Social Support Health Research Articles

Assessing health literacy among migrants and associated socioeconomic factors

Abstract Health literacy, the ability to understand, access, appraise, remember and use health information and health services, has great potential to reduce health inequalities and improve access to and quality of health care, particularly among groups that experience vulnerability, including migrant groups. Across Europe, including in Portugal, little is known about the health literacy strengths, needs and preferences among migrants. We aimed to assess the health literacy of diverse migrants living in Portugal and identify if health literacy needs differ across sociodemographic subgroups. A cross-sectional survey was administered to migrants living in Portugal. Data were collected using the Health Literacy Questionnaire (HLQ), an internationally tested and robust multi-dimensional measurement tool with nine scales, and a demographic and socioeconomic questionnaire. Associations were tested using Welch's ANOVA. In total, 1126 adult migrants were surveyed: 53.4% female, mean age of 35.8 years (range 18-77), 48.9% from African countries, 29.5% from Middle East/Asian countries, 21.6% from Brazil. Low scores on most HLQ scales were clearly associated with sociodemographic characteristics such as lower levels of education: 1. Feeling understood and supported by healthcare providers (p = 0.045); 2. Having sufficient information to manage health (p < 0.001); 3. Actively managing health (p = 0.036); 4. Social support for health (p = 0.001); 5. Appraisal of health information (p < 0.001); 7. Navigating the health system (p = 0.031); 8. Finding health information (p = 0.007). Similar patterns were found for participants who were unemployed and with lower income (<650€). Health literacy needs of migrant communities should be taken into account when designing interventions aiming to mitigate health inequalities and to promote health literacy. This is even more pertinent in the current context of the COVID-19, where its adverse social and economic impacts are likely to aggravate health inequalities. Key messages Lower health literacy is related to lower socioeconomic status. Mapping health literacy needs can inform interventions to mitigate health inequalities among vulnerable migrant groups.

Health workforce protection and preparedness during COVID-19: a rapid assessment of EU countries

Abstract Background Healthcare workers face high pressures and new threats during the COVID-19 pandemic, and health systems and governance are key to improve preparedness and protection. This study aims to introduce a tool for rapid assessment based on an integrated multi-level governance approach and to empirically explore preparedness and protection. Methods The study is explorative in nature and applies a comparative approach. The assessment tool comprises four major dimensions of governance: system, sector, occupational and sociocultural issues (focus on gender issues and migrant healthcare workers) of protection and preparedness. Secondary sources and expert information serve the empirical exercise, using material from Denmark, Germany, Portugal and Romania. Results We revealed similar developments across countries: action has been taken to improve physical protection, vaccination of healthcare workers and digitalisation, while social and mental health support programmes were poor or lacking. Developments were more diverse in relation to occupational/ organisational preparedness: some ad-hoc transformations of work routines and tasks were observed in all countries, yet skill-mix innovation and collaboration were strong in Demark and weak in Portugal and Romania. We are able to identify major governance gaps in relation to integration of education and health systems, social and mental health support programmes, gendered issues of health workforce capacity, integration of migrant healthcare workers, and comprehensive surveillance and monitoring. Conclusions There is a need to step up efforts and make health systems more accountable to the needs of healthcare workers during global public health emergencies.

Macaque Models of Psychosis

While the benefits of social support for physiological health are well established, the underlying pathways by which support can influence cardiovascular reactivity (CVR) are still being elucidated. In the present study, we adapted an attachment framework to further explore the support-CVR link. Specifically, we experimentally tested the effect of attachment and social support on CVR by manipulating the provision of invisible support from a stranger, across individuals with secure, anxious and avoidant attachment styles. Employing a 3 × 2 design, a sample of young adults (N = 138) from across each of the three attachment styles were randomly assigned to either an invisible support (from a stranger), or no support, condition. All participants were subject to an acute standardised stress testing protocol where cardiovascular indices were monitored throughout. Results from a factorial ANOVA showed no significant interaction between support and attachment on any cardiovascular reactivity parameter (SBP, DBP, HR) or any main effect of attachment or support. These findings suggest that, in this case, social support was not effective in buffering the effects of stress across various attachment styles. The benefits of incorporating a developmental perspective to the study of social support and health are discussed.

Short-term psychological consequences of the COVID-19 pandemic: Results of the first wave of an ecological daily study in the Italian population

COVID-19 pandemic involved several psychosocial consequences. We aimed at monitoring the mental health of Italian adults during the lockdown imposed by the government. We present here results from the baseline assessment of the “EmotionalThermometer [TermometroEmotivo] project on a sample of 1548 Italian adults. We assessed the socio-demographic conditions of participants, individuals’ perception of the COVID-19-situation, psychological distress, emotion regulation strategies, and perceived social support. Having a worse representation of COVID-19 and consulting news more frequently, with higher anxiety and less credibility of different sources of information, were positively associated with psychological distress and post-traumatic responses. Being female, younger age, living in high-risk regions, having symptoms of COVID-19, and having relatives/friends with such symptoms represented risk factors for a worse perception of COVID-19 and distress. Social support and cognitive reappraisal represented protective factors for mental health.

Key components of recovery predict occupational performance and health in peer support specialists.

Objective: The primary purpose of the study was to explore and identify how components of recovery are associated with occupational performance and health among peer support specialists. Methods: One hundred and twenty-one peer support specialists were recruited from statewide peer certification training programs and the International Association of Peer Supporters. Study respondents completed a survey package including demographic questions and psychometrically sound self-report measures. Two hierarchical multivariable linear regression models were conducted to evaluate whether the recovery components of the process of recovery, social support for recovery, and work self-determination (i.e., work autonomy, work competence, and work relatedness) were associated with indicators of occupational performance (i.e., work engagement) and health (i.e., job satisfaction). Results: Work autonomy was associated with the occupational performance indicator, while the process of recovery and social support for recovery were the only recovery components associated with the indicator for occupational health. Conclusions and Implications for Practice: Findings support the importance of work self-determination and social support and recovery for occupational performance and health among peer support specialists. Mental health and rehabilitation professionals should address these key components of recovery when working with and supporting the work well-being of peer support specialists. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Understanding the life experiences of people with multiple complex needs: peer research in a health needs assessment.

BackgroundMultiple complex needs (MCN) describe a population experiencing a combination of homelessness, substance use, offending and/or mental ill-health. Using peer researchers, this study aimed to explore the perspectives of individuals with lived experience of MCN with regards to (i) issues leading to MCN and (ii) key intervention opportunities.MethodsAs part of a health needs assessment in Gateshead (North East England), trained peer researchers interviewed 27 adults (aged ≥18 years) with experience of MCN, identified using purposive sampling methods. Peer researchers designed a topic guide for interviews which were audio recorded and thematically analyzed.ResultsInterviewees reported adverse childhood experiences leading to MCN including abuse, bereavement, parental imprisonment, family break-up and inadequate support. Mental ill-health, substance use, poverty, early experiences of unstable housing and acute homelessness were identified as major precedents for adulthood experiences of MCN. Between 16 and 20 years, access to housing, social and mental health support was perceived as having the potential to prevent circumstances worsening. Individuals perceived removing barriers to mental health, housing and welfare and financial supports could help.ConclusionsThis study highlights the perceived role austerity, adverse childhood events and current service provision have in current and future experiences of MCN. Individuals expressed a need for future interventions and support to be judgement free and provided by workers who are educated about MCN and related adversity. Involving peer researchers and individuals with experience of MCN in future research and service provision could ensure appropriate measures and supports are put in place.

A Cross-Sectional Study to Evaluate the Quality of Life of Caregivers for Children with Cerebral Palsy in Saudi Arabia, Jeddah

Background: Cerebral palsy (CP) is a group of disorders characterized by long-term disabilities that affect the quality of life (QoL) of both patients and those caring for them. Objective: The objective of this study was to measure the QoL of caregivers of CP patients. Methods: A cross-sectional study was conducted for one year period (June 2017 to July 2018) to evaluate the QoL of caregivers of cerebral palsy children aged 4-18 years using a self-structured questionnaire. Logistic regression was used in the analysis. Results: A total of 93 caregivers of CP children participated in the study. Parents were the caregivers in most of the cases (94.7%) of which mothers were the main care providers (71%). More than half (57.2%) of the caregivers had a low QoL with a mean of 8.98±3.22. Physical health, social health, family and society support and financial problems showed a significant relationship with the overall quality score of the caregivers of cerebral palsy patients (p<0.05). Conclusion: Quality of life of parents of children with CP was affected in all domains. The mean overall QoL scores were significantly poorer for caregivers of a child with cerebral palsy and mothers were the main care providers in the family. A multidisciplinary team should be involved to provide maximal benefit for the child suffering from CP and also to improve the quality of life and health of caregivers of children with cerebral palsy. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: The study protocol was approved by the Institutional ethical committee at King Abdul-Aziz University Hospital (KAUH). A verbal informed consent was taken from the mothers of participants after discussing the objective of the study.

Social support as a protective factor for the mothers of children with Congenital Zika Syndrome

Mothers of children with CZS face exceptional challenges caring for their offspring. Due to this reality, the availability of social support can function as an important protective factor. In this respect, this study aimed to evaluate the role of informal and formal social support in mental health, parental self-efficacy and satisfaction in the life of mothers of children with CZS. A total of 69 mothers of children with CZS (M = 26.4 years; SD = 6.23) living in the state of Ceará, Brazil participated in this study. They filled out the Social Support Satisfaction Scale, General Health Questionnaire, Parental Self-efficacy Scale and Satisfaction with Life Scale. The results show that the greater perception of informal social support significantly enables better mental health and satisfaction with life levels. In addition, access to formal social support significantly enables enhanced perception of parental self-efficacy. The results observed with the mothers of children with CZS are consistent with those reported in other studies with mothers of children with chronic conditions, pointing out that formal and informal social support have different effects on mental health, parental self-efficacy, and satisfaction with life, even controlling the effect of sociodemographic variables.

Communicative health literacy in patients with non-communicable diseases in Ethiopia: a cross-sectional study

BackgroundHealth literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia.MethodsA cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations.ResultDescriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains.ConclusionThe overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.

Pulmonary Rehabilitation Improves Self-Management Ability in Subjects With Obstructive Lung Disease.

Optimizing self-management is a key element in multidisciplinary pulmonary rehabilitation in patients with asthma or COPD. This observational study aimed to investigate the changes in self-management following pulmonary rehabilitation in subjects with chronic lung disease. Data were prospectively and routinely gathered at initial assessment and discharge in subjects taking part in a 12-week multidisciplinary out-patient pulmonary rehabilitation program. Measures of self-management included the Patient Activation Measure (PAM), the Health Education Impact Questionnaire (HEIQ) (8 subscales), a Self-Efficacy Questionnaire (2 subscales), the Lung Information Needs Questionnaire (LINQ), and the Health Literacy Questionnaire (HLQ) (9 subscales). Mean differences with 95% CI and effect sizes were computed. A total of 70 subjects (62.9% women) were included, with a median age of 63.5 y; most of the subjects had been diagnosed with COPD (77%). Between admission and discharge, all measures of self-management increased significantly except for the HEIQ subscales of constructive attitudes and approaches, social integration and support, and health services navigation; and the HLQ subscale of social support for health. The largest improvements (effect size > 0.55) were seen for the PAM (0.57); the HEIQ subscales of health-directed behavior (0.71), self-monitoring and insight (0.62), and skill and technique acquisition (1.00); the HLQ subscales of having sufficient information to manage my health (1.21) and actively managing my health (0.66); and the LINQ (1.85). Self-management, including activation, improved significantly in subjects with asthma or COPD who took part in a multidisciplinary pulmonary rehabilitation program.

The male breadwinner nuclear family is not the 'traditional' human family, and promotion of this myth may have adverse health consequences.

The importance of social support for parental and child health and wellbeing is not yet sufficiently widely recognized. The widespread myth in Western contexts that the male breadwinner-female homemaker nuclear family is the 'traditional' family structure leads to a focus on mothers alone as the individuals with responsibility for child wellbeing. Inaccurate perceptions about the family have the potential to distort academic research and public perceptions, and hamper attempts to improve parental and child health. These perceptions may have arisen partly from academic research in disciplines that focus on the Western middle classes, where this particular family form was idealized in the mid-twentieth century, when many of these disciplines were developing their foundational research. By contrast, evidence from disciplines that take a cross-cultural or historical perspective shows that in most human societies, multiple individuals beyond the mother are typically involved in raising children: in evolutionary anthropology, it is now widely accepted that we have evolved a strategy of cooperative reproduction. Expecting mothers to care for children with little support, while expecting fathers to provide for their families with little support, is, therefore, likely to lead to adverse health consequences for mothers, fathers and children. Incorporating evidence-based evolutionary, and anthropological, perspectives into research on health is vital if we are to ensure the wellbeing of individuals across a wide range of contexts. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Health Literacy Co-Design in a Low Resource Setting: Harnessing Local Wisdom to Inform Interventions across Fishing Villages in Egypt to Improve Health and Equity.

Fishermen in low resource settings have limited access to health services and may have a range of health literacy-related difficulties that may lead to poor health outcomes. To provide solutions and interventions based on their needs, co-design is considered best practice in such settings. This study aimed to implement a co-design process as a step towards developing health literacy interventions to improve health and equity in the Borollos Lake region of northern Egypt, a low resource setting with a high prevalence of chronic diseases. This study was guided by the Ophelia (Optimising Health Literacy and Access) process, a widely used and flexible co-design process that seeks to create local and fit-for-purpose health literacy solutions through genuine engagement and participation of community members and relevant stakeholders. Following a health literacy survey using the Health Literacy Questionnaire (HLQ), cluster analysis was conducted to identify the diverse health literacy profiles among the fishing communities. Seven health literacy profiles were identified. Vignettes, representing these profiles, were presented and discussed in ideas generation/co-design workshops with fishermen and health workers to develop intervention ideas. Seventeen fishermen, 22 wives of fishermen, and 20 nurses participated in four workshops. Fifteen key strategies across five themes, including ‘Enhancing education among fishing communities’, ‘Provide good quality health services’, ‘Financial support for health’, ‘Social support for health’, and ‘Promote better health-related quality of life among fishermen’, were generated. The ideas did not only target the individuals but also required actions from the government, non-government organizations, and fishermen syndicates. By harnessing local wisdom, the Ophelia process has created meaningful engagement with the local communities, leading to a wide range of practical and feasible solutions that match the special needs and environment of a low resource setting.

High Perceived Stigma Among People Living with HIV/AIDS in a Resource Limited Setting in Western Ethiopia: The Effect of Depression and Low Social Support.

BackgroundAntiretroviral therapy (ART) is only one part of a successful range of care among people living with HIV/AIDS (PLWHA). Stigma and low social support are emerging issues worsening the success of ART for PLWHA. This study thus aimed to investigate the level of perceived stigma among PLWHA.MethodsAn institution-based cross-sectional study was conducted in Nekemte, western Ethiopia. A multivariable logistic regression model was used to identify associations between perceived stigma and low social support, depression, and other potential predictor variables using SPSS version 24.0 and adjusted odds ratios (AORs), considering statistical significance at p<0.05.ResultsA total of 418 study participants were included in the study, with a response rate of 100%. About 48.6% of PLWHA had experienced perceived stigma, and more than two-fifths had poor social support. The following factors were associated with perceived stigma among PLWHA: age (18–29 years) (AOR=4.88, 95% CI:1.76–13.5), female sex (AOR=2.10, 95% CI 1.15–3.82), <12 months on ART (AOR=2.63, 95% CI 1.09–6.34), depression (AOR=1.86, 95% CI 1.08–3.19), social support (poor: AOR=3.45, 95% CI 1.65–7.23; medium: AOR=2.22, 95% CI 1.09–4.54), and non-disclosure of HIV status (AOR=2.00, 95% CI 1.11–3.59).Conclusion and RecommendationThe magnitude of perceived stigma among PLWHA was high, highlighting the importance of integrating social and mental health support within standard ART for PLWHA.

Cardiovascular reactivity to acute stress: Attachment styles and invisible stranger support

While the benefits of social support for physiological health are well established, the underlying pathways by which support can influence cardiovascular reactivity (CVR) are still being elucidated. In the present study, we adapted an attachment framework to further explore the support-CVR link. Specifically, we experimentally tested the effect of attachment and social support on CVR by manipulating the provision of invisible support from a stranger, across individuals with secure, anxious and avoidant attachment styles. Employing a 3 × 2 design, a sample of young adults (N = 138) from across each of the three attachment styles were randomly assigned to either an invisible support (from a stranger), or no support, condition. All participants were subject to an acute standardised stress testing protocol where cardiovascular indices were monitored throughout. Results from a factorial ANOVA showed no significant interaction between support and attachment on any cardiovascular reactivity parameter (SBP, DBP, HR) or any main effect of attachment or support. These findings suggest that, in this case, social support was not effective in buffering the effects of stress across various attachment styles. The benefits of incorporating a developmental perspective to the study of social support and health are discussed.

Positive and negative uses of social media among adolescents hospitalized for suicidal behavior

There is public concern about potential associations between adolescent social media/smartphone use and risk for suicide. However, no prior studies leverage qualitative methods to explore the experiences of adolescents currently at-risk for suicide. This study examined social technology use from the perspectives of adolescents (n=30; Mage=16.1 years) currently hospitalized for a recent suicide attempt or severe ideation. We conducted in-depth interviews and coded transcripts using thematic analysis. We had three research questions: What (1) negative and (2) positive experiences do suicidal adolescents report related to their use of social media/smartphones? (3) How do adolescents describe their disconnection from these technologies use during inpatient hospitalization and views on a subsequent return to digital connectivity after discharge? Results reveal both positive and negative social technology uses, with most participants reporting mixed (positive and negative) experiences. Negatives/risks included trouble regulating use, stress related to social media metrics, encounters with "triggering" content, hostility and meanness, self-denigrating comparisons, and burdensome friendship expectations. Positives/benefits included social connection, social support, affect-enhancing content, shared interests, and resources for mental health and coping. Overall, the documented risks and benefits of social technology use correspond with established (offline) risk and protective factors for suicidal thoughts and behaviors. Participants generally valued the break from social technologies during hospitalization, and also viewed them as integral to social re-entry and identified related concerns. Future studies should test well-being focused 'digital hygiene' interventions for maximizing potential benefits and minimizing potential harms of social technologies for at-risk adolescents.

Effectiveness of social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. As a secondary output of this review, and to assist in conceptualising future research focused on social network and social support interventions, we aim to develop a logic model theorising the relationship between social networks or social support and heart disease outcomes. We will draw on existing models of social support for health (e.g. Berkman 2000), as well as established approaches to theorising and implementing behaviour change (e.g. Michie 2011).

Shifting the Paradigm: The Dress-COV Telegram Bot as a Tool for Participatory Medicine.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic management is limited by great uncertainty, for both health systems and citizens. Facing this information gap requires a paradigm shift from traditional approaches to healthcare to the participatory model of improving health. This work describes the design and function of the Doing Risk sElf-assessment and Social health Support for COVID (Dress-COV) system. It aims to establish a lasting link between the user and the tool; thus, enabling modeling of the data to assess individual risk of infection, or developing complications, to improve the individual’s self-empowerment. The system uses bot technology of the Telegram application. The risk assessment includes the collection of user responses and the modeling of data by machine learning models, with increasing appropriateness based on the number of users who join the system. The main results reflect: (a) the individual’s compliance with the tool; (b) the security and versatility of the architecture; (c) support and promotion of self-management of behavior to accommodate surveillance system delays; (d) the potential to support territorial health providers, e.g., the daily efforts of general practitioners (during this pandemic, as well as in their routine practices). These results are unique to Dress-COV and distinguish our system from classical surveillance applications.

Relationship between social support and positive mental health: A three-wave longitudinal study on college students

The present study aims to understand the current situation and developmental trend of college students’ positive mental health, explore the relationship among social support and positive mental health.749 college students from 6 colleges in Shanghai participated for the follow-up survey in May 2013, May 2015 and May 2016. The social support scale (F-SozU) and psychological resilience scale (RS-11) and the life satisfaction scale (SWLS) were used to examine the changes in social support, resilience and life satisfaction. This study finds that the development of social support and life satisfaction of college students showed an upward first and then downward trend, while the development of resilience showed an upward trend. The mutually reinforcing relationship between social support and positive mental health was different during the college. Identifying the interaction between social support and positive mental health of college students, social workers working with college students need to recognize the important role of social support in positive mental health, provide suggestions for college students’ education of mental health, and further help them improve their positive mental health.

Pathways and Processes Linking Social Support to Health: Development of an Exploratory Model With South African Caregivers.

Despite ample evidence of the protective role of social support for mental and physical health, key gaps remain in our understanding of the pathways and mediating processes explaining these relationships in specific vulnerable populations. The author applies a theoretical framework developed by House et al. to qualitative data, collected with 24 caregivers of children living in HIV-endemic South African communities, to explore potential effects and processes linking social support to health. The data used for this analysis were part of a sequential mixed-methods research study with caregivers of children; previous survey findings (n = 2,477) showed significant associations between more social support and better mental health and self-reported physical health. Results point to multiple pathways and biopsychosocial mediating processes possibly explaining the support-health relationship. The author develops an exploratory model to illustrate these findings, based on the House et al. framework, and discusses implications for research, interventions, and theory.

Changing Health Behavior with Social Technology? A Pilot Test of a Mobile App Designed for Social Support of Physical Activity.

Mobile applications targeting people engaged in physical activity have increased. However, while research has identified social support as a key factor for people’s engagement in physical activity, most mobile health (mHealth) applications are designed for individual use. In this paper, we report on a research study exploring opportunities for designing mHealth to facilitate social support around physical activity. A mHealth application was designed, and pilot tested for eight weeks with healthcare professionals (n = 3) and two groups of citizens (n = 20) who were motivated but challenged physically due to various health conditions. Data was collected via online monitoring of the use of the mHealth application during the pilot test and via qualitative interviews with the participants before and after. The results support the idea that designing for social health support is important but so is identifying key challenges related to (i) the facilitation of technology-mediated social health support, especially to a target group that is living with health challenges, and (ii) finding a balance between social and health agendas that bring social support to the foreground for the participants.