"When the whole 'bloke' thing starts to crumble"

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Why are men under-represented as users of arthritis self management programs? This study explores the interaction between gender, work, age and self management of a chronic illness from a socio- constructive perspective. A mixed method study was conducted including analyses of service use records, in-depth interviews with men with arthritis and their partners, and a trial to test the applications of the research findings. It was found that men's decisions to access arthritis self management programs were strongly influenced by dominant social expectations of men to be strong and independent. This meant that they tended to avoid seeking help until their condition deteriorated to a point of crisis, usually represented by an inability to continue working. This pattern of behaviour was particularly evident in men in the middle stages of life with the greatest work and family obligations. More work needs to be done to explore the options for reaching men before they arrive at a critical stage in the progress of their condition. The roles of general practitioners and partners need to be taken into account.