a set time once a month for educational and discussion sessions with a GP, during which each participant receives a free pint (or non-alcoholic drink).
Groups are run by volunteer GPs with support from Dr McGowan, who is PNAP’s founding medical director. That support includes a script that covers off the main points with plenty of room for each GP to fill in the gaps.
Georgia Ramsden is a medical student researcher from the University of Melbourne’s Department of Rural Health who has been involved in evaluating PNAP. She describes GPs as central to the project’s success.
‘They are responsible for the delivery of the educational material, and help set the tone and facilitate the group,’ she told newsGP. ‘They need to be trusted and respected by members of the group.’
The ‘prick’ aspect of the program refers to the fact men are encouraged at the start of PNAP to establish an ongoing relationship with a GP and take a set of recommended blood tests.
‘We don’t go through their individual blood results in the program, but we do talk about things like, “This is what you would expect your cholesterol to be”; cardiovascular risk percentages and what we’re aiming for; blood sugar levels, so they can go back and reflect on their own results and see how they compare,’ Dr Christie Rodda, a GP who has been involved in PNAP since it began three years ago, explained.
Dr Rodda has found the men in her group to be extremely engaged and interested – to the point where group meetings often run longer than they are scheduled.
‘I give them a talk for supposedly 30–45 minutes. In my group’s case, it often goes to more like an hour, an hour and 15 minutes,’ she said.
‘I think too often in medicine we dumb things down or we don’t give enough information and education, and we underestimate the appetite for learning about one’s own health. I’ve got a group of guys who, once you start talking about a little bit of basic physiology, they just love it and they go to town with their questions. It really keeps me on my toes.’

Prick-and-a-Pint-Article-(1).jpgDr Christie Rodda (top right) said she has found increasing men’s health literacy with the Prick and a Pint project extremely satisfying.
Dr Rodda has found the PNAP group has encouraged positive changes among the men who attend.
‘Every single one of them has made definitive, long-lasting changes in their health,’ she said.
‘For example, a couple of them have said, “I never drink soft drinks anymore. I wasn’t aware they were so bad”. There are others that have really increased their exercise every week, or reduced their alcohol intake.’
The groups have also encouraged deeper connection between members, and benefits have even spilled out beyond the group itself.
‘That regular engagement once a month with a group of guys who are all on the same page, breaking down those barriers about talking out loud about things, including mental health and relationships, it’s developed a sense of camaraderie and teamsmanship within that group,’ Dr Rodda said.
‘And they are now health advocates in our small community who are more confident to talk to their mates, to say, “How are you going? You seem like you’re not going okay anymore, perhaps you’d better go and see a GP”.’
After initially running as five pilot groups in north-east Victoria, there are now plans to roll out the PNAP program nationally from January 2019, beginning in New South Wales and South Australia in addition to Victoria.
‘We did find the program worked in a way that empowered the participants,’ Ms Ramsden said. 
‘Various aspects helped to give the men a sense of control over their health and the decisions they made regarding their health, and this may have made it easier to improve health related behaviours in their own lives.’
Dr McGowan is proud of PNAP’s achievements and is looking forward to expanding nationwide.
‘Men become more of an expert rather than “the dummy” in the house regarding their own health issues,’ she said. ‘We have also improved the men’s relationships with their GPs and understanding of the health system and their role in it.’
Dr Rodda has found the experience of PNAP very fulfilling, and encourages other GPs to get involved.
‘It’s a fantastic opportunity for men in the community, but it’s just such a great opportunity for GPs as well,’ she said.
‘It’s very satisfying to think that you’re making an impact and educating a population, which we do every day in every single consult. But to be able to do it in such a clear, effective way en masse, that’s not within our own ranks – we’re all used to educating our own registrars and medical students, but to actually educate our population in this kind of setting is very satisfying.
‘It really is a wonderful program to be engaged in from a GP point of view, too.’

Men’s health PNAP Prick and a Pint

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