Can We Improve Our Physical Health by Altering Our Social Networks?

Racial-Ethnic Disparities in Hearing Aid Use: Price Responsiveness Among Older Adults with Hearing Loss

OBJECTIVE

To explore the role of racial-ethnic background, income, residential context, and historic variation in hearing aid (HA) price HA usage among a nationally representative cohort of older adults with hearing loss.

METHODS

Multilevel logistic regression models evaluated data from the 2012 through 2017 Medical Expenditure Panel Survey (MEPS) to 1) compare historic HA use between subgroups, 2) test for differential responsiveness to price changes between racial and ethnic groups, and 3) assess the relative role of demographic characteristics and HA use.

RESULTS

Between 2012 and 2017, the price of economy HAs decreased by 5% while HA use among Non-Hispanic (NH) Whites and Hispanics with hearing loss increased by 30% and 20% respectively, but usage among NH-Blacks increased by less than 10%. After controlling for relevant covariates, NH-Blacks were two times less likely than NH-Whites to use a HA. Household income and price were only significant for NH-Whites who showed that a 1% increase in income was associated with a 10% increase in the likelihood of HA use. Calculation of subgroup participation showed that, when the price of HAs dropped by 1%, the likelihood of HA use by NH-Whites increased by 14.2%, Hispanics increased by 13.2%, and Others increased by 14.8%, but only 2.8% among NH-Blacks.

CONCLUSION

Results suggest that cost is not the primary barrier to HA utilization among minoritized individuals from racial and ethnic groups. Additional analyses are needed to evaluate the role of social, cultural, and environmental influences on HA utilization.

Role of the Sibling Relationship to Reduce the Negative Impact of Adverse Childhood Experiences (ACEs) on Wellbeing in Adulthood

Over the past two decades, public health research has demonstrated that Adverse Childhood Experiences (ACEs) are associated with significant and prolonged physical and mental health problems, demanding investigation into the factors that may mitigate the poor outcomes. One potential factor that may attenuate the negative impact of ACEs on individuals' health is social support. An important source of social support, both during and after adverse childhood experiences, is sibling relationships. Consequently, the purpose of the current study was to examine if two components of sibling relationships-perceived warmth and conflict-affect the relationship between ACEs and wellbeing in adulthood. A total of 439 participants (Mage = 35.06, SD = 11.19) completed self-report measures of their ACEs, their perceived warmth and conflict with a living sibling, and their wellbeing. Results revealed that sibling relationships characterized by higher perceived warmth-and, interestingly, higher perceived conflict-attenuated the negative impact of ACEs on wellbeing in adulthood. Findings from the current study provide valuable information about how psychologist, social workers, and other health professionals may use siblings as a source of social support to mitigate the negative effects of ACEs on wellbeing in adulthood.

Cancer Patients' Social Relationships During 3 Years After Diagnosis-Generic and Cancer-Specific Social Networks

BACKGROUND

Social relationships are important health resources and may be investigated as social networks. We measured cancer patients' social subnetworks divided into generic social networks (people known to the patients) and disease-specific social networks (the persons talked to about the cancer) during 3 years after diagnosis.

METHOD

Newly diagnosed patients with localized breast cancer (n = 222), lymphoma (n = 102), and prostate cancer (n = 141) completed a questionnaire on their social subnetworks at 2-5 months after diagnosis and 9, 18, and 36 months thereafter. Generic and cancer-specific numbers of persons of spouse/partner; other family; close relatives, in detail; and friends were recorded as well as cancer-specific numbers of persons in acquaintances; others with cancer; work community; healthcare professionals; and religious, hobby, and civic participation. The data was analyzed with regression models.

RESULTS

At study entry, most patients had a spouse/partner, all had close relatives (the younger, more often parents; and the older, more often adult children with families) and most also friends. The cancer was typically discussed with them, and often with acquaintances and other patients (74-86%). Only minor usually decreasing time trends were seen. However, the numbers of distant relatives and friends were found to strongly increase by the 9-month evaluation (P < 0.001).

CONCLUSION

Cancer patients have multiple social relationships and usually talk to them about their cancer soon after diagnosis. Most temporal changes are due to the natural course of life cycle. The cancer widened the patients' social networks by including other patients and healthcare professionals and by an increased number of relatives and friends.

Sense of neighborhood belonging and health: geographic, racial, and socioeconomic variation in Wisconsin

Background

Individuals' sense of belonging (SoB) to their neighborhood is an understudied psychosocial factor that may influence the association between neighborhood characteristics, health, and disparities across socio-demographic groups.

Methods

Using 2014-2016 data from the Survey of the Health of Wisconsin (SHOW, N = 1,706), we conduct a detailed analysis of SoB and health in an American context. We construct OLS and logistic regressions estimating belonging's association with general, physical, and mental health. We explore geographic, racial, and socioeconomic variation to understand both the differential distribution of SoB and its heterogeneous relationship with health.

Results

A higher SoB is positively associated with better physical, mental, and general health. White participants report higher SoB than Black participants, yet the association between SoB and mental health is strongest among participants of color and urban residents.

Conclusion

Sense of belonging to neighborhood significantly predicts many facets of health, with place and individual characteristics appearing to moderate this relationship. Racial, geographic, and socioeconomic disparities in belonging-health associations raise important questions about who benefits from the social, economic, and physical aspects of local communities.

Enduring Bonds: Duration and Contact in Close Relationships in Late Life

BACKGROUND AND OBJECTIVES

Older adults maintain ties to long-duration social partners, some with whom have regular contact and some with whom have little contact. We asked whether these ties with little contact still offer a sense of connection and security, and buffer the effects of interpersonal stress in daily life. Helping older adults foster these ties may improve their mental health.

RESEARCH DESIGN AND METHODS

Participants (n = 313) aged 65+ completed a baseline interview reporting duration and contact frequency of their closest ties. Then, participants completed ecological momentary assessments every 3 hr for 5-6 days, reporting their social encounters and mood.

RESULTS

We classified ties according to duration (10+ years = long vs shorter duration) and frequency of contact (at least once a month = active vs dormant). Throughout the day, participants were more likely to have stressful encounters with long-duration active ties. Encounters with active ties were associated with more positive mood (regardless of duration) and encounters with long-duration dormant ties with more negative mood. Having more active ties buffered effects of interpersonal stress on mood, but more long-duration dormant ties exacerbated these effects.

DISCUSSION AND IMPLICATIONS

Supporting social integration theory, ties with frequent contact were associated with positive mood. Surprisingly, long-duration ties with infrequent contact exacerbated effects of interpersonal stress on mood. Older adults who lack contact with long-duration social partners may be more sensitive to interpersonal stress. Future interventions might focus on phone or electronic media to increase contact with long-duration social partners.

Social relationships, stress, and treatment adherence perceptions in type 2 diabetes and hypertension: between-person, within-person, and compositional associations

OBJECTIVE

Type 2 diabetes and hypertension are "intertwined" conditions with lifestyle treatment plans, but patients often struggle to consistently engage in and follow treatment plans. To identify potential mechanisms for improving patient adherence to lifestyle treatment plans for type 2 diabetes and hypertension, this longitudinal study investigated the extent to which situational changes in patient-practitioner relationships, close relationships, and stress, explain between-person, immediate within-person, and compositional change in patient behavior and attitudes.Methods and measures: Over one year, 167 participants with type 2 diabetes and/or hypertension completed seven questionnaires assessing adherence perceptions (adherence, benefit, and burden), patient-practitioner experiences (alliance and confusion), close interpersonal interactions (positive and negative), and stress.

RESULTS

Multilevel structural equation modeling analyses revealed that nearly all hypothesized between-person associations were significant. Moreover, all hypothesized predictors explained within-person change in at least one adherence outcome. Predictors also produced compositional effects where outcomes were predicted by scores sustained over time. Most social and stress variables had unique associations with adherence perceptions after controlling for other predictors.

CONCLUSION

Results highlight the complexity of change processes and importance of social relationships and stress for adherence. Greater understanding of these processes may improve outcomes for individuals with type 2 diabetes and/or hypertension.

Living arrangements, health lifestyles, and health outcomes among Chinese oldest-old

Background

Prior literature has documented a strong correlation between living arrangements and older adults' health outcomes. However, few studies have explained why this association exists. This study took the health lifestyle theory approach and brought health lifestyles into the link between living arrangements and Chinese oldest-old health outcomes. It examined (1) whether healthy lifestyle behaviors among the oldest-old varied by household contexts and (2) whether the health disparities among the Chinese oldest-old in different household contexts could be partially explained by their healthy lifestyles.

Methods

Using the most recent 2018 data released by the Chinese Longitudinal Healthy Longevity Survey (CLHLS), latent class analysis was applied to identify predominant health lifestyles among the Chinese oldest-old aged 85-105 years. Regression analyses were used to test the mediating effect of health lifestyles.

Results

Three distinct classes representing the health lifestyles of Chinese oldest-old emerged; health lifestyle patterns were found to vary by elders' living arrangements. The respondent's health lifestyles in diverse residential structures served as a mediator which can partially explain the health disparities among the oldest-old.

Conclusion

The results suggested that health lifestyles can serve as a mediator to explain the association between oldest-old living arrangement patterns and their health outcomes. The findings highlighted the importance of family, lifestyles, and cultural contexts to the health of the oldest-old.

Universal patterns in egocentric communication networks

Tie strengths in social networks are heterogeneous, with strong and weak ties playing different roles at the network and individual levels. Egocentric networks, networks of relationships around an individual, exhibit few strong ties and more weaker ties, as evidenced by electronic communication records. Mobile phone data has also revealed persistent individual differences within this pattern. However, the generality and driving mechanisms of social tie strength heterogeneity remain unclear. Here, we study tie strengths in egocentric networks across multiple datasets of interactions between millions of people during months to years. We find universality in tie strength distributions and their individual-level variation across communication modes, even in channels not reflecting offline social relationships. Via a simple model of egocentric network evolution, we show that the observed universality arises from the competition between cumulative advantage and random choice, two tie reinforcement mechanisms whose balance determines the diversity of tie strengths. Our results provide insight into the driving mechanisms of tie strength heterogeneity in social networks and have implications for the understanding of social network structure and individual behavior.

Social networks, social support, and life expectancy in older adults: the Cardiovascular Health Study

BACKGROUND

Social support and social networks have long been postulated to impact health outcomes but their impact on life expectancy and disability in older adults remains poorly quantified.

METHODS

As part of the Cardiovascular Health Study, we followed 5,749 adults aged 65 years and older from 4 US field centers for 25 years. We assessed the Lubben social network score [range 0-50] and a social support score [range 0-24] derived from the Interpersonal Support Evaluation List (ISEL-12) in two consecutive years starting at study recruitment. We used remaining years of life (YOL) from study enrollment to death to approximate life expectancy. We defined years of active life (YAL) as the number of study years in which participants lived without any difficulties in activities of daily living. We used compression of disability to reflect the proportion of life lived able (YAL/YOL). We used linear regression to adjust for socio-demographics and comorbidity.

RESULTS

The mean (standard deviation [SD]) scores were 32.3 ± 6.8 points for social network score and 8.3 ± 2.4 points for social support score. For every 1-SD increase in social network score, adjusted participant life expectancy was 0.40 years higher (95% CI 0.22-0.58; p<0.0001) and disability-free life expectancy 0.35 years higher (95% CI 0.18-0.53; p<0.0001). The association with life expectancy was modified by participant age (p<0.001), but it remained significant even among participants aged ≥75 years (3 months per SD; 95% CI 0.1-6 months, p = 0.04). Further adjustment for frailty did not attenuate the estimates. The social support scale was not significantly associated with YOL or YAL after adjustment for social network score, and neither measure was associated with compression of disability.

DISCUSSION

In older adults, higher social network scores are significantly associated with longer life expectancy and disability-free life expectancy.

Relationship of personality, psychological distress, and substance use with social network characteristics of college going young adults

Background

Causes of substance use are multifactorial. Factors such as personality, psychological distress, and the person's social ties contribute to the understanding of substance use problems of college students.

Aim

The current study aimed to investigate the association between personality traits and psychological distress with ego-centric social networks of substance-using and non-using college students.

Method

This cross-sectional descriptive study involved 902 undergraduate students from the government (n = 2) and government-aided (n = 9) colleges. The socio-demographic data sheet, Big Five Personality Inventory, Depression Anxiety and Stress Scale, and the semi-structured Ego-centric Social Network Questionnaire were used to collect data.

Results

Of 902 participants, 26.9% of participants used substances. The mean score of anxiety (P < 0.002) and depression (P < 0.002) was significantly higher among the substance users compared with non-users. Agreeableness (P < 0.001) and conscientiousness (P < 0.001) scores were significantly higher among non-users. Depression (P < 0.01), anxiety (P < 0.01), and stress (P < 0.01) correlated positively with the total number of substance users in the network. Agreeableness (P < 0.01) and conscientiousness (P < 0.01) were positively correlated with parents and siblings in the network. Stress emerged as a predictor (OR 1.61, CI 1.09-3.04, P < 0.001) for considering substance users to the social network.

Conclusion

Personality and psychological distress are associated with an individual's social network and significantly contribute to student substance use problems.

Effect of online and offline social network group clusters on life satisfaction across age groups

Background

Positive social relationships are critical for better subjective well-being across ages. Future research will benefit from examining how to improve life satisfaction by utilizing social groups in new, ever-changing social and technological contexts. This study aimed to evaluate the effect of online and offline social network group clusters on life satisfaction across different age groups.

Methods

Data were derived from the Chinese Social Survey (CSS) (2019), which is a nationally representative survey. We adopted a K-mode cluster analysis algorithm to categorize participants into four clusters according to their online and offline social network groups. ANOVA and chi-square analysis were used to understand the associations among age groups, social network group clusters, and life satisfaction. Multiple linear regression was applied to identify the association between social network group clusters and life satisfaction across age groups.

Results

Younger and older adults had higher life satisfaction than middle-aged adults. Individuals who joined diverse social network groups had the highest life satisfaction, followed by those who joined personal and working social groups, while those who joined restricted social groups had the lowest life satisfaction (F = 81.19, p < 0.001). According to the results of multiple linear regression, individuals who belonged to diverse social groups had higher life satisfaction than those who belonged to restricted social groups among adults aged 18-59 years, except students (p < 0.05). Individuals who joined personal and working social groups had higher life satisfaction than those who joined restricted social groups among adults aged 18-29 and 45-59 years (β = 2.15, p < 0.01; β = 1.45, p < 0.01).

Conclusions

Interventions to promote participation in diverse social network groups among adults aged 18-59 years, except for students, are highly recommended to improve life satisfaction. Health practitioners could provide interventions to encourage young and middle-aged adults to join both personal and working social groups.

The Importance of Positive Social Support During Reentry From Prison: Examining the Role of Volunteer Mentoring

Social support appears to be important in improving outcomes for incarcerated individuals during the reentry process not only in terms of general wellbeing but also in gaining employment and avoiding recidivism. Mentoring programs have become increasingly popular interventions that are intended to provide such support during reentry. However, research on mentoring programs is limited and tends to focus solely on the programs' impact on recidivism, a distal outcome. Through the use of semi-structured, in-depth interviews, this qualitative study focuses on more proximal outcomes, exploring how reentering individuals who are receiving volunteer mentoring through a transitional housing program define successful reentry and perceive the value of different types of support they received from their mentors. Participants identified several indicators of successful reentry and discussed the types of support that were helpful, harmful, or absent. Implications for practice and areas for future research are discussed.

Diversity in Social Communication and Support: Implications for Loneliness Among LGB Adults

BACKGROUND AND OBJECTIVES

Current research indicates that structural and functional social network attributes influence older adults' well-being. However, these linkages may vary by sexual orientation. This study examines how social communication diversity and support diversity are related to loneliness and differ between lesbian, gay, and bisexual (LGB) and heterosexual adults.

RESEARCH DESIGN AND METHODS

Using data from the American Association of Retired Persons Foundation's Loneliness and Social Connection Survey of adults 45+ (N = 3,009), including 10% who identified as LGB, we derive entropy scores, which capture the extent to which network size and quality of relationships are evenly distributed. A series of linear regressions were conducted to examine sexual orientation, social network indicators, and their interactions in predicting loneliness.

RESULTS

We found a positive association between social communication diversity and loneliness. This finding was qualified by the interaction with sexual orientation. In addition, we found a negative association between support diversity and loneliness, an effect that was stronger for LGB participants than for heterosexual participants. The effect of support diversity on loneliness was much stronger for LGB adults than heterosexual adults.

DISCUSSION AND IMPLICATIONS

While LGB adults tend to score higher on the loneliness scale overall, the findings suggest that communication and support diversity have uniquely different patterns of associations for sexual minority groups. This study highlights the importance of considering multiple dimensions of social networks and has implications for addressing loneliness for heterosexual and LGB adults.

Protocol for a feasibility randomized trial of a social support intervention plus usual care versus usual care, targeting patients treated for cardiac disease who experience loneliness

INTRODUCTION

In patients treated for cardiac disease, loneliness is known to contribute negatively to health behavior, health outcome, and increase risk of cardiac and all-cause mortality. Even so, in health care research, social support interventional studies targeting patients who experience loneliness are lacking.

AIM

To determine the feasibility of an individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness.

DESIGN

A feasibility study based on randomized clinical trial design with 1:1 randomization to a 6-month social support program, plus usual care (intervention) versus usual care, (i.e., regular guidelines-based follow-up).

INTERVENTION

Patients classified as high risk lonely according to the High Risk Loneliness tool will be provided with an informal caregiver in the 6 months rehabilitation phase following cardiac disease treatment. The informal caregiver will be designated by the patient from the existing social network or a peer, depending on patients' preferences. The core content of the intervention is through nurse consultations at baseline and 1, 3, and 6 months, to enhance and reinforce the informal caregiver's competences to be a social support resource. The theoretical framework of the nurse consultations will be based on middle-range theory of self-care.

OUTCOME

Feasibility will be evaluated in terms of acceptability and adherence according to predefined feasibility criteria. The preliminary effect of the intervention on patient-reported outcomes, health behaviors, and health outcomes will be evaluated in the intervention and the control group at baseline and 1, 3, 6, and 12 months.

DISCUSSION

The present study will contribute with knowledge on how to implement a feasible social support intervention targeting patients treated for cardiac disease who experience loneliness and, furthermore, investigate the preliminary effect on health behavior and health outcome in the early rehabilitation period.

TRIAL REGISTRATION

The trial is registered on clinicaltrials.gov (NCT05503810) 18.08.2022.

Weak, but not strong, ties support coalition formation among wild female chimpanzees

In social species, individuals may be able to overcome competitive constraints on cooperation by leveraging relationships with familiar, tolerant partners. While strong social ties have been linked to cooperation in several social mammals, it is unclear the extent to which weak social ties can support cooperation, particularly among non-kin. We tested the hypothesis that weakly affiliative social relationships support cooperative coalition formation using 10 years of behavioural data on wild female chimpanzees. Female chimpanzees typically disperse and reside with non-kin as adults. Their social relationships are differentiated but often relatively weak, with few dyads sharing strong bonds. Females occasionally form aggressive coalitions together. Three measures of relationship quality-party association, five-metre proximity and whether a dyad groomed-positively predicted coalitions, indicating that relationship quality influenced coalition partnerships. However, dyads that groomed frequently did not form more coalitions than dyads that groomed occasionally, and kin did not cooperate more than expected given their relationship quality. Thus, strong bonds and kinship did not bolster cooperation. We conclude that cooperative coalitions among female chimpanzees depend on social tolerance but do not require strong bonds. Our findings highlight social tolerance as a distinct pathway through which females can cultivate cooperative relationships. This article is part of the theme issue 'Cooperation among women: evolutionary and cross-cultural perspectives'.

La vida en la frontera: protocol for a prospective study exploring stress and health resiliencies among Mexican-origin individuals living in a US-Mexico border community

BACKGROUND

Mexican-origin adults living near the U.S.-Mexico border experience unique and pervasive social and ecological stressors, including poverty, perceived discrimination, and environmental hazards, potentially contributing to the high burden of chronic disease. However, there is also evidence that residents in high-density Mexican-origin neighborhoods exhibit lower prevalence rates of disease and related mortality than those living in other areas. Understanding the factors that contribute to health resiliencies at the community scale is essential to informing the effective design of health promotion strategies.

METHODS

La Vida en la Frontera is a mixed-methods participatory study linking a multi-disciplinary University of Arizona research team with Campesinos Sin Fronteras, a community-based organization founded by community health workers in San Luis, Arizona. This paper describes the current protocol for aims 2 and 3 of this multi-faceted investigation. In aim 2 a cohort of N≈300 will be recruited using door-to-door sampling of neighborhoods in San Luis and Somerton, AZ. Participants will be surveyed and undergo biomarker assessments for indicators of health and chronic stress at three time points across a year length. A subset of this cohort will be invited to participate in aim 3 where they will be interviewed to further understand mechanisms of resilience and wellbeing.

DISCUSSION

This study examines objective and subjective mechanisms of the relationship between stress and health in an ecologically diverse rural community over an extended timeframe and illuminates health disparities affecting residents of this medically underserved community. Findings from this investigation directly impact the participants and community through deepening our understanding of the linkages between individual and community level stress and chronic disease risk. This innovative study utilizes a comprehensive methodology to investigate pathways of stress and chronic disease risk present at individual and community levels. We address multiple public health issues including chronic disease and mental illness risk, health related disparities among Mexican-origin people, and health protective mechanisms and behaviors.

A school intervention promotes compassion, empathy and social relationships in children

There is increasing evidence to show that compassion and altruism are highly beneficial when cultivated from an early age. In the present study we explore the benefits of an intervention programme that seeks to develop affective empathy, compassion and altruism in 9-year-old children from a school of Buenos Aires, Argentina. A pretest-posttest controlled study was carried out with 48 children, half of whom carried out the intervention. The remaining children, who constituted the waitlist group, participated in academic tutoring activities conducted by the same research team. The intervention was successful in promoting children's altruistic and compassionate attitudes, evidenced by the results obtained in the universal altruism test, social integration, and affective response. Effect sizes ranged from medium to large in the intervention group. These positive findings were not observed in the waitlist group (non-significant effect sizes). This study shows that children's self-awareness and awareness of others tend to foster compassion and affective empathy, contributing to individual and collective well-being.

Mental health of unaccompanied refugee minors in Europe: A systematic review

BACKGROUND

Nearly half of the refugee and asylum seeking population in Europe is under the age of 18, and many of these individuals are unaccompanied children and adolescents.

OBJECTIVE

The aim of this systematic review is both to summarize findings regarding the prevalence of mental health disorders among unaccompanied refugee minors (URM) in European countries since the last available systematic review (October 2017), and to describe associated risk factors.

METHODS

Five databases were systematically searched for articles published between October 1, 2017 and May 1, 2022.

RESULTS

The findings from 23 studies conducted in 9 countries which examined 80,651 child and adolescent URM are explained. Afghanistan was the most common country of origin in the majority of studies and >75 % of the subjects were boys. Most of the studies (N = 13, 56.5 %) assessed posttraumatic stress disorder (PTSD) prevalence. We found a high prevalence of mental health disorders among URM children and adolescents, which varied considerably between studies, ranging from 4.6 % to 43 % for (PTSD), 2.9 % to 61.6 % for depression, 32.6 % to 38.2 % for anxiety and 4 to14.3 % for behavioral problems. Two studies looking at suicide attempts and deaths, also observed higher rates in URM compared to the host population of the same age. The studies looking at mental health risk factors suggest that levels of social support in the host country, rearing environment, and other factors are associated with psychopathology. Moreover, a meta-analysis of four studies regarding PTSD in URM and accompanied refugee minors (ARM) showed a lower prevalence among ARM: -1.14 (95%CI:-1.56-0.72).

CONCLUSIONS

PTSD, depression and anxiety are the most prevalent problems among the URM population in Europe. Early intervention in host countries is needed in order to improve mental health outcomes for this vulnerable population and avoid possible neglect.

Post-Traumatic Growth and Quality of Life among World Trade Center Health Registry Enrollees 16 Years after 9/11

A recent study of World Trade Center Health Registry enrollees found that about one-third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees' overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental functioning quality of life scales in a sample of 4760 enrollees from the Registry's Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry's baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sociodemographic and other variables. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: b = 0.15 (-0.45, 0.75), mental: b = 3.61 (2.85, 4.37)). Those who were physically injured during 9/11 showed larger improvements in mental functioning than those who were not. PTG has implications for the overall mental quality of life that should be further investigated.

Sosyal ağ çeşitliliği ve sosyal desteğin sağlık çalışanlarının gelişimine etkisi

Objectives: The well-being of healthcare workers is a critical indicator in the provision of high-quality care. Although researchers have stressed the importance of social interactions and social support, scarce data exist about their effects on healthcare workers’ well-being. In this study, we aim to advance the research on the relationships between social network diversity (SND), social support and thriving. Methods: In a cross-sectional design, an anonymous online link was shared among healthcare workers in a university hospital. The survey included questions on demographics, medical diseases, as well as items from the SND index, the multidimensional perceived social support scale, and the brief and comprehensive inventories of thriving scales. Results: A total of 103 individuals participated in the study (mean age ± standard deviation = 33±7.2; male/female = 33/70). Men and women did not differ in SND, perceived social support, or thriving scores. Healthcare workers older than 38 years exhibited higher scores in belonging (p=0.032), skills (p=0.006), self-worth (p=0.048), meaning and purpose (p

Assessing Interpersonal Proximity Evaluation in the COVID-19 Era: Evidence From the Affective Priming Task

Social proximity has since ever been evaluated as positive. However, the outbreak of the COVID-19 pandemic has dramatically reduced our social relations to avoid spreading the contagion. The present study aims to investigate people's current assessment of social proximity by using an affective priming paradigm (APP). We hypothesized that if our evaluation of social proximity is positive, then words with positive valence (e.g., relaxed) should be processed faster when preceded by images of social proximity than social distancing. On the contrary, if our evaluation of social proximity is turning negative, then words with a negative valence (e.g., sad) should be processed faster when preceded by images of social proximity than social distancing. To this end, we presented participants with prime images showing line drawings representing humans in situations of proximity or distancing and asked them to evaluate the valence (i.e., positive or negative) of a subsequent target word. In a follow-up session, the same participants evaluated the prime images as being positively or negatively valenced. Results showed that a large subset of participants who rated the prime images of social proximity as positive also processed positive words faster when these were preceded by images of social proximity than social distancing. Conversely, a smaller subset of participants who rated the prime images of social proximity as less positive processed negative words faster when these were preceded by images of social proximity than social distancing. These results suggest individual differences in the assessment of social proximity likely driven by the pandemic.

Life course transitions and changes in network ties among younger and older adults

Several theories of the life course highlight the importance of social connections and ties for coping with transitions that occur at different ages. Individuals rely on family, friends, and colleagues to adapt to these transitions which may in turn change the composition of their networks. Yet, little is known about the association between life cycle transitions and changes in network characteristics. We used fixed effects regression models with three waves of egocentric network data from the UC Berkeley Social Network Study (UCNets) to examine how career- and family-related life cycle transitions during two key life stages-young adulthood and the transition from middle to old age-are associated with network turnover, the proportion of the network comprised of kin, and confidence in receiving support from personal networks. Younger adults experienced churn following a birth and marriage or partnership, while no life transition was associated with changes in proportion kin, and only with the birth of a child did confidence decline. Among older adults, no transition was associated with any measured event, suggesting that older adults maintain more stable relationships compared to young adults and can weather life events without significant disruptions to their networks.

Experiences during COVID-19: Needs of college students with a history of foster care

The effects of the coronavirus disease 2019 (COVID-19) have been nothing short of profound, with disparate impact among historically marginalized and under-resourced populations. Eighty undergraduate college students, with a history of foster care placement, describe their experiences during Shelter in Place due to COVID-19. Former and current foster youth already experience challenges in accessing and completing higher education; these challenges were exacerbated by the measures taken to deal with risks associated with the pandemic. Study findings build upon previous studies that indicated that former and current foster youth have unique and significant pandemic related financial, physical and psychosocial concerns, by using conventional content analysis methods to describe what participants identified as needed resources. Findings have implications for future research and policy development, as well as resource provision during ongoing remote learning, and in preparation for the eventual transition back to in-person instruction.

Loneliness and Psychological Distress in Women Diagnosed with Ovarian Cancer: Examining the Role of Self-Perceived Burden, Social Support Seeking, and Social Network Diversity

The aim of the present study was to examine the role of self-perceived burden, social support seeking, and social network diversity in loneliness and psychological distress among women with ovarian cancer. A cross-sectional design was employed whereby 130 women diagnosed with ovarian cancer, recruited through various online sources (e.g., social media), completed the study via Qualtrics. Participants completed questionnaires that assessed self-perceived burden, social support seeking, social network diversity, loneliness, and psychological distress (anxiety, depressive symptoms). The models examined indicated that there were indirect effects of self-perceived burden and social network diversity on psychological distress via loneliness. Social support seeking was not significant in the models. Loneliness, self-perceived burden, and social network diversity should be of clinical concern among those working to support women with ovarian cancer. Future studies on longitudinal patterns or examining other factors associated with loneliness are needed to better understand the mental health of women with ovarian cancer.

Student ethnicity predicts social learning experiences, self-regulatory focus and grades

CONTEXT

Ethnic minority students find that their ethnicity negatively affects the evaluation of their capacities and their feelings in medical school. This study tests whether ethnic minority and majority students differ in their 'self-regulatory focus' in clinical training, that is, their ways to approach goals, due to differences in social learning experiences. Self-regulatory focus consists of a promotion and prevention focus. People who are prone to stereotypes and unfair treatments are more likely to have a prevention focus and conceal certain identity aspects. The objectives of the study are to test whether ethnic minority students, as compared with ethnic majority students, are equally likely to have a promotion focus, but more likely to have a prevention focus in clinical training due to more negative social learning experiences (Hypothesis 1), and whether the relationship between student ethnicity and clinical evaluations can be explained by students' gender, social learning experiences, self-regulatory focus and impression management (Hypothesis 2).

METHODS

Survey and clinical evaluation data of 312 (71.2% female) clerks were collected and grouped into 215 ethnic majority (69.4%) and 95 ethnic minority students (30.6%). Students' social learning experiences were measured as perceptions of unfair treatment, trust in supervisors and social academic fit. Self-regulatory focus (general and work specific) and impression management were also measured. A parallel mediation model (Hypothesis 1) and hierarchical multiple regression analyses were used (Hypothesis 2).

RESULTS

Ethnic minority students had higher perceptions of unfair treatment and lower trust in their supervisors in clinical training. They were more prevention focused in clinical training, but this was not mediated by having more negative social learning experiences. Lower clinical evaluations for ethnic minority students were unexplained. Promotion focus in clinical training and trust in supervisors positively relate to clinical grades.

CONCLUSION

Student ethnicity predicts social learning experiences, self-regulatory focus and grades in clinical training. The hidden curriculum plausibly plays a role here.

Does Diversity of Social Ties Really Matter More for Health and Leisure Activity than Number of Social Ties? Evidence from Later Adulthood

OBJECTIVES

Claims that the diversity of social ties matters more for health than the sheer number of ties have largely gone untested. This study accordingly compared the unique associations of number versus diversity of social ties with key health-related outcomes: functional limitations and leisure activities. Additionally, positive and ambivalent ties were distinguished.

METHODS

Social networks, health, and leisure activities were assessed in a national sample of older adults (N = 874; ages 65-91).

RESULTS

Regression analyses revealed that number of ties related to each outcome at a magnitude comparable to, or exceeding, that of diversity in most models. For positive ties, number related more strongly than diversity to greater leisure activities. For ambivalent ties, number related more strongly than diversity to worse functional limitations.

DISCUSSION

Contrary to prevailing views, diversity of ties is not necessarily more important than number of ties. Findings extend scientific understanding and approaches to interventions.

One size does not fit all: A qualitative study exploring preferences and barriers towards the design of a loneliness reduction intervention in patients with coronary heart disease

Aim

To explore preferences and barriers towards the design of a loneliness reduction intervention in patients treated for coronary heart disease who experience loneliness.

Design

A qualitative study using patient involvement methodology.

Methods

Seventeen patients participated in either focus groups or individual interview sessions. The interview guide was based on patient involvement methodology. Interviews were analysed using deductive content analysis.

Results

Four overall findings emerged as follows: (a) An intervention involving a social network member must comply with patients perceived social norms; (b) An intervention involving a peer provides benefits from reciprocity and shared experiences, but also requires surplus mental energy; (c) The history of an existing relationship can act as both provider and barrier for confidentiality and (d) Start‐up, timeframe and structure of the intervention should be individually tailored to the patient's preferences. Findings illuminated preferences and barriers towards the design of a loneliness reduction intervention in patients with coronary heart disease.

Social Innovation Toward a Meaningful Everyday Life for Nursing Home Residents: An Ethnographic Study

Background: The literature shows that innovation, which includes culture change, may be important to create a meaningful everyday life for nursing home residents. However, there is a gap in how social innovation practices may contribute to this. The theoretical discourse for the study is person-centered care.

Aim: The main aim was to explore phenomena within social innovation that can contribute to improving nursing home residents’ everyday lives.

Design and Method: This study uses an ethnographic design with observations and interviews in two nursing homes in Southern Norway.

Findings: The main theme was that social innovation within working practices in nursing homes includes phenomena that contribute to a meaningful everyday life for the residents. This main theme includes five subthemes: (1) opening the nursing home to the surroundings; (2) expanding and strengthening the community of practice; (3) facilitating customized activities; (4) ensuring sufficient nutrition and facilitating enjoyable mealtimes; and (5) preventing unrest and disturbing behavior.

Conclusion: The study reveals that innovation practices grounded in person-centered care in nursing homes may contribute to opening the nursing home to the community and establishing a common community practice for all members of the nursing home. This enables residents to experience meaningful everyday life through customized activities, sufficient nutrition, and a pleasant milieu during mealtimes. Disturbing behavior is also prevented, making it possible to promote meaningful lives in nursing homes.

Good Theories in Need of Better Data: Combining Clinical and Social Psychological Approaches to Study the Mechanisms Linking Relationships and Health

The study of intimate relationships and health is a fast-growing discipline with numerous well-developed theories, many of which outline specific interpersonal behaviors and psychological pathways that may give rise to good or poor health. In this article, we argue that the study of relationships and health can move toward interrogating these mechanisms with greater precision and detail, but doing so will require a shift in the nature of commonly used research methods in this area. Accordingly, we draw heavily on the science of behavior change and discuss six key methodologies that may galvanize the mechanistic study of relationships and health: dismantling studies, factorial studies, experimental therapeutics, experimental mediation research, multiple assessments, and recursive modeling. We provide empirical examples for each strategy and outline new ways in which a given approach may be used to study the mechanisms linking intimate relationships and health. We conclude by discussing the key challenges and limitations for using these research strategies as well as novel ideas about how to integrate this work into existing paradigms within the field.

Competing motives in a pandemic: Interplays between fundamental social motives and technology use in predicting (Non)Compliance with social distancing guidelines

During the COVID-19 pandemic, individuals were advised to adhere to social distancing guidelines limiting physical interpersonal contact. Humans have a suite of adaptations to satisfy belonging needs while avoiding diseased conspecifics. Competition between motivational systems may explain adherence and resistance to social distancing guidelines and how technologically mediated interactions further shape these decisions. This study is a preregistered analysis of data in a representative sample collected during the pandemic investigating how individual differences in affiliative and pathogen-avoidant motives predict interest in physical interactions (N = 2409). Germ aversion predicted disinterest in physical interactions and need to belong predicted interest. Additional analyses revealed technology use satisfied belonging motives that unexpectedly heightened interest in physical contact. Exploratory analyses further indicate that internet speed was similarly associated with greater interest in physical interactions. We frame these results through a competing fundamental social motives framework and discuss how to address future pandemics effectively.

Husband Support Mediates the Association between Self-Efficacy and Cervical Cancer Screening among Women in the Rural Area of Indonesia

Objective:

Standard cervical cancer screening is seen as the most efficient way of preventing cases of cervical cancer. This study aimed to test indirect husband support pathways and the use of self-efficacy and Visual Inspection with Acetic Acid (VIA) testing among women in Indonesian rural areas.

Methods:

The research implemented a cross-sectional design carried out in East Java, Indonesia, a remote county. The inclusion criteria were women between the ages of 30 and 50 years, married or women having experienced of having sexual intercourse, have been utilized VIA test at least 3 years ago. The Self-Efficacy Scale and the Husband Help Survey were used to test the interest variable. A structural equation modeling was used to assess the relationship between husband help and VIA test self-efficacy.

Results:

The study was followed by a total of 219 respondents. Women's mean age was 33.03 years (standard deviation [SD]: 6.44), and the mean age for the husband was 37.51 (SD: 7.45). Just 7.31% had a year ago VIA test, and most (65.75%) had a VIA test within 4 years. A husband's help had the greatest direct impact on the use of Papanicolaou tests, with a 0.312 direction coefficient (P < 0.001). The mediator between the husband's help and the use of VIA tests was self-efficacy (standardized coefficients of the path: 0.123, P < 0.001).

Conclusions:

Our analysis revealed a route through which husband help influences the use of VIA tests among women in Indonesian rural areas. Providers must consider the effect of husband support on VIA testing in promoting the use of VIA tests among females in Indonesia. One potential communication approach is that providers make improvements to improve the use of VIA tests in supporting self-efficacy.

Having more virtual interaction partners during COVID-19 physical distancing measures may benefit mental health

Social interactions play an extremely important role in maintaining health and well-being. The COVID-19 pandemic and associated physical distancing measures, however, restricted the number of people one could physically interact with on a regular basis. A large percentage of social interactions moved online, resulting in reports of "Zoom fatigue," or exhaustion from virtual interactions. These reports focused on how online communication differs from in-person communication, but it is possible that when in-person interactions are restricted, virtual interactions may benefit mental health overall. In a survey conducted near the beginning of the COVID-19 pandemic (N2020 = 230), we found that having a greater number of virtual interaction partners was associated with better mental health. This relationship was statistically mediated by decreased loneliness and increased perceptions of social support. We replicated these findings during the pandemic 1 year later (N2021 = 256) and found that these effects held even after controlling for the amount of time people spent interacting online. Convergent with previous literature on social interactions, these findings suggest that virtual interactions may benefit overall mental health, particularly during physical distancing and other circumstances where opportunities to interact in-person with different people are limited.Open Science Framework repository: https://osf.io/6jsr2/ .

Sustainable Urban Development for Older Australians: Understanding the Formation of Naturally Occurring Retirement Communities in the Greater Brisbane Region

As most older Australians prefer to age-in-place, providing sustainable and age-friendly communities poses a significant challenge to urban policymakers. The naturally occurring retirement communities (NORCs) have organically emerged as a collaborative model of care to support older adults to age-in-place, but neither academic research nor government policies recognise this housing option for older Australians. This paper aims to analyse the distributions and temporal patterns of NORCs in the Greater Brisbane Region, Australia, to understand the formation and development of NORCs. The geovisualisation method was employed to identify the distribution changes of NORCs between 2006 and 2016. The Global Moran’s I and Local Moran’s I measures were utilised to analyse the spatial correlation and the clusters of NORCs. The results show that NORCs increased significantly from 2006 to 2016, and their distribution was mainly clustered or co-located along the coastline and Brisbane River areas. The evolvement of NORCs reflected the change of aggregation pattern of older population between 2006 and 2016. Understanding the distribution trend of NORCs informs government policy and decisions in addressing issues of service delivery and community cooperation, and eventually leads to sustainable urban development and successful ageing in place for older Australians.

Prognostic value of a brief loneliness questionnaire for patients with coronary heart disease: Proposal for a prediction model

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.

Social integration after moving to a new city predicts lower systolic blood pressure

Residential mobility is linked to higher incidence of cardiovascular disease (CVD) and mortality. A mechanism by which residential relocation may impact health is through the disruption of social networks. To examine whether moving to a new city is associated with increased CVD risk and whether the extent to which movers rebuild their social network after relocating predicts improved CVD risk and psychosocial well-being, recent movers (n = 26), and age- and sex-matched nonmovers (n = 20) were followed over 3 months. Blood pressure, C-reactive protein/albumin ratio (CRP/ALB), social network size, and psychosocial well-being were measured at intake (within 6 weeks of residential relocation for movers) and 3 months later. Multiple regression indicated higher systolic blood pressure (SBP) for movers (M = 107.42, SD = 11.39), compared with nonmovers (M = 102.37, SD = 10.03) at intake, though this trend was not statistically significant. As predicted, increases in movers' social network size over 3 months predicted decreases in SBP, even after controlling for age, sex, and waist-to-hip ratio, b = -2.04 mmHg, 95% CI [-3.35, -.73]. Associations between increases in movers' social ties and decreases in depressive symptoms and stress were in the predicted direction but did not meet the traditional cutoff for statistical significance. Residential relocation and movers' social network size were not associated with CRP/ALB in this healthy sample. This study provides preliminary evidence for increased SBP among recent movers; furthermore, it suggests that this elevation in CVD risk may decrease as individuals successfully rebuild their social network.

The experience of close personal relationships after stroke: scoping review and thematic analysis of qualitative literature

Background and Purpose:

Psychosocial difficulties, including changed relationships are among the most pervasive and concerning issues following stroke. This study aimed to collate and thematically analyse qualitative literature describing the experience of close personal relationships from the perspective of stroke survivors.

Method:

Using a scoping review methodology, four databases (CINAHL/EBSCO, MEDLINE/Pubmed, Embase, Psychinfo) were systematically searched, yielding 3100 citations. Following exclusion of duplicates and screening against inclusion criteria at title/abstract and full text levels, 53 articles were included in the review. Data were charted and thematically analysed.

Results:

While research has increased since 2000, longitudinal designs are few. Four overarching themes and 12 subthemes were identified. ‘Social disruption’ described changing social worlds, lost social opportunities and shrinking networks. ‘Changed relationships’ included changed family and spousal relationships and changed parenting relationships. The third theme ‘relationships help’ highlighted positive aspects including belonging, support and a life worth living. The final theme was ‘coping with an altered social world’ and described adjustment and emotional responses.

Conclusions:

Relationships are an important aspect of life post stroke but are subject to changes and challenges. This article brings together a breadth of qualitative data to describe lived experiences. Further research, in particular, longitudinal research is required.

A School Intervention Helps Decrease Daily Stress While Enhancing Social Integration in Children

Stress coping is highly relevant during childhood. This study analyses how the participation in a behavioral intervention involving mindfulness-based practices and empathic collaboration activities impact on diurnal cortisol rhythm and social integration in children. In both experimental and waitlist groups, we evaluated before and after the intervention: daily stress, by sampling salivary cortisol at three measurement time-points, and social integration, assessed by a social preference index. Daily average cortisol (DAC) and the area under the curve (AUC) differed when comparing pre-post intervention values in both groups: in the experimental group these measures decreased while in the waitlist group DAC and AUC increased. At the end of the intervention, the experimental group showed an enhancement in the social preference index whereas this parameter diminished in the waitlist group. This kind of behavioral intervention seems to be effective at reducing daily stress and improving social integration in Primary School children.

No Evidence for Social Surrogacy in Fostering Intentions to Follow Social Distancing Guidelines

Abstract. We tested whether temporary social needs satisfaction through social surrogacy would ensure greater willingness to adhere to social distancing recommendations elicited by the COVID-19 pandemic. Participants were randomly assigned to social exclusion or inclusion via Cyberball ( n = 534) followed by either a social surrogacy manipulation (imagine favorite TV show), or one of two control states. No restorative effects emerged following a social surrogacy prime. An exploratory analysis considering age as a moderator ( MAge = 36.89 years, SD = 10.88, range = 19–70 years) found that excluded adults (i.e., middle and older ages) reported more intentions to deviate following surrogacy experiences relative to control experiences; no effects emerged for younger adults in this analysis. We discuss the limitations of social surrogacy in fostering compliance with social distancing initiatives.

Association between social network structure and physical activity in middle-aged Korean adults

PURPOSE

Evidence suggests that physical activity participation is shaped through a myriad of structural aspects of social relationships. We examined the relationship between social network structure based on egocentric social network and physical activity.

METHODS

From 6799 middle-aged Korean adults, we assessed the social network density and proportion of closed triads, using the name generator module. Self-reported physical activity for functional and leisure purposes was calculated in metabolic equivalent of task (MET)-min/week. We employed sex-stratified, multivariable linear regression to assess the association between each network structure variable and total physical activity, adjusting for age, network size, socioeconomic status, and comorbidities. We also examined the association with moderate-to-vigorous physical activity (MVPA) and wrist-worn accelerometer assessed physical activity.

RESULTS

The network members of female participants were more likely to be of same sex and family member compared to those of males. There were no sex differences in average network size. Network density based on affiliation was sex-differentially associated with physical activity (male β -346.7, p 0.2221 and female β -528.6, p 0.0002). In parallel, the proportion of closed triads was negatively associated with physical activity only in females (male β -542.6, p 0.0551 and female β -641.51, p < 0.0001). However, network density and closed triads were insignificantly yet positively associated with MVPA in male (density β 229.7, p 0.3193 and closed triad β 109.21, p 0.6333). Network structure by contact frequency or emotional closeness and accelerometer-assessed physical activity showed inconsistent results.

CONCLUSION

Understanding the role of social network structures can help to achieve ideal physical activity level in the context of primary prevention of cardiometabolic disorders.

Life after incarceration: The impact of stability on formerly imprisoned Oxford House residents

According to the National Institute on Drug Abuse, roughly 65% of the US prison population is diagnosed with a substance use disorder (SUD) and over 600,000 individuals are released from incarceration yearly. Thus, it is important to better understand the factors that allow individuals recovering from SUD to reintegrate into communities after incarceration. This study sought to understand the relationship between a personality mediator (stability) and quality of life (QOL) and belonging support (BS), as well as the relationship between this mediator and QOL and psychological sense of community (PSOC) for 131 individuals living in Oxford House (OH) recovery homes. Stability was found to mediate the relationship between BS and QOL, as well as PSOC and QOL. The findings suggest that OH is a supportive and positive recovery community for those with criminal justice backgrounds, particularly those with higher stability.

The Socioecological Model as a framework for exploring factors influencing childhood immunization uptake in Lagos state, Nigeria

Background

Nigeria is one of the ten countries globally that account for 62% of under- and unvaccinated children worldwide. Despite several governmental and non-governmental agencies’ interventions, Nigeria has yet to achieve significant gains in childhood immunization coverage. This study identifies intrapersonal, interpersonal, organizational, community, and policy-level factors that influence childhood immunization uptake from various stakeholders’ perspectives using the Socioecological Model (SEM).

Methods

Using the Socioecological Model as a guiding framework, we conducted ten focus group sessions with mothers/caregivers and community leaders residing in Lagos state and nine semi-structured interviews with healthcare workers who provide routine immunization services in Lagos state primary healthcare facilities. We performed a qualitative analysis of focus groups and semi-structured interviews using deductive coding methods.

Results

The study sample included 44 mothers/caregivers and 24 community leaders residing in Lagos State, Nigeria, and 19 healthcare workers (routine immunization focal persons) working in the primary healthcare setting in Lagos state. Study participants discussed factors at each level of the SEM that influence childhood immunization uptake, including intrapersonal (caregivers’ immunization knowledge, caregivers’ welfare and love of child/ren), interpersonal (role of individual relationships and social networks), organizational (geographical and financial access to health facilities, health facilities attributes, staff coverage, and healthcare worker attributes), community (community outreaches and community resources), and policy-level (free immunization services and provision of child immunization cards). Several factors were intertwined, such as healthcare workers’ education of caregivers on immunization and caregivers’ knowledge of vaccination.

Conclusions

The reciprocity of the findings across the Socioecological Model levels emphasizes the importance of developing multi-pronged interventions that operate at multiple levels of the SEM. Our results can inform the design of culturally appropriate and effective interventions to address Nigeria’s suboptimal immunization coverage.

Disentangling the root causes of COVID-19 related increases in alcohol consumption

Recent studies suggest that the COVID-19 pandemic has increased alcohol sales and alcohol related problems. This may be due to the synergistic effects of unemployment, stress from childcare or additional caregiving responsibilities, reduced social interactions and negative coping strategies. Weerakoon and colleagues set out to identify the most robust risk factors for alcohol consumption, binge drinking, and changes in drinking patterns due to the COVID-19 pandemic. One-third of the sample reported consuming more alcohol after COVID-19 compared to pre-COVID-19. In addition, each additional week spent at home under stay-at-home orders was increased the odds of binge drinking by 19%. Individuals who have been diagnosed with depression and were currently experiencing depressive symptoms were more than three times more likely (OR = 3.37) to have increased their alcohol consumption during COVID-19 compared to those with no history or symptoms of depression. Parents of children was associated with decreased COVID-19 related binge drinking (OR = .74). As many daily life factors have been altered due to the pandemic, a more holistic lifestyle disruption construct may help further investigate the long term effects of social isolation on alcohol use as the pandemic continues. Furthermore, the role of social support in mitigating COVID-19-related stress has yet to be examined and may be a protective factor against alcohol related problems. As stress continues, researchers should continue assessing the longitudinal effects of COVID-19 lockdowns with the goal of early identification for those at the highest risk of problematic alcohol use.

Effects of Living Conditions, Subjective Integration, and Social Networks on Health-Related Quality of Life among the Migrant Elderly Following Children in Jinan, China

With accelerated urbanization in China, an increasing number of the migrant elderly following children (MEFC) have appeared. This study aims to explore the effects of living conditions, subjective integration, and social networks on the health-related quality of life (HRQOL) of MEFC in Jinan, China. HRQOL was assessed by the 12-item Short-Form Health Survey, which included the mental component summary (MCS) and the physical component summary (PCS). Univariate analyses and binary logistic regression were used to investigate the association between the above indicators and HRQOL. A total of 656 MEFC were selected by multi-stage cluster random sampling, 25.2% and 25.0% of whom were defined as poor MCS and poor PCS, respectively. Those who understood the local dialect, could trust others, and connected with friends were more likely to have good MCS; those with a nanny, faulty elevator, and no support from their spouse were the reverse. MEFC who were trans-city, had no elevator or a faulty elevator, and went to the hospital alone were more likely to have poor PCS; those who approved of living conditions in their hometowns were the reverse. Results indicated that better living conditions, stronger subjective integration, and wider social networks led to higher HRQOL of MEFC. Implications of the government, communities, and families of MEFC were given to improve their HRQOL.

Revisiting the "The Breakfast Club": Testing Different Theoretical Models of Belongingness and Acceptance (and Social Self-Representation)

The current work tests different theoretical models of belongingness and acceptance as fundamental needs for human motivation. In the current study, 372 participants were presented with 52 different items measuring five different theoretical models of belongingness (with a total of 32 items) and three different theoretical models of acceptance (with a total of 20 items). In a first step, Confirmatory Factor Analysis (CFA) failed to provide support for these eight theoretical models. In a second step, we therefore applied Exploratory Factor Analysis yielding three factors, which we interpreted as communicating: (1) Belongingness, (2) Emotion-Acceptance, and (3) Social Self-Representation. In a third step, these three factors were corroborated by a CFA. We discuss how these two factors of “belongingness,” “emotion-acceptance” respond to the literature on the need to belong and be accepted, and we reflect on how ‘social self-representation’ seems to be an alternative motivation for how we present ourselves to our social relations to fulfill our needs.

Social Symptoms of Parkinson's Disease

Parkinson's disease (PD) is typically well recognized by its characteristic motor symptoms (e.g., bradykinesia, rigidity, and tremor). The cognitive symptoms of PD are increasingly being acknowledged by clinicians and researchers alike. However, PD also involves a host of emotional and communicative changes which can cause major disruptions to social functioning. These incude problems producing emotional facial expressions (i.e., facial masking) and emotional speech (i.e., dysarthria), as well as difficulties recognizing the verbal and nonverbal emotional cues of others. These social symptoms of PD can result in severe negative social consequences, including stigma, dehumanization, and loneliness, which might affect quality of life to an even greater extent than more well-recognized motor or cognitive symptoms. It is, therefore, imperative that researchers and clinicans become aware of these potential social symptoms and their negative effects, in order to properly investigate and manage the socioemotional aspects of PD. This narrative review provides an examination of the current research surrounding some of the most common social symptoms of PD and their related social consequences and argues that proactively and adequately addressing these issues might improve disease outcomes.

Perceived Social Support and Its Effects on Changes in the Affective and Eudaimonic Well-Being of Chilean University Students

The beginning of university life can be a stressful event for students. The close social relationships that they can experience can have positive effects on their well-being. The objective of this paper is to estimate the effect of perceived social support on the changes of the hedonic and eudaimonic well-being of Chilean university students during the transition from the first to the second academic year. Overall, 205 students participated (63.90% men and 36.09% women) with an average age of 19.14 years (SD = 1.73), evaluated during their first academic year (2017) and the succeeding one (2018). For the evaluation of perceived social support, the Spanish version of the Perceived Social Support Questionnaire "MSPSS" was used, and PERMA-profiler was used to measure hedonic and eudaimonic well-being. Changes through the time of hedonic well-being and social support and the correlations between the variables were analyzed. Changes in the perception of social support were analyzed according to four categories of hedonic well-being. The prediction of social support for eudaimonic well-being was evaluated. Results indicated that the perception of students' social support did not change over time. Statistically significant differences were found in hedonic well-being scores in the two measurements, being significantly higher in the first measurement than in the second one. More than 50% of the participants presented a positive balance of affections. The perception of social support is associated with the two types of well-being. Students who had a high balance of affections had a greater perception of general social support than the groups of positive evolution of affections and a low balance of affections. In the case of the friends and family support dimensions, the perception in the high-balance group of affections concerning the low-scale group is greater. Improving the perception of social support increases the eudaimonic well-being of university students. The perception of support that students had during the beginning of their university life benefits their general well-being, which contributes to their mental health.