Being a financially vulnerable solopreneur: The health toll

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

It is widely acknowledged that teachers are at greater risk of work-related health problems. At the same time, employee perceptions of different dimensions of organizational climate can influence their attitudes, performance, and well-being at work. This study applied and extended a safety climate model in the context of the education sector in Hong Kong. Apart from safety considerations alone, the study included occupational health considerations and social capital and tested their relationships with occupational safety and health (OSH) outcomes. Seven hundred and four Hong Kong teachers completed a range of questionnaires exploring social capital, OSH climate, OSH knowledge, OSH performance (compliance and participation), general health, and self-rated health complaints and injuries. Structural equation modeling (SEM) was used to analyze the relationships between predictive and outcome variables. SEM analysis revealed a high level of goodness of fit, and the hypothesized model including social capital yielded a better fit than the original model. Social capital, OSH climate, and OSH performance were determinants of both positive and negative outcome variables. In addition, social capital not only significantly predicted general health directly, but also had a predictive effect on the OSH climate-behavior-outcome relationship. This study makes a contribution to the workplace social capital and OSH climate literature by empirically assessing their relationship in the Chinese education sector.

The rise of social networking sites (SNSs) have provided a new avenue for interpersonal communication. Facebook, as the largest SNS targeted at providing access to interpersonal social networks, has been found to be a source of social support. Facebook-based social support has been found to be beneficial across a number of health outcomes, however, no systematic evaluation of these effects, and the factors that influence them, has been conducted. A systematic review has been conducted to examine the effects of Facebook- based social support on health. A total of 27 studies met selection criteria and were included in the final review. Facebook-based social support was found to impact health across three major domains: general health, mental illness, and well-being. Facebook-based social support was found to improve general physical and mental health, as well as well-being. It was also found reduce to symptomology associated with mental illness, including depression, anxiety, online victimisation, and loneliness. There were a number of behavioural factors that influenced these outcomes, including social comparison, communication competence, and self-disclosure. While the effects of Facebook-based social support was found to be generally positive, future research is required to explore how best to maximise this new form of social support.

PurposeRecent studies have shown that perceived social support is associated with gratitude and sense of coherence, but evidence for this concept remains scarce. In the present study, we investigated relationships between social support, gratitude, and sense of coherence, focusing on the construct of and source of social support among young women.MethodsThe study was conducted in 2014 in Japan. Participants comprised 208 female university students (aged 19.9 ± 1.1 years), who completed a self-administered anonymous questionnaire regarding perceived social support, gratitude, and sense of coherence.ResultsEmotional and instrumental social support from acquaintances were found to be lower than those from family and friends. Gratitude was positively correlated with all forms of social support except instrumental social support from acquaintances. However, sense of coherence was positively correlated with both emotional and instrumental social support from family and only emotional social support from acquaintances. Multiple regression analysis showed that emotional support from family and emotional support from acquaintances were positively associated with gratitude whereas emotional support from family was associated with sense of coherence.ConclusionThese results indicate that emotional social support from family was related to both gratitude and sense of coherence.

BackgroundInformal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with individual level variation in carers’ health outcomes.MethodsThe study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.ResultsInformal carers suffered from poor mental (Beta = − 0.587, p = 0.003) and general health (Beta = − 0.670, p = 0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12–13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers.ConclusionIt seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.

Background: Various instruments used to measure social support have emphasized the importance of examining the relationships between this interpersonal-level factor and specific health outcomes among cancer survivors. Through these instruments, an increase in certain factors of social support (i.e. sources of social support, type of social support, etc.) have been shown to improve the quality of life among cancer survivors. Unfortunately, social support instruments were not developed specifically for African American cancer survivors and therefore may not address the cultural contexts of this population. Objective: To conduct a systematic review examining the cultural contexts of social support instruments used with African American cancer survivors. Methods: PubMed, PsychINFO, and EMBASE were utilized to identify full-text quantitative articles that 1) possessed a study sample of at least 50% African American cancer survivors, and 2) referenced or documented the psychometric properties of the social support instrument. Results: We screened 1,161 titles and 113 abstracts. Eleven articles met the eligibility criteria and used nine different social support instruments. Only one of the instruments, the Ways of Coping Questionnaire, was developed with a sample of African American cancer survivors. The remaining instruments were piloted with study samples that were either comprised of racially diverse undergraduates (n=4), married couples (n=1), breast cancer survivors (n=2), or individuals with various chronic illnesses (n=1). The Ways of Coping Questionnaire, was the only instrument that inquired about support from church members and God. Four of the remaining instruments, solely focused on support from other informal sources (i.e. family, friends, significant others). Emotional support was also observed to be the most prevalent type of social support within five of the nine instruments. Conclusion: African American cancer survivors were rarely represented during the development of social support instruments. As a result, the unique experiences and cultural contexts of African American cancer survivors are not adequately assessed by these commonly used social support instruments. Therefore, the science of survivorship, particularly with African American cancer survivors, suffers from the notable gap of cultural contexts when measuring social support. Moreover, additional types of social support (i.e. instrumental social support, belonging social support, and tangible social support), were rarely captured within the instruments despite their influence on the overall quality of life among cancer survivors. Developing an instrument that is initially piloted among African American cancer survivors would generate a better understanding of how different factors of social support may impact the overall quality of life of this population. Citation Format: Shaila M Strayhorn, Perla Chebli, Catherine Pichardo, Yamilé Molina, Carol J Ferrans, Kimlin T. Ashing. Evaluating cultural contexts in social support instruments used with African American cancer survivors: A systematic review [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D024.

ABSTRACTObjective: to evaluate the instrumental and emotional social support of patients with chronic kidney disease on hemodialysis. Method: descriptive cross-sectional study. The sample was sized for convenience and included 103 participants under treatment in a Renal Replacement Therapy Unit. Data were collected through individual interviews, using the Social Support Scale. Results: the mean scores of the emotional and instrumental social support were 3.92 (± 0.78) and 3.81 (± 0.69) respectively, an indication of good support received. The most frequent sources of instrumental and emotional social support mentioned by participants were partners, spouse, companion or boyfriend and friends. Conclusion: patients with chronic kidney disease have high social support, both instrumental and emotional, and the main support comes from the family.

Social support has been found in many contexts, and in urban Ecuador, to be protective of health, particularly in the context of disaster. Fewer studies have explored the presence and impact of social support in rural Ecuador. This study engages a rural community in Ecuador to examine the general levels of social support, differences in social support based on different demographic groupings and relationships among social support and health outcomes and protective health behaviors. A cross-sectional design was used to survey 416 people in a rural Ecuadorian community that had recently experienced an earthquake. Spanish-language versions of the Multidimensional Scale of Perceived Social Support and the Interpersonal Support Evaluation List-12 were applied, as well as questions about demographics and risk reduction behaviors. Body mass index, blood pressure, and cholesterol and blood sugar levels were assessed. Analysis of variance assessed differences in social support among demographic groupings, risk reduction behaviors, and health outcomes. Levels of social support were moderate. Few statistically significant (ie p<0.05) differences in amount of social support received or in sources of social support were found. Men, people 80 years or older, divorced or widowed people, and people living in peripheral areas received less social support than women, people of all other ages, married/cohabitating people, and people living within the village, respectively. Effect sizes of these differences were small. No relationship between social support and health outcomes were found, and few were found for risk reduction factors. These findings indicate that social support may function differently in rural Ecuador than in urban contexts. Those promoting social support in rural communities may wish to focus on community-level, not individual-level, interventions. Limitations of applying an assessment of social support from urban Ecuadorian contexts to rural Ecuadorian contexts are discussed.

Stress, Social Support, and Health of Urban Latinas Na Ra Jang Latinas are one of the largest and fastest growing minority groups in the United States (U.S.) and are at risk for poor health outcomes due to stress. However, little is known about the buffering effects of social support on stress and health in Latinas. In this cross-sectional study, we applied a structural equation modeling (SEM) approach to examine stress, social support and health outcomes in urban Latinas who participated in a community survey. We conducted iterative development of conceptual and analytic models through exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and SEM. Four hypotheses were tested with SEM: 1) Higher levels of stress are associated with worse health outcomes; 2) Lower levels of social support are associated with worse health outcomes; 3) Being older or having lower levels of education is associated with worse health outcomes; and 4) Social support moderates the relationship between stress and health outcomes. The study sample comprised 2,035 Latinas who were predominantly immigrants from the Dominican Republic, had a mean age of 50; the majority reported low levels of chronic stress, lower than national average psychological distress scores, and rated their health as good or better. Levels of online social support were low – about 20%. The EFA rendered a three-factor solution with strong factor loadings: chronic stress, online social support, and health. The CFA models had adequate model fit indices. The hypotheses were not supported in the SEM. This is the first study to apply EFA and SEM approaches to develop and evaluate measurements of stress, social support, and health in a large sample of Latinas. Consequently, this research provides an important foundation for further examination of these constructs. This is an essential prerequisite to development of culturally appropriate social support interventions including those that are online for the rapidly growing U.S. Latina population.

IntroductionWorking conditions and social support given from organization have a significant impact on employees for working for a long time. Confidence of employees to their jobs is related to the things that they live. Autonomy of employees in the organization affects the level of social suport perceived by employees (Eisenbergerand etc., 1999: 1026-1040).While the concept of social support had been a defined and measured concept until the 1980s, the concept of organizational support has been a topic of discussion for nearly 70 years (Zagenczyk, 2006: 8). Social support can be defined as a perception that is related to supporting level of behaviors of individuals provided by social networks like school, close-friend, classmates, teacher, father and mother for increasing functions of individuals and/or providing a buffer zone against negative consequences (House & Kahn, 1985: 83, 108; Malecki & Demaray, 2006: 375-395). It is also regarded as social and psyhchological support (Yildirim, 1997: 81-87) that an individual gets from his/her environment. Social support can be said to be indispensable because it helps people to dissolve their problems, helps people to reduce stress, helps people to adopt to environment and make people to feel better psychologically.Social support is the primary determinant of one's own characteristic. A family member can perceive all of other family members as a supporter or an obstacle. The second determinant of the perceived support is the person whom support taken from. The person who provides social support doesn't get as much attention as the person who perceives social support in the literature. However, perceptions of support may reflect the characteristic of the person whom support taken from. The third determinant of the perceived support is interaction between the person who perceives support and the person whom support taken from. This special interaction reflects the special situation between two people (Yalcin, 2004: 45). Perceived social support can be evaluated as perceptions and expectations that can be taken from reliable individulas around him/her when needed.The buffer effect model and the main effect model have been proposed as two basic models about in which situations social support is necessary. The buffer effect model based on idea of providing source from the individuals in the social support network in order to overcome problems when faced stressful events. According to the main affect model, social support sources are effective factors on the protection of individulas' psychological and physical health without considering whether the individual is under stress or not (Krespi, 1993; Cohen & Wills, 1985: 310-357).When evaluated in terms of teachers, social support offers facilities for professional dialogue and cooperation between colleagues and offers solutions to understanding and solving problems at schools. In this cooperation and support process, teachers help and support each other more (Kroger, 1995: 545-551). Teachers are able to cooperate and support each other inside and outside the classroom through formal and informal ways. Systems that provide support for teachers can be classified as group directed by outside consultant, teacher support team and teacher support groups for individual teachers. Informal approach between colleagues may take place during coffee and tea breaks, in the corridor or in any social environment. This informal support is also important in the formation of collaborative environment in the school. The formal approaches for cooperation of colleagues are coaching and mentoring applications (Creese and etc., 1998: 109-114; Berardi & Hall, 2007; Tastan, 2008: 114). Because teaching profession is a quite stressful profession, teachers' perception of professional social support is very important. When teachers face irrelevant and low-motivated students in classrooms and receive low supports for improving their working conditions they may feel lonely. …

The purpose of this study was to examine the relationship between sources of social support and subjects’ preferred treatment of illness. After the 2010 earthquake in Haiti, health care workers and facilities were scarce; 10 percent of Haiti's health care staff was killed and 60 percent of the health care facilities destroyed. The study was based on social support as a psychosocial factor serving as an intermediary between environmental stress and an individual's preference for treatment of their illness. The literature suggests that social support improves treatment of illness and health outcomes through stress buffering and main effects. This study of 110 Haitians was conducted two years after the earthquake in a small town outside Port au Prince. Participants mean age was 39.85 years; 57% were female. The instrument used was designed to determine the sources of social support (family, friends, church, community) and how illnesses were managed (“ medsin” prepared by an herbalist and often related to voodoo, tonics or teas, vitamins and prescription drugs). A backwards stepwise logistic regression was conducted for each of the variables. If the church was used for social support, prescription drugs were primarily used (r = 0.20; p = 0.0261); if friends provided illness care, vitamins were used (r = 0.20; p = 0.0263); if community organizations used, vitamins were used (r = 0.20; p = 0.027) and when family provided care, medsin and teas were used (r = 0.20; p = 0.0268). Participants relied on a variety of sources for illness and included prescription medicines, herbal remedies and a Haitian tea. Participants indicated a high importance placed on the church as a source of social support. Reliance on the church is understandable based on the culture and often provides comfort.

Adult siblings who live near one another can be a source of social support, but little is known about sibling proximity after childhood. Using the National Survey of Families and Households (NSFH), we examine predictors of distance to nearest sibling as well as patterns of support and contact among sibling neighbors for respondents age 55 and over. Blacks are more likely than Whites to live in close proximity to siblings in adulthood. Despite the closer proximity among Black siblings, analysis of sibling neighbors finds no racial difference in exchange of instrumental support. However, frequent contact with sibling neighbors is more common among Blacks than Whites. Results also indicate that older persons receive more support from nearby siblings when they do not have other core family members (spouses, children or parents) in family network. Key Words: adult sibling relationships, family neighbors, intragenerational, proximity, social support. Sonia Miner* and Peter Uhlenberg The significance of family relationships throughout adulthood and old age is now widely recognized by family researchers. While most attention has focused on the family of procreation and intergenerational relationships, some recent studies have examined intragenerational relationships between older adult siblings (Bedford, 1989; Cicirelli, 1980; Connidis, 1994; Gold, 1989a, 1989b; Seltzer, 1989; White & Riedmann, 1992). It is clear that most adults in the United States have siblings and that many have meaningful relationships with siblings. Studies have focused on adult siblings as a source of social and instrumental support (Cicirelli, 1985; Cicirelli, Coward, & Dwyer, 1992; Connidis, 1994; Scott, 1983; Suggs, 1985; White & Riedmann, 1992) as well as on psychological dimensions of the relationship (Gold, 1989a, 1989b). Mui and Morrow-Howell (1993) combined the issues of support exchange and psychological outcomes in research on caregiving role strain experienced by siblings in later life. This study explores two questions related to residential proximity of siblings in middle and later life. First, what variables predict the residential proximity of older adult siblings? Second, for siblings who live in the same community, what factors influence the level of social, expressive, and instrumental support exchange in relationship? In looking at both questions, special attention is given to racial comparisons and to the effects of kinship structure. The reason for interest in these variables is developed in the next section where previous studies of sibling relationships are reviewed. Background Siblings frequently have long term, permanent, and supportive (instrumental and affective) relationships. The sibling relationship typically continues as both siblings pass through all stages of the life course. In contrast, spouse relationships begin in adulthood with individuals who seldom share a common childhood history. Similarly, the parent-child relationship is not as long term as sibling relationships, because it is usually terminated by the death of the parent. Cicirelli (1988) notes this special feature of sibling relationships when he writes: Sibling relationships have a longer course than most other human relationships, beginning at the birth of the younger child and continuing (for most) through the life span (p. 608). Cicirelli (1988) also notes that sibling relationships are unique because of their egalitarian nature, common genetic heritage, common cultural milieu and common early experiences (p. 608). Because of these commonalities and a sense of family unity, siblings tend to retain affection for one another in later life and in some cases may even provide support to one another (Cicirelli et al., 1992). While other sources of support are more common for older persons (e.g., spouses and children), siblings may serve as an insurance policy for people if other sources of support are not available (Hochschild, 1973; Gold, 1990). …

Improving patients' perception of social support is significant not only for their re-adaptation to life but also for alleviating caregivers' burden. This study aims to examine an integrated model regarding social support, psychotic symptoms and caregiver burden. Persons with schizophrenia (N1 = 300) and their family caregivers (N2 = 300) in Xinjin County, Chengdu, China, completed the survey to report their demographics, patients' perception of social support (Duke Social Support Index), psychotic symptoms (Positive and Negative Syndrome Scale) and caregiver burden (Burden Scale for Family Caregivers, Short Version). Structural equation modelling was utilised to test the proposed model. The degree of caregiver burden differed significantly within subgroups of patients' gender and education, as well as caregivers' gender, education and employment. Caregiver burden was negatively related to patients' age and household income. Social interaction partially mediated the relationship between instrumental and subjective social support (total effect = 0.451, p < .01). Subjective social support fully mediated the impact of social interaction on psychotic symptoms (total effect = -0.099, p < .05). In the final model, instrumental social support was positively associated with social interaction (p < .001) and increased subjective social support (p < .05). Increased subjective social support showed correlation with a lower degree of psychotic symptoms (p < .01), which was related to a lower level of caregiver burden (p < .001). This study shows the associations of patients' social support with psychotic symptoms and caregiver burden. Culture-specific psychosocial interventions should be provided for both patients and caregivers to enrich external support and reduce psychotic symptoms and caregivers' burden within the health care environment.

Little is known about the buffering role of social support among orphans living in Africa. This study examined (1) how perceived social support (PSS) varied across orphan‐related characteristics (e.g., orphan status, such as single, maternal or paternal, and their living environments, such as in child‐headed households, on the street, in an orphanage or in a foster home) and (2) the relative importance of sources of PSS (relatives/community/adults and peers) and functional social support (emotional/informational/instrumental and social) and its association with emotional well‐being and mental distress. The participants included 430 orphaned Rwandan children and youth aged between 10 and 25 years (Mean age = 17.74), of whom (n = 179, 41.6%) were females and (n = 251, 58.4%) were males. Result showed that children living in an orphanage exhibited a higher level of PSS from all sources of social support than did children in other living environments. A higher level of PSS from relatives, communities and adults was associated with high level of emotional well‐being, and only adult support was associated with low level of mental distress. Furthermore, the functional PSS indicated that emotional support and companionship support were equally important in their association with higher levels of emotional well‐being and lower levels of mental distress. The findings highlight the importance of having different sources of social support and their functions in relation to psychosocial well‐being.

Little is known about the buffering role of social support among orphans living in Africa. This study examined (1) how perceived social support (PSS) varied across orphan‐related characteristics (e.g., orphan status, such as single, maternal or paternal, and their living environments, such as in child‐headed households, on the street, in an orphanage or in a foster home) and (2) the relative importance of sources of PSS (relatives/community/adults and peers) and functional social support (emotional/informational/instrumental and social) and its association with emotional well‐being and mental distress. The participants included 430 orphaned Rwandan children and youth aged between 10 and 25 years (Mean age= 17.74), of whom (n =179, 41.6 percent) were females and (n = 251, 58.4 percent) were males. Result showed that children living in an orphanage exhibited a higher level of PSS from all sources of social support than did children in other living environments. A higher level of PSS from relatives, communities and adults was associated with high level of emotional well‐being, and only adult support was associated with low level of mental distress. Furthermore, the functional PSS indicated that emotional support and companionship support were equally important in their association with higher levels of emotional well‐being and lower levels of mental distress. The findings highlight the importance of having different sources of social support and their functions in relation to psychosocial well‐being.