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PubMed1994

Effect of social networks on cancer-screening behavior of older Mexican-American women.

BACKGROUND: Previous studies have determined that Hispanic women and, in particular, Mexican-American women have the lowest rates of cancer screening of any race and ethnic group in the United States. In the development of cancer control strategies for this population, little attention has been given to factors that encourage Mexican-American women to seek cancer preventive care. Recent studies suggest that social networks can have a positive influence on cancer-screening participation. PURPOSE: We determined the extent to which differences in social networks account for variations in breast and cervical cancer-screening practices among low-income Mexican-American women. METHODS: The data analyzed in this study were obtained from a baseline survey of knowledge, attitudes, and cancer-screening practices conducted prior to implementation of community interventions designed to improve Pap smear and mammography screening in low-income Mexican-American women 40 years old and older living along the U.S.-Mexican border in El Paso County, Texas. A random selection of 1300 households served as a sampling frame to identify Mexican-American women 40 years old and older for personal interviews. Of the 549 households identified as having at least one eligible female, 450 women completed the personal interviews that provided the data for this study. Personal interviews solicited information on age, income, marital status, place of birth, education, health insurance coverage, Pap smear- and mammogram-screening practices, and six questions relating to social network. A social network score was assigned to each woman by summation of the following six variables: number of confidants, number of close friends, number of close relatives, frequency of contact with these close friends or relatives per month, church membership, and church attendance. Women were grouped into three linear strata of social network (low, medium, high) based on tertiles of the scores. Cancer-screening history was also ascertained during the interview. RESULTS: The 2-year prevalence of Pap smear and mammography use increased with social network. For each gain in social network level (low, medium, high), adjusted for sociodemographic factors, the odds ratio for Pap smear use was 1.33 (95% confidence interval = 1.02-1.73); it was 1.40 (95% confidence interval = 1.02-1.93) for mammogram use. Of the six social network components, the number of close friends was the most important predictor of mammography (P = .002) and Pap smear (P = .025) screening. CONCLUSION: Social networks appear to be an important determinant of cancer-screening behavior among low-income, older Mexican-American women.

Adult↗
PubMed2000

A dynamic model of social network formation.

We consider a dynamic social network model in which agents play repeated games in pairings determined by a stochastically evolving social network. Individual agents begin to interact at random, with the interactions modeled as games. The game payoffs determine which interactions are reinforced, and the network structure emerges as a consequence of the dynamics of the agents' learning behavior. We study this in a variety of game-theoretic conditions and show that the behavior is complex and sometimes dissimilar to behavior in the absence of structural dynamics. We argue that modeling network structure as dynamic increases realism without rendering the problem of analysis intractable.

Behavior↗
PubMed1995

Using social network analysis to study patterns of drug use among urban drug users at high risk for HIV/AIDS.

Few studies have examined the current social relationships of injecting drug users. This paper examines the structural and relationship characteristics of the social networks of injecting drug users, and the relation of social network characteristics to the HIV infection risk behavior of frequency of injecting heroin and cocaine. The study sample was comprised of 293 inner city injecting drug users in Baltimore, Maryland. Most participants (89%) reported at least one family member in their social network, and 44% listed their mother or step-mother in their network. Presence of family members in personal social networks was not related to patterns of drug use examined here; however, those who reported a partner in their personal social network injected significantly less often than those who did not report a partner. Network density and size of drug subnetworks were positively associated with frequency of drug injection. The results of this study suggest that social network analysis may be a useful tool for understanding the social context of HIV/AIDS risk behaviors.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Social networks and service use among representative cases of psychosis in south London.

BACKGROUND: Large social networks in patients with severe mental illness have been reported to be associated with a low rate of hospitalisation. We aim to determine whether social network size is related to the likelihood of hospitalisation and the amount of service use. METHOD: As part of a prospective controlled study, baseline interview data for a random sample of one-year prevalent cases with non-organic psychosis were analysed with respect to social network characteristics and service use during a six-month period. RESULTS: The likelihood of hospitalisation decreased with an increase in network size, while the number of services used by patients grew as the social network size increased. CONCLUSIONS: While larger social networks may be associated with a lower likelihood of hospitalization, they may also be related to wider use of non-hospital services.

Adolescent↗
PubMed1999

Social networks and disability transitions across eight intervals of yearly data in the New Haven EPESE.

OBJECTIVES: There is considerable evidence that social networks are strongly related to survival and other health outcomes. However, findings regarding the effect of social networks on disability outcomes have been inconsistent. This study examines this relationship with respect to the risk of developing disability and recovering from disability. METHODS: Data come from a community-based sample of the New Haven population aged 65 years and older, with nine annual interviews conducted between 1982 and 1991. Disability was measured by a 6-item index of activities of daily living (ADL), and a 3-item Rosow-Breslau index, with disability defined as impairment in one or more tasks on each measure. Social network variables were constructed for each of four domains of ties: children, relatives, friends, and a confidant, and a summary measure of total social networks. A Markov model was used to estimate one-year disability transitions averaged across all 8 intervals, after controlling for sociodemographic and health-related variables. RESULTS: Total social networks was associated with a significantly reduced risk of developing ADL disability (beta = -0.009, p < .01), and a significantly increased likelihood of ADL recovery (beta = 0.017, p < .01). Emotional and instrumental support did not affect the protective effect of social networks against disability, but partially accounted for their effect on enhanced recovery. Network variables related to relatives and friends were significantly associated with disability and recovery risks, but those related to children or a confidant were not. The associations with disability transitions as measured by the Rosow-Breslau index were generally smaller and nonsignificant. DISCUSSION: The findings lend further support for the role of social relationships in important health outcomes in old age. They suggest that being "embedded" in a social network of relatives and friends reduces risk for ADL disability, and enhances recovery from ADL disability.

Activities of Daily Living↗
PubMed1976

Social networks, support, and coping: an exploratory study.

This paper reports a study that investigated the areas of stress, support, and coping, using the structural model of the social network. The social network model is borrowed from sociology and anthropology and is used to describe and quantify not only an individual's immediate family but also all of those with whom the individual has regular contact. By comparing the networks of a sample of "normal" and schizophrenic males, it was possible to identify differences in their relationships to their social networks, in the make-up of the networks themselves, and in the coping styles and recent histories of the subjects. The results suggest, first, that the network model can be used to investigate the larger social system with which individuals interact and, second, that it may be a valuable approach to the expansion of family research.

Achievement↗
PubMed1999

The relationship between social network characteristics and breast cancer screening practices among employed women.

This study examined the relationship between social network characteristics and breast cancer screening practices among employed women. We hypothesized that larger social networks, higher levels of support from networks, and stronger social influences to undergo screening would be positively associated with regular utilization of mammograms and clinical breast examinations. Data were collected from women aged 52 and over who were employed in 27 worksites (N = 1,045). Social network characteristics, breast cancer screening practices, and sociodemographic factors were assessed in a self-administered survey. Bivariate analyses revealed that social influences were significantly associated with regular screening; social support was only marginally associated with regular screening; and social network size was not at all associated. In multivariate analyses, only the perception that screening is normative among one's peers was predictive of regular screening. Provider recommendation was the single most potent predictor of regular screening. These findings provide support for the importance of social norms in motivating women to adhere to screening guidelines. In addition, they underscore the potent impact of provider recommendations on women's screening practices.

Aged↗
PubMed2005

Social networks and health service utilization.

While social networks have been examined in the context of many economic choices and outcomes, this study is the first to investigate the effects of social networks on health service utilization decisions. Networks can affect utilization decisions in many ways. They can provide information on institutional details of the health care system, and can reduce the search costs of locating an appropriate health care provider. Networks can even alter the demand for services by affecting the perceived efficacy or desirability of the available services. Using health service utilization decisions to study networks has two main advantages over work that studies other public programs. First, because health care in Canada is universal, there are no questions of eligibility. Second, by studying the different measures of utilization, it is possible to observe how the network effects vary across measures that reflect visits primarily instigated by the patient, to measures that reflect visits instigated by both patients and their physician. Using data from three cycles of the Canadian National Population Health Survey, this work exploits regional and language group variation to identify network effects. Strong and robust evidence of networks effects is found on the decision to utilize services reflecting initial contact with the health care system. As well, this work presents novel evidence that utilization of health services by immigrants increases with the number of doctors that speak their language in their neighborhood.

Adult↗
PubMed1981

Social supports, social networks, and schizophrenia.

This article considers the meaning of "social support" and its relationship to social networks, and discusses a structural approach to analysis of social connections in the study of schizophrenia. The concept of social supports is seen as methodologically more problematic and less strategic than the more structurally oriented concepts of social networks and social connections. It is argued that in terms of research strategy, if social connections are studied structurally as they change and develop over time, the impact of the specifically social processes can be better separated from that of the personal characteristics of the focal individual than seems possible with other approaches. Analysis of the properties of the networks around the focal individual, independently of that individual's own social behavior, can help to disentangle the interwoven complex of causes, characteristics, and consequences of schizophrenia.

Dependency, Psychological↗
PubMed2001

Quantitative and qualitative aspects of the social network in schizophrenic patients living in the community. Relationship to sociodemographic characteristics and clinical factors and subjective quality of life.

Quantitative and qualitative aspects of the social network were investigated in a sample of 120 schizophrenic out-patients. Sociodemographic and clinical factors as well as subjective quality of life were investigated as to their relationship to the social network. The Interview Schedule for Social Integration (ISSI) was used to assess social network and Lancashire Quality of Life Profile was used to assess subjective quality of life. Psychopathology was measured by BPRS and psychosocial functioning by GAF. The patients reported a significantly worse social network compared to a normal sample both regarding quantitative and qualitative aspects of the network. Almost half of the patients wanted access to more social contacts. Relatives and friends turned out to be the patient's main source of supportive contacts. More severe negative and positive symptoms were related to a worse social network. Support was found for an association between characteristics of the social network, such as satisfaction with social contacts, and quality of life. The results give reason to suggest that the care system should consider the informal caregivers' situation and focus on interventions, which enhance the patient's satisfaction with social contacts.

Adult↗
PubMed2006

The impact of a social network intervention on retention in Belgian therapeutic communities: a quasi-experimental study.

BACKGROUND: Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. AIMS: The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. DESIGN, SETTING AND PARTICIPANTS: Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake (n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). FINDINGS: Hierarchical regression analyses showed that client-perceived social support (F1,198 = 10.9, P = 0.001) and treatment motivation and readiness (F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable 'significant others' participation in network intervention' (network involvement) in the model, the fit clearly improved (F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased (F1,197 = 2.9; P = 0.091). CONCLUSIONS: Participation in the social network intervention was associated with improved treatment retention controlling for other client characteristics. This suggests that the intervention may be of benefit in the treatment of addicted individuals.

Adult↗
PubMed1995

Friendships and social networks in childhood and adolescence: fluidity, reliability, and interrelations.

Social networks and friendships were tracked over a 3-week period for 132 students enrolled in fourth- and seventh-grade classrooms. Individual interviews were employed to collect data on friendships. Social group membership was determined by the composite social-cognitive map (SCM) procedure and by self-reports. Considerable overlap was found among the methods for establishing relational patterns (i.e., friendships, self-reported groups, composite social-cognitive maps). When loose criteria for stability were employed, high stability was found in friendships (p = .56-.75) and social group membership (p = .90) over a 3-week period. But when stringent criteria were employed, only modest social relationship stability was observed in both methods, suggesting that there is much greater fluidity in peer bonds than has been generally recognized. The relationship between friendship and social network measures, the distinctive information yielded by social networks, and gender and age differences in group structure, fluidity, and friendships are discussed.

Adolescent↗
PubMed2001

[Association between work exposure to neurotoxic substances with workers' relationships with their social network].

BACKGROUND: This study explored the impact on family life and social relations that may result from symptoms associated with exposure to neurotoxic substances in the workplace. We assessed the associations between exposure to neurotoxic substances in the workplace, workers'mental health, and workers'relationships with their social network. METHODS: A sample of 53 workers and their spouse completed a series of questionnaires, an interview on work history, and a structured interview assessing their personal relationships. Exposure to neurotoxic substances in the workplace were assessed by an interview, using a semiquantitative classification system. Mental health was measured with the Profile of Mood States (POMS), and marital satisfaction with the Marital Adjustment Test (MAT). The social network's characteristics were assessed with the Northern California Community Study Interview Schedule (NCCS). The associations between exposure and social networks were assessed with regression analyses. RESULTS: There were no associations between exposure and marital satisfaction. However, we found a negative association between workers'exposure and degrees of overlap between husbands' and wives' social networks (Pearson's correlation r=-0.27; p<0.05) and a positive association between exposure and workers' dependency on their support network (r=0.46; p<0.01). CONCLUSION: The results are discussed in terms of variables potentially linking exposure to social relationships as well as in terms of couples' vulnerability to marital distress among exposed workers.

Adult↗
PubMed2006

Social networks and self-rated health: a cross-cultural examination among older Israelis.

OBJECTIVE: This article examines the relationship of social network and self-rated health among different cultural groups. METHODS: This study examined associations between network structure, interaction, support and social engagement and self-rated health, controlling for sociodemographic background and psychobiological pathways among veteran Jewish-Israelis (n = 2,043), Arab-Israelis (n = 609), and new immigrants from the former Soviet Union (n = 751). Hierarchical multiple regression analysis was performed. RESULTS: Three different patterns emerged. The association of social network and self-rated health among the majority veteran Jewish culture in Israel was similar to that found in Western societies. Among Arab-Israelis, self-rated health was explained by more traditional, familial, and communal network dynamics. The characteristic association between social network and self-rated health among the new immigrants was explained by migration-induced factors. DISCUSSION: The findings demonstrate that social networks impact health differently in different cultural groups and under conditions of social change, such as migration in later-life.

Aged↗
PubMed1984

Life events, social network, life-style, and health: an analysis of the 1979 National Survey of Personal Health Practices and Consequences.

The relationships among social structure, stress, social support, life-style health behavior, and health status are explored in this multivariate analysis of data from the National Survey of Personal Health Practices and Consequences. Path analyses showed social structural factors to influence life-style practices both directly and indirectly through social network and negative life events. For women, social network and life events had direct relationships to health related life-style practices, while age and income acted both directly and indirectly through social network and, for income, through life events. Education was also directly related to life-style. For men, social network and education had the only direct effects on health practices, and age and income had indirect effects through network. We then examined the relative contributions of the social network index elements, life events, and demographic variables to each of the life-style practices. These analyses confirmed the importance of gender, education, age, and income to predicting life-style behaviors. Negative life events were associated with smoking for both men and women, sleep for women only, and physical activity and alcohol use for men, which suggests sex-specific norms for coping with stress. For both sexes, church attendance and marriage were associated with favorable smoking and alcoholic use, implicating cognitive social support or social control as a mediator of health promotion. Finally, analyses for each gender using health status as the outcome variable indicated that age, income, education, and life events affected health directly, while the effects of church attendance and marriage were likely mediated through smoking and alcohol behaviors.

Attitude to Health↗
PubMed2006

Interpersonal and social network influences on gay men's communication about unprotected sex.

This study documents gay men's communication patterns about unprotected sex. Gay men (n = 206) completed a structured interview about their social networks. The 167 men who had had unprotected sex identified 1390 social relations; 32.6% had involved discussing an episode of unprotected sex. Discussions about unprotected sex were associated with the nature of the relationship, whether the other party was gay or lesbian, how often the parties spent time together, whether the relationship had been sexual, and the density of the other parties' social network. Social networks provide an important context for the maintenance of safe sex cultures.

Adult↗
PubMed1993

Social networks and methadone treatment outcome: the costs and benefits of social ties.

OBJECTIVE: This study assessed the impact of social ties on substance abuse treatment outcome. Two models which predict alternative hypotheses were evaluated. 1) Based on the self-medication model, it was hypothesized that social support would aid in coping with painful affect and decrease the need for drugs. 2) Based on a social learning model, it was hypothesized that drug use in the social network would threaten abstinence due to modeling and conditioning effects. METHOD: Seventy methadone maintenance patients were given baseline measures of mood, stress, social support, and drug use in the network and followed prospectively for 3 months with weekly urine drug screens. RESULTS: Social support was correlated with positive affect (r = .59, p < .001), and stress with negative affect (r = .46, p < .001), but no measures of social support, affect, or stress correlated with the proportion of drug positive urines. However, patients with at least one drug user among the closest significant others had 63 +/- 38% positive urines versus 35 +/- 36% positive among those without a drug-using significant other (t = -3.2, p < .002). CONCLUSIONS: Substance use in the social network had a substantial negative impact on treatment outcome. Consistent with the social learning model and the traditional "persons, places, and things," this suggests interventions should get drug-using significant others into treatment and teach patients coping skills to reduce their negative influence.

Adult↗
PubMed2006

The association between change in social network characteristics and non-fatal overdose: results from the SHIELD study in Baltimore, MD, USA.

BACKGROUND: Social network factors have been reported to be associated with non-fatal overdose. Yet, few studies have examined how changes in social network characteristics may influence overdose risk. The purpose of this study was to examine the relationship between changes in social network and non-fatal overdose. METHODS: Data for this study came from 659 participants enrolled in the Self-Help in Eliminating Life-Threatening Diseases (SHIELD) study, who reported details about their non-fatal overdose experience between enrollment and a follow-up visit. Social network characteristics were described at both time points and net change in network composition was calculated. RESULTS: The sample was predominately male (56%), African-American (96%) and unemployed (78%). Experience of non-fatal overdose between time points was reported by 15%. Older age was associated with non-fatal overdose. Interaction between incarceration status and drug use was statistically significant. Protective factors were having a denser network at baseline and a network that became denser after adjusting for gender, homelessness, incarceration, drug use and total network size. CONCLUSIONS: Drug users' social networks are an important target for overdose prevention interventions. Further research on overdose risk and movement of specific network members in and out of networks is warranted.

Adult↗