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Liu S, Cao Z, He Z, Shi W, Li J. Social support and the burden of physical and psychiatric comorbidities in the patients with late-onset epilepsy in China: A cross-sectional study. Epilepsy Behav 2024; 155:109775. [PMID: 38640724 DOI: 10.1016/j.yebeh.2024.109775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Epilepsy is the third most common neurological disorder in elderly people. Patients with epilepsy (PWEs) are more likely to have comorbidities. Social support is very important for PWEs. However, there are many gaps in the research on social support in older PWEs, especially the correlation between social support and comorbidities. METHODS A cross-sectional study was conducted in three hospitals in China. Social support was assessed using the Social Support Rate Scale. The burden of physical comorbidities was assessed using the CCI, and global disability was assessed using the mRS. The NDDIE was used to assess depression, the GAD7 was used for anxiety, the CDR was used for cognitive status, and the NPI was used for psychotic symptoms. RESULTS A total of 154 older PWEs participated in the study. There were 97 patients with at least one physical comorbidities. The burden of physical comorbidities was negatively correlated with overall social support (Adj. r = -0.35, P < 0.001) and global disability (Adj. r = -0.45, P < 0.001). In terms of psychiatric comorbidities, anxiety, depression, and cognitive status were not correlated with overall social support (Adj. r = -0.03, -0.02, and -0.11, P > 0.05). Psychotic symptoms were correlated with overall social support (Adj. r = -0.20, P < 0.05). The overall burden of psychiatric comorbidities was associated with overall social support (r = 0.30, P < 0.01). DISCUSSION Neurologists and social workers should consider more personalized biopsychosocial care to improve the quality of life of older PWEs.
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Affiliation(s)
- Shengyi Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
| | - Zhen Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Department of Geriatrics, The Second People's Hospital of Yibin, Yibin, China.
| | - Zihua He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, China.
| | - Wenyan Shi
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
| | - Jinmei Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
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Nam HK, Chang SJ, Kim CB, Jeong KS, Kim SK, Kang DR, Jeong YW, Lee H, Zhao B, Koh SB. The Association between Social Support, Metabolic Syndrome, and Incidence of Cardio-Cerebrovascular Diseases in Older Adults: The ARIRANG Study. Yonsei Med J 2024; 65:363-370. [PMID: 38804031 PMCID: PMC11130590 DOI: 10.3349/ymj.2023.0455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 05/29/2024] Open
Abstract
PURPOSE We investigated the association between social support, metabolic syndrome, and incident cardio-cerebrovascular disease (CCVD) in rural Koreans aged ≥50 years. MATERIALS AND METHODS We conducted a prospective study using the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population (KoGES-ARIRANG) dataset. From the baseline of 5169 adults, 1682 participants were finally included according to the exclusion criteria. For outcomes, myocardial infarction, angina, and stroke were included. For independent variables, the social support score and metabolic syndrome were used. Descriptive statistics and multivariate logistic regression were performed to investigate the association among the variables. Paired t-test was conducted to analyze the longitudinal variation of social support scores. RESULTS During the 6.37 years of median follow-up, 137 participants developed CCVD. The adjusted odds ratio (aOR) of metabolic syndrome with persistently high social support was 2.175 [95% confidence interval (CI): 1.479-3.119]. The aOR of metabolic syndrome with persistently low social support was 2.494 (95% CI: 1.141-5.452). The longitudinal variation of the social support score of persistently high social support group was increased significantly by 4.26±26.32. The score of the persistently low social support group was decreased by 1.34±16.87 with no statistical significance. CONCLUSION The presence of metabolic syndrome increases the likelihood of developing onset CCVD. Within the metabolic syndrome positive group, when social support was persistently low, the cohort developed more cardio-cerebrovascular disease compared to the persistently higher social support group. The social support score of the persistently low social support group could be improved through proper intervention. To prevent CCVD, metabolic syndrome components and low social support should be improved in the study participants.
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Affiliation(s)
- Hae-Kweun Nam
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Sei-Jin Chang
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chun-Bae Kim
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Hongcheon County Hypertension and Diabetes Registration and Education Center, Hongcheon, Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung-Kyung Kim
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yong Whi Jeong
- Department of Medical Informatics and Biostatistics, Graduate School, Yonsei University, Wonju, Korea
| | - Hocheol Lee
- Department of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea
| | - Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, Wonju, Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Auer A, Semmer NK, von Känel R, Thomas L, Zuccarella-Hackl C, Wiest R, Wirtz PH. Taking appreciation to heart: appreciation at work and cardiovascular risk in male employees. Front Public Health 2024; 12:1284431. [PMID: 38500730 PMCID: PMC10944862 DOI: 10.3389/fpubh.2024.1284431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/09/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction While perceived appreciation at work has been associated with self-reported health and wellbeing, studies considering biological health markers are lacking. In this study, we investigated whether appreciation at work would relate to coronary heart disease (CHD) risk as well as the specificity of this proposed association. Methods Our study comprised a total of 103 male participants, including apparently healthy, medication-free, non-smoking men in the normotensive to hypertensive range (n = 70) as well as medicated hypertensive and CHD patients (n = 33). CHD risk was assessed by blood pressure [mean arterial pressure (MAP)], the diabetes marker glycated hemoglobin A1c (HbA1c), blood lipids [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C) ratio], coagulation activity (D-dimer and fibrinogen), and inflammation [interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP)]. Perceived appreciation at work, as well as potentially confounding psychological factors (social support, self-esteem, and work strain due to a lack of appreciation), were measured by self-report questionnaires. Results We found higher appreciation at work to relate to lower overall composite CHD risk (p's ≤ 0.011) and, in particular, to lower MAP (p's ≤ 0.007) and lower blood lipids (p's ≤ 0.031) in medication-free participants as well as all participants. This overall association was independent of confounding factors, including related psychological factors (p's ≤ 0.049). Discussion Our findings indicate that appreciation at work might be an independent health-promoting resource in terms of CHD risk. Implications include that encouraging appreciation at work may help reduce the development and progression of CHD.
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Affiliation(s)
- Alisa Auer
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany
| | - Norbert K. Semmer
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
- Psychology of Work and Organizations, Department of Psychology, University of Bern, Bern, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Livia Thomas
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern,University of Bern, Bern, Switzerland
| | - Petra H. Wirtz
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany
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Figtree GA, Vernon ST, Harmer JA, Gray MP, Arnott C, Bachour E, Barsha G, Brieger D, Brown A, Celermajer DS, Channon KM, Chew NWS, Chong JJH, Chow CK, Cistulli PA, Ellinor PT, Grieve SM, Guzik TJ, Hagström E, Jenkins A, Jennings G, Keech AC, Kott KA, Kritharides L, Mamas MA, Mehran R, Meikle PJ, Natarajan P, Negishi K, O'Sullivan J, Patel S, Psaltis PJ, Redfern J, Steg PG, Sullivan DR, Sundström J, Vogel B, Wilson A, Wong D, Bhatt DL, Kovacic JC, Nicholls SJ. Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors: JACC State-of-the-Art Review. J Am Coll Cardiol 2023; 82:1343-1359. [PMID: 37730292 PMCID: PMC10522922 DOI: 10.1016/j.jacc.2023.06.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 09/22/2023]
Abstract
Reducing the incidence and prevalence of standard modifiable cardiovascular risk factors (SMuRFs) is critical to tackling the global burden of coronary artery disease (CAD). However, a substantial number of individuals develop coronary atherosclerosis despite no SMuRFs. SMuRFless patients presenting with myocardial infarction have been observed to have an unexpected higher early mortality compared to their counterparts with at least 1 SMuRF. Evidence for optimal management of these patients is lacking. We assembled an international, multidisciplinary team to develop an evidence-based clinical pathway for SMuRFless CAD patients. A modified Delphi method was applied. The resulting pathway confirms underlying atherosclerosis and true SMuRFless status, ensures evidence-based secondary prevention, and considers additional tests and interventions for less typical contributors. This dedicated pathway for a previously overlooked CAD population, with an accompanying registry, aims to improve outcomes through enhanced adherence to evidence-based secondary prevention and additional diagnosis of modifiable risk factors observed.
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Affiliation(s)
- Gemma A Figtree
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
| | - Stephen T Vernon
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Jason A Harmer
- Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia
| | - Michael P Gray
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia
| | - Clare Arnott
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Eric Bachour
- Consumer Representative, Agile Group Switzerland AG, Zug, Switzerland
| | - Giannie Barsha
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia
| | - David Brieger
- Department of Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Alex Brown
- National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capitol Territory, Australia; Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - David S Celermajer
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Keith M Channon
- British Heart Foundation Centre of Research Excellence, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - James J H Chong
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia; Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Clara K Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Peter A Cistulli
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Department of Respiratory & Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Patrick T Ellinor
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA; Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stuart M Grieve
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Imaging and Phenotyping Laboratory, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Tomasz J Guzik
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom; Department of Internal Medicine and Omicron Medical Genomics Laboratory, Jagiellonian University Medical College, Krakow, Poland
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Alicia Jenkins
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia; Diabetes and Vascular Medicine, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Garry Jennings
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony C Keech
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Katharine A Kott
- Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Leonard Kritharides
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia; The ANZAC Research Institute, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognostic Research, Keele University, Keele, United Kingdom; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Roxana Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, Vicotria, Australia
| | - Pradeep Natarajan
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Kazuaki Negishi
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Department of Cardiology, Nepean Hospital, Kingswood, New South Wales, Australia
| | - John O'Sullivan
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Precision Cardiovascular Laboratory, University of Sydney, Camperdown, New South Wales, Australia; Heart Research Institute, University of Sydney, Camperdown, New South Wales, Australia
| | - Sanjay Patel
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Heart Research Institute, University of Sydney, Camperdown, New South Wales, Australia
| | - Peter J Psaltis
- Vascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, SAHMRI, Adelaide, South Australia, Australia; Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Department of Cardiology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Julie Redfern
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia; Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Philippe G Steg
- Université de Paris, Assistance Publique-Hôpitaux de Paris, French Alliance for Cardiovascular Trials and INSERM Unité 1148, Paris, France
| | - David R Sullivan
- Department of Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Johan Sundström
- The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia; Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Birgit Vogel
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrew Wilson
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Dennis Wong
- Monash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia; MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, New York, USA
| | - Jason C Kovacic
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen J Nicholls
- Victorian Heart Institute, Monash University, Clayton, Victoria, Australia
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Purcell C, Dibben G, Hilton Boon M, Matthews L, Palmer VJ, Thomson M, Smillie S, Simpson SA, Taylor RS. Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. Cochrane Database Syst Rev 2023; 6:CD013820. [PMID: 37378598 PMCID: PMC10305790 DOI: 10.1002/14651858.cd013820.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND Globally, cardiovascular diseases (CVD, that is, coronary heart (CHD) and circulatory diseases combined) contribute to 31% of all deaths, more than any other cause. In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease, and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve outcomes of these programmes, but whether and how these interventions work is poorly understood. OBJECTIVES: To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. The comparator was usual care with no element of social support (i.e. secondary prevention alone or with cardiac rehabilitation). SEARCH METHODS: We undertook a systematic search of the following databases on 9 August 2022: CENTRAL, MEDLINE, Embase, and the Web of Science. We also searched ClinicalTrials.gov and the WHO ICTRP. We reviewed the reference lists of relevant systematic reviews and included primary studies, and we contacted experts to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of social network or social support interventions for people with heart disease. We included studies regardless of their duration of follow-up, and included those reported as full text, published as abstract only, and unpublished data. DATA COLLECTION AND ANALYSIS Using Covidence, two review authors independently screened all identified titles. We retrieved full-text study reports and publications marked 'included', and two review authors independently screened these, and conducted data extraction. Two authors independently assessed risk of bias, and assessed the certainty of the evidence using GRADE. Primary outcomes were all-cause mortality, cardiovascular-related mortality, all-cause hospital admission, cardiovascular-related hospital admission, and health-related quality of life (HRQoL) measured at > 12 months follow-up. MAIN RESULTS: We included 54 RCTs (126 publications) reporting data for a total of 11,445 people with heart disease. The median follow-up was seven months and median sample size was 96 participants. Of included study participants, 6414 (56%) were male, and the mean age ranged from 48.6 to 76.3 years. Studies included heart failure (41%), mixed cardiac disease (31%), post-myocardial infarction (13%), post-revascularisation (7%), CHD (7%), and cardiac X syndrome (1%) patients. The median intervention duration was 12 weeks. We identified notable diversity in social network and social support interventions, across what was delivered, how, and by whom. We assessed risk of bias (RoB) in primary outcomes at > 12 months follow-up as either 'low' (2/15 studies), 'some concerns' (11/15), or 'high' (2/15). 'Some concerns' or 'high' RoB resulted from insufficient detail on blinding of outcome assessors, data missingness, and absence of pre-agreed statistical analysis plans. In particular, HRQoL outcomes were at high RoB. Using the GRADE method, we assessed the certainty of evidence as low or very low across outcomes. Social network or social support interventions had no clear effect on all-cause mortality (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.49 to 1.13, I2 = 40%) or cardiovascular-related mortality (RR 0.85, 95% CI 0.66 to 1.10, I2 = 0%) at > 12 months follow-up. The evidence suggests that social network or social support interventions for heart disease may result in little to no difference in all-cause hospital admission (RR 1.03, 95% CI 0.86 to 1.22, I2 = 0%), or cardiovascular-related hospital admission (RR 0.92, 95% CI 0.77 to 1.10, I2 = 16%), with a low level of certainty. The evidence was very uncertain regarding the impact of social network interventions on HRQoL at > 12 months follow-up (SF-36 physical component score: mean difference (MD) 31.53, 95% CI -28.65 to 91.71, I2 = 100%, 2 trials/comparisons, 166 participants; mental component score MD 30.62, 95% CI -33.88 to 95.13, I2 = 100%, 2 trials/comparisons, 166 participants). Regarding secondary outcomes, there may be a decrease in both systolic and diastolic blood pressure with social network or social support interventions. There was no evidence of impact found on psychological well-being, smoking, cholesterol, myocardial infarction, revascularisation, return to work/education, social isolation or connectedness, patient satisfaction, or adverse events. Results of meta-regression did not suggest that the intervention effect was related to risk of bias, intervention type, duration, setting, and delivery mode, population type, study location, participant age, or percentage of male participants. AUTHORS' CONCLUSIONS: We found no strong evidence for the effectiveness of such interventions, although modest effects were identified in relation to blood pressure. While the data presented in this review are indicative of potential for positive effects, the review also highlights the lack of sufficient evidence to conclusively support such interventions for people with heart disease. Further high-quality, well-reported RCTs are required to fully explore the potential of social support interventions in this context. Future reporting of social network and social support interventions for people with heart disease needs to be significantly clearer, and more effectively theorised, in order to ascertain causal pathways and effect on outcomes.
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Affiliation(s)
- Carrie Purcell
- Faculty of Wellbeing, Education and Language Studies, The Open University in Scotland, Edinburgh, UK
| | - Grace Dibben
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michele Hilton Boon
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lynsay Matthews
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Victoria J Palmer
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Meigan Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Susie Smillie
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
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Ogden J, Quirke-McFarlane S. Sabotage, Collusion, and Being a Feeder: Towards a New Model of Negative Social Support and Its Impact on Weight Management. Curr Obes Rep 2023:10.1007/s13679-023-00504-5. [PMID: 37280423 DOI: 10.1007/s13679-023-00504-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE OF REVIEW Whilst research indicates the positive impact of social support across a number of health domains, including weight management, not all social support is beneficial. RECENT FINDINGS This paper reviews the evidence for both positive and negative social support in the context of behavioural interventions and surgery for obesity. It then presents a new model of negative social support focusing on sabotage ('active and intentional undermining of another person's weight goals'), feeding behaviour ('explicit over feeding of someone when they are not hungry or wishing not to eat'), and collusion ('passive and benign negative social support to avoid conflict') which can be conceptualised within the context of relationships as systems and the mechanisms of homeostasis. There is increasing evidence for the negative impact of social support. This new model could form the basis of further research and the development of interventions for family, friends, and partners to maximise weight loss outcomes.
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Affiliation(s)
- Jane Ogden
- School of Psychology, University of Surrey, Guildford, GU2 7XH, Surrey, UK.
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Brady SS, Arguedas A, Huling JD, Shan L, Lewis CE, Fok CS, Van Den Eeden SK, Markland AD. Interpersonal Stressors and Resources for Support: Associations with Lower Urinary Tract Symptoms and Impact Among Women. J Womens Health (Larchmt) 2023; 32:693-701. [PMID: 37040312 PMCID: PMC10278020 DOI: 10.1089/jwh.2022.0483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
Background: This study utilizes Coronary Artery Risk Development in Young Adults (CARDIA) data to examine whether women's perceived emotional support and interpersonal stressors are associated with lower urinary tract symptoms (LUTS) and their impact on quality of life. Materials and Methods: Emotional support was assessed at baseline/year 0 (1985-86), year 2 (1987-88), year 15 (2000-01), and year 20 (2005-06); interpersonal stressors were assessed at years 15 and 20. In 2012-13, LUTS and impact were assessed. LUTS/impact category (a composite variable ranging from bladder health to mild, moderate, and severe LUTS/impact) was regressed on trajectory groups of emotional support from years 0 to 20. Separately, LUTS/impact was regressed on mean emotional support and interpersonal stressors across years 15-20. Analyses were adjusted for age, race, education, and parity (n = 1104). Results: In comparison to women whose support trajectory from years 0 to 20 was consistently high, women whose support decreased from high to low had over twice the odds (odds ratio [OR] = 2.72; 95% confidence interval [CI] = 1.76-4.20) of being classified into a more burdensome LUTS/impact category. Mean support and interpersonal stressors across years 15-20 were independently associated with lower odds (OR = 0.59; 95% CI = 0.44-0.77) and greater odds (OR = 1.52; 95% CI = 1.19-1.94), respectively, of being classified into a more burdensome LUTS/impact category. Conclusions: In the CARDIA cohort, quality of women's interpersonal relationships, assessed between 1985-86 and 2005-06, was associated with LUTS/impact assessed in 2012-13. Additional research collecting LUTS/impact data at multiple time points is needed to test potential bidirectional associations of emotional support and interpersonal stressors with LUTS/impact, as well as potential mechanisms of association.
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Affiliation(s)
- Sonya S. Brady
- Division of Epidemiology and Community Health, and University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Andrés Arguedas
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jared D. Huling
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Liang Shan
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Cora E. Lewis
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cynthia S. Fok
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Stephen K. Van Den Eeden
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Alayne D. Markland
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care and the Birmingham/Atlanta Geriatrics Research, Education, and Clinical Center, University of Alabama at Birmingham School of Medicine and Birmingham VA Health Care System, Birmingham, Alabama, USA
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8
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Zwack CC, McDonald R, Tursunalieva A, Vasan S, Lambert GW, Lambert EA. Stress and social isolation, and its relationship to cardiovascular risk in young adults with intellectual disability. Disabil Rehabil 2023; 45:974-985. [PMID: 35311428 DOI: 10.1080/09638288.2022.2046186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Stress produces many physiological changes, some of which may contribute to the development of cardiovascular disease (CVD). Individuals with intellectual disability (ID) are exposed to multiple and stressful challenges everyday which may put them at increased cardiovascular risk. This current study aimed to establish whether adults with ID experience higher levels of subjective stress and encounter different stressors (including social isolation) than the general population, and whether there is a relationship between stress and cardiometabolic profile in this population. METHODS Adults with ID (n = 35) aged 18-45 years completed the Subjective Stress Survey, and underwent a physiological assessment to measure blood pressure, metabolic profile and subclinical CVD risk factors, and were compared to a control group (n = 29). Multiple regression was used to investigate whether cardiometabolic parameters were predicative of SSS scores. RESULTS Findings showed adults with ID have higher perceived stress levels (total score ID: 21.3 ± 11.4 vs control: 13.9 ± 9.0, p = 0.006), which is elicited by unique stressors, when compared to people without ID. Stress was strongly associated with increased social isolation (r = -0.38, p = 0.002) and with obesity in females with mild ID (r = 0.72). Regression showed that arterial stiffness was predictive of total SSS score (p = 0.038). CONCLUSIONS Adults with ID aged 18-45 years report higher levels of perceived stress when compared to people without ID.Implications for RehabilitationReducing stress in this young population may prevent development of arterial stiffness, and consequently lower the risk of cardiometabolic morbidity and mortality.There are unique targets for stress management in young adults with intellectual disability, including supporting decision-making and improving self-efficacy.Improving community integration and reducing social isolation may decrease perceived stress in young adults with intellectual disability.
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Affiliation(s)
- Clara C Zwack
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Rachael McDonald
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Ainura Tursunalieva
- Department of Econometrics and Business Statistics, Monash University, Clayton, Australia
| | - Shradha Vasan
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
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9
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Rosland AM, Piette JD, Trivedi R, Lee A, Stoll S, Youk AO, Obrosky DS, Deverts D, Kerr EA, Heisler M. Effectiveness of a Health Coaching Intervention for Patient-Family Dyads to Improve Outcomes Among Adults With Diabetes: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2237960. [PMID: 36374502 PMCID: PMC9664266 DOI: 10.1001/jamanetworkopen.2022.37960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE More than 75% of US adults with diabetes do not meet treatment goals. More effective support from family and friends ("supporters") may improve diabetes management and outcomes. OBJECTIVE To determine if the Caring Others Increasing Engagement in Patient Aligned Care Teams (CO-IMPACT) intervention improves patient activation, diabetes management, and outcomes compared with standard care. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted from November 2016 to August 2019 among participants recruited from 2 Veterans Health Administration primary care sites. All patient participants were adults aged 30 to 70 years with diabetes who had hemoglobin A1c (HbA1c) levels greater than 8% of total hemoglobin (to convert to proportion of total hemoglobin, multiply by 0.01) or systolic blood pressure (SBP) higher than 150 mm Hg; each participating patient had an adult supporter. Of 1119 recruited, 239 patient-supporter dyads were enrolled between November 2016 and May 2018, randomized 1:1 to receive the CO-IMPACT intervention or standard care, and followed up for 12 to 15 months. Investigators and analysts were blinded to group assignment. INTERVENTIONS Patient-supporter dyads received a health coaching session focused on dyadic information sharing and positive support techniques, then 12 months of biweekly automated monitoring telephone calls to prompt dyadic actions to meet diabetes goals, coaching calls to help dyads prepare for primary care visits, and after-visit summaries. Standard-care dyads received general diabetes education materials only. MAIN OUTCOMES AND MEASURES Intent-to-treat analyses were conducted according to baseline dyad assignment. Primary prespecified outcomes were 12-month changes in Patient Activation Measure-13 (PAM-13) and UK Prospective Diabetes Study (UKPDS) 5-year diabetes-specific cardiac event risk scores. Secondary outcomes included 12-month changes in HbA1c levels, SBP, diabetes self-management behaviors, diabetes distress, diabetes management self-efficacy, and satisfaction with health system support for the involvement of family supporters. Changes in outcome measures between baseline and 12 months were analyzed using linear regression models. RESULTS A total of 239 dyads enrolled; among patient participants, the mean (SD) age was 60 (8.9) years, and 231 (96.7%) were male. The mean (SD) baseline HbA1c level was 8.5% (1.6%) and SBP was 140.2 mm Hg (18.4 mm Hg). A total of 168 patients (70.3%) lived with their enrolled supporter; 229 patients (95.8%) had complete 12-month outcome data. In intention-to-treat analyses vs standard care, CO-IMPACT patients had greater 12-month improvements in PAM-13 scores (intervention effect, 2.60 points; 95% CI, 0.02-5.18 points; P = .048) but nonsignificant differences in UKPDS 5-year cardiac risk (intervention effect, 1.01 points; 95% CI, -0.74 to 2.77 points; P = .26). Patients in the CO-IMPACT arm also had greater 12-month improvements in healthy eating (intervention effect, 0.71 d/wk; 95% CI, 0.20-1.22 d/wk; P = .007), diabetes self-efficacy (intervention effect, 0.40 points; 95% CI, 0.09-0.71 points; P = .01), and satisfaction with health system support for the family supporter participants' involvement (intervention effect, 0.28 points; 95% CI, 0.07-0.49 points; P = .009); however, the 2 arms had similar improvements in HbA1c levels and in other measures. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, the CO-IMPACT intervention successfully engaged patient-supporter dyads and led to improved patient activation and self-efficacy. Physiological outcomes improved similarly in both arms. More intensive direct coaching of supporters, or targeting patients with less preexisting support or fewer diabetes management resources, may have greater impact. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02328326.
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Affiliation(s)
- Ann-Marie Rosland
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - John D. Piette
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Ranak Trivedi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, California
| | - Aaron Lee
- Department of Psychology, University of Mississippi, University
| | - Shelley Stoll
- Department of Internal Medicine and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Ada O. Youk
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - D. Scott Obrosky
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Denise Deverts
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Eve A. Kerr
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- Department of Internal Medicine and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Michele Heisler
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- Department of Internal Medicine and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
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10
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Comparing the effectiveness of Family Support for Health Action (FAM-ACT) with traditional community health worker-led interventions to improve adult diabetes management and outcomes: study protocol for a randomized controlled trial. Trials 2022; 23:841. [PMID: 36192769 PMCID: PMC9527393 DOI: 10.1186/s13063-022-06764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/17/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diabetes self-management education and support (DSMES) programs have struggled to deliver sustainable, effective support for adults with diabetes (AWDs) to improve self-management behaviors, achieve glycemic goals, and reduce risk for complications. One largely untapped resource for this support is AWDs' social networks. Fifty to 75% of AWDs have an unpaid family member or friend ("support person") who provides ongoing help with diabetes management. However, DSMES interventions to date lack structured and effective approaches to directly engage support persons in AWDs' diabetes management. METHODS This parallel arm randomized trial is designed to determine the effectiveness of Family Support for Health Action (FAM-ACT), a novel community health worker (CHW)-delivered program focused on educating and supporting patients with type 2 diabetes (T2D) and their support persons (SPs), relative to an established, CHW-delivered, individual patient-focused DSMES and care management (I-DSMES) intervention. Both interventions were developed using a community-based participatory research (CBPR) approach. The study will be conducted in partnership with an urban Federally Qualified Health Center (FQHC) serving a low-income, Latino/a community, with target enrollment of 268 dyads consisting of an FQHC patient with T2D with high HbA1c and an SP. Patient-SP dyads will be randomized to receive FAM-ACT or I-DSMES over 6 months. The primary outcome is change in patient HbA1c from baseline to 6 months. Secondary patient outcomes include 12-month change in HbA1c, changes in patient blood pressure, diabetes self-management behaviors, diabetes distress, patient activation, diabetes self-efficacy, and perceptions of and satisfaction with SP support for diabetes. Secondary SP outcomes include self-efficacy for helping the patient with diabetes management and SP distress about the patient's diabetes. We also will assess the effect of the COVID-19 pandemic on patient's ability to manage diabetes. DISCUSSION This study will inform scalable, evidence-based approaches that leverage family support to help AWDs improve and sustain self-management strategies that underpin optimal management of multiple diabetes complication risk factors. The protocol is designed for and evaluated with a low-income and predominantly Latino/a community, which may increase applicability to other similar communities. The COVID-19 pandemic presented several challenges to study protocol and intervention delivery; modifications made to address these challenges are described. TRIAL REGISTRATION ClinicalTrials.gov NCT03812614. Registered on 18 January 2019.
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11
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Dion-Albert L, Bandeira Binder L, Daigle B, Hong-Minh A, Lebel M, Menard C. Sex differences in the blood-brain barrier: Implications for mental health. Front Neuroendocrinol 2022; 65:100989. [PMID: 35271863 DOI: 10.1016/j.yfrne.2022.100989] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/07/2022] [Accepted: 02/19/2022] [Indexed: 12/13/2022]
Abstract
Prevalence of mental disorders, including major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ) are increasing at alarming rates in our societies. Growing evidence points toward major sex differences in these conditions, and high rates of treatment resistance support the need to consider novel biological mechanisms outside of neuronal function to gain mechanistic insights that could lead to innovative therapies. Blood-brain barrier alterations have been reported in MDD, BD and SZ. Here, we provide an overview of sex-specific immune, endocrine, vascular and transcriptional-mediated changes that could affect neurovascular integrity and possibly contribute to the pathogenesis of mental disorders. We also identify pitfalls in current literature and highlight promising vascular biomarkers. Better understanding of how these adaptations can contribute to mental health status is essential not only in the context of MDD, BD and SZ but also cardiovascular diseases and stroke which are associated with higher prevalence of these conditions.
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Affiliation(s)
- Laurence Dion-Albert
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Luisa Bandeira Binder
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Beatrice Daigle
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Amandine Hong-Minh
- Smurfit Institute of Genetics, Trinity College Dublin, Lincoln Place Gate, Dublin 2, Ireland
| | - Manon Lebel
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Caroline Menard
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada.
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12
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Min LY, Islam RB, Gandrakota N, Shah MK. The social determinants of health associated with cardiometabolic diseases among Asian American subgroups: a systematic review. BMC Health Serv Res 2022; 22:257. [PMID: 35216607 PMCID: PMC8876533 DOI: 10.1186/s12913-022-07646-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Asian Americans represent one of the fastest-growing immigrant groups in the U.S. and are at high risk for cardiometabolic diseases (CMDs), including type 2 diabetes, hypertension, coronary artery disease, and stroke. Despite the growth of Asians in the U. S, there is a gap in understanding the heterogeneity of CMDs across Asian subgroups and how these might be affected by the social determinants of health (SDOH), or the environment in which people live and work. Objective The purpose of this systematic review is to examine the current literature on CMDs among Asian Americans and identify the SDOH that are associated with the incidence and/or prevalence of CMDs among specific Asian subgroups. Methods PubMed, Embase, Web of Science were searched for articles published in Jan 2000-Nov 2020. The reproducible strategy yielded 2732 articles. The articles were reviewed based on the following inclusion criteria: (1) observational study published in the U.S., (2) adult population includes specific Asian subgroups, (3) exposures include SDOH, and (4) outcomes include a CMD, defined as type 2 diabetes, hypertension, coronary artery disease, or stroke. Results In this review, 14 studies were identified and organized into four key themes: acculturation (n = 9), socioeconomic status (SES) (n = 6), social context (n = 2), and health literacy (n = 1). The most represented Asian subgroups in the literature were Chinese, Filipino, and South Asians. Acculturation was the most described social factor in the included reviews. Seven studies found associations between higher acculturation levels and higher prevalence of CMD. However, the measure of acculturation varied by study and included various combinations of the country of birth, number of years residing in the U.S., and English proficiency. The effects of SES, measured as income level and educational attainment, varied by racial subgroups. One study found that higher levels of education were associated with CMD among South Asians. Conclusion Acculturation, SES, social context, and health literacy impact the risk of CMD among Asian Americans; these vary across subgroups. Future research disentangling SDOHs on the risk of CMDs by Asian subgroup is necessary to provide better informed preventive practices and interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07646-7.
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Affiliation(s)
- Lucy Y Min
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rehnuma B Islam
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Nikhila Gandrakota
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Megha K Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA.
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13
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Uchino BN, Baucom BRW, Landvatter J, de Grey RGK, Tacana T, Flores M, Ruiz JM. Perceived social support and ambulatory blood pressure during daily life: a meta-analysis. J Behav Med 2022; 45:509-517. [PMID: 35034219 PMCID: PMC9283536 DOI: 10.1007/s10865-021-00273-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/11/2021] [Indexed: 11/27/2022]
Abstract
Perceived social support has been linked to lower rates of morbidity and mortality. However, more information is needed on the biological mechanisms potentially responsible for such links. The main aim of this paper was to conduct a meta-analytic review of the association between perceived social support and awake ambulatory blood pressure (ABP) which is linked to cardiovascular morbidity and mortality. The review identified 12 studies with a total of 3254 participants. The omnibus meta-analysis showed that higher perceived social support was not significantly related to lower ABP (Zr = -0.052, [ -0.11, 0.01]). In addition, there was evidence of significant bias across several indicators. Future research will be needed to explore the boundary conditions linking social support to ABP and its implications for theoretical models and intervention development.
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Affiliation(s)
- Bert N Uchino
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Brian R W Baucom
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Joshua Landvatter
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Robert G Kent de Grey
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Tracey Tacana
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Melissa Flores
- Department of Psychology, University of Arizona, Tucson, AZ, 85721, USA
| | - John M Ruiz
- Department of Psychology, University of Arizona, Tucson, AZ, 85721, USA
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14
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Aheto JMK, Dagne GA. Multilevel modeling, prevalence, and predictors of hypertension in Ghana: Evidence from Wave 2 of the World Health Organization's Study on global AGEing and adult health. Health Sci Rep 2021; 4:e453. [PMID: 34938897 PMCID: PMC8661999 DOI: 10.1002/hsr2.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/22/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS Hypertension is a major public health issue, an important risk factor for cardiovascular diseases and stroke, especially in developing countries where the rates remain unacceptably high. In Africa, hypertension is the leading driver of cardiovascular disease and stroke deaths. Identification of critical risk factors of hypertension can help formulate targeted public health programs and policies aimed at reducing the prevalence and its associated morbidity, disability, and mortality. This study attempts to develop multilevel regression, an in-depth statistical model to identify critical risk factors of hypertension. METHODS This study used data on 4667 individuals aged ≥18 years from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 conducted in 2014/2015. Multilevel regression modeling was employed to identify critical risk factors for hypertension based on systolic blood pressure (SBP) (ie, SBP > 140 mmHg). Of the 4667, 27.3% were hypertensive. Final data on 4381 individuals residing in 3790 households were analyzed using multilevel models, and results were presented as adjusted odds ratios (aOR) and their associated 95% confidence intervals (CI). RESULTS Risk factors for hypertension identified were age (aOR) = 5.4, 95% CI: 4.11-7.09), obesity (aOR = 1.51, 95% CI: 1.19-1.91), marital status (aOR = 0.75, 95% CI: 0.64-0.89), perceived health state (moderate; aOR = 1.38, 95% CI: 1.15-1.65 and bad/very bad; aOR = 1.35, 95% CI: 1.0-1.83), and difficulty with self-care (aOR = 1.64, 95% CI: 1.1-2.44). We found unobserved significant differences in the likelihood of hypertension prevalence between different households. CONCLUSION Addressing the problem of obesity, targeting specific interventions to those aged over 50 years, and improvement in the general health of Ghanaians are paramount to reducing the prevalence and its associated morbidity, disability, and mortality. Lifestyle modification in the form of dietary intake, knowledge provision supported with strong public health message, and political will could be beneficial to the management and prevention of hypertension.
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Affiliation(s)
- Justice Moses K. Aheto
- Department of BiostatisticsSchool of Public Health, College of Health Sciences, University of GhanaAccraGhana
- College of Public Health, University of South FloridaTampaFloridaUSA
| | - Getachew A. Dagne
- College of Public Health, University of South FloridaTampaFloridaUSA
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15
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Social and sexual behaviors predict immune system activation, but not adrenocortical activation, in male rhesus macaques. Behav Ecol Sociobiol 2021. [DOI: 10.1007/s00265-021-03083-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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16
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Blakoe M, Christensen AV, Palm P, Højskov IE, Thrysoee L, Thorup CB, Borregaard B, Mols RE, Rasmussen TB, Berg SK. Prognostic value of a brief loneliness questionnaire for patients with coronary heart disease: Proposal for a prediction model. J Clin Nurs 2021; 31:1686-1696. [PMID: 34473870 DOI: 10.1111/jocn.16023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/15/2021] [Accepted: 08/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In patients with coronary heart disease (CHD), loneliness is associated with increased risk of morbidity and mortality. No predictive tool is available to detect patients who are influenced by loneliness to a degree that impacts mortality. AIM To: (i) propose a prediction model that detects patients influenced by loneliness to a degree that increases one-year all-cause mortality, (ii) evaluate model classification performance of the prediction model, and (iii) investigate potential questionnaire response errors. METHOD A cohort of patients with CHD (n = 7169) responded to a national cross-sectional survey, including two questions on loneliness. Information on cohabitation and follow-up information on one-year all-cause mortality were obtained from national registers. Prediction model development was based on the prognostic values of item responses in the questionnaire on loneliness and of cohabitation, evaluated with Cox-proportional Hazards Ratio (HR). Item responses which significantly predicted one-year mortality were included in the high-risk loneliness (HiRL) prediction model. Sensitivity, specificity and likelihood ratio were calculated to evaluate model classification performance. Sources of response errors were evaluated using verbal probing technique in an additional cohort (n = 7). The TRIPOD checklist has been used to ensure transparent reporting. RESULTS Two item responses significantly predicted one-year mortality HR = 2.24 (95%CI = 1.24-4.03) and HR = 2.65 (95%CI = 1.32-5.32) and were thus included in the model. Model classification performance showed a likelihood ratio of 1.89. Response error was evaluated as low. CONCLUSION Based on the prognostic value in a loneliness questionnaire, a prediction model suitable to screen patients with CHD for high-risk loneliness was suggested. RELEVANCE TO CLINICAL PRACTICE The HiRL prediction model is a short and easy-to-use screening tool that offers clinical staff to identify patients with CHD who are influenced by loneliness to a degree that impacts mortality. However, further evaluation of model performance and questionnaire validation is recommended before integrating the model into clinical practice.
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Affiliation(s)
- Mitti Blakoe
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Pernille Palm
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ida Elisabeth Højskov
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars Thrysoee
- Department of Cardiology, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Charlotte Brun Thorup
- Department of Cardiology and Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Britt Borregaard
- Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Rikke Elmose Mols
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Selina Kikkenborg Berg
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Clark EM, Ma L, Williams BR, Park CL, Knott CL, Schulz EK, Ghosh D. Social Support as a Mediator of the Personality-Physical Functioning Relationship in a National Sample of African Americans: A Two-Wave Longitudinal Study. JOURNAL OF BLACK PSYCHOLOGY 2021. [DOI: 10.1177/00957984211037970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigates whether social support mediates the relationship between personality traits and physical functioning among African Americans over 2.5 years. Data were collected from a national probability sample of African American adults (analytic sample N = 312). Telephone surveys included measures of the five-factor model personality traits, social support, and physical functioning. Personality traits were assessed at Time 1 (T1), and social support and physical functioning were assessed 2.5 years later at Time 2 (T2). Physical functioning was assessed using the SF-12 at T2. Results indicated that T2 social support mediated the relationship between T1 personality traits and T2 physical functioning for the traits of conscientiousness, extraversion, agreeableness, and neuroticism, but not for openness to experience. This information may be useful to healthcare providers and community members in developing strategies targeting personality traits in cultivating social support for health promotion.
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Affiliation(s)
- Eddie M. Clark
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Lijing Ma
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Beverly R. Williams
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Crystal L. Park
- Psychological Sciences Department, University of Connecticut, Storrs, CT, USA
| | - Cheryl L. Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Debarchana Ghosh
- Psychological Sciences Department, University of Connecticut, Storrs, CT, USA
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Ansari S, Muhammad T, Dhar M. How Does Multi-Morbidity Relate to Feeling of Loneliness among Older Adults? Evidence from a Population-Based Survey in India. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09343-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Chai HW, Ayanian JZ, Almeida DM. Non-spousal family support, marital status, and heart problems in adulthood. Psychol Health 2021; 36:1003-1020. [PMID: 32930017 PMCID: PMC7956915 DOI: 10.1080/08870446.2020.1809660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 07/17/2020] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Support from one's spouse has long been documented as a significant determinant of health for married individuals. However, non-spousal family support may play an important role in health particularly for unmarried individuals. Therefore, this study examined whether the association between non-spousal family support and diagnosis of heart problems differed by marital status and whether gender and education moderated these associations. DESIGN Data came from the first two waves of the Midlife in the United States (MIDUS) study. This study selected respondents who participated in both waves of MIDUS and were not diagnosed with a heart problem at Wave 1 (N = 3,119). MAIN OUTCOME MEASURES Participants reported whether they had any heart trouble. Discrete-time event history analysis was used to examine the risk of heart problems between MIDUS Waves 1 and 2. RESULTS A higher level of non-spousal family support was associated with a lower risk of developing a heart problem only among unmarried women and unmarried individuals with high school education or less, and not for married individuals. CONCLUSION Findings highlight the importance of considering specific sources of family support when studying heart health, and the health-protective role of non-spousal family support for those who are not married.
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Affiliation(s)
- Hye Won Chai
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - John Z. Ayanian
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Division of General Medicine, Medical School, University of Michigan, Ann Arbor, MI, USA
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - David M. Almeida
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
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20
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Bonsaksen T, Leung J, Schoultz M, Thygesen H, Price D, Ruffolo M, Geirdal AØ. Cross-National Study of Worrying, Loneliness, and Mental Health during the COVID-19 Pandemic: A Comparison between Individuals with and without Infection in the Family. Healthcare (Basel) 2021; 9:healthcare9070903. [PMID: 34356281 PMCID: PMC8305116 DOI: 10.3390/healthcare9070903] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 01/31/2023] Open
Abstract
Objective: The objective of this study was to examine differences in worry, loneliness, and mental health between those individuals infected by COVID-19 or having someone their family infected, and the rest of the population. Methods: A cross-sectional online survey was conducted in Norway, UK, USA, and Australia during April/May 2020. Participants (n = 3810) were recruited via social media postings by the researchers and the involved universities. Differences between those with and without infection in the family were investigated with chi-square tests and independent t-tests. Multiple regression analyses were used to assess associations between sociodemographic variables and psychological outcomes (worry, loneliness, and mental health) in both groups. Results: Compared to their counterparts, participants with infection in the family reported higher levels of worries about themselves (p < 0.05) and their family members (p < 0.001) and had poorer mental health (p < 0.05). However, the effect sizes related to the differences were small. The largest effect (d = 0.24) concerned worries about their immediate family. Poorer psychological outcomes were observed in those who were younger, female, unemployed, living alone and had lower levels of education, yet with small effect sizes. Conclusions: In view of the small differences between those with and without infection, we generally conclude that the mental health effects of the COVID-19 situation are not limited to those who have been infected or have had an infection within the family but extend to the wider population.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland University of Applied Sciences, Hamarvegen 112, 2418 Elverum, Norway
- Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
- Correspondence:
| | - Janni Leung
- Faculty of Health and Behavioural Science, The University of Queensland, St. Lucia, QLD 4072, Australia;
| | - Mariyana Schoultz
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Hilde Thygesen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
- Faculty of Health Studies, VID Specialized University, 0370 Oslo, Norway
| | - Daicia Price
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA; (D.P.); (M.R.)
| | - Mary Ruffolo
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA; (D.P.); (M.R.)
| | - Amy Østertun Geirdal
- Department of Social Work, Faculty of Social Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
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21
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Seixas AA, Olaye IM, Wall SP, Dunn P. Optimizing Healthcare Through Digital Health and Wellness Solutions to Meet the Needs of Patients With Chronic Disease During the COVID-19 Era. Front Public Health 2021; 9:667654. [PMID: 34322469 PMCID: PMC8311288 DOI: 10.3389/fpubh.2021.667654] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/21/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic exposed and exacerbated longstanding inefficiencies and deficiencies in chronic disease management and treatment in the United States, such as a fragmented healthcare experience and system, narrowly focused services, limited resources beyond office visits, expensive yet low quality care, and poor access to comprehensive prevention and non-pharmacological resources. It is feared that the addition of COVID-19 survivors to the pool of chronic disease patients will burden an already precarious healthcare system struggling to meet the needs of chronic disease patients. Digital health and telemedicine solutions, which exploded during the pandemic, may address many inefficiencies and deficiencies in chronic disease management, such as increasing access to care. However, these solutions are not panaceas as they are replete with several limitations, such as low uptake, poor engagement, and low long-term use. To fully optimize digital health and telemedicine solutions, we argue for the gamification of digital health and telemedicine solutions through a pantheoretical framework-one that uses personalized, contextualized, and behavioral science algorithms, data, evidence, and theories to ground treatments.
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Affiliation(s)
- Azizi A. Seixas
- Department of Population Health, Department of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Iredia M. Olaye
- Department of Medicine Division of Clinical Epidemiology and Evaluative Sciences Research, Weill Cornell Medical College, New York, NY, United States
| | - Stephen P. Wall
- Department of Emergency Medicine, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Pat Dunn
- American Heart Association, Center for Health Technology and Innovation, New York, NY, United States
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Takahashi N, Nakao M. Social-life factors associated with participation in screening and further assessment of colorectal cancer: A nationwide ecological study in Japanese municipalities. SSM Popul Health 2021; 15:100839. [PMID: 34189242 PMCID: PMC8215283 DOI: 10.1016/j.ssmph.2021.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 12/24/2022] Open
Abstract
The burden of colorectal cancer in developed countries is high, and it is a major public health concern in Japan. Improving the quality of evidence on colorectal cancer screening participation and further assessment participation rates is important to reduce this burden. This study examined the social-life factors that influence colorectal cancer screening programs in Japan, particularly the effects of the proportion of elderly people and social capital, using a municipality-level national database and existing health reports. Data from a national municipality-based study were analyzed to identify social-life factors associated with participation in colorectal cancer screening and further assessment. Administrative data on the Japanese municipal screening programs were drawn from the Report on Regional Public Health Services and Health Promotion Services 2017. Available data used as predictors of interest for all 1719 municipalities as of 2017 were from the national census, statistical reports on the land area by prefecture and municipality, municipal financial surveys, a survey of physicians, dentists and pharmacists, and other databases. The mean rate of participation in colorectal cancer screening was 13.8%, and that of further assessment was 73.6%. Multiple linear regression analyses of the two outcomes showed that the proportion of elderly people was most significantly positively associated with colorectal cancer screening programs (β = 0.51 for participation, β = 0.13 for further assessment participation), and the proportion of single-elderly-person households was most significantly negatively associated (β = −0.45 and −0.19, respectively). It is suggested that the health behaviors required for participation in colorectal cancer programs in Japanese elderly populations are greatly affected by family members. The disease burden of colorectal cancer is increasing in developed countries. An ecological study of the colorectal cancer screening program was conducted. The proportion of elderly people was positively associated with the screening rates. The single-elderly-person households was negatively associated with the screening rates.
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Affiliation(s)
- Noriaki Takahashi
- Division of Screening Assessment and Management, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Graduate School of Public Health, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan
| | - Mutsuhiro Nakao
- Graduate School of Public Health, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan.,Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, Hatakeda 852, Narita, Chiba, 286-8686, Japan
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23
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Geirdal AØ, Ruffolo M, Leung J, Thygesen H, Price D, Bonsaksen T, Schoultz M. Mental health, quality of life, wellbeing, loneliness and use of social media in a time of social distancing during the COVID-19 outbreak. A cross-country comparative study. J Ment Health 2021; 30:148-155. [PMID: 33689546 DOI: 10.1080/09638237.2021.1875413] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The COVID-19 outbreak raised questions about how people experience their mental health, quality of life (QoL), wellbeing and loneliness in the context of social distancing, and the use of social media during this time. AIMS To examine the experience of mental health, QoL, wellbeing and loneliness and use of social media among people living in Norway, USA, UK and Australia. METHODS A cross-country comparative survey of people living in Norway, USA, UK and Australia. Relevant statistical analyses were used to examine differences between the countries and to explore associations between demographic, mental health and psychosocial variables and use of social media. RESULTS There were 3810 respondents from four countries, of which 50 - 74% showed a high level of emotional distress. The Norwegian population reported significantly better mental health, QoL and wellbeing and lower levels of loneliness compared to the other countries. High-frequent use of social media after the COVID-19 outbreak was associated with poorer mental- and psychosocial health. CONCLUSIONS The results suggest that the COVID-19 outbreak took a toll on people's experience of mental health, QoL, wellbeing and experienced loneliness, and high-frequent use of social media was associated with these factors.
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Affiliation(s)
- Amy Østertun Geirdal
- Faculty of Social Sciences, Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Mary Ruffolo
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Janni Leung
- Faculty of Health and Behavioural Science, The University of Queensland, St Lucia, QLD, Australia
| | - Hilde Thygesen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Daicia Price
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Tore Bonsaksen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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24
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Costa-Cordella S, Arevalo-Romero C, Parada FJ, Rossi A. Social Support and Cognition: A Systematic Review. Front Psychol 2021; 12:637060. [PMID: 33708164 PMCID: PMC7941073 DOI: 10.3389/fpsyg.2021.637060] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/02/2021] [Indexed: 12/18/2022] Open
Abstract
Although the influence of social support in health is a widely acknowledged factor, there is a significant gap in the understanding of its role on cognition. The purpose of this systematic review was, therefore, to determine the state-of-the-art on the literature testing the association between social support and cognition. Using six databases (WoS, PubMed, ProQuest, PsycINFO, Scopus and EBSCOhost), we identified 22 articles published between 1999 and 2019 involving an empirical quantitative focus which meet the inclusion criteria. Data extraction was performed following PRISMA recommendations. To summarize the extracted data, we used a narrative synthesis approach. Despite limitations, there is overall preliminary evidence of a relevant positive association between social support and cognition. Our results demonstrate there is enough information for an outbreak of experimental research in the area and an expansion of this body of knowledge. We argue that the present evidence lays the foundations for a more comprehensive theoretical model, one that corresponds with the complexity of the topic and possibly considers models derived from social interaction and active inference theories.
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Affiliation(s)
- Stefanella Costa-Cordella
- Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Centro de Estudios en Psicología Clínica y Psicoterapia, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Camilo Arevalo-Romero
- Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Programa de Magíster en Neurociencia Social, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Francisco J. Parada
- Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Alejandra Rossi
- Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
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25
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Purcell C, Smillie S, Boon MH, Simpson SA, Taylor RS. Effectiveness of social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. Cochrane Database Syst Rev 2021; 2021:CD013820. [PMID: 36743076 PMCID: PMC7611922 DOI: 10.1002/14651858.cd013820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. As a secondary output of this review, and to assist in conceptualising future research focused on social network and social support interventions, we aim to develop a logic model theorising the relationship between social networks or social support and heart disease outcomes. We will draw on existing models of social support for health (e.g. Berkman 2000), as well as established approaches to theorising and implementing behaviour change (e.g. Michie 2011).
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Affiliation(s)
- Carrie Purcell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Susie Smillie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michele Hilton Boon
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
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26
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Weissman M. Interpersonal psychotherapy reaches out. HEART AND MIND 2021. [DOI: 10.4103/hm.hm_54_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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27
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Clark EM, Ma L, Knott CL, Williams BR, Park CL, Schulz EK, Ghosh D. A longitudinal examination of social support as a mediator of the personality-health relationship in a national sample of African Americans. JOURNAL OF BLACK PSYCHOLOGY 2020; 46:607-637. [PMID: 34354319 DOI: 10.1177/0095798420966826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigates whether social support mediates the relationship between personality traits and health among African Americans over a five-year period, filling a gap in the literature on longitudinal tests of the personality-health association. Data were collected from a national probability sample of African American adults (N = 200). Personality was assessed at Time 1 (T1), social support was assessed 2.5 years later (T2), and physical functioning was examined 5 years (T3) after T1. Telephone surveys included measures of the Five Factor Model personality traits (T1), social support (T2), and physical functioning (T3). Results suggested that relationships between the T1 personality traits and T3 physical functioning were not mediated by T2 social support. Secondary analyses found that among all T1 personality traits, higher openness and lower neuroticism uniquely predicted higher T2 social support. Further, among T1 personality traits, higher conscientiousness uniquely predicted better T3 physical functioning. This information may be useful to healthcare providers and community members in developing prevention and intervention strategies for African Americans.
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Future Time Perspective and Perceived Social Support: The Mediating Role of Gratitude. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186707. [PMID: 32942583 PMCID: PMC7559088 DOI: 10.3390/ijerph17186707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/08/2020] [Accepted: 09/13/2020] [Indexed: 11/17/2022]
Abstract
Future time perspective, perceived social support, and dispositional gratitude are topics of interest that positively influence people’s psychological health. Although gratitude has been positively associated with future time perspective and social support, this is the first study to investigate its mediating role in the relationships of future time perspective with perceived social support. A convenience sample of 1256 adults (55.1% women), mean age 34.55 years (SD = 13.92), completed self-reported measures of future time perspective (conceptualized as remaining time and opportunities), dispositional gratitude, and received and given social support. Results indicated that higher dispositional gratitude mediated the relationship between the perception of more remaining time and opportunities and greater perception of received and given social support. These findings highlight the importance of considering dispositional characteristics to better understand the impact of perceived future on the individuals’ subjective experience of social exchanges. Interventions addressing future time perspective and dispositional gratitude might have beneficial effects on individuals’ social well-being.
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Sugiyama M, Kondo K, Jeong S, Shiraishi N, Matsumoto D, Hayashi T, Tanaka H. Effect of Care Capacity on Stroke Patients' Recovery in Activities of Daily Living: A Multi-Hospital Study. J Stroke Cerebrovasc Dis 2020; 29:105187. [PMID: 32912554 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/11/2020] [Accepted: 07/19/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aimed to investigate whether care capacity for patients following stroke contributes to improved activities of daily living (ADL) at discharge from hospital based on the degree of stroke severity. DESIGN Retrospective, observational, longitudinal study. SETTING Acute phase hospitals. PARTICIPANTS From 2005 to 2011, 5006 patients with stroke at acute phase hospitals were registered in a database. There were 2501 individuals from 11 hospitals who met the following four criteria: (1) a pre-stroke modified Rankin Scale (mRS) score of 0-3; (2) admission to hospital within 7 days of suffering a stroke; (3) ischemic or hemorrhagic stroke; and (4) staying in hospital for 8-60 days. MAIN OUTCOME MEASURES The main outcome measure was the Functional Independence Measure (FIM, version 3.0) score at discharge. The FIM is an internationally used scale, which is used as an ADL outcome assessment scale for after rehabilitation. RESULTS Among patients with stroke, those with care capacity had higher FIM scores at hospital discharge than did those without care capacity (unstandardized coefficient = 2.3, P = 0.015). Examination of this relationship by stroke severity showed that the FIM score at discharge was only significantly higher in patients who suffered from a moderate to severe stroke (unstandardized coefficient = 7.0, P = 0.040). No associations were observed in patients who suffered from minor, moderate, or severe stroke. CONCLUSIONS These results suggest that care capacity facilitates total recovery of the FIM, especially among patients who suffer from a moderate to severe stroke.
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Affiliation(s)
- Motoya Sugiyama
- Department of Rehabilitation, Chubu Rosai Hospital, 1-10-6 Koumei, Minato-ku, Nagoya-city 455-8530, Aichi-ken, Japan.
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba-city, Chiba-ken, Japan; Department of Social Science, National Center for Geriatrics and Gerontology, Obu-city, Aichi-ken, Japan.
| | - Seungwon Jeong
- Department of Community Welfare, Faculty of Health Sciences, Niimi University, Niimi-city, Okayama-ken, Japan.
| | - Nariaki Shiraishi
- Department of Rehabilitation, Faculty of Health Science, Nihon Fukushi University, Chita-gun, Aichi-ken, Japan.
| | - Daisuke Matsumoto
- Department of Physical Therapy, Faculty of Health Science, Kio University, Kitakatsugi-gun, Nara-ken, Japan.
| | - Takahiro Hayashi
- Department of Rehabilitation and Care, Seijoh University, Tokai-city, Aichi-ken, Japan.
| | - Hirotaka Tanaka
- Department of Rehabilitation, Chubu Rosai Hospital, 1-10-6 Koumei, Minato-ku, Nagoya-city 455-8530, Aichi-ken, Japan.
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Porter B, Kolaja CA, Powell TM, Pflieger JC, Stander VA, Armenta RF. Reducing the Length of the Multidimensional Scale of Perceived Social Support. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2020. [DOI: 10.1027/1015-5759/a000553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract. The Multidimensional Scale of Perceived Social Support (MSPSS) is a widely used 12-item measure that assesses perceived social support from three sources: friends, family, and significant others. Previously published psychometric properties indicate that a shorter version of this scale may adequately assess perceived social support and reduce participant burden. The current studies sought to develop such a reduced scale across two studies. Study 1 examined a sample of spouses of US military personnel ( N = 5,436) randomly separated into exploratory and confirmatory samples. In the exploratory sample, we developed a 6-item reduced MSPSS using multidimensional item response theory. In the confirmatory sample, the reduced MSPSS fit the hypothesized structure and was highly correlated with the full MSPSS. Study 2 administered the full and reduced MSPSS separately within a sample of undergraduate students ( N = 188). The reduced MSPSS had high correlations with the full measure ( r = .90) and fit the hypothesized factor structure. Across both studies, correlations with related constructs were similar between the reduced and full MSPSS, demonstrating almost no loss of construct validity. Overall, the reduced MSPSS captured perceived social support with little loss of information. This reduced scale may be useful for minimizing survey length and participant burden.
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Affiliation(s)
| | | | | | - Jacqueline C. Pflieger
- Military Population Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Valerie A. Stander
- Military Population Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Richard F. Armenta
- Leidos, Inc., Reston, VA, USA
- Department of Kinesiology, College of Education, Health and Human Services, California State University San Marcos, CA, USA
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Maki KG. Social Support, Strain, and Glycemic Control: A Path Analysis. PERSONAL RELATIONSHIPS 2020; 27:592-612. [PMID: 34108841 PMCID: PMC8184015 DOI: 10.1111/pere.12333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/24/2020] [Indexed: 06/12/2023]
Abstract
Social support and strain have been linked with many health outcomes. However, less is known about whether these psychosocial factors are associated with Type 2 diabetes risk. This study uses the Midlife in the United States (MIDUS) dataset to examine the relationship between social support and strain from friends, family members, and spouse/partners and blood hemoglobin A1c levels in married/cohabiting adults who have not been diagnosed with diabetes. In addition, health locus of control is examined as a possible mediator. The study's findings suggest that support from friends is negatively associated with HbA1c levels, indicating a relationship between better glycemic control and social support from friends, and an indirect association for spouse/partner support. A direct effect for internal health locus of control was also found.
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Uchino BN, Landvatter J, Zee K, Bolger N. Social Support and Antibody Responses to Vaccination: A Meta-Analysis. Ann Behav Med 2020; 54:567-574. [PMID: 32415849 DOI: 10.1093/abm/kaaa029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social support and social integration have been linked to lower rates of morbidity and mortality. However, the biological mechanisms responsible for such links need greater attention. Vaccine paradigms provide an integrative window into immune system involvement in the protective influence of social support/integration. PURPOSE The main aim of this article was to conduct a meta-analytic review of the association between social support/social integration and antibody responses to vaccines. Exploratory analyses also examined effect sizes and confidence intervals as a function of several factors to inform future research. METHOD A literature search was conducted using the ancestry approach and with PsycInfo, Medline, and the Psychology and Behavioral Science Collection by crossing the exact keywords of social support or social integration with vaccine or antibodies. The review identified nine studies with a total of 672 participants. RESULTS The omnibus meta-analysis showed that social support/social integration was related to higher antibody levels following vaccination, but the average effect size was small and the lower bound of the confidence interval included zero (Zr = 0.06 [-.04, .15]). These results did not appear to differ much as a function of the operationalization of social relationships, participant age, or follow-up period, although effect sizes appeared larger for studies using a primary antigen. CONCLUSIONS These data provide some evidence that social support may be linked to antibody responses to vaccines. However, effect sizes are mostly small and zero overall effect cannot be ruled out. Future studies would benefit from larger sample sizes and greater consideration of methodological issues associated with secondary immune responses to antigen.
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Affiliation(s)
- Bert N Uchino
- Department of Psychology, University of Utah, Salt Lake City, UT
| | | | - Katherine Zee
- Department of Psychology, Columbia University, Amsterdam Avenue, New York, NY
| | - Niall Bolger
- Department of Psychology, Columbia University, Amsterdam Avenue, New York, NY
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Lu X, Juon HS, He X, Dallal CM, Wang MQ, Lee S. The Association Between Perceived Stress and Hypertension Among Asian Americans: Does Social Support and Social Network Make a Difference? J Community Health 2020; 44:451-462. [PMID: 30604222 DOI: 10.1007/s10900-018-00612-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Prior research suggests that stress plays role in the etiology and progression of hypertension. To lend a more accurate depiction of the underlying mechanisms between stress and hypertension, this study aims to assess the associations between perceived stress and hypertension across varying levels of social support and social network among Asian Americans. We conducted a cross-sectional study using data on 530 Chinese, Korean and Vietnamese Americans recruited from a liver cancer prevention program in the Washington D.C.-Baltimore metropolitan area. Hypertension prevalence was 29.1%. Individuals with high perceived stress were 61% more likely to have hypertension compared to those with low levels of perceived stress (odds ratio 1.61, 95% confidence interval 1.15, 2.46). There was no evidence that social support and social network acted as effect modifiers. Social support had a direct beneficial effect on hypertension, irrespective of whether individuals were under stress. The relationship between perceived stress and hypertension was modified by gender and ethnicity whereby a significant positive association was only observed among male or Chinese participants. Our study highlights the importance of understanding the associations between stress, social support, and hypertension among Asian American subgroups. Findings from the study can be used to develop future stress management interventions, and incorporate culturally and linguistically appropriate strategies into community outreach and education to decrease hypertension risk within the Asian population.
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Affiliation(s)
- Xiaoxiao Lu
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2242 Valley Drive, College Park, MD, 20742, USA.
| | - Hee-Soon Juon
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2242 Valley Drive, College Park, MD, 20742, USA
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2242 Valley Drive, College Park, MD, 20742, USA
| | - Ming Qi Wang
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Sunmin Lee
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2242 Valley Drive, College Park, MD, 20742, USA
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Pushkarev GS, Zimet GD, Kuznetsov VA, Yaroslavskaya EI. The Multidimensional Scale of Perceived Social Support (MSPSS): Reliability and Validity of Russian Version. Clin Gerontol 2020; 43:331-339. [PMID: 30587089 DOI: 10.1080/07317115.2018.1558325] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To assess factorial and construct validity along with reliability of the Russian version of the Multidimensional Scale of Perceived Social Support (MSPSS) in cardiac patients.Methods: The study included 1018 patients with coronary artery disease. All patients were offered the opportunity to complete a questionnaire to detect psychosocial risk and protective factors, including the MSPSS.Results: Internal consistency of the Russian version of the MSPSS was high: Cronbach's alpha coefficient in the group of patients with stable angina was .91 vs. .90 in the group with acute coronary syndrome. The three-factor structure of the MSPSS was proved with exploratory and confirmatory factor analyses. As expected, the Russian version of the MSPSS was negatively correlated with measures of anxiety and depression, and positively correlated with curiosity.Conclusions: The Russian version of MSPSS corresponds closely with the English version in reliability, consistency, and internal structure. Test-retest reliability was satisfactorally high and construct validity was supported with the results of the correlation analysis.Clinical Implications: Our study confirms that MSPSS questionnaire is a high valid tool to estimate social support and it can be successfully applied to define social support in patients with cardiac pathology.
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Affiliation(s)
- G S Pushkarev
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - G D Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA
| | - V A Kuznetsov
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - E I Yaroslavskaya
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
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Arrebola-Moreno M, Petrova D, Garrido D, Ramírez-Hernández JA, Catena A, Garcia-Retamero R. Psychosocial markers of pre-hospital decision delay and psychological distress in acute coronary syndrome patients. Br J Health Psychol 2020; 25:305-323. [PMID: 32065483 DOI: 10.1111/bjhp.12408] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/18/2020] [Indexed: 12/28/2022]
Abstract
Objectives Both pre-hospital decision delay - the time patients wait before seeking medical attention after symptoms have started - and high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors. Design A cross-sectional study of 102 consecutive, clinically stable ACS survivors. Methods Participants completed a questionnaire measuring pre-hospital decision delay, psychological distress, and several known psychosocial factors related to cardiovascular health: type D personality, resilience, social support, and concerns during the cardiac event. Multiple linear regression and mediation analyses were conducted. Results Type D personality and fewer concerns about the serious consequences of delaying help-seeking were related to more psychological distress post-ACS, and these relationships were mediated by longer pre-hospital decision delay. In contrast, resilience was related to lower psychological distress. Social support and social concerns about help-seeking were not related to the outcome variables. Conclusions Type D personality may be a risk factor for more delayed help-seeking for an ACS and higher psychological distress after the cardiac event. Resilience, in contrast, emerged as a potential protective factor of patients' mental health after the cardiac event. Pre-hospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one's family) but not about social concerns (e.g., wasting other people's time) during the cardiac episode. Statement of Contribution What is already known on this subject? Longer pre-hospital decision delay, that is waiting longer to seek medical attention after symptoms have started, predicts poor prognosis of acute coronary syndrome patients. High psychological distress post-ACS, such as the development of anxiety and/or depression, also predicts poor prognosis of these patients. What does this study adds? This study identifies several psychosocial markers of longer prehospital decision delay and high psychological distress post-ACS. Prehospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one's family) but not about social concerns (e.g., wasting other people's time) during the cardiac episode. Type D personality and fewer concerns about the serious consequences of delaying help-seeking were related to more psychological distress, and these relationships were mediated by longer prehospital decision delay. Resilience was related to lower psychological distress post-ACS.
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Affiliation(s)
| | - Dafina Petrova
- Escuela Andaluza de Salud Pública, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dunia Garrido
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - José Antonio Ramírez-Hernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain.,Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany
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Balog P, Janszky I, Chen H, Rafael B, Hemmingsson T, László KD. Social relations in late adolescence and incident coronary heart disease: a 38-year follow-up of the Swedish 1969-1970 Conscription Cohort. BMJ Open 2019; 9:e030880. [PMID: 31822540 PMCID: PMC6924710 DOI: 10.1136/bmjopen-2019-030880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Increasing evidence suggests that low social support is associated with an elevated risk of coronary heart disease (CHD). Earlier studies in this field were conducted in predominantly middle-aged or older samples; thus, the associations reported previously may have been confounded by subclinical manifestations of the disease. We investigated whether social relationships in late adolescence, that is, well before symptoms of subclinical disease manifest, are associated with CHD during a 38-year follow-up. SETTING Sweden. PARTICIPANTS Men born 1949-1951 and conscripted for military service in Sweden during 1969-1970 (n=49 321). At conscription, participants completed questionnaires about social relationships, lifestyle and health-related factors and underwent a medical examination. PRIMARY AND SECONDARY OUTCOME MEASURES CHD, acute myocardial infarction (AMI). RESULTS We found no relationship between having no confidant and frequency of confidential discussions with friends and the risk of CHD or AMI in the first 30 years of follow-up. However, after 30 years, men with no confidant at baseline had increased CHD and AMI risks relative to those having a confidant; the childhood socioeconomic status-adjusted HR and 95% CIs (CI) were 1.25 (1.10 to 1.41) and 1.27 (1.08 to 1.49), respectively. The frequency of confidential discussions with friends had an inverse U-shaped relationship with the outcomes after 30 years; the HR (95% CI) for 'sometimes' versus 'quite often' was 1.16 (1.04 to 1.29) for CHD and 1.16 (1.01 to 1.33) for AMI. These associations persisted after adjusting for mental ill-health, lifestyle factors and systolic blood pressure. A low number of friends in late adolescence was not related to an increased CHD or AMI risk. CONCLUSIONS Not having a confidant in late adolescence was associated positively, while the frequency of confidential discussions with friends had an inverse U-shaped relationship with CHD and AMI after 30 years of follow-up, suggesting that these associations are not due to subclinical disease manifestations.
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Affiliation(s)
- Piroska Balog
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Imre Janszky
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Hua Chen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Beatrix Rafael
- Institute of Psychology, University of Szeged, Szeged, Hungary
- Department of Medical Rehabilitation and Physical Medicine, University of Szeged, Szeged, Hungary
| | - Tomas Hemmingsson
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Krisztina D László
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Clark EM, Williams RM, Park CL, Schulz E, Williams BR, Knott CL. Explaining the Relationship Between Personality and Health in a National Sample of African Americans: The Mediating Role of Social Support. JOURNAL OF BLACK PSYCHOLOGY 2019. [DOI: 10.1177/0095798419873529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Though associations between personality and health have been previously observed, less is known about why such relationships exist. The present study examines whether social support mediated the relationship between personality traits and health among African Americans. We hypothesized that social support would help explain the relationship between each of the five-factor model traits and physical functioning. Data were collected from a national probability sample of 803 African American adults using a telephone survey including measures of the five-factor model personality traits, social support, and physical functioning. Results of mediational analyses suggested that higher openness to experience, conscientiousness, extraversion, and agreeableness, and lower neuroticism predicted higher social support. Higher openness, conscientiousness, extraversion, and lower neuroticism, but not agreeableness, predicted higher physical functioning. The relationships between physical functioning and personality traits were at least partially mediated by social support. This study reinforces the importance of identifying the mechanisms underlying the personality-health relationship. This information may be useful to community members and health care providers in developing prevention and treatment strategies for African Americans.
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Affiliation(s)
| | | | | | - Emily Schulz
- Northern Arizona University, Phoenix, AZ, USA
- A.T. Still University, Mesa, AZ, USA
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Hanssen DJC, Rabeling-Keus IM, Lucassen PLBJ, Naarding P, van den Brink RHS, Comijs HC, Penninx BWJH, Oude Voshaar RC. Measuring social support in psychiatric patients and controls: Validation and reliability of the shortened Close Persons Questionnaire. J Psychiatr Res 2019; 116:118-125. [PMID: 31229726 DOI: 10.1016/j.jpsychires.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/07/2019] [Accepted: 06/11/2019] [Indexed: 11/19/2022]
Abstract
Although previous studies have underlined the protective role of social support for physical and psychological health, no self-report questionnaires are validated for measuring social support in large-scale psychiatric epidemiological studies. In the current study, we aim to validate the shortened version of the Close Persons Questionnaire (CPQ), a self-report questionnaire that is administered twice to measure social support received from the partner (CPQ-p) as well as from a close friend/family member (CPQ-f). Data of psychiatric patients (n = 1891) and controls (n = 1872) from three Dutch epidemiological studies that assessed determinants of psychopathology were used to validate the shortened CPQ. This included determining factor structure and reliability for the different scales. Using multigroup confirmatory factor analyses, a four-factor model proved to be the best fitting model for both the CPQ-p and CPQ-f. The resulting subscales -emotional support, practical support, negative support experiences, inadequacy of support-showed moderate to good reliability for both the CPQ-p and the CPQ-f, and were all correlated with other social measures in the expected directions. The shortened version of the CPQ proves to be a valid and reliable measure of social support for both psychiatric patients and controls. Further research is needed to assess usability of the shortened version of the CPQ for clinical practice.
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Affiliation(s)
- Denise J C Hanssen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands.
| | - Inge M Rabeling-Keus
- Radboud University Nijmegen, School of Psychology and Artificial Intelligence, Nijmegen, the Netherlands
| | - Peter L B J Lucassen
- Radboud University Nijmegen Medical Centre, Department of Primary and Community Care, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Paul Naarding
- Department of Old-age Psychiatry, GGNet, Apeldoorn, the Netherlands
| | - Rob H S van den Brink
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Hannie C Comijs
- Department of Psychiatry / EMGO Institute for Health and Care Research VU University Medical Center / GGZinGeest, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry / EMGO Institute for Health and Care Research VU University Medical Center / GGZinGeest, Amsterdam, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
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Interplay of Self-efficacy and Social Support in Predicting Quality of Life in Cardiovascular Patients in Pakistan. Community Ment Health J 2019; 55:855-864. [PMID: 30600399 DOI: 10.1007/s10597-018-0361-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
The primary objective of the present study was to assess independent and interactive relations of perceived social support and self-efficacy with four quality of life (QOL) domains namely physical, psychological, social, and environmental in cardiovascular disease (CVD) patients from a South Asian region. Participants were 172 (age 22-60 years) patients recruited from three major government sector hospitals from the fifth biggest city of South Asia. It was found that overall CVD patients had a better QOL in psychological and environmental domains compared to social and psychological. Furthermore, findings from hierarchical regression analyses indicated that perceived social support and self-efficacy were positively associated with the four QOL domains. Besides main effects, a synergistic interaction between social support and self-efficacy emerged indicating that perceived social support was strongly associated with physical and social QOL in CVD patients who had higher self-efficacy levels, while, perceived social support was weakly associated with the physical and social QOL in CVD patients who had lower self-efficacy levels.
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Jo E, Kim SR, Kim HY. Predictive model for quality of life in patients with recurrent coronary artery disease. Eur J Cardiovasc Nurs 2019; 18:501-511. [DOI: 10.1177/1474515119847544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: The aims of this study were to construct and verify a model that explains the quality of life in patients with recurrent coronary artery disease. Methods: Participants were 212 patients with recurrent coronary artery disease undergoing percutaneous coronary intervention. Data were collected through structured questionnaires from 21 December 2016–30 April 2017, and were analyzed using SPSS 23.0 and AMOS 23.0. Results: The model’s fit indices were adequate. Type D personality, symptom experience, and resilience had a direct effect on quality of life, while type D personality, cardiac function status, social support, and resilience had an indirect effect on quality of life. Type D personality, cardiac function status, social support, symptom experience, and resilience explained 55% of the total variance in quality of life. Thus, type D personality, cardiac function status, social support, symptom experience, and resilience affected the quality of life in patients with recurrent coronary artery disease. Conclusions: Systematic and integrated intervention programs considering factors related to quality of life may be useful for improving quality of life for patients with recurrent coronary artery disease.
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Affiliation(s)
- Eunhee Jo
- Department of Nursing, Kunsan College of Nursing, Korea
| | | | - Hye Young Kim
- College of Nursing, Research Institute of Nursing Science, Chonbuk National University, Korea
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Viet Vu CH, Uchino M, Kawashima M, Yuki K, Tsubota K, Nishi A, German CA, Sakata K, Tanno K, Iso H, Yamagishi K, Yasuda N, Saito I, Kato T, Arima K, Tomita Y, Shimazu T, Yamaji T, Goto A, Inoue M, Iwasaki M, Sawada N, Tsugane S. Lack of social support and social trust as potential risk factors for dry eye disease: JPHC-NEXT study. Ocul Surf 2019; 17:278-284. [DOI: 10.1016/j.jtos.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
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Pushkarev G, Kuznetsov V, Yaroslavskaya E, Bessonov I. Social support for patients with coronary artery disease after percutaneous coronary intervention. J Psychosom Res 2019; 119:74-78. [PMID: 30947821 DOI: 10.1016/j.jpsychores.2019.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND To assess how social support relates to parameters of patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI), and how social support affects patient's prognosis within 1 year after surgery. METHODS The study included 739 male and 236 female patients (975) who underwent PCI. To determine level of social support, the Multidimensional Scale of Perceived Social Support was used. The mean duration of a prospective follow-up was 12.0 ± 1.7 months. The Cox multivariate regression proportional hazard model was used to estimate the hazard ratio (HR) of death from all causes and cardiovascular disease (CVD). RESULTS A low level of social support in 5.7% of patients was observed, while 30.5% had a moderate level and 63.8% had a high level. Patients with low and moderate levels of social support were older than those with high level. Among patients with high levels of social support, more were male compared to patients with moderate level. During observation, 24 patients died from all causes (2.5%), while 21 (2.2%) died from CVD. In the multivariate Cox regression model the HR of social support for all causes of death was 0.97 (95% confidence interval, [CI], 0.94-0.99, p = 0.007), while death from CVD was 0.97 (95% CI, 0.94-1.00, p = 0.048). For patients with low level of social support, the HR for death from all causes was 4.52 (95% CI, 1.37-14.95, p = 0.013), while death from CVD was 3.66 (95% CI, 0.94-14.25, p = 0.061). CONCLUSION Social support level was associated with age and gender, and significantly and independently affected CAD patients' risk of death after PCI.
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Affiliation(s)
- Georgiy Pushkarev
- Scientific Department of Instrumental Research Methods, Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia.
| | - Vadim Kuznetsov
- Scientific Department of Instrumental Research Methods, Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Elena Yaroslavskaya
- Scientific Department of Instrumental Research Methods, Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Ivan Bessonov
- Scientific Department of Instrumental Research Methods, Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
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Trajectories of perceived social support in acute coronary syndrome. Qual Life Res 2019; 28:1365-1376. [DOI: 10.1007/s11136-018-02095-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 01/14/2023]
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Social support buffers the negative effects of stress in cardiac patients: a cross-sectional study with acute coronary syndrome patients. J Behav Med 2018; 42:469-479. [PMID: 30523503 DOI: 10.1007/s10865-018-9998-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 11/29/2018] [Indexed: 12/12/2022]
Abstract
Cardiac patients who have social support generally have better prognosis than patients who lack social support. Several theoretical mechanisms have been proposed to explain this protective effect, including the capacity of social support to buffer the negative effects of stress. We tested this buffering effect in a study of patients hospitalized for acute coronary syndrome (ACS) in Spain. Several days after the cardiac event patients answered a questionnaire measuring stressful events during their lifetime, perceived social support around the time of the cardiac event, and depression symptoms in the past week. Results showed that stressful life events were related to depressive symptoms and worse renal function post-ACS only among patients with low perceived social support. Among patients who reported enough social support, lifetime stress was not related to depressive symptoms. No similar effects were observed on other prognostic indicators such as troponin levels or the number of obstructed arteries. These results suggest that social support can buffer the negative effects of stress on the mental and physical well-being of cardiac patients.
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Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Netw Open 2018; 1:e182136. [PMID: 30646154 PMCID: PMC6324481 DOI: 10.1001/jamanetworkopen.2018.2136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
IMPORTANCE New US health care payment models have increasingly incentivized health care systems to promote health and reduce health care spending at the population level, with Medicare beneficiaries representing one of the largest populations affected by new payment models. Identifying novel strategies to promote health and reduce health care spending is necessary. OBJECTIVE To assess whether the overall well-being of a population is associated with health care spending for people 65 years of age or older. DESIGN, SETTING, AND PARTICIPANTS This US national, population-based cross-sectional study examined the association between county well-being and Medicare fee-for-service (FFS) spending. Population well-being, a holistic assessment of the overall health of the population comprising interrelated domains, including physical, mental, and social health, as measured by the Gallup-Sharecare Well-Being Index (2010), was linked to the mean spending per Medicare FFS beneficiary (2010) and county characteristics data for all US counties assessed. The data were adjusted for prevalence of 4 low-variation conditions (hip fracture, stroke, colorectal cancer, and acute myocardial infarction) and regional penetration of Medicare Advantage. Data analyses were conducted October 13, 2016, to October 31, 2017. MAIN OUTCOMES AND MEASURES Mean spending per Medicare FFS beneficiary per county. RESULTS In total, 2998 counties were assessed using county-level mean values, with 4 to 7317 participants (mean [SD] number of participants, 755 [1220]) per county. The mean (SD) values of the demographic characteristics of the participants were 50.8% (1.3%) female, 74.9% (16.5%) white, 12.1% (13.0%) black, 4.0% (5.3%) Asian, and 13.7% (14.8%) Hispanic with a mean (SD) of the median county age of 38.2 (4.4) years. Medicare spent a mean (SE) of $992 ($110) less per Medicare FFS beneficiary in counties in the highest quintile of well-being compared with counties in the lowest well-being quintile. This inverse association persisted after accounting for key population characteristics such as median household income and contextual factors such as urbanicity and health care system capacity. Medicare spent a mean (SE) of $1233 ($104) less per Medicare FFS beneficiary in counties with the greatest access to basic needs than in those with the lowest access. CONCLUSIONS AND RELEVANCE In this US national study, the overall well-being of a geographically defined population was inversely associated with its health care spending for people 65 years and older. Identifying this association between well-being and health care spending at the population level may help to lay the foundation for further study to first illuminate the mechanisms underlying the association and to second study interventions aimed at creating greater well-being and lower health care spending at the population level.
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Affiliation(s)
- Carley Riley
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Brita Roy
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Jeph Herrin
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
- Health Research and Educational Trust, Chicago, Illinois
| | - Erica S. Spatz
- Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Anita Arora
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | | | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
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Roy B, Riley C, Sears L, Rula EY. Collective Well-Being to Improve Population Health Outcomes: An Actionable Conceptual Model and Review of the Literature. Am J Health Promot 2018; 32:1800-1813. [PMID: 30079743 DOI: 10.1177/0890117118791993] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To propose collective well-being as a holistic measure of the overall "health" of a community. To define collective well-being as a group-level construct measured across 5 domains (vitality, opportunity, connectedness, contribution, and inspiration) and introduce an actionable model that demonstrates how community characteristics affect collective well-being. To review the literature describing each domain's association with health outcomes and community characteristics' associations with collective well-being. METHODS We came to consensus on topics describing each component of our conceptual model. Because "well-being" is not indexed in MEDLINE, we performed topic-specific database searches and examined bibliographies of papers retrieved. We excluded articles that were limited to narrow subtopics or studies within small subpopulations. Preference was given to quasi-experimental or randomized studies, systematic reviews, or meta-analyses. Consensus was reached on inclusion or exclusion of all articles. RESULTS Reviewed literature supported each of the proposed domains as important aspects of collective well-being and as determinants of individual or community health. Evidence suggests a broad range of community characteristics support collective well-being. CONCLUSIONS The health and quality of life of a community may be improved by focusing efforts on community characteristics that support key aspects of well-being. Future work should develop a unified measure of collective well-being to evaluate the relative impact of specific efforts on the collective well-being of communities.
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Affiliation(s)
- Brita Roy
- 1 Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Carley Riley
- 2 Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,3 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Higuchi M, Suzuki K, Ashida T, Kondo N, Kondo K. Social Support and Access to Health Care Among Older People in Japan: Japan Gerontological Evaluation Study (JAGES). Asia Pac J Public Health 2018; 30:425-436. [PMID: 30066571 DOI: 10.1177/1010539518786516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated cross-sectional associations between social support and access to health care among older Japanese people. From larger cohort datasets of community-dwelling people aged 65 years or older, 23 079 respondents were extracted. We summarized patterns of social support by gender and age group, then analyzed associations between social support and the experience of unmet health care needs, as a negative indicator of access. Adjusting for socioeconomic factors, multiple logistic regression identified that respondents who received instrumental support were less likely to experience unmet health care needs except males aged 65 to 69 years. The effect of receiving instrumental social support was larger than for household income and similar to anxiety about unexpected expenses. In the low-income group, these findings were highlighted among females aged 65 to 69 years and males aged 70 years and older. In addition to redistribution of financial resources, facilitating suitable social support may contribute to alleviating the access gap among older people.
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Rosland AM, Piette JD, Trivedi R, Kerr EA, Stoll S, Tremblay A, Heisler M. Engaging family supporters of adult patients with diabetes to improve clinical and patient-centered outcomes: study protocol for a randomized controlled trial. Trials 2018; 19:394. [PMID: 30041685 PMCID: PMC6057090 DOI: 10.1186/s13063-018-2785-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/04/2018] [Indexed: 01/02/2023] Open
Abstract
Background Most adults with diabetes who are at high risk for complications have family or friends who are involved in their medical and self-care (“family supporters”). These family supporters are an important resource who could be leveraged to improve patients’ engagement in their care and patient health outcomes. However, healthcare teams lack structured and feasible approaches to effectively engage family supporters in patient self-management support. This trial tests a strategy to strengthen the capacity of family supporters to help adults with high-risk diabetes engage in healthcare, successfully enact care plans, and lower risk of diabetes complications. Methods/design We will conduct a randomized trial evaluating the CO-IMPACT (Caring Others Increasing EnageMent in Patient Aligned Care Teams) intervention. Two hunded forty adults with diabetes who are at high risk for diabetes complications due to poor glycemic control or high blood pressure will be randomized, along with a family supporter (living either with the patient or remotely), to CO-IMPACT or enhanced usual primary care for 12 months. CO-IMPACT provides patient-supporter dyads: it provides one coaching session addressing supporter techniques for helping patients with behavior change motivation, action planning, and proactive communication with healthcare providers; biweekly automated phone calls to prompt dyad action on new patient health concerns; phone calls to prompt preparation for patients’ primary care visits; and primary care visit summaries sent to both patient and supporter. Primary outcomes are changes in patient activation, as measured by the Patient Activation Measure-13, and change in 5-year cardiac event risk, as measured by the United Kingdom Prospective Diabetes Study cardiac risk score for people with diabetes. Secondary outcomes include patients’ diabetes self-management behaviors, diabetes distress, and glycemic and blood pressure control. Measures among supporters will include use of effective support techniques, burden, and distress about patient’s diabetes care. Discussion If effective in improving patient activation and diabetes management, CO-IMPACT will provide healthcare teams with evidence-based tools and techniques to engage patients’ available family or friends in supporting patient self-management, even if they live remotely. The core skills addressed by CO-IMPACT can be used by patients and their supporters over time to respond to changing patient health needs and priorities. Trial registration ClinicalTrials.gov, NCT02328326. Registered on 31 December 2014. Electronic supplementary material The online version of this article (10.1186/s13063-018-2785-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ann-Marie Rosland
- VA Pittsburgh Center for Health Equity Research and Promotion, University Drive (151C), Building 30, 2nd Suite 2A128, Pittsburgh, PA, 15240-1001, USA. .,Department of Internal Medicine, University of Pittsburgh, 230 McKee Place, Pittsburgh, PA, 15213, USA.
| | - John D Piette
- Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI, 48109, USA
| | - Ranak Trivedi
- Center for Innovation to Implementation, VA Palo Alto Center for Innovation to Implementation, 795 Willow Road, 152MPD Building 324, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Standford University Medical School, 401 Quarry Road, Stanford, CA, 94305-5717, USA
| | - Eve A Kerr
- Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA.,Department of Internal Medicine, University of Michigan Medical School, 1600 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Shelley Stoll
- Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI, 48109, USA
| | - Adam Tremblay
- Department of Internal Medicine, University of Michigan Medical School, 1600 Plymouth Road, Ann Arbor, MI, 48109, USA.,Department of Ambulatory Care, VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
| | - Michele Heisler
- Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI, 48109, USA.,Department of Internal Medicine, University of Michigan Medical School, 1600 Plymouth Road, Ann Arbor, MI, 48109, USA
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Kroenke CH. A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival. Transl Behav Med 2018; 8:629-642. [PMID: 30016520 PMCID: PMC6065533 DOI: 10.1093/tbm/ibx061] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Women with larger personal social networks have better breast cancer survival and a lower risk of mortality. However, little work has examined the mechanisms through which social networks influence breast cancer outcomes and cancer outcomes more generally, potentially limiting the development of feasible, clinically effective interventions. In fact, much of the emphasis in cancer research regarding the influence of social relationships on cancer outcomes has focused on the benefits of the provision of social support to patients, especially through peer support groups, and only more recently through patient navigation. Though critically important, there are other ways through which social relationships might influence outcomes, around which interventions might be developed. In addition to social support, these include social resources, social norms, social contagion, social roles, and social burdens and obligations. This narrative review addresses how social networks may influence cancer outcomes and discusses potential strategies for improving outcomes given these relationships. The paper (a) describes background and limitations of previous research, (b) outlines terms and provides a conceptual model that describes interrelationships between social networks and relevant variables and their hypothesized influence on cancer outcomes, (c) clarifies social and psychosocial mechanisms through which social networks affect downstream factors, (d) describes downstream behavioral, treatment, and physiological factors through which these subsequently influence recurrence and mortality, and (e) describes needed research and potential opportunities to enhance translation. Though most literature in this area pertains to breast cancer, this review has substantial relevance for cancer outcomes generally. Further clarification and research regarding potential mechanisms are needed to translate epidemiological findings on social networks into clinical and community strategies to improve cancer outcomes.
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Affiliation(s)
- Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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