How Masculinity Impedes African American Men From Seeking Mental Health Treatment.

This study addresses the pronounced mental health disparities faced by African American men, characterized by the heightened severity of mental health conditions and their reluctance to seek mental health treatment. Persistent neglect toward the mental health of African American men perpetuates systemic inequities and heightens the stigma surrounding mental well-being within their communities. This study investigates the interaction of masculinity, distrust in doctors, and parental support on attitudes influencing African American men's reluctance to seek mental health care. A survey administered to 74 African American men revealed a negative correlation between masculinity and attitudes toward seeking mental health treatment. In contrast, no significant correlations were found between distrust in doctors and parental support on attitudes toward seeking mental health treatment. These findings were analyzed using Pearson's correlation, underscoring the urgent need to address masculine norms in mental health discourse among African American men. Implications of the findings and future directions for masculinity in African American men are discussed.

Monkeys Predict US Elections.

How people vote often defies rational explanation. Physical traits sometimes sway voters more than policies do-but why? Here we show that rhesus macaques, who have no knowledge about political candidates or their policies, implicitly predict the outcomes of U.S. gubernatorial and senatorial elections based solely on visual features. Given a pair of candidate photos, monkeys spent more time looking at the loser than the winner, and this gaze bias predicted not only binary election outcomes but also the candidates' vote share. Analysis of facial features revealed candidates with more masculine faces were more likely to win an election, and vote share was a linear function of jaw prominence. Our findings endorse the idea that voters spontaneously respond to evolutionarily conserved visual cues to physical prowess and that voting behavior is shaped, in part, by ancestral adaptations shared with nonhuman primates.

Sociocultural and masculinity influences on colorectal cancer screening participation among Hispanic/Latino men in Florida, New York, and Texas.

BACKGROUND: This cross-sectional study explored how masculinity beliefs may influence colorectal cancer (CRC) screening participation among ethnic subgroups of screening-age-eligible (45-75 years) Hispanic/Latino men. METHODS: Using a consumer panel, we recruited self-identified Hispanic/Latino men fluent in English or Spanish, and residing in Florida, New York, or Texas. The Masculinity Barriers to Medical Care (MBMC) scale and its six subscales were used to assess masculinity beliefs. Multivariable logistic regression was used to estimate the association between MBMC and CRC screening participation, adjusting for Hispanic/Latino subgroup, marital status, survey language, age group, and health insurance status. Results were then stratified by Hispanic/Latino subgroup. RESULTS: Of the participants (n=611), approximately 31% identified as Puerto Rican, 30% as other Hispanic/Latino, 26% as Mexican, and 14% as Cuban; 63% had ever been screened for CRC. We found no differences in the prevalence of screening participation by Hispanic/Latino subgroup. The majority of participants had completed both a stool-based test and an exam-based screening test (29.3%). After adjusting for confounding, MBMC reduced the odds of screening participation. Slight MBMC-subscale differences were observed by Hispanic/Latino subgroup. For example, higher scores on the Restrictive Emotionality subscale were associated with a lower likelihood of screening participation among Puerto Rican men, but higher odds of screening for Cuban men. CONCLUSIONS: Masculinity barriers to CRC screening may exist. Tailored interventions to address masculinity barriers among specific Latino subgroups may improve CRC screening uptake in this population.

Deconstructing the Trauma-Altered Identity of Black Men.

Multiple and continuous traumatic events experienced by Black men impose altering effects on their identities, and their mentalization and presentation of themselves in society. However, the unique dynamics of the impact of trauma in shaping Black men's identities are not well understood, because their experiences with trauma are not well documented. This paper is a secondary analysis of the qualitative component of a mixed method study that explored trauma, social support, and resilience among 103 racialized youth survivors of gun violence in Toronto, Canada. The analysis for this paper specifically focused on young Black male participants in the study to understand their disproportional experiences with gun violent trauma. Thematic analysis of their narrative demonstrated three themes: 1) trapped by the trauma of systemic oppression; 2) identity marred by the trauma of systemic oppression; and 3) masculinity shifted by the trauma of systemic oppression. The thematic mapping of themes and subthemes yielded the trauma-altered identity (TAI), a concept coined to represent the intersections of trauma, systemic oppression, masculinity, and the identity of Black male survivors. Using a metaphoric artwork to conceptualise the TAI, we explore its psychosocial impacts and set strategies for deconstructing its influence on Black men. While we acknowledge that trauma experiences may vary among Black males, we recognise that understanding intersections of risks associated with trauma among young Black males presents opportunities for policy discussions, advocacy, and social justice reforms.

Evaluation of male-specific psychoeducation for major depressive disorder compared to cognitive behavioral therapy psychoeducation: A randomized controlled investigation in mentally distressed men.

Background: Research suggests that male-specific psychotherapy approaches for major depressive disorder (MDD) that consider traditional masculinity ideologies (TMI) may achieve improved treatment efficacy and reduced therapy dropout. However, studies examining male-specific psychotherapy for MDD or specific therapy aspects remain lacking. Methods: An anonymous online study on men's mental health examined 152 self-reporting mentally distressed cisgender men (Mage = 25.5 ± 9.1) from German-speaking countries of Europe. After completing baseline assessments (T1) of state self-esteem, state shame, positive/negative affect, depressive symptoms, and TMI, men were randomly assigned to read either a male-specific (MSP) or a cognitive behavioral therapy-oriented (CBT) psychoeducation text for MDD. Immediately afterwards, participants rated its usefulness and completed follow-up assessments (T2). Results: Men in the MSP condition showed a stronger decrease in shame and negative affect as compared to men in the CBT-psychoeducation condition. Furthermore, in the MSP condition, prototypical depression symptoms tended to increase as compared to the CBT-psychoeducation, whereas male-typical externalizing depression symptoms tended to decrease. Conclusion: MSP for MDD may help depressed men feel less ashamed about their MDD and experience less negative affect about their condition than CBT-psychoeducation. Furthermore, MSP for MDD may elicit a shift from male-typical externalizing depression symptoms to prototypical depression symptoms.

Incident, Individual, and Campus Factors Associated with Cisgender Men's Post Sexual Victimization Formal Help Seeking.

INTRODUCTION: This study explored factors associated with help seeking among cisgender men college and university students who experienced sexual victimization. METHODS: We used multilevel logistic regression on data from 33 campuses (n = 4,474 students, 4,674 incidents) to model the association between cisgender men's help seeking and incident, individual, and campus factors. RESULTS: Incident, individual, and campus factors were associated with help seeking odds. Some factors were associated with increased help seeking odds (e.g. perpetrator in a position of power, being gay or having a disability, campus-level racial diversity), others with decreased odds (e.g. drinking before an incident). CONCLUSIONS: Findings have implications for programs and policies. Future studies should attend to the roles of masculinity, power, and campus contexts.

The Commercial Determinants of Men's Health Promotion: A Case Study of Gambling, Nonnies, and Athleisurewear.

Although the social determinants of health have guided equity work with the tailoring of men's health promotion programs, the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood. While four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, there is a need to recognize that consumer goods industries can make both positive and negative contributions to health. This article begins much-needed discussions about what we might learn from, and strategically tap in the commercial sector to seed, scale, and sustain men's health promotion programs. Three case studies, online sports betting, beer and the rise of the nonny, and athleisurewear, are discussed. Connections between online sports betting and masculinities explain young men's disproportionate involvement and gambling addictions with recommendations to legislate an end to gambling advertisements and de-incentivize industry profiteering through penalties and higher taxes. Regarding beer and the rise of the nonny, brewers have innovated with non-alcoholic beer based on shifting consumption patterns and masculinities in their core market-men. The nonny reminds health promoters to know their end-user's values and behaviors to bolster program acceptability. Detailing Under Armour and Lululemon, two highly gendered but diversifying athleisurewear brands, the complexities of, and potential for, leveraging public health and industry collaborations are underscored. Taken together, the article findings suggest men's health promoters should rigorously explore tapping key commercial entities and tax revenues to advance the health of men and their communities.

Overcoming Rape: A Mixed-Methods Approach to Understanding Psychological and Physical Health Functioning of Male Survivors.

When examining sexual assault, men are often hidden from the literature. The current study employed a mixed-methods, convergent parallel design to examine the experiences of 22 male survivors of sexual assault (mean age = 44.19, SD = 13.28, range 18-65; 91% European American; 50% heterosexual). Survivors were administered an online survey using quantitative and qualitative questions to assess rape myths, gender roles, self-esteem, self-efficacy, resiliency, coping, overall mental and physical health, and diagnostic criteria for alcohol abuse, post traumatic stress disorder (PTSD), and sexual dysfunction. Three key themes emerged from the integration of quantitative and qualitative data: (a) Help is Elusive, (b) Internal Struggles and External Strengths, and (c) Living with Clinical Diagnoses. This study adds to an important area of the literature that increases understanding of men's experiences with sexual violence and honors the voices of these survivors.

"A sweet in a polythene is not sweet": men's perceptions of their roles and experiences with family planning in East Uganda.

The significance of men's influence as partners in contraceptive decision-making and family size is often understated, particularly in patriarchal societies. Understanding men's experiences and perceptions of family planning is necessary to address women's unmet needs for contraception. This study examined men's involvement in contraceptive use and decision-making in the Busoga region of east Uganda. Twenty-four in-depth interviews were conducted with both male users and non-users of contraception living in urban and rural areas. Among participants, differences in preferred family size were influenced by competing norms valuing large families and economic wellbeing as reflections of men's role as a provider. Although the majority of interviewees were not opposed in principle to contraception, some men felt contraceptives undermined their own desire for a larger family. Men who supported family planning cited the economic benefits of smaller, healthier families and being able to fulfil their role as the primary breadwinner. Resistance to vasectomy and perceptions of condom use as protection against unwanted pregnancies and STIs/HIV in casual relationships, meant participants were unlikely to use male contraceptives. Efforts to increase contraceptive uptake among men should recognise the socio-cultural context of men's place within Ugandan society, to design reproductive health initiatives that engage men effectively.

Stochastic Gender-Based Violence: How Incels Justify and Encourage Sexualized Violence Against Women.

This study examines how involuntarily celibate ("incels") men justify gender-based and sexualized violence against women. Based on an analysis of 22,060 discussion board comments, we argue that: (1) incel justifications of sexualized violence are tied to their perception of gender relations, (2) incels justify sexual assault as a form of revenge for their incel status, and (3) incels misuse science to argue that women enjoy sexual assault. Adapting the concept of "stochastic terrorism," we argue that incels and similar communities produce stochastic gender-based violence, wherein communities justify and encourage acts of violence. Findings are discussed in relation to gender-based violence, rape culture, masculinities theory, and policy.

Positive masculinity programmes and attitudes towards nonconforming gender identities among young males in urban Democratic Republic of Congo, Nigeria, and Rwanda.

Implementing programmes on sexual and reproductive health and rights (SRHR) in sub-Saharan Africa often involves promoting inclusive sexual identity/orientation. However, whether and how the programmes are changing gender norms in the target populations have not been established. This study was designed to determine whether participation in Positive Masculinity (PM) programmes can change attitudes associated with prevailing gender norms. We explored attitudes towards nonconforming sexual identity/orientation among young males in selected informal settlements in Democratic Republic of the Congo (DRC), Nigeria and Rwanda. The key variables we tested included "country of participation" and other socio-demographics such as "education", "marital status" and "prior residential location" (rural or urban). We found no significant association between participation in PM programmes with attitudes towards nonconforming sexual identities/orientations across our target populations irrespective of educational qualification, marital status, and previous location of residence. By contrast, religious teachings showed up in the qualitative responses as a significant factor influencing young people's resistance to PM programmes' advocating for inclusive sexuality. Additionally, negative masculinity attributes had significant negative association with attitudes towards nonconforming sexual identity, while respondents with violent tendencies showed significant positive attitudes. We conclude that current PM interventions do not significantly contribute to positive attitudes towards inclusive sexuality in DRC, Nigeria, and Rwanda.

La mise en œuvre de programmes sur la santé et les droits sexuels et reproductifs (SDSR) en Afrique subsaharienne implique souvent la promotion d'une identité/orientation sexuelle inclusive. Cependant, il n'a pas été établi si et comment les programmes modifient les normes de genre dans les populations cibles. Cette étude a été conçue pour déterminer si la participation à des programmes de masculinité positive (PM) peut changer les attitudes associées aux normes de genre dominantes. Nous avons exploré les attitudes à l'égard de l'identité/orientation sexuelle non conforme chez les jeunes hommes dans des quartiers informels sélectionnés en République démocratique du Congo (RDC), au Nigeria et au Rwanda. Les variables clés que nous avons testées comprenaient le « pays de participation ¼ et d'autres données sociodémographiques telles que « l'éducation ¼, « l'état civil ¼ et « le lieu de résidence antérieur ¼ (rural ou urbain). Nous n'avons trouvé aucune association significative entre la participation à des programmes de PM et les attitudes à l'égard des identités/orientations sexuelles non conformes au sein de nos populations cibles, indépendamment du diplôme, de l'état civil et du lieu de résidence précédent. En revanche, les enseignements religieux sont apparus dans les réponses qualitatives comme un facteur important influençant la résistance des jeunes aux programmes PM prônant une sexualité inclusive. De plus, les attributs négatifs de la masculinité présentaient une association négative significative avec les attitudes à l'égard d'une identité sexuelle non conforme, tandis que les répondants ayant des tendances violentes montraient des attitudes positives significatives. Nous concluons que les interventions actuelles de PM ne contribuent pas de manière significative à des attitudes positives envers une sexualité inclusive en RDC, au Nigeria et au Rwanda.

Positive masculinity programmes and sexual and reproductive health behaviours among boys and men in poor urban settlements in Democratic Republic of Congo, Nigeria, and Rwanda.

As Positive Masculinity (PM) Programmes continue to develop globally, it is important to examine their role in Sexual and Reproductive Health and Rights (SRHR) outcomes. This multi-country qualitative study was conducted using in-depth interviews (IDI) and focus group discussions (FGDs) with community members, beneficiaries and implementers of PM programmes. The findings show that PM programmes are designed using a gender lens to make boys and men more aware and conscious of harmful masculinity traits and their effect on SRHR. The beneficiaries of the interventions report imbibing positive SRHR behaviours by being sexually responsible - upholding sexual rights, taking precautions against sexually transmitted Infections (STIs) and learning proper communication with their partners. They also report acting as vanguards of positive gender norms to their families and peers. Although there are challenges in implementing PM programmes, the results of the study suggest that interventions targeting boys and men hold promise for improving boys' and men's health behaviours and promoting gender equality in poor urban settings.

Alors que les programmes de masculinité positive (PM) continuent de se développer à l'échelle mondiale, il est important d'examiner leur rôle dans les résultats en matière de santé et de droits sexuels et reproductifs (SDSR). Cette étude qualitative multi pays a été menée à l'aide d'entretiens approfondis (IDI) et de discussions de groupe (FGD) avec des membres de la communauté, des bénéficiaires et des responsables de la mise en œuvre des programmes PM. Les résultats montrent que les programmes PM sont conçus en utilisant une optique de genre pour rendre les garçons et les hommes plus conscients des traits de masculinité néfastes et de leurs effets sur la SDSR. Les bénéficiaires des interventions déclarent avoir adopté des comportements positifs en matière de SDSR en étant sexuellement responsables ­ en respectant leurs droits sexuels, en prenant des précautions contre les infections sexuellement transmissibles (IST) et en apprenant une bonne communication avec leurs partenaires. Ils déclarent également agir en tant qu'avant-gardes des normes de genre positives auprès de leurs familles et de leurs pairs. Bien que la mise en œuvre des programmes PM présente des difficultés, les résultats de l'étude suggèrent que les interventions ciblant les garçons et les hommes sont prometteuses pour améliorer les comportements de santé des garçons et des hommes et promouvoir l'égalité des sexes dans les milieux urbains pauvres.

Nurturing Black Male Mental Health Through the Black Church: A Conceptual Approach from a Social Work Perspective.

This article introduces a conceptual framework rooted in social work principles to support the mental well-being of Black males within the nurturing and supportive setting of the Black Church. It addresses how historical trauma, societal views of Black masculinity, and social determinants of health have made Black men more likely to experience mental health challenges. The framework combines vulnerability theory and social work theory to focus on Black men's strengths and cultural sensitivities. It emphasizes the Black Church as a critical resource for promoting mental wellness and resilience. The approach includes implementing effective interventions to challenge stigma, improve the availability of mental health services, and encourage Black men to seek assistance. This article presents a holistic approach aimed at addressing mental health disparities experienced by Black males. It proposes using the strengths of the Black Church to promote resilience, facilitate healing, and encourage Black men to prioritize their mental well-being.

The enduring echoes of juvenile bullying: the role of self-esteem and loneliness in the relationship between bullying and social media addiction across generations X, Y, Z.

Objective: Being bullied is a profoundly distressing experience for children and adolescents, with the potential for adverse mental and behavioral outcomes throughout their adult years. This study aims to explore the association between juvenile bullying, self-esteem, loneliness, and social media addiction among men across three generational cohorts: X, Y, and Z. Method: The study utilized an online survey, administering structured questionnaires to 797 men aged 18-58 divided into three generational cohorts: 142 individuals from Gen X (born between 1965 and 1980), 275 from Gen Y (born between 1981 and 1996), and 380 from Gen Z (born between 1997 and 2005). Results: The findings demonstrate that across all three generations, there was a positive correlation between experiencing bullying in one's youth and social media addiction in adulthood. Among Gen X, self-esteem did not act as a mediator in this relationship, nor did loneliness moderate the links between bullying and social media addiction, or between self-esteem and social media addiction. However, for Gen Y and Z, self-esteem was found to mediate the relationship between bullying and social media addiction. Loneliness moderated the association between self-esteem and social media addiction in Gen Y and the association between bullying and social media addiction in Gen Z. Conclusion: The differences observed among generational cohorts can be attributed to changes in masculinity norms, the evolution of bullying types, and the rapid development of social media platforms, catering to the distinct needs and gratifications of each generation.

The Sexual Double Standard toward Non-Heterosexual Populations: Evaluations of Sexually Active Gay Men and Lesbian Women.

We examined the sexual double standard (SDS) toward sexually active gay men and lesbian women and the role that participants' masculinity and femininity played in their evaluations. We hypothesized that there would be a reverse SDS in which highly sexually active lesbian women would be evaluated positively and highly sexually active gay men negatively, with both being evaluated more negatively than less sexually active gay men and lesbians. We also hypothesized that masculinity would moderate this effect, with participant masculinity being positively related to stronger negative evaluations of highly sexually active gay targets and more positive evaluations of highly sexually active lesbian targets. Results indicate a weak SDS in the areas of likability and morality, with highly sexually active lesbians being liked by masculine participants the most and highly sexually active gay men being rated as the least moral. The SDS appears to be influenced by expectations of gender roles and may be reversed for gay men and lesbian women because of these expectations.

A Grounded Theory Approach to Understanding Men Confronting Infertility.

Purpose: This study aims to delve into the process of men confronting infertility. Design: This research employed the Straussian grounded theory approach. Methods: The study encompassed interviews with 16 participants from a private fertility center in Isfahan, Iran, between March 2023 and March 2024. The interviews were semistructured. Data analysis was carried out concurrently using constant comparative methods and standard grounded theory techniques. the participants' main concerns were identified, culminating in developing a substantive theory centered around a core category. Findings: The primary category for men struggling with infertility was "forced concealment." This was exhibited through the suppression of emotions, maintaining secrecy about infertility, hiding treatment, and attributing infertility to their wives to counteract threats to their masculinity. Factors such as partners, family, societal surroundings, care providers, and beliefs influenced the adopting of the "forced concealment" strategy. Conclusions: The "forced concealment" theory offers insights into the experiences of men struggling with infertility. The study highlights the necessity of formulating culturally sensitive strategies that enable healthcare providers, nurses, and health system managers to effectively fulfill their roles and address the challenges and needs of couples confronting male infertility. This can be realized through a comprehensive approach that integrates nursing skills and competencies.

Perception of Femininity and Masculinity in Voices as Rated by Transgender and Gender Diverse People, Professional Speech and Language Pathologists, and Cisgender Naive Listeners.

OBJECTIVE: To explore whether cisgender naive listeners, transgender and gender diverse (TGD) listeners, and speech-language pathologists (SLPs) experienced in providing gender-affirming voice training differ in their perception of femininity and masculinity in voices. METHODS: Samples of spontaneous speech were collected from 95 cisgender, and 37 TGD speakers. Three listener groups of cisgender naive (N = 77), TGD (N = 30), and SLP (N = 14) listeners, respectively, rated the voices on visual analog scales in two randomly ordered blocks, in which the perceived degree of femininity was rated separately from the perceived degree of masculinity. RESULTS: The three listener groups showed similar patterns in their distribution of ratings on the femininity and masculinity scales. The TGD listeners' mean ratings did not differ from the cisgender naive listeners', whereas SLPs showed a small, but significant, difference in their ratings compared with both TGD and cisgender naive listeners and rated the voices lower on both the femininity and masculinity scales. CONCLUSION: The results differ from previous studies as TGD, and cisgender naive listeners rated the voices very similarly. The lower ratings of femininity and masculinity by the SLPs were likely influenced by their awareness of the complexity in the perception of voices. Therefore, SLPs providing gender-affirming voice training should be attentive to how their professional training may influence their perception of femininity and masculinity in voices and encourage discussions and explorations of the TGD voice client's perceptions of voices.

How Does Masculinity Play a Protective Role for Gay Men? The Mediation Effect of Mindfulness Between Gender Role and Mental Distress.

Masculinity is validated as a protective factor in mental health for gay population. However, potential mediators between masculinity and mental health remain unclear. Mindfulness, as one of the individual's traits has been proved to play an essential role on mental health. Yet the correlation between mindfulness and masculinity has barely been examined, and whether mindfulness could serve as a key mediator to explain the protective effect masculinity bringing to mental health for gay men remains unknown. To test this hypothesis, we recruited 210 gay men in China to conduct online questionnaires containing scales of FFMQ, BSRI, DASS-21 and demographic features. Based on mediation analysis, we found among gay men, mindfulness significantly mediates the negative relationship between masculinity and stress (SIE (standardized indirect effect) = -.20, 95% CI [-.28 -.11]), anxiety (SIE = -.17, 95% CI [-.26 -.09]) and depression (SIE = -.20, 95% CI [-.29 -.11]). Furthermore, by decomposing sub-dimensions of mindfulness, we found both "describing" and "acting with awareness" exhibit significant mediation effects between masculinity and mental distress. We further found "being analytical", one key sub-dimension of masculinity, positively correlates with mindful describing (r = .369, p < .001). Our results indicate that trait mindfulness serves as a core mediator between masculinity and mental health, the key trait in masculinity (being analytical) closely connects with the essential element of mindfulness (describing) and low in masculinity might undermine gay men's abilities of acting with awareness (staying focused). Our findings may also shed light on developing gay men-aimed mindfulness-based clinical interventions.

PeerOnCall: Exploring how organizational culture shapes implementation of a peer support app for public safety personnel.

BACKGROUND: Public safety personnel (PSP) such as firefighters, paramedics, and police are exposed to traumatic situations, which increase their risk for mental health issues. However, many PSP do not seek help in a timely manner. Peer support interventions have the potential to decrease stigma and increase treatment-seeking behaviours among PSP. However, little is known regarding how the organizational culture of public safety organizations (PSOs) affects the implementation of a peer-based intervention. This study aims to understand the extent to which organizational culture, including masculinity contest cultures (MCC), within Canadian PSOs could affect implementation of PeerOnCall, a new peer support app for PSP. METHODS: A qualitative multiple case study design was adopted, integrating semi-structured interviews with organizational champions from five PSOs. One to three champions from each PSO acted as key informants regarding their organizations. Interviews explored champions' perceptions of how organizational culture might shape implementation. Interview data were analyzed using inductive thematic analysis. RESULTS: Three themes were identified in analysis of the champion interviews. The first theme focused on external drivers and the second theme focused on internal drivers of organizational culture shift. The third theme focused on how culture can create resistance to implementation. Importantly, the MCC norm of show no weakness was described as a source of potential resistance when implementing the app. CONCLUSIONS: Each PSO had a unique and changing culture. Understanding how champions anticipate the role of culture in shaping implementation of an app-based intervention like PeerOnCall can guide the creation of contextually relevant strategies that optimize implementation within PSOs. Recommendations for optimizing implementation and areas for further study are provided.

Promoting men's health through sports clubs: A systematic rapid realist review.

BACKGROUND: Health promotion (HP) interventions delivered through sports clubs have demonstrated promising outcomes among men, but less is known about which aspects of the interventions work, for whom, and under what circumstances. This rapid realist review aims to understand the contexts, mechanisms, and outcomes of HP interventions for men delivered through sports clubs. METHODS: A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SPORTDiscus databases. INCLUDED STUDIES: (a) were delivered by or in collaboration with sports clubs, (b) targeted men aged 18+ years, and (c) reported 1 or more HP outcome. A grey literature search was also performed. Studies were included in a realist synthesis based on richness and rigor. Hereafter, context-mechanisms-outcome (CMO) configurations were developed. RESULTS: We identified and screened 3356 studies, finally including 60 studies describing 22 interventions. Most HP interventions were delivered in high income countries, included Caucasian men aged 35-65 years with overweight/obesity, and used professional sports clubs (mostly football) for recruitment and facilities. Quantitative HP outcomes were reported across 19 interventions. Of these 19 interventions, the majority reported on weight (n = 18), physical activity (n = 12), mental health (n = 10), and diet (n = 9). We identified 12 CMOs related to how HP interventions affected men's recruitment, engagement, and health behavior maintenance. CONCLUSION: Our findings show that using sports clubs for HP interventions is effective for engaging men. Recruitment was facilitated by leveraging sports clubs' identity, addressing masculinity-related barriers, improving accessibility, and building trust. Engagement was enhanced through shared identity experiences, safe spaces, inclusive competition, and self-efficacy. However, there's limited evidence on behavior maintenance post-intervention, though involving community stakeholders seemed vital. In general, considerations should be made to avoid perpetuating traditional masculine norms, which may exclude some men and reinforce unhealthy behaviors. These findings can guide intervention development, emphasizing the need to harness men's perspectives in the process.