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PubMed1992

Developing partnerships for health and social science research: the International Clinical Epidemiology Network (INCLEN) social science component.

A decade after its inception, the International Clinical Epidemiology Network (INCLEN) adopted a social science component. Health social science concepts were added to a physician training curriculum encompassing epidemiology, biostatistics and clinical economics, and a position was created for qualified social scientists at 26 clinical epidemiology units in developing country medical schools. This paper describes the INCLEN model for strengthening partnerships among clinical epidemiologists and social scientists. The rationale for interdisciplinary training is presented along with the difficulties inherent in attracting social scientists to a new career path. These include problems of recruitment, training curricula, re-entry, and career sustainability. The need is identified for collaborative international efforts to promote an infrastructure for professional growth and sustainable careers in health social science.

Biometry↗
PubMed1998

Private support and social security.

"The issue is addressed whether assistance to persons in need can be left to the ¿family' and the ¿community'. In that case people depend on their social networks. The support a person receives through a given network of social ties is examined. However, ties are diverse and subject to change. By means of a model of the dynamics of social ties, the conditions for adequate private support are analyzed. The sustainability of private support over time is examined by incorporating the impact on social ties of lending and receiving support. It is shown that support is only an effective alternative in a limited number of situations."

Economics↗
PubMed1983

Social support networks of the elderly: racial differences and health care implications.

Interest in social support networks has increased in recent years. A configuration of family, friendships, neighbors, neighborhood groups, comprise the social support network of individuals and families. Other entities referred to in social network of individuals and families. Other entities referred to in social support literature include self-help and mutual help organizations. Interest in descriptive studies of social support networks includes both structural and interactional factors. In analyses of structural factors in social support networks, the focus is most frequently on size (number of persons), density (proportion of linkages) and centrality (extent of accessibility).

Black or African American↗
PubMed1994

Capacity building for health social science: the International Clinical Epidemiology Network (INCLEN) social science program and the International Forum for Social Science in Health (IFSSH).

This paper describes the unfolding of two complementary efforts to build global capacity in health social science. The INCLEN model aims to infuse a genuine transdisciplinary perspective into international health through equipping social scientists to speak a common language with clinical epidemiologists and sensitising clinicians to the ways social sciences contribute to research and policy. Issues are raised pertinent to the model's viability, including recruitment of scholars for fellowships, curriculum substance, and mechanisms for integrating social science fellows when they return home. The future success of the INCLEN program, and comparable donor initiatives, depends upon a wider infrastructure of career supports played out at the international level in which donor and operating agencies nourish the emergence of an expanded body of health social scientists. The International Forum for Social Sciences in Health (IFSSH) has been formed to help build this infrastructure and provide impetus for a viable scientific community of health social scientists. The IFSSH 'global agenda' is portrayed and an illustration is given of how this agenda is being implemented in the Asia and Pacific region.

Career Choice↗
PubMed1989

Social support and the outcome of major depression.

One hundred and fifty middle-aged and elderly adults with a diagnosis of major depression were assessed initially as in-patients, and were reinterviewed 6-32 months later. Both size of social network and subjective social support were significant predictors of depressive symptoms at follow-up, with baseline depression scores and other predictors of outcome status statistically controlled. Subjective social support was most strongly associated with major depression; this effect was significantly stronger for middle-aged than older adults, and for men than women. Differences in the effects of marital status, size of social network, and subjective social support also suggest the importance of distinguishing between involvement in and quality of interpersonal relationships.

Adult↗
PubMed2003

Social support, early retirement, and a retirement preference: a study of 10,489 Finnish adults.

The aim of the study was to examine associations of social support with early retirement and reported retirement preference. Logistic regression analyses of early retirement (retired before the age of 55) were based on a cohort of 10,489 respondents (5960 female, 4529 male) aged 40-55 years. Analyses of retirement preference (planning of early retirement) were based on a sub-cohort of 7759 full-time employees (4233 female, 3526 male). The measures for social support were the social network size (number of close personal relationships) and social network heterogeneity (number of different roles as sources of social support). Among women, early retirement was associated with small social networks (OR 5.1, 95% CI = 2.8-9.2) and low social network heterogeneity (OR 9.1, 95% CI = 3.2-25.9). Among men, the corresponding associations were somewhat smaller (1.5; 0.9-2.6 and 8.0; 1.8-35.7, respectively). Adjustments for age, occupational training, and spouse at home did not considerably affect these associations. Among men, the association between social network heterogeneity and early retirement was not statistically significant after additional adjustments had been made for marital status and perceived health status. The characteristics of the social network were not associated with a retirement preference among employed men. Among women, the lack of social relations was associated with low retirement preference. Our findings suggested that social support is not independently associated with a retirement preference among men. Socially isolated women prefer retirement less often than other women do. Being retired before the age of 55 years may be predicted by limited social support or it may restrain one's possibilities to establish and maintain social relationships.

Adult↗
PubMed1984

The structure and function of social support networks in families with handicapped children.

Three structural characteristics of social support networks (size, density, and boundary density) and two relationship characteristics (reciprocity and dimensionality) were assessed in a sample of 56 families with a child with spina bifida and 53 matched comparison families. The results indicate that social networks of families with handicapped children tended to be smaller than the networks of comparison families, particularly with regard to mothers' total and friendship networks. The networks of families with handicapped children were more dense as well. As predicted, there was greater boundary density in spousal networks in families with handicapped children. Differences in network reciprocity were inconclusive while the results indicate that families with handicapped children tended to rely more heavily upon multidimensional network contacts than did comparison families. The results are discussed in light of our understanding of stress, social support, and the social ecological context of families.

Adolescent↗
PubMed2005

Micro-social structural approaches to HIV prevention: a social ecological perspective.

To be effective and sustainable, HIV-prevention interventions need to be sufficiently powerful to counteract prevailing social norms and diffuse through the targeted community to provide social reinforcement for behaviour change. Social structural and environmental factors are major influences on HIV-related behaviours yet the dearth of conceptualization and operationalization of these factors impede progress in intervention development. In this paper we propose a social ecological perspective to intervention and highlight relevant theories from social psychology and organizational behaviour literatures. We examine social networks and social settings as micro-structural and environmental influences on HIV risk behaviours, social identities and norms, and as important targets for HIV-prevention intervention. Intervention approaches are proposed that target networks and behavioural settings and provide participants with socially meaningful and rewarding behavioural options that are consistent with valued prosocial identities or roles. Examples are presented on how such an approach has been utilized in prior HIV prevention interventions, including our social network-oriented intervention that trained disadvantaged former and current illicit drug users to conduct peer outreach. We describe how behavioural interventions may enhance or introduce new prosocial identities and social roles, and that network members may confer social approval to reinforce these identities and roles, leading to sustained behavioural risk reduction and changes in risk behaviour norms.

Community Health Services↗
PubMed2006

Mechanisms through which drug, sex partner, and friendship network characteristics relate to risky needle use among high risk youth and young adults.

Drug injector social networks are a primary social space in which risky needle use behaviors associated with HIV transmission occur, but the mechanisms through which these social networks influence risky needle use are unclear. This study investigated two mechanisms, social support and social regulation, through which injection drug users' social networks might relate to risky needle use behaviors. We investigated how these mechanisms work in three types of social networks, namely, drug user, sex partner, and friendship networks. Data are from a study of HIV risk and protective behaviors of youth and young adults, ages 14-43, in the United States who were injection drug users and/or the sexual partners of users (N = 277). The three types of networks were constructed based on information respondents provided about their drug use partners, sexual partners, and friends. The networks were characterized by structural (i.e., size and density) and interactional (i.e., multiplexity and closeness) characteristics. We conducted tests for mediation using ordered probit models and multiple linear regression. In the drug networks, social regulation partially meditated the relationship between multiplexity and risky needle use (p<.10). In the sex partner networks, emotional support partially mediated the relationship between network size and risky needle use (p<.001), fully mediated the relationship between network closeness and risky needle use (p<.001), and partially mediated the relationship between multiplexity and risky needle use (p<.01). Mediators were not identified in the friendship networks. The findings demonstrate that network mechanisms explaining risky needle use differ for drug user and sex partner networks in ways consistent with the functional nature of each type of network tie.

Adolescent↗
PubMed1998

An ecologically differentiated, multifactor model of adolescent network orientation.

The paper presents a test of an ecologically differentiated model of social network orientation for adolescents that distinguished between different social network reference groups (family, peers, and nonfamily adults). The model was tested in two consecutive studies. Study 1 describes initial model development (N = 120). Study 2 presents a confirmatory factor analysis with a second sample (N = 430) to replicate the factor structure developed in Study 1. Results supported a three-factor model of network orientation that differentiated between network reference groups. Analyses of concurrent and predictive validity indicated that orientation to network reference groups was differentially related to the perceived quality and frequency of support from members of respective social network groups. Group differences (gender, race) regarding network orientation to different network reference groups were consistent with studies of other social network processes. Implications for the study of the network orientation and the study of social networks more generally are discussed.

Adaptation, Psychological↗
PubMed2002

Quality of relationships and structural properties of social support networks of female survivors of abuse.

The purposes of this study were to examine the structural properties of the social support networks of female survivors of violence and abuse and to investigate the quality of the relationship, and specific level of satisfaction, survivors have with their social support networks. Participants averaged 5.8 persons in their social support networks. Their levels of satisfaction with the emotional, practical, financial, guidance, and socializing support they received from members of their social support networks were higher with respect to close friends and coworkers than with respect to family members and professionals (e.g., attorneys and social workers). The most common type of support provided by close friends who were themselves victims of abuse was emotional, guidance, and socializing support, and the most satisfying support was the financial and practical help that came from parents or family. An interesting finding was the significant presence of men in the survivors' social support networks. Overall satisfaction with the quality of support from the social support networks was high, and satisfaction with support from men was comparable, if not higher, than support from women. Multiple regression models revealed that satisfaction with support networks was a potent predictor of self-esteem, emotional health, and loneliness. Intimacy, especially in terms of exclusiveness and trust or loyalty, with at least a few members of the support network contributed significantly to the variance in self-esteem, emotional health, and loneliness among the abused women. The size of the support network also emerged as a limited contributor to well-being. Implications and applications are discussed for professionals working with female survivors of abuse.

Activities of Daily Living↗
PubMedDate not supplied

[Social support network evolution after the birth of their first baby: comparison between lower and middle class mothers].

The social support networks of a group of low socio-economic status (S.E.S.) mothers (n = 87) and a group of higher S.E.S. mothers (n = 44) are described and compared at the 30th week of pregnancy and at the third week after the birth of their first baby. The evolution of the support networks for these two groups of mothers during this period is also examined. A modified form of the ASSIS from Barrera has been used to measure the social support network. Results show that, during pregnancy, the social support network of low-S.E.S. mothers is more restricted than that of higher S.E.S. mothers. Although the actual number of people around them after the birth of the baby did not increase, low-S.E.S. mothers said they felt a slight increase in the number of people available to give support in some way. They also reported that conflicts were more frequent with some of them. For higher S.E.S. mothers, all social network variables remained stable from pregnancy through the first postpartum month.

Adult↗
PubMed1991

A population-based study of functional status and social support networks of elderly patients newly diagnosed with cancer.

We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.

Activities of Daily Living↗
PubMed2002

The role of social support networks for rural hospital nurses: supporting and sustaining the rural nursing work force.

OBJECTIVE: This survey study describes the workplace social support networks of rural hospital nurses in one geographic region of Colorado. This rural sample was compared with data from a sample of urban hospital nurses in Colorado. BACKGROUND: Social support networks influence nurses' satisfaction and retention. Nursing recruitment and retention is especially critical in rural areas where it takes healthcare facilities 60% longer than urban facilities to fill nursing vacancies. Little is known about rural nurses' social support networks. METHODS: The Social Network Questionnaire (SNQ) was mailed to all nurses within one rural region of Colorado. Descriptive, correlational and comparative statistics were used to evaluate the structure and function of these nurses' networks. RESULTS: The nurses' networks were predominantly peer-based, but managers provided significant functional supports. The types of support provided by managers depended on the managers' placement in the nurses' networks. Some managers provided only performance feedback, and other managers offered physical assistance and emotional support. Rural nurses expected more guidance from management than did their urban counterparts. IMPLICATIONS: This sample of nurses clearly delineated the types of leadership styles most beneficial to them. Communication of roles and expectations between staff and management can enhance nursing satisfaction in the workplace setting.

Adult↗
PubMed1986

Social ties and mortality in Evans County, Georgia.

In an attempt to replicate Berkman and Syme's study of social networks and mortality in Alameda County, California, the authors investigated the relationship between a social network index and survivorship from 1967 to 1980 in the Evans County, Georgia, cohort. They constructed an index modeled after the Berkman Social Network Index and tested it in race- and sex-specific proportional hazards models for 2,059 subjects who were examined in 1967-1969 during the Evans County Cardiovascular Epidemiologic Study. The present study emphasized a priori specification of the social network index and statistical hypothesis test. Descriptive analyses were consistent with a modest social networks effect (e.g., hazard ratio (95 per cent confidence interval) of 1.6 (1.2-2.2) ). Among white males, the age-adjusted hazard ratio comparing the lowest to the highest value of our six-level index was 2.0 (1.2-3.4), but control for potential confounders (principally cardiovascular disease risk factors) reduced this value to 1.5 (0.8-2.6). The social networks effect among white females, black males, and black females was weaker and clearly nonsignificant. Exploratory analyses suggested that marital status, church activities, and an alternate social network index predicted survivorship, but not in a dose-response fashion. Reduced survivorship among older subjects with few social ties was the most important feature of the data.

Adolescent↗
PubMed1982

The effects of social support networks on the health of the elderly.

This is a study of the relationship between social support networks and health of the elderly. The aim was to identify and measure the specific dimensions (characteristics) of a social support network and determine which have the greatest effect on an older person's health status. Also, the study examined the collective effect of all measurable dimensions of the network on health status. The major finding was that there was a high statistical correlation between the social support network and health. This provides objective research evidence to what has been suspected intuitively by social workers. That is, knowledge about the social support network is important in assessing health.

Age Factors↗
PubMed2000

Cluster of HIV-infected adolescents and young adults--Mississippi, 1999.

From February through June 1999, seven human immunodeficiency virus (HIV)-infected young persons were identified in a small town in rural Mississippi. Two persons were identified through routine voluntary HIV testing during sexually transmitted disease (STD) evaluations, and five were identified subsequently through contact investigation by the local health department. Contact investigation identified sex partners and social contacts (i.e., persons who shared social surroundings) and defined a social network of 122 sex and social contacts. Seven (9%) of 78 persons tested from the social network were HIV-infected. Within the social network, a sexual contact network of 44 persons (the seven HIV-infected persons and their sex partners) was identified. The Mississippi State Department of Health asked CDC to join the investigation to describe further the cluster and help direct prevention efforts. This report summarizes the investigation of this cluster and underscores the need for HIV prevention and treatment in rural areas.

Adolescent↗
PubMed2006

Xenophobia, ethnic community, and immigrant youths' friendship network formation.

Immigrant youth often rebuild their friendships and other social networks after arriving in a new country. The difficulties involved can threaten their psychosocial development. Formation of social networks needs to be understood within the macro sociocultural context that shapes the experience. Nonetheless, the current literature on social network formation rarely captures that context. Knowledge about immigrant youths' social network, for example, is often embedded in assimilation, ethnic identity, and adaptation literature. This paper examines how the sociocultural context enables immigrant youth to rebuild their friendship networks. A critical ethnography was conducted in the northwest region of the United States. Sixteen Taiwanese immigrant youth and their parents (N = 13) participated in the study. Data collection consisted of semi-structured in-depth interviews, a demographic questionnaire, and participant observations. The findings showed that because of limited English proficiency, the youth kept at a distance from American peers to avoid nervousness and embarassment. Further analysis, derived from xenophobia, found that limited English proficiency increases segregation between American peers ("we") and immigrant youth ("the other"). The English as a Second Language program inadvertently perpetuates the immigrants' sense of "otherness" and increases the odds of their becoming targets of discrimination. A protective factor for these youths is living near an ethnic community because the inclusion of coethnics increases new friendship networks. Knowledge about the teen culture in coethnics' countries of origin (China, Hong Kong, or the United States), also influences their selection of friends.

Acculturation↗