By Ewan Walker, Population Health Sciences (PhD)
I recently completed some Patient and Public Involvement and Engagement (PPIE) discussion sessions in collaboration with China Harrison at the University of Bristol. Funded by the Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science and Evaluation (BSE) Dragons Den initiative our aim was to explore men’s knowledge of testicular health and fertility (i.e. male reproductive health).
This was to inform the development of a grant application China was working on to co-develop a reproductive health intervention with men to improve their awareness, knowledge and timely help-seeking behaviour in the event of a concern. When I initiated this work, I reflected on my experience of learning about male reproductive health in my younger years – which was non-existent. To me, this highlighted the relevance and importance of this work, in addition to the need to actively involve men in shaping how research in this area is developed, conducted and communicated.
What we wanted to find out?
We explored:
- Men’s awareness and knowledge of reproductive health
- Their thoughts on creating an intervention to improve it
- What they believed such an intervention should include
Why it matters?
Male factors are involved in around half of all heterosexual couples’ fertility challenges, yet many men remain unaware of their reproductive health, associated risks, signs and symptoms of problems with their testicles and how to seek help. This knowledge gap can have serious consequences. It is therefore important to collaborate with men to gain valuable insight into understanding the reasons why this may be, explore possible ways to improve awareness and knowledge, enhance help-seeking behaviour, and develop effective interventions in this area
Who took part?
We engaged with men aged 16–48 from diverse backgrounds, including those with and without personal experience of testicular or fertility issues. This helped us better understand age-specific needs and existing barriers to care
What did we do?
China distributed adverts asking men to volunteer to participate in one of three online group discussion sessions. The three sessions covered the age groups: 16-18 years, 19-25 years and 26-48 years and each session included men from diverse socio-demographic backgrounds with and without personal experience of testicular health and/or fertility issues. I then facilitated each of these sessions. Each session covered:
- Awareness of testicular health and fertility.
- Experiences or knowledge of available services
- Ideas for improving awareness and communication.
I tailored each discussion to the group’s dynamic to ensure a comfortable, open environment. For example, I structured the discussion differently depending on the group’s tone, interest, level of collaboration and active participation. This style allowed for a more conversational and natural feeling to the session which I feel allowed, and even encouraged, them to comfortably share their perspectives and thoughts freely. This is something I wanted to ensure because of the sensitive nature of the discussion, the age groups of those involved and having men with and without personal experience of testicular health and/or fertility issues.
What did we find out?
Some key insights from the discussions included:
- The lack of knowledge and awareness of male reproductive health and associated services available regardless of age.
- A strong desire for safe, non-judgemental spaces to talk.
- consensus that awareness raising is crucial, especially via social media, though it must be used carefully. .
- Embarrassment and stigma remain major barriers.
- Early education from a young age is key.
Real-world impact?
This work directly shaped a new grant application to co-develop a male reproductive health intervention. Participants will continue to be involved if the project is funded—a great example of research being shaped by those it aims to benefit.
Personal Reflection
As an early-career researcher, leading these sessions was both challenging and incredibly rewarding. Facilitating the PPIE sessions came with various challenges including the difficulty of bridging the input received from members of the group, ensuring each input was acknowledged and validated while also trying to maintain a focused but natural discussion. Maintaining a good balance was difficult. However, I really enjoyed how engaged all the groups were. Naturally, some individuals were shyer than others, but I found myself being somewhat constrained by the allocated time of the sessions as, as the session went on, conversations progressed and were often in full flow when it was time to end. Hearing men’s honest views was powerful. The experience has helped me grow professionally and confirmed how essential it is to involve the public meaningfully in research.
Not only have I gained experience and transferable skills for my own research moving forward, but I have also been able to contribute to a project in a research area that I believe has great potential moving forward. I would like to thank China Harrison, the University of Bristol and the BSE Dragon’s Den funding initiative for the opportunity to be introduced to facilitating PPIE activities.
