The male-focused marital relationship enrichment and sexual well-being interventions: A scoping review


Background: There is an increasing need for sexual well-being and health promotion strategies that effectively engage men. Researchers have evaluated the efficacy of sexual and reproductive health-related and marital enhancement interventions in maledominated societies. However, few have focused on culturally appropriate and genderspecific program effects.

Objective: This review aims to evaluate evidence of existing interventions aimed at enriching marital relationships and sexual well-being in adult men.

Materials and Methods: This scoping review was conducted by searching various databases (CINAHL, PsycINFO, EMBASE, Google Scholar, PubMed, Scopus, SID, and Noormags), and other available resources in both English and Persian languages. We located all publications up to January 2023 with no time restriction. Inclusion criteria were studies targeting men in the enrichment of marital and sexual relationships, which focus on marital/sexual enrichment, Sexual and reproductive health (SRH) program, passionate relationship, or sexual satisfaction as the main outcomes. PRISMA guidelines were utilized in this review.

Results: Of records 34,405 retrieved by searching, after removing duplicate articles, 8 articles were included based on the inclusion criteria. SRH program was the main focus of 6 articles. Marital and sexual enhancement were common areas of focus in 2 studies. Research methods included 2 semi-experimental, 3 clinical trials, 1 systematic review, 1 content analysis, and a mixed method. According to the assessment result, 4 articles were moderate and 4 were of high quality.

Conclusion: Our findings reveal that a small number of interventions specifically offering SRH or marital and sexual enhancement programs to men should be conducted. As the majority were heterosexual couples, we recommend male-focused programs recognizing men’s sexuality.

Key words: Sexual health, Men, Marriage, Health promotion.

[1] Martin CE, Parlier-Ahmad AB, Beck L, Jain V, Terplan M. A comparison of sex-specific reproductive and sexual health needs between addiction medicine and primary care treatment settings. Subst Use Misuse 2022; 57: 1229–1236.

[2] Klaman SL, Lorvick J, Jones HE. Provision of and barriers to integrating reproductive and sexual health services for reproductive-age women in opioid treatment programs. J Addict Med 2019; 13: 422–429.

[3] Buzi RS, Smith PB. Access to sexual and reproductive health care services: Young men’s perspectives. J Sex Marital Ther 2014; 40: 149–157.

[4] World Health Organization. Medical eligibility criteria for contraceptive use. Switzerland: World Health Organization; 2010.

[5] Sen G, Ostin P. Unequal, unfair, ineffective and inefficient gender inequity in health: Why it exists and how we can change it. Sweden: Karolinska Institute; 2007.

[6] Newcomb ME. Romantic relationships and sexual minority health: A review and description of the Dyadic health model. Clin Psychol Rev 2020; 82: 101924.

[7] Alqashan H. Enrichment training program and successful marriage in Kuwait: A field study on Kuwaiti couples. Digest Middle East Stud 2008; 17: 1–16.

[8] Carvalho SA, Castilho P, Seabra D, Salvador C, Rijo D, Carona C. Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs). In: Thwaites R. The cognitive behaviour therapist. UK: Cambridge University Press; 2022.

[9] Baker CE. Organizational levers for frontline health care employee well-being in long-term care. [Ph.D. Thesis]. USA: University of Southern California; 2022.

[10] Schmader T. Gender inclusion and fit in STEM. Annu Rev Psychol 2022; 74: 219–243.

[11] Seaton ChL, Bottorff JL, Jones-Bricker M, Oliffe JL, DeLeenheer D, Medhurst K. Men’s mental health promotion interventions: A scoping review. Am J Mens Health 2017; 11: 1823–1837.

[12] Sun Sh, Nardi W, Loucks EB, Operario D. Mindfulnessbased interventions for sexual and gender minorities: A systematic review and evidence evaluation. Mindfulness 2021; 12: 2439–2459.

[13] Doss BD, Roddy MK, Wiebe SA, Johnson SM. A review of the research during 2010-2019 on evidence-based treatments for couple relationship distress. J Marital Fam Ther 2022; 48: 283–306.

[14] Kardan-Souraki M, Hamzehgardeshi Z, Asadpour I, Mohammadpour RA, Khani S. A review of marital intimacy-enhancing interventions among married individuals. Glob J Health Sci 2016; 8: 53109.

[15] Davis AC, Arnocky S. An evolutionary perspective on appearance enhancement behavior. Arch Sex Behav 2020; 51: 3–37.

[16] Sinkovic M, Towler L. Sexual aging: A systematic review of qualitative research on the sexuality and sexual health of older adults. Qual Health Res 2019; 29: 1239–1254.

[17] Yakubu I, Garmaroudi Gh, Sadeghi R, Tol A, Yekaninejad MS, Yidana A. Assessing the impact of an educational intervention program on sexual abstinence based on the health belief model amongst adolescent girls in Northern Ghana, a cluster randomised control trial. Reprod Health 2019; 16: 124.

[18] Rezabeigi Davarani E, Khanjani N, Iranpour A, Mohseni M, Najar Mansoori S. [Educational needs of couples attending in pre-marriage counseling classes in health center of Kerman]. Health Based Res 2016; 2: 69–80. (in Persian)

[19] Rakhshaee Z, Maasoumi R, Nedjat S, Khakbazan Z. Sexual health literacy, a strategy for the challenges of sexual life of infertile women: A qualitative study. Galen Med J 2020; 9: e1862.

[20] Haberland N, Rogow D. Sexuality education: Emerging trends in evidence and practice. J Adolesc Health 2015; 56: S15–S21.

[21] Sell K, Oliver K, Meiksin R. Comprehensive sex education addressing gender and power: A systematic review to investigate implementation and mechanisms of impact. Sex Res Soc Policy 2023; 20: 58–74.

[22] Kohansal F, Nourizadeh R, Attarzadeh Jahdi NS, Mehrabi E, Bafrani MA. The effect of educational interventions on sexual behavior and reproductive health of women: A systematic review. Adv Nurs Midwifery 2022; 31: 14–21.

[23] Vasconcelos P, Paúl C, Serruya SJ, Ponce de León RG, Nobre P. A systematic review of sexual health and subjective well-being in older age groups. Rev Panam Salud Publica 2022; 46: e179.

[24] Diener E. Guidelines for national indicators of subjective well-being and ill-being. J Happiness Stud 2006; 7: 397– 404.

[25] Narasimhan M, Logie CH, Moody K, Hopkins J, Montoya O, Hardon A. The role of self-care interventions on men’s health-seeking behaviours to advance their sexual and reproductive health and rights. Health Res Policy Syst 2021; 19: 23.

[26] Alimoradi Z, Simbar M. [Male involvement in reproductive and sexual health: A systematic review of Iranian litreture]. Hakim Health Syst Res 2014; 17: 209–222. (in Persian)

[27] Hosseini N, Lau PL, Baranovich D-L. Enhancing marital satisfaction through acceptance and commitment therapy: A review of marital satisfaction improvement of Iranian couples. Int J Educ Psychol Counsel 2019; 4: 53–60.

[28] Munn Z, Aromataris E, Tufanaru C, Stern C, Porritt K, Farrow J, et al. The development of software to support multiple systematic review types: The Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information ( JBI SUMARI). Int J Evid Based Healthc 2019; 17: 36–43.

[29] Delkhosh M, Ardalan A, Rahimiforoushani A, Keshtkar A, Farahani LA, Khoei EM. Interventions for prevention of intimate partner violence against women in humanitarian settings: A protocol for a systematic review. PLoS Curr 2017; 9: 1–11.

[30] Yoshany N, Morowatisharifabad MA, Mihanpour H, Bahri N, Jadgal KM. The effect of husbands’ education regarding menopausal health on marital satisfaction of their wives. J Menopausal Med 2017; 23: 15–24.

[31] Bay R, Ismail SB, Zahiruddin WM, Arifin WN. Effect of combined psycho-physiological stretching and breathing therapy on sexual satisfaction. BMC Urol 2013; 13: 16.

[32] Pulerwitz J, Barker G, Segundo M, Nascimento M. Promoting more gender-equitable norms and behaviors among young men as an HIV/AIDS prevention strategy. Washington: Population Council; 2006.

[33] Miller E, Jones KA, Culyba AJ, Paglisotti T, Dwarakanath N, Massof M, et al. Effect of a community-based gender norms program on sexual violence perpetration by adolescent boys and young men: A cluster randomized clinical trial. JAMA Netw Open 2020; 3: e2028499-e.

[34] Manlove J, Parekh J, Whitfield B, Griffith I, Garg A, Fasula AM. A mixed-methods pilot evaluation of Manhood 2.0, a program to reduce unintended pregnancy among young men. Am J Mens Health 2022; 16: 15579883221104895.

[35] Miller E, Tancredi DJ, McCauley HL, Decker MR, Virata MCD, Anderson HA, et al. “Coaching boys into men”: A cluster-randomized controlled trial of a dating violence prevention program. J Adolesc Health 2012; 51: 431–438.

[36] Hurt TR, Beach SR, Stokes LA, Bush PL, Sheats KJ, Robinson SG. Engaging African American men in empirically based marriage enrichment programs: Lessons from two focus groups on the ProSAAM project. Cultur Divers Ethnic Minor Psychol 2012; 18: 312–315.

[37] Onyango MA, Owoko S, Oguttu M. Factors that influence male involvement in sexual and reproductive health in western Kenya: A qualitative study. Afr J Reprod Health 2010; 14: 32–42.

[38] Hardee K, Croce-Galis M, Gay J. Are men well served by family planning programs? Reprod Health 2017; 14: 14.

[39] Godwin LN, Stevens CE, Brenner NL. Forced to play by the rules? Theorizing how mixed-sex founding teams benefit women entrepreneurs in male-dominated contexts. Entrepreneurship Theory Pract 2006; 30: 623– 642.

[40] Merghati Khoei E, Whelan A, Cohen J. Sharing beliefs: What sexuality means to Muslim Iranian women living in Australia. Cult Health Sex 2008; 10: 237–248.

[41] Levenson RW, Carstensen LL, Gottman JM. Long-term marriage: Age, gender, and satisfaction. Psychology Aging 1993; 8: 301–313.

[42] Kiecolt-Glaser JK, Newton TL. Marriage and health: His and hers. Psychol Bull 2001; 127: 472–503.

[43] Ball FL, Cowan P, Cowan CP. Who’s got the power? Gender differences in partners’ perceptions of influence during marital problem-solving discussions. Fam Process 1995; 34: 303-321.

[44] Sternberg P, Hubley J. Evaluating men’s involvement as a strategy in sexual and reproductive health promotion. Health Promot Int 2004; 19: 389–396.

[45] Mirzaii Najmabadi K, Karimi L, Ebadi A. Exploring the barriers to sexual and reproductive health education for men in Iran: A qualitative study. Iran J Nurs Midwifery Res 2019; 24: 179–186.

[46] Sharma S, Kc B, Khatri A. Factors influencing male participation in reproductive health: A qualitative study. J Multidiscip Healthc 2018; 11: 601–608.

[47] Gopal P, Fisher D, Seruwagi G, Taddese HB. Male involvement in reproductive, maternal, newborn, and child health: Evaluating gaps between policy and practice in Uganda. Reprod Health 2020; 17: 114.

[48] Byamugisha R, Tumwine JK, Semiyaga N, Tylleskär T. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: A cross-sectional survey. Reprod Health 2010; 7: 12.

[49] Ghanotakis E, Hoke T, Wilcher R, Field S, Mercer S, Bobrow EA, et al. Evaluation of a male engagement intervention to transform gender norms and improve family planning and HIV service uptake in Kabale, Uganda. Glob Public Healt 2017; 12: 1297–1314.