The Men's Center Approach: Ecological Interventions for College Men's Health

College men are facing a health crisis. Although many men experience positive, healthy outcomes of male socialization on individual (e.g., heroism, bonding and caring through action, self-reliance, use of humor) and group (e.g., humanitarian work, team orientation) levels (Kiselica & Englar-Carlson, 2010), researchers have found that men who adhere to more restrictive notions of masculinity are at higher risk for encountering significant, negative health outcomes (O'Neil & Crasper, 2011). In particular, college men have been identified as a group of men facing a health crisis. For example, compared with college women, college-age men participate in more harmful behaviors, such as consuming large quantities of alcohol, abusing substances, and pursuing unsafe sexual encounters (Bonar et al., 2011; Borsari, Murphy, & Barnett, 2007). Furthermore, approximately 10% of college men admit to at least one incidence of physical aggression toward a partner (Gallagher & Parrott, 2011). College men are also less likely to engage in health-promoting behaviors, such as preventive care (Courtenay, 2011; Courtenay, McCreary, & Merighi, 2002), are 3 times as likely as female peers to complete suicide (Centers for Disease Control and Prevention [CDC], 2009), and account for roughly two thirds of deaths among individuals ages 15-24 (U.S. Department of Health and Human Services, 2008). College men also hold more unrealistic health beliefs (e.g., compared with their female counterparts, they evaluate problems associated with marijuana as less severe and less likely) and doubt their vulnerability to contract disease (Courtenay et al., 2002) despite much higher rates of sexually transmitted infections compared with women (CDC, 2009; Courtenay, 2011). All of these behaviors and outcomes are intertwined with the university community and beyond in terms of bidirectional influences with men's families, roommates, friends, fraternity brothers, coworkers, classmates, neighborhoods, and religious communities. However, despite conceptual and empirical advancements in the scholarship on men and masculinity, few have attended to interactions among the multiple systems in which men are embedded, and few have connected men's health risks with the contextual demands and developmental tasks that occur alongside gender role socialization (O'Neil, 2008). We use Bronfenbrenner's ecological model (Bronfenbrenner, 1979, 1986; Bronfenbrenner & Ceci, 1994) to provide a multisystemic perspective on (a) contextual influences on the expression of masculinity ideology and health behaviors, (b) potential costs of those behaviors, and (c) counseling intervention opportunities (Courtenay, 2011; Isacco, Garfield, & Rogers, 2010; Smiler, 2004). Our rationale for using the ecological model rests in the complexity of our goal to change college men's masculine ideals. To address that goal, we have found it crucial to use multiple interventions at multiple levels. We also integrate the ecological model with the men's center approach (MCA) and the concept of "possible masculinities" (Davies, Shen-Miller, & Isacco, 2010) to guide the design and implementation of systemic, culturally sensitive interventions for college men. Using Bronfenbrenner's Ecological Model to Understand College Men's Health According to Bronfenbrenner (1979, 1989; Bronfenbrenner & Ceci, 1994), development occurs within an individual ecology comprised of nested systems, including the macrosystem, exosystem, mesosystem, and microsystem (see Figure 1). Moving inward from the outermost system, each system has an increasingly direct influence on the individual, yet inner (or proximal) systems can also effect change in more distal ones. Bronfenbrenner (1979, 1989) emphasized how perceptions of relations within and among an individual's varied systems influence attitudes, behaviors, and expression of social roles. Change in one system invariably triggers change in others through a process of mutual accommodation. …