Size and composition of the informal helper networks of elderly blacks.

Research on the support networks of impaired elderly adults suggests that membership in sociodemographic subgroups influences use of specific informal helpers. This study explored the relationships of sociodemographic, health, and family factors to informal helper choice among a nationally representative sample (N = 581) of older (55 years and above) blacks (National Survey of Black Americans). Nine categories of helpers were examined: spouse, son, daughter, father, mother, brother, sister, friend, and neighbor. Logistic regression analyses revealed that marital status is important in selecting the categories of sister, friend, and neighbor. Presence of children decreased the likelihood that siblings and friends would be chosen. Perceived family closeness facilitated the selection of siblings but inhibited the choice of friends. Regional differences suggest a greater likelihood of selecting the categories of sister, friend, and neighbor among Southern residents.

Several studies of frail older people have focused on the relationship between formal and informal care, while others have examined the character of inter-generational relationships. Yet knowledge of the significance of the informal-support networks of older people who receive formal care is still scarce. The aim of this paper was to explore how older Swedes who receive formal elder-care experienced their informal support networks. The findings presented emanate from a qualitative case study. The structural, interaction and functional dimensions of the support networks were the main analytical tools. In the study population, the size of the formal support network varied from one to 12 people (or categories of people), and the size of the informal support network varied from one to six people (or categories of people). The main results demonstrate the importance of informal support with reciprocal relationships, and the value of confidants and emotional support, both of which contribute to feelings of belonging, security and wellbeing. A well-functioning formal and informal support network allows individuals to maintain autonomy in old age, even when they have to depend on help from others.

The impact of familial and demographic factors on the receipt of support from family members was examined among a sample of blacks (National Survey of Black Americans). The findings indicated that income, age, family contact, subjective family closeness, and proximity of relatives were determinants of receiving support. In addition, an interaction was revealed between age and the presence of a child in determining support from family members. The findings substantiate the importance of adult children in the informal social support networks of elderly blacks. The use of multivariate analyses extends previous work in this area and suggests that these relationships are more complex than originally thought.

BackgroundInformal support is essential for enabling many older people to age in place. However, there is limited research examining the information needs of older adults’ informal support networks and how these could be met through home monitoring and information and communication technologies.ObjectiveThe purpose of this study was to investigate how technologies that connect older adults to their informal and formal support networks could assist aging in place and enhance older adults’ health and well-being.MethodsSemistructured interviews were conducted with 10 older adults and a total of 31 members of their self-identified informal support networks. They were asked questions about their information needs and how technology could support the older adults to age in place. The interviews were transcribed and thematically analyzed.ResultsThe analysis identified three overarching themes: (1) the social enablers theme, which outlined how timing, informal support networks, and safety concerns assist the older adults’ uptake of technology, (2) the technology concerns theme, which outlined concerns about cost, usability, information security and privacy, and technology superseding face-to-face contact, and (3) the information desired theme, which outlined what information should be collected and transferred and who should make decisions about this.ConclusionsOlder adults and their informal support networks may be receptive to technology that monitors older adults within the home if it enables aging in place for longer. However, cost, privacy, security, and usability barriers would need to be considered and the system should be individualizable to older adults’ changing needs. The user requirements identified from this study and described in this paper have informed the development of a technology that is currently being prototyped.

This article examines the influence of sociodemographic and family, friendship, fictive kin, church, and neighbor network variables on two measures of subjective well-being (i.e., life satisfaction and happiness) among a national sample of African Americans. The analyses were conducted on the National Survey of Black Americans, a national cross-section study of the adult (age 18 and older) Black population (N = 2,107). Multivariate analyses revealed that sociodemographic (i.e., age, income, region, health, marital status, urbanicity) and social relations and network factors (i.e., subjective family closeness, support from family, number of friends, presence of fictive kin, church attendance, and frequency of contact with neighbors) were significantly associated with subjective well-being. The findings are discussed in relation to previous work on the sociodemographic, health, and social network correlates of subjective well-being.

Gender, informal social support networks, and elderly urban African Americans

The purpose of this study was to explore how informal support networks are used as a source of strength among mother-headed households in an informal settlement. The four objectives of this study were to understand the challenges mothers face in mother-headed households in an informal settlement; to explore how mothers deal with such challenges personally, within their families and in the context of the settlement; to inquire about what support systems exist to strengthen mother-headed households in informal settlements; and to understand how such support systems are used to transcend difficulties experienced. This study used a qualitative descriptive design which explored the experiences of mothers between the ages of 21-59, who headed households in eThekwini, KwaZulu-Natal. Purposive, convenience and snowball sampling were used to recruit participants for this study. The data was collected through 12 semi-structured interviews and subsequently analysed using thematic analysis. From the study, four main themes emerged. Theme one focused on the nature of the support systems. The three sub-themes that emerged were the social systems that participants got from religious organisations/churches; family and neighbours; and social media sites. Theme two related to the benefits of social networks experienced by the participants. The three sub-themes that emerged were dealing with personal difficulties and celebrating success; comfort and support during death and bereavement; and economic benefits. Theme three focused on the challenges faced by mothers who head households. The nine sub themes that emerged were stress and anxiety; overload of the role as a mother; unemployment and poverty; food insecurity; poor infrastructure, service delivery and unhealthy living conditions; energy poverty; exposure to natural vulnerabilities and shack fires; discrimination, social class bias and stigmatisation; and crime and gender-based violence. Theme four focused on the coping skills used by the mothers. The three sub-themes that emerged were the coping skills based on the informal social support; degree of spirituality and religiosity; and resilience and hope. This is one of the first qualitative studies in KwaZulu Natal, known to the researcher, to highlight how informal support networks are used as a source of strength among mother-headed households in an informal settlement. It emerged that informal support networks are a source of strength for mothers; hence it improved the quality of life. All participants had favourable experiences with informal social networks, with some mothers expressing that informal social networks were the most effective way of accessing their social and livelihood needs. This was despite their experience with different socio-economic challenges. This study builds on the body of knowledge for informal social networks management and supports the use of these networks for livelihood and household management. Future studies should include more qualitative research studies on the psychosocial impact of informal networks amongst the informal settlement population. The impact of poverty, inequalities and crime on informal networks should be further investigated in other qualitative studies. A more detailed study should be undertaken to ascertain the impact and efficacy of informal networks for the reduction and eradication of socio-economic challenges faced by residents in the informal settlements.

BackgroundIn recent years, people with mental health problems are increasingly using online social networks to receive social support. For example, in online depression communities, patients can share their experiences, exchange valuable information, and receive emotional support to help them cope with their disease. Therefore, it is critical to understand how patients with depression develop online social support networks to exchange informational and emotional support.ObjectiveOur aim in this study was to investigate which user attributes have significant effects on the formation of informational and emotional support networks in online depression communities and to further examine whether there is an association between the two social networks.MethodsWe used social network theory and constructed exponential random graph models to help understand the informational and emotional support networks in online depression communities. A total of 74,986 original posts were retrieved from 1077 members in an online depression community in China from April 2003 to September 2017 and the available data were extracted. An informational support network of 1077 participant nodes and 6557 arcs and an emotional support network of 1077 participant nodes and 6430 arcs were constructed to examine the endogenous (purely structural) effects and exogenous (actor-relation) effects on each support network separately, as well as the cross-network effects between the two networks.ResultsWe found significant effects of two important structural features, reciprocity and transitivity, on the formation of both the informational support network (r=3.6247, P<.001, and r=1.6232, P<.001, respectively) and the emotional support network (r=4.4111, P<.001, and r=0.0177, P<.001, respectively). The results also showed significant effects of some individual factors on the formation of the two networks. No significant effects of homophily were found for gender (r=0.0783, P=.20, and r=0.1122, P=.25, respectively) in the informational or emotional support networks. There was no tendency for users who had great influence (r=0.3253, P=.05) or wrote more posts (r=0.3896, P=.07) or newcomers (r=–0.0452, P=.66) to form informational support ties more easily. However, users who spent more time online (r=0.6680, P<.001) or provided more replies to other posts (r=0.5026, P<.001) were more likely to form informational support ties. Users who had a big influence (r=0.8325, P<.001), spent more time online (r=0.5839, P<.001), wrote more posts (r=2.4025, P<.001), or provided more replies to other posts (r=0.2259, P<.001) were more likely to form emotional support ties, and newcomers (r=–0.4224, P<.001) were less likely than old-timers to receive emotional support. In addition, we found that there was a significant entrainment effect (r=0.7834, P<.001) and a nonsignificant exchange effect (r=–0.2757, P=.32) between the two networks.ConclusionsThis study makes several important theoretical contributions to the research on online depression communities and has important practical implications for the managers of online depression communities and the users involved in these communities.

e18012 Background: Little is known about the size and characteristics of informal decision support networks of women diagnosed with breast cancer and whether involvement of informal decision supporters (DSP) influences breast cancer treatment decisions. Methods: A population-based sample of newly diagnosed breast cancer patients reported to the Georgia and Los Angeles SEER registries in 2014-15 were surveyed approximately 6 months after diagnosis (N = 2,502, 68% response rate). Network size was estimated by asking women to list up to 3 of the most important DSPs who helped them with locoregional therapy decisions. For each individual DSP listed, respondents reported how important each DSP’s opinion was in treatment decision making, and how satisfied they were with their involvement (5 pt. scales, “not at all” to “very”). Decision deliberation was measured using 5-items assessing degree patients thought through the decision, with higher scores reflecting more deliberative treatment decisions. We compared network size (0-3 or more) across patient-level characteristics and estimated the association between network size and deliberation using multivariable linear regression. Results: Of the 2,502 women in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years old, and black women were all more likely to report larger networks (all p &lt; 0.001). Partnered women most often reported their partner as their main DSP (37.9%), whereas not partnered/unmarried women most often reported children (38.4%). The majority of women were highly satisfied with their DSP being involved in their decisions (76.5%) and 68.6% felt their DSP was very important in their decision making. Larger support networks were associated with more deliberative surgical treatment decision-making (p &lt; 0.001). Conclusions: Most women engaged multiple DSPs in their treatment decision making, including spouses, children, and friends. Involving more DSPs was associated with more deliberative treatment decisions. Future initiatives to improve breast cancer treatment decision making should acknowledge and engage informal DSPs.

PurposeThe purpose of this paper is to provide an empirical analysis of factors that affect support networks among retirees in 13 countries.Design/methodology/approachIt examines two propositions drawing from support network theory and the classification of countries by welfare systems. It uses fixed‐effect causal models to examine how retirement and socio‐demographic variables influence kinship and friendship support networks. Data are drawn from the Social Relations and Support Systems module of the International Social Survey Programme 2001.FindingsThe results show that retirees' friendship‐based support networks are almost one‐third smaller than those of working persons. Furthermore, this difference is greater in welfare systems that spend more on social well‐being.Research limitations/implicationsHowever, the relationship between informal support networks and welfare systems is complex, which indicates a need to further the debate on the co‐existence of formal and informal aid systems.Originality/valueThis study's main sociological confirmation is that the relationship between the size of support networks and the type of welfare system is irregular and complex. The results make a significant contribution to the debate on the relationship between formal and informal care among a group of people during a critical life‐cycle phase, such as retirement.

Purpose: To explore how the process of undergoing and recovering from knee replacement surgery alters patients’ experiences and use of their support networks.Methods: Ten patients having knee replacement surgery for osteoarthritis were invited to take part in in-depth interviews prior to surgery and 2–4 weeks, 6 and 12 months post-operatively. Transcripts were analyzed using Interpretative Phenomenological Analysis.Results: Three superordinate themes were identified: (1) relationships with health professionals over the knee replacement journey; (2) implications for informal relationships and support networks and (3) providing support to others.Conclusions: Transformation from a person with osteoarthritis to someone recovering from a surgical intervention can lead to alterations in the source, type and level of support people receive from others, and can also change the assistance that they themselves are able to offer. Findings highlight the value of the concept of interdependence to our understanding of participants’ experiences. Activity undertaken by informal support networks assists participants to cope with the consequences of osteoarthritis and surgery, and fills in the gap when more formal support is lacking. However, it is essential that provision of care is individually tailored and that formal support is adequate at times when informal support networks are unavailable.Implications for RehabilitationActivity undertaken by informal support networks can help patients who undergo knee replacement cope with the consequences of their operation; filling the void when support from health professionals is lacking.Contact with health professionals after surgery enhances confidence and offers reassurance; helping to facilitate the recovery process from knee replacement.Findings highlight, from patients’ own perspectives, the potential value of post-operative physiotherapy received soon after surgery and the possible role of long-term follow up.Missing or ill-timed support from health professionals can have negative psychosocial consequences for patients going through joint replacement.

The incidence of disability pension (DP), especially due to mental diagnoses, has increased in many countries, but knowledge of socio-demographic risk factors for DP is limited. Further, the influences of genetics and early-life factors (jointly called familial factors) on these associations remain to be studied. The aims were to study incidence of DP (due to all and mental diagnoses) and associations with socio-demographic factors, and also to establish whether associations differ with DP diagnosis and sex, and are influenced by familial factors. A prospective cohort study of all twins born in 1928-1958 (n = 52,609) in Sweden was conducted. The twins were followed from 1993 to 2008 regarding DP. Cox proportional hazard models were applied. The cumulative incidence of DP was 17 %. Of all the DP diagnoses 20 % were mental. Higher age (≥45 years), being a woman or unmarried, and/or living in a semi-urban area were risk factors for DP. Low education, being a blue-collar worker or being self-employed predicted either higher (all diagnoses) or lower (mental diagnoses) risk of DP. Rural areas were associated with DP due to mental diagnoses. The estimates varied for men and women. After adjustment for familial factors the associations of DP with education and marital status were attenuated and no longer significant. Similar results were apparent for DP due to mental diagnoses and socioeconomic status. Familial factors may select individuals into some of the established risk environments for DP. Studies investigating the causes of DP need to take such confounding into account.

DIMENSIONS OF INFORMAL SUPPORT NETWORK DEVELOPMENT IN AN ASIAN AMERICAN COMMUNITY IN THE NEW SOUTH: A GROUNDED THEORY By SUZIE S. WENG, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2013 Major Director: Dr. Mary Katherine O’Connor Professor, School Of Social Work The continuum of care framework posits that individuals move from one level to the next in seeking resources for help ranging from first using informal support to finally using formal services. Yet, the literature is mostly focused on formal services. It is well-known in the literature that existing formal services are underutilized by the Asian American population. If that is also the case in nontraditional settlement cities like Richmond, Virginia, the continuum of care framework and existing literature suggest that Asian Americans are turning to their informal support networks to meet their needs. Thus far, the literature on informal support networks is very limited and a focus on Asian American communities is nonexistent. Furthermore, there is not an adequate theory to explain and predict this phenomenon. This study uses a grounded theory design to develop a testable theory that could further the understanding of informal support networks in the Asian American community. The theory posits that the Asian culture and community influence how individuals within the community seek help in times of need and, in turn, the helping process developed within the informal support network is a reinforcement of the Asian culture and community. When individuals have needs, they look to the informal support network and the network is developed in response to those needs. However, the informal support network is not able to meet all the needs of the Asian American community. At times, though infrequent, when the informal support network cannot meet the need, individuals are referred to mainstream services. Therefore, the informal support network serves as a gatekeeper to mainstream services. In addition, needs are rarely successfully met directly by mainstream services because of inaccessibility. Consequently, mainstream services provide infrequent help in meeting the needs of the Asian American community. It is important to comprehend how these developing communities in the new South are responding to their own needs. This understanding will allow mainstream services to extend formal systems of care and better partner with existing resources to effectively serve the increasing Asian American population in the South.

More male caregivers are assuming primary caregiving roles for older adults with chronic health conditions. One of the main sources of support for many caregivers is the assistance that is provided by members of their informal support network. Little is known about the relationship between male caregivers and their informal support networks. This qualitative study examines the experience of male caregivers with their informal support networks, specifically looking at two phenomena: (1) Perceptions of the male caregivers about the willingness of their informal support networks to provide caregiving assistance and (2) Willingness of the male caregivers to ask their informal support networks for assistance. Twenty male caregivers were recruited across a rural Midwestern state. Each male caregiver engaged in two interviews that lasted between 60 and 120 minutes. Seven themes emerged from the data about the male caregivers experience with their informal support networks. Results from this study have implications for geriatric health professionals who work with male caregivers to obtain the necessary amount of caregiving assistance.

Prevalence and factors associated with snoring in 3-year olds: Early links with behavioral adjustment