Missing men - why health promotion leaves them behind and how to bring them on board: results of a rapid qualitative evidence synthesis.

BACKGROUND: Men show a higher mortality than women, especially at a young age (between 15 and 39 years). They are more likely to engage in unhealthy behaviours and tend not to implement preventative efforts or to seek help. While (mental) health promotion programmes aim to foster healthy behaviours, men often do not feel addressed by them and are therefore reluctant to participate. This synthesis aims at drawing together barriers to and facilitators of male participation in (mental) health promotion programmes and identifying how to best address men in health communication and programme promotion. METHODS: This rapid qualitative evidence synthesis includes a sample of 21 studies. 18 are qualitative studies and 3 are mixed-methods studies with separately reported qualitative findings that captured the perspectives of males aged 12 to 79 years and of professionals working in men's health on the barriers to and facilitators of participation in (mental) health promotion programmes and on preferred health communication. Studies were purposefully selected to maximise variation across interview content, context, and participant characteristics (e.g., age, occupation). The selection was restricted to studies published between 2015 and 2025. RESULTS: Gender norms were one of the main barriers to participation in men's (mental) health promotion programmes. Preferably such programmes should be integrated into settings attractive or familiar to men, such as sport clubs or handicraft workshops, or the workplace. Peers and peer support played a crucial role within men's health promotion and were found to facilitate positive behavioural changes. When reaching out to men, clinical and stigmatising terminology should be avoided in favour of action-oriented language that emphasises control and practical solutions while keeping the messaging simple and focused on tangible benefits. CONCLUSIONS: Health promotion programmes for men require embedding interventions within male-relevant contexts, such as sports, workplaces, and peer networks, that ease participation and reduce stigma. To reach and benefit men, communication strategies should use relatable, non-stigmatising language from credible messengers and should frame self-care as compatible with masculine identities.