Availability Of Social Support Research Articles

A qualitative exploration of the reasons and influencing factors for pregnancy termination among young women in Soweto, South Africa: a Socio-ecological perspective

BackgroundPregnancy termination is an essential component of reproductive healthcare. In Southern Africa, an estimated 23% of all pregnancies end in termination of pregnancy, against a backdrop of high rates of unintended pregnancies and unsafe pregnancy terminations, which contributes to maternal morbidity and mortality. Understanding the reasons for pregnancy termination may remain incomplete if seen in isolation of interpersonal (including family, peer, and partner), community, institutional, and public policy factors. This study therefore aimed to use a socio-ecological framework to qualitatively explore, in Soweto, South Africa, i) reasons for pregnancy termination amongst women aged 18–28 years, and ii) factors characterising the decision to terminate.MethodsIn-depth interviews were conducted between February to March 2022 with ten participants of varying parity, who underwent a termination of pregnancy since being enrolled in the Bukhali trial, set in Soweto, South Africa. A semi-structured, in-depth interview guide, based on the socioecological domains, was used. The data was analysed using reflexive thematic analysis, and a deductive approach.ResultsAn application of the socio-ecological framework indicated that the direct reasons to terminate a pregnancy fell into the individual and interpersonal domains of the socioecological framework. Key reasons included financial dependence and insecurity, feeling unready to have a child (again), and a lack of support from family and partners for the participant and their pregnancy. In addition to these reasons, Factors that characterised the participants’ decision experience were identified across all socio-ecological domains and included the availability of social support and (lack of) accessibility to termination services. The COVID-19 pandemic and resultant lockdown policies also indirectly impacted participants’ decisions through detrimental changes in interpersonal support and financial situation.ConclusionsAmongst the South African women included in this study, the decision to terminate a pregnancy was made within a complex structural and social context. Insight into the reasons why women choose to terminate helps to better align legal termination services with women’s needs across multiple sectors, for example by reducing judgement within healthcare settings and improving access to social and mental health support.

Family Influence on Student Mental Health and Academic Achievement in University Transition

This study explores the crucial role of social support in facilitating the transition of adolescents from high school to university, focusing on two respondents, BM and MM. BM, in his second semester at a state university, struggles with the challenges of living independently in a boarding house, feeling significant emotional strain due to limited parental communication. MM, a student at a private university, maintains a close and supportive relationship with his father, despite the absence of his mother since he was two years old. The research highlights the importance of different types of social support—appraisal, belonging, and tangible—in aiding students' adaptation to university life. Appraisal support involves the availability of someone to discuss problems, while belonging support encompasses emotional and task-related assistance from family members. Tangible support refers to material assistance provided by parents. The findings indicate that effective social support, particularly from family, is essential for promoting mental health, academic success, and overall well-being during this critical transition period. The study underscores the need for future research to explore these dynamics further, considering broader cultural and socio-economic contexts that influence the availability and effectiveness of social support.

The effect of social support on the emotional well-being of people with amyotrophic lateral sclerosis: Exploring the mediating role of spirituality.

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that, so far, is considered always fatal. Treatments mainly consist in increasing survival and aim to improve the quality of life of people with ALS (pwALS). Social support and spirituality have been shown to play a key role in pwALS' quality of life. Our study explored it in depth by investigating the underlying mechanisms linking social support, spirituality, and emotional well-being. Thirty-six pwALS underwent a battery of tests evaluating emotional well-being (emotional well-being scale of the 40-item Amyotrophic Lateral Sclerosis Assessment Questionnaire), social support (6-item Social Support Questionnaire), and spiritual well-being (12-item Functional Assessment of Chronic Illness Therapy - Spiritual well-being). Our recruitment was web-based through the FILSLAN and the ARSLA websites as well as through Facebook® advertisements (ALS groups). Data were analyzed by Pearson correlation analysis and Process macro was used in an SPSS program to analyze the mediator variable effect. Availability of social support, spiritual well-being, and 2 of its dimensions, i.e., meaning and peace, were positively correlated with emotional well-being. The mediational analyses showed that spiritual well-being, meaning, and peace act as mediators in the association between availability of social support and good emotional well-being. Availability of social support and spirituality are essential for the emotional well-being of pwALS. Spirituality as a mediator between availability of social support and emotional well-being appears as real novel finding which could be explored further. Spiritual well-being, meaning, and peace appear as coping resources for pwALS. We provide practical guidance for professionals working with pwALS.

A Comparison of Loneliness and Social Support among South African Older Persons during a Pandemic

Pandemics, such as the outbreak of the novel coronavirus (Covid-19) in March 2020, have a negative impact on older persons’ (60 years and older) physical and mental health. Research on the effects of Covid-19 on older persons’ experience of loneliness and self-reported social support has predominately originated from the Global North. Applying the strengths perspective, the present study aimed to determine and compare the loneliness and social support among South African older persons during a pandemic. A cross-sectional survey was operationalised to collect data from community-dwelling older persons (n = 139) and older persons residing in residential care facilities (n = 99) through purposive sampling across five South African provinces. A loneliness scale was used to measure the respondents’ overall loneliness, including emotional and social loneliness. A social support scale was used to measure the availability of social support across four domains. The survey focused on social contact, number of close friends/relatives, socio-demographics, and subjective physical and mental health, respectively. Independent samples t-tests were run to explore any statistically significant differences between the two groups. Community-dwelling older persons were found to present with marginally higher levels of loneliness. No statistically significant differences were identified between the two groups. Community-dwelling older persons measured higher on social support than their peers in residential care. Two domains of social support, namely, affectionate support and positive social interaction, were found to be significantly different (p < 0.01). Based on the study’s results, implications for strengths-based gerontological social work services in resource-constrained settings during a pandemic were delineated.

Personality as a predictor of changes in perceived availability of social support during the COVID-19 pandemic

Personality is a well-established contributor to perceptions of social support availability, a coping resource that was particularly affected by the social repercussions of the COVID-19 pandemic. The present study uses lagged regression to examine the role of Big Five personality traits in predicting changes in perceived availability of social support during the COVID-19 pandemic among a sample of 1386 North Americans. Controlling for perceived availability of social support in 2020, we found that extraversion and conscientiousness were associated with greater perceived support in 2021, whereas neuroticism was associated with less. The findings provide insight into how perceived availability of social support, although often found to be stable, exhibited variability during the COVID-19 pandemic and point to personality as a key contributor to the process. Expanding on previously documented cross-sectional associations between perceptions of social support availability and Big Five personality traits, the present study reveals how such traits may serve as risk and protective factors and be used to identify those at risk of degradation in perceived availability of social support during times of heightened stress. In doing so, results also point to the potential clinical utility of brief measures of personality for preventive interventions.

Characterizing personal recovery in severe mental illness: French psychometric validation of the Questionnaire about the Process of Recovery (QPR-Fr).

The support of the personal recovery of people with lived experience of mental illness is a major issue in clinical practice. Thus, a valid instrument to assess personal recovery is needed. The present study aimed to validate the French translation of the 22-item Questionnaire about the Process of Recovery (QPR-Fr). A convenience sample of 222 participants reporting a severe mental illness diagnosis was recruited online. Psychometric properties of the QPR-Fr were evaluated. A confirmatory factor analysis was conducted for structural validity. Internal consistency and test-retest reliability were assessed. To test for convergent validity, we conducted multiple linear regression analysis to explore the QPR-Fr associations with psychological distress and the CHIME framework (with Connectedness, Hope and optimism about the future, Identity, Meaning in life, and Empowerment) proxy measures (perceived social support, hope, self-esteem, quality of life, and empowerment). An adequate fit was found for a 19-item unidimensional factor structure. Internal consistency was excellent. Test reliability was good. The QPR-Fr total score was significantly positively associated with quality of life, hope, self-esteem, and social support satisfaction and negatively associated with psychological distress. No significant association was found with social support availability nor with empowerment. This study provides additional data to support the cross-cultural validity of the Questionnaire about the Process of Recovery. The QPR-Fr is a valid and reliable tool to assess personal recovery. Practitioners could use the QPR-Fr to assess personal recovery in collaboration with people with lived experience. Convergent validity with CHIME proxy measures supports the validity of the CHIME framework in a French cultural context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Affecting Compliance with The Use of PPE (Personal Protective Equipment) in Nurses the Inpatient Room of Ananda Bekasi Hospital

Occupational health and safety is a crucial aspect in the hospital environment. Even though there are regulations governing the use of Personal Protective Equipment (PPE) by nurses, compliance with its use is still a challenge. This research was conducted at Ananda Bekasi Hospital to understand the factors that influence nurses' compliance in using PPE. Quantitative methods with a cross-sectional approach were used with a sample of 60 nurses from inpatient rooms. Data was obtained through questionnaires, and statistical analysis was carried out using univariate, bivariate and multivariate tests. The results show a significant relationship between work experience, attitudes, knowledge, availability of PPE, supervision, and social support with the use of PPE. The dominant factors influencing the use of PPE are length of service, attitude and social support. The implication is that attention needs to be paid to education, training, better supervision, as well as a supportive culture and attitude to increase compliance with the use of PPE among nurses in hospitals.

Perceived Social Support and Glycemic Control among Type 2 Diabetes Patients in a Tertiary Care Center in Chennai, Tamil Nadu, India

Introduction: Support from the external environment for enabling behavioral change, is often instrumental in mediating glycemic control in patients coping with diabetes. While evidence is scant in the Indian setting, there is a lack of consistency in findings among studies done elsewhere. Objective: To assess the perceived availability of social support and its association with glycemic control among type 2 diabetics. Method: Between October and December 2019, Cross sectional study was conducted among 150 adult patients, selected using convenient sampling method at the Diabetology clinic in a tertiary care centre in Chennai. Outpatients with a confirmed diagnosis of type 2 diabetes for at least one year, were recruited by convenient sampling. Perceived social support was assessed using the RAND-MOS social support survey instrument, while average of last three fasting blood glucose (FBG) readings determined glycemic status. Non-parametric Kruskal Wallis and Mann-Whitney U tests were used to analyze association of social support with glycemic control and socio-demographic determinants. Spearman’s correlation coefficients with 95% CIs are reported for association of individual domain scores with average FBG. All analyses were performed with SPSS Version 23. Results: Study participants were aged 35 to 85 years, and living with type 2 diabetes for a mean duration of 10 ± 7.7 years. The average FBG in the past year ranged from 79 to 398 mg/dl in these patients, with 41 (27%) and 109 (73%) being classified as having good and poor glycemic control, respectively. The median (IQR) social support summary score was 62 (40-81) on a scale of 0 – 100; perceived social support was reportedly low, intermediate, and high in 36 (24%), 74 (49%) and 40 (27%) participants, respectively. The level of social support was not found to be significantly associated with glycemic control (P=0.628); average FBG and summary social support score showed no correlation [ρ=.081 (95% CI: -.097, .253), P =.322]. Conclusion: While a three- fourths majority reported availability of social support for coping with diabetes, this was not found to be significantly associated with glycemic status. The potential role of support networks, beyond the immediate family, in improving health outcomes needs to be examined.

Qualitative Pilot Interventions for the Enhancement of Mental Health Support in Doctoral Students

Doctoral degrees include Doctor of Philosophy (PhD) and other professional doctorates such as Engineering Doctorate (EngD), Doctor of Education (EdD), or Doctor of Clinical Psychology (DClinPsy). Unlike undergraduate- or postgraduate-taught students, doctoral study focuses on a single, autonomous piece of research. Research indicates a high occurrence of mental health problems in doctoral students. This paper describes the piloting and qualitative evaluation of a range of interventions designed to enhance the mental health support for doctoral students at one UK university. These interventions sought to target an array of known factors that affect the mental health of doctoral students, including individual capacity for coping with stress and social support availability.

Role of social support in culturally sensitive diabetes self-management education among an ethnic minority population in Denmark.

CUSTOM is a culturally sensitive diabetes self-management education and support programme tailored to Urdu, Turkish and Arabic-speaking people in Denmark. The aim of this study was twofold: first, to examine the functional social support perceived by CUSTOM participants before and after the intervention; and, second, to explore how participants' structural social support affected the physical and mental health benefits of the intervention. The participants were people with type 2 diabetes whose primary language was Urdu, Arabic or Turkish (n = 73). Outcomes included A1C, body fat percentage, diabetes distress, well-being and functional social support. Changes were observed between baseline and six months after participation in a single-group pre-test/post-test design. The Cochran-Armitage trend test was used to assess pre-post differences in functional social support. The role of structural social support was assessed using moderation regression analysis. Participants reported higher availability of functional social support after the programme (p < 0.05), although the change in loneliness was not significant. In addition, cohabitating with adult children increased the average body fat percentage reduction achieved following the programme, while living with a partner lowered the average body fat percentage reduction achieved. The intervention was particularly successful in improving diabetes distress among those with weak structural social support. Culturally sensitive diabetes self-management education and support can improve social support among people with an ethnic minority background. The structure of social relations may influence the benefit of culturally sensitive diabetes self-management education and support. Future programmes should include family members and other social relations more actively, drawing attention to both positive and negative aspects of social relations.

The Levels and Associated Factors for Participation and Autonomy Among People with Parkinson´s Disease: A Cross-Sectional Study.

Promoting participation and autonomy (PA) in society has been highlighted as an ultimate goal of rehabilitation for people with chronic diseases by the World Health Organization, but few studies have focused on PA in people with Parkinson's disease (PD). Therefore, this study aimed to determine the level of PA in PD patients and investigate the associated psychological and behavioural factors. PD patients were recruited from the Department of Neurology of the First Hospital Affiliated with Dalian Medical University using convenience sampling for this cross-sectional study. A questionnaire covering social-demographic and disease-related characteristics, Chinese version of Impact on Participation and Autonomy (IPA) Questionnaire, Connor-Davidson Resilience Scale (CD-RISC), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Medical Coping Modes Questionnaire (MCMQ), Social Support Rating Scale (SSRS), Hoehn-Yahr Staging System and Unified Parkinson's Disease Rating Scale (UPDRS) were used for investigation. A multivariate stepwise linear regression analysis was used to determine the factors that influence IPA. A total of 326 PD patients responded to all the questionnaires. The patients had a mean IPA score of 46.6 (SD 21.79). Multiple linear regression analyses revealed that UPDRS II (β = 0.35, p < 0.001) had the strongest correlation with IPA, followed by tenacity, which was the second strongest factor (β = -0.25, p < 0.001). Hoehn-Yahr stage (β = 0.19, p < 0.001) and availability of social support (β =-0.12, p =0.001) were also strong factors. The average level of PA among PD patients was at the lower middle-level. Among PD patients, physical function, psychological resilience and social support were the strongest factors associated with PA. These findings provide valuable insights into PD patients' PA and can help medical professionals identify the early risks of restricted PA among PD patients, implement interventions to promote PA and ultimately achieve rehabilitation.

Network analysis of symptoms, physiological, psychological and environmental risk factors based on unpleasant symptom theory in patients with chronic heart failure.

Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other. The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure. A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors. The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression-anxiety, subjective social support-objective social support, and subjective social support-social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA-dyspnea, depression-difficulty sleeping, and social support availability-dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes. Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health.

Supporting People Seeking Asylum in the Australian Community: A Service Provider Perspective

AbstractDeterrence of asylum seekers, including via restrictive refugee determination processes, is increasingly common in many countries. In Australia, people who sought asylum by sea between 13 August 2012 and 1 January 2014 (the ‘legacy caseload’), have been subject to increasing restrictions on their social and economic rights. As a result, these people rely on support from non-government organisations, whilst they progress through Australia’s refugee determination process. This research explored service providers’ role in mediating the impacts of asylum policy on the legacy caseload. Findings from 20 in-depth, semi-structured interviews, conducted between December 2018 and February 2020, highlight how service providers in both statutory and community sectors in Victoria challenge and subvert deterrence policies, even as the policy environment constrains their ability to support people seeking asylum. To redress these constraints, increased availability of social supports for people seeking asylum, continuing and additional funding for non-government organisations, and increased support for workers across sectors are recommended by this study. Service providers play a crucial role in enabling the effective engagement of people seeking asylum with the refugee determination process. These findings serve as a further warning from countries seeking to emulate the ‘Australian model’ of harm.

Contrasting ecological contexts among treatment-seeking military sexual assault survivors: Consideration of relationships with sexual and gender minority identification.

Survivors of military sexual trauma (MST) seeking mental health services may present with concerns extending beyond symptom relief. Attention to social, economic, and coping resource contexts is salient for care consideration. Although those identifying as sexual and gender minorities (SGM) are overrepresented among service members exposed to assaultive MST, research contrasting ecological resource variability among treatment seekers is limited. The present study delineates modifiable risk and protective factors that might be used to inform MST-related health care for Veterans, broadly, and SGM-identifying Veterans, specifically. Veterans (N = 493, 12.8% identifying as SGM) presenting for treatment secondary to military sexual assault completed a semistructured clinical interview and intake survey including demographic characteristics, diversity-related factors, and access to psychosocial resources. SGM/non-SGM-identifying groups were contrasted on individual-, interpersonal-, and community-level ecological characteristics. SGM-identifying Veterans were less likely to report access to sufficient financial resources and had double the prevalence rate of housing instability in contrast to non-SGM-identifying Veterans. No significant differences emerged in terms of past-year interpersonal violence exposure, endorsement of helpful spiritual beliefs, or availability of social support based on SGM identification. Findings underscore the importance of attending to the intersection of SGM identity and ecological factors that can influence Veterans' clinical presentation and treatment engagement. Recommendations for provision of MST services are made. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The mediating role of social support in associations between childhood adversity, military sexual trauma, and homelessness in a nationally representative sample of USveterans.

Among veterans, availability of social support and histories of military sexual trauma (MST) and/or adverse childhood experiences (ACEs) are particularly salient correlates of homelessness.Using path analyses, we investigated whether social support (i.e., interpersonal social support and community integration) would at least partially account for the relationships of MST and ACEs with any lifetime homelessness in a large, nationally representative sample of veterans (N = 4069, 9.8% female).Interpersonal social support and community integration partially explained the relationship between ACEs and any lifetime homelessness. However, they did not mediate the relationship between MST and any lifetime homelessness. Female veterans also reported higher trauma rates and lower perceived social support than male counterparts during correlational analyses.These results reinforce existing literature on the importance of research and interventions tailored to veterans with low social support and integration. Results have potential to inform interventions and policy for veterans experiencing and/or at risk for homelessness.

Improving motivation and treatment uptake behaviors of patients with eating disorders using patient narrative videos: study protocol of a pilot randomized controlled trial

BackgroundPatients with eating disorders (ED) typically report delays between the onset of symptoms and engagement with treatment services. Personal barriers including stigma, shame, and guilt, as well as the availability of social support may influence patients’ decisions to engage with treatment services. Patient narratives are personalized stories discussing the illness and recovery of previously affected persons. Such narratives can reduce self-stigma and provide current patients with hope for their own recovery.MethodThis pilot study will examine the effects of patient narrative videos on the treatment motivation and uptake of treatment services for patients with ED. Three narrative videos were developed from the perspectives of (a) a former patient with an ED, (b) an ED specialist, and (c) the same former patient discussing a somatic condition unrelated to ED. Patients will be randomized into three video viewing and one treatment-as-usual group. Effects on treatment motivation will be assessed using the University of Rhode Island Change Assessment Scale (URICA-S) immediately after viewing the videos, as well as one-week and three-month follow-ups. Treatment uptake will be assessed during follow-up using a questionnaire listing possible treatment interactions. A post-intervention questionnaire and semi-structured interviews will be used to assess the feasibility and acceptability of patient narrative videos for this population.DiscussionThere is an urgent need to encourage patients with ED to engage with specialized treatments as soon as possible. Patient narratives may be a pivotal approach to implementing cost effective and easy to disseminate early intervention programs to future patients with ED.

Impact of the COVID-19 pandemic on perceived changes in responsibilities for adult caregivers who support children and youth in Ontario, Canada.

The COVID-19 pandemic has created long-lasting changes in caregiving responsibilities, including but not limited to increased demands, loss of support, worsening mental and physical health, and increased financial worries. There is currently limited evidence regarding factors associated with perceived changes in caregiving responsibilities. This observational study aimed to investigate factors (sociodemographic characteristics of caregivers and mental health and/or addiction concerns of the caregiver and their youth) that predict perceived negative changes in caregiving responsibilities among adult caregivers (aged 18+ years) of children and youth (aged 0-25 years) in Ontario, Canada, during the COVID-19 pandemic. Data were collected from 1381 caregivers of children and youth between January and March of 2022 through a representative cross-sectional survey completed online. Logistic regression was conducted to determine predictors contributing to perceived negative changes in caregiving responsibilities. Among the sociodemographic characteristics, only ethnicity significantly predicted outcome. Higher caregiver strain (odds ratio [OR] = 10.567, 95% CI = 6.614-16.882, P < 0.001), worsened personal mental health (OR = 1.945, 95% CI = 1.474-2.567, P < 0.001), a greater number of children/youth cared for per caregiver (OR = 1.368, 95% CI = 1.180-1.587, P < 0.001), dissatisfaction with the availability of social supports (OR = 1.768, 95% CI = 1.297-2.409, P < 0.001) and negative changes in mental well-being in at least one child/youth (OR = 2.277, 95% CI = 1.660-3.123, P < 0.001) predicted negative changes in caregiving responsibilities. These results support further exploration of the implications of negative perceptions of caregiving responsibilities and what processes might be implemented to improve these perceptions and the outcomes.

Multidimensional social connectedness of sexual and gender minority midlife and older adults: Findings from the National Health, Aging, and Sexuality/Gender Study (NHAS).

This article introduces the multidimensional properties of social connectedness among sexual and gender minority (SGM) midlife and older adults and examines the relationship between these properties and general health. Data were analyzed from Aging With Pride: National, Aging, and Sexuality/Gender Study, including 2,450 SGM adults aged 50 and older in the United States. The structure, function, and quality of interpersonal relations as well as community-level activities and engagement were measured through a self-administered survey and an in-person interview. Findings indicated that SGM midlife and older adults, on average, had a large social network with high bridging potential and low density, consisting of more nonrelative family members than immediate family members. They also showed frequent availability of social support, moderate or higher satisfaction with interpersonal relations, and moderate SGM community engagement. Properties of social connectedness differed by gender, sexual identity, and gender identity, with SGM men, sexually diverse women, and transgender people showing distinct challenges in interpersonal relations. All aspects of social connectedness were positively associated with good general health, particularly network diversity, outdoor leisure activity engagement, and access to health-related decision support, controlling for age and chronic conditions. Care receiving and loneliness were negatively associated with good general health. Intervention development can target these factors to promote social and community connectivity and reduce the negative health effects of persistent social stressors. This study underscores the necessity of addressing all facets (i.e., structure, function, and quality) of interpersonal relations encompassing both immediate and chosen family as well as community-level social connectedness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health-related quality of life among people living with HIV in the era of universal test and treat: results from a cross-sectional study in KwaZulu-Natal, South Africa

Background The World Health Organisation’s (WHO) key population-based strategy for ending the human immunodeficiency virus (HIV) epidemic is universal HIV test and treat (UTT) along with pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Despite the successful scale-up of the UTT strategy in sub-Saharan Africa (SSA), the quality of life (QoL) of people living with HIV (PLHIV) remains sub-optimal. Poor QoL in PLHIV may threaten the UNAIDS 95-95-95 programme targets. Monitoring QoL of PLHIV has become a key focus of HIV research among other outcomes so as to understand health-related QoL (HRQoL) profiles and identify interventions to improve programme performance. This study aimed to describe HRQoL profiles and identify their predictors in PLHIV in KwaZulu Natal, South Africa. Methods We conducted a secondary data analysis of a cross-sectional survey conducted between May and June 2022 among PLHIV (n = 105) accessing HIV services at an outpatient clinic in KwaZulu-Natal, South Africa. Socio-demographic, HRQoL (EQ-5D-5L index scores), clinical data, depressive symptoms (CES-D-10), and viral load data were collected from all participants. We examined predictors of HRQoL using generalised linear models controlling for age and sex. Results The mean age of the participants was 45 years (SD = 13). The proportion of participants with disabilities and comorbidities were 3% and 18%, respectively. Depressive symptoms were present in 49% of the participants. Participant’s mean EQ-5D-5L index score was 0.87 (SD = 0.21) and ranged from 0.11 to 1.0. The mean general health state (EQ-VAS) was 74.7 (SD = 18.8) and ranged from 6 to 100. Factors that reduced HRQoL were disability (β = −0.607, p ≤ 0.001), comorbidities (β = − 0.23, p ≤ 0.05), presence of depressive symptoms (β = −0.10, p ≤ 0.05), and old age (β = −0.04, p ≤ 0.05). Factors that increased HRQoL were a good perceived health state (β = 0.147, p ≤ 0.001) and availability of social support (β = 0.098, p ≤ 0.05). Conclusion A combination of old age (60 years and above), any disability and comorbidities had a considerable effect on HRQoL among PLHIV. Our findings support the recommendation for an additional fourth UNAIDS target that should focus on ensuring that 95% of PLHIV have the highest possible HRQoL. Psycho-social support interventions are recommended to improve the HRQoL of PLHIV.

LEVERAGING THE COMMUNITY AS PARTNERS TO ADVANCE CANCER RESEARCH IN SOCIALLY DIVERSE OLDER ADULT POPULATIONS

Abstract Older Black adults with cancer suffer a “double disadvantage” to their health due to the compounding effects of ageism and racism. This “double disadvantage” further fuels the disparities in cancer-related mortality observed for this population. For example, multiple myeloma (MM) is an incurable and debilitating blood cancer that predominantly affects older Black adults. Despite overall improvements in MM-related survival observed following the introduction of novel therapies, older Black persons with MM continue to die at twice the rate of their White counterparts. This survival gap is largely driven by differential healthcare access and disappears when older Black adults are given equal access to care. Using MM as a chronic disease model, we are partnering with a community advisory board to design and pilot test a community lay navigator program that seeks to address some of the upstream determinants of healthcare access that limit how older Black adults newly diagnosed with MM perceive the need for, seek, reach and engage with the healthcare system. Through our foundational qualitative work focused on older North Carolinians (patients and caregivers) affected by MM, we have identified the following multilevel (individual, interpersonal, and community level) intervention targets: trust, knowledge and health beliefs, availability and adequacy of social support, and patient empowerment. In addition, we are leveraging the resources of an established core (Rapid Case Ascertainment) housed within our Comprehensive Cancer Center and linked to the statewide N.C. Central Cancer Registry to facilitate early identification of eligible participants (within 4-8 weeks of diagnosis) and patient outreach.