Support Network Members Research Articles

REPRODUCTIVE HEALTH IN TRANS AND GENDER-DIVERSE PATIENTS: Psychosocial counseling of transgender and gender-diverse individuals in fertility and reproductive medicine: a narrative review.

Transgender and gender-diverse (TGD) people have similar desires for parenting as cisgender individuals but are likely to face greater barriers in accessing fertility treatment than their cisgender peers. Mental health professionals are well-positioned to advocate for and support TGD individuals seeking fertility care through pre-fertility treatment implications counseling regarding the psychosocial aspects of fertility treatment and family building. Transgender and gender-diverse (TGD) individuals experience significantly greater all-cause mortality and mental health disparities compared to their cisgender peers. Gender-affirming hormone therapy (GAHT) is a safe and effective treatment option for gender dysphoria that dramatically improves psychosocial health outcomes but may adversely impact fertility. Medical society guidelines recommend medical fertility preservation (FP) counseling and pre-fertility treatment psychoeducational implications consultation from qualified, reproductive mental health professionals (MHPs) for TGD individuals pursuing FP or third-party reproductive treatment. However, sparse literature exists specific to the structure of mental health psychoeducational consultation for TGD individuals pursuing FP. This narrative review highlights important areas for discussion in pre-fertility treatment mental health consultations. Results indicate that implications counseling should be conducted by an MHP with specialized training in reproductive mental health with TGD populations to reduce the risk of harm and promote successful emotional navigation of fertility treatment. Such counseling should be psychoeducational and not gatekeeping in nature and may include consideration of the psychosocial (e.g. emotional, relational, ethical, spiritual, social) risks and benefits of various family-building options. During these consultations, TGD individuals can explore their hopes and fears related to fertility and future family-building plans and discuss realistic treatment expectations, individual strengths, coping and communication strategies, and identify key support network members who may aid in navigating the fertility treatment process. MHPs can provide referrals to appropriate resources if necessary to help TGD individuals navigate treatment while coping with psychological symptoms and promoting behavior change.

Impacts of Peer Support on Coping and Cortisol Levels for Women Affected by Domestic Violence and Coercive Control.

Gendered domestic violence and coercive control are prevalent public heath concerns in Canada with dire consequences for survivors. Peer support groups may address and reduce negative impacts of domestic violence and coercive control on women's stress, coping, safety, and alliances with social support network members, the focus of this study. A one-group, pre-test/post-test quasi-experimental study was undertaken to evaluate the effectiveness of Growth Circle, a 14-week peer support program offered at an agency serving women affected by domestic violence in a major western Canadian city. Through convenience sampling, women 18 years and older who experienced domestic violence were recruited and provided data on stress, coping, safety-related empowerment, and social support/alliances. Thirty-five participants provided all pre-test and post-test data, with a subsample of 14 providing repeated hair samples. Hair was employed to determine stress hormone (cortisol) levels. A significant reduction in self-reported levels of perceived stress and stress hormone levels following completion of the Growth Circle program was revealed. Participants also reported a significant increase in safety-related empowerment, and supportive alliances with group members. The Growth Circle peer support program was demonstrated to be effective. Further implementation and research into the Growth Circle program across Canada is recommended.

'E koekoe te Tūī, e ketekete te Kākā, e kuku te Kererū, The Tūī chatters, the Kākā cackles, and the Kererū coos': Insights into explanatory factors, treatment experiences and recovery for Māori with eating disorders - A qualitative study.

Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Māori. Kaupapa Māori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Māori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whānau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding. Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Māori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Māori culture and whānau aspirations helped with recovery. The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tūī, Kākā and Kererū possess their own unique birdcalls, so do Māori with eating disorders and their whānau have their own experiences, needs and required treatment responses.

Social support network factors associated with verbal fluency among vulnerable persons living with HIV

ABSTRACT Vulnerable persons living with HIV (PLWH) are at high risk of cognitive impairment and challenges accessing quality social support in later life. Impaired verbal fluency (VF), a cognitive domain linked to HIV, could impede social support associated with health and well-being for already vulnerable PLWH. We examined the structure of social support, using latent class analysis, and the associations among quantity, specific forms and quality of social support and VF among PLWH. Participants enrolled in the BEACON study (n = 383) completed the Controlled Oral Word Association test (COWAT) and a social support network inventory. Latent class analysis with count variables was used to determine the number of classes of PLWH based on their social network characteristics. The majority of PLWH were male (61.4%) and African American (85.9%). Two distinct latent classes, with a major distinction in the number of network members who were female, knew participants’ HIV status and HIV medication usage. Fewer support network members (β = -.13, p < 0.01), greater negative interactions (β = -.16, p < 0.01), and less positive interactions with network members (β = .15, p < 0.05) were significantly associated with lower COWAT scores. Comprehensive screening of high-risk PLWH and early intervention with those with cognitive impairment are important for addressing social support needs.

The Behaviour Support Elements Checklist: Profiling intervention elements in community-based behaviour support for sexualised behavior after acquired brain injury

ABSTRACT Background The challenges associated with behavior dysregulation post acquired brain injury (ABI) are well documented. In a previous publication, we described a case series in which sexualized behavior post-ABI was reduced using multi-element behavior support interventions. In this publication, we describe the intervention elements used, as summarized using a one-page recording tool: The Behavior Support Elements Checklist (BSEC). Instrument The BSEC contains three categories indicating the target for change: the individual with ABI, their support network members, or other environmental aspects. Each category lists a number of elements being used in the routine practice of a community-based behavior support service. Results In total, 173 intervention elements were recommended, averaging seven per participant. Elements from all three categories were routinely incorporated into interventions, but changes to the (category) environment were rated by clinicians as most effective in changing behavior; some elements (e.g., meaningful activities) were considered more effective than others (e.g., ABI education). Conclusions The BSEC could assist service agencies and researchers to record and analyze clinician practices to improve service delivery, detect professional development needs, and steer resource allocation. Although the BSEC reflects the context in which it was constructed, it could readily be adapted to other service contexts.

Community-, network-, and individual-level predictors of uptake of medication for opioid use disorder among young people who inject drugs and their networks: A multilevel analysis

BackgroundOpioid use has been increasing at alarming rates over the past 15 years, yet uptake of medication for opioid use disorder (MOUD) remains low. Much of the research on individual characteristics predicting MOUD uptake is equivocal, and there is a dearth of research on setting-level and network-level characteristics that predict MOUD uptake. Towards a more holistic, multilevel understanding, we explore individual-level, network-level, and community-level characteristics associated with MOUD uptake. MethodsBaseline data from a longitudinal study of young people who inject drugs and their injection and support network members living in Chicago (N = 165) was used to conduct cross-sectional multilevel logistic regression analyses to examine associations between MOUD uptake and a set of potential predictors at the individual-, network-, and community-levels that were chosen based on theoretical relevance or support from previous empirical studies. ResultsStigma at both the individual and community levels was significantly associated with MOUD uptake (though in different directions). Greater individual-level stigma was associated with a higher likelihood of MOUD uptake, while having a more normatively stigmatizing community environment was associated with a lower likelihood of MOUD uptake. Using heroin and cocaine simultaneously and having a larger support network were associated with a greater likelihood of MOUD uptake. ConclusionsThe present study’s holistic, multilevel approach identified three individual-level characteristics, one network-level characteristic, and one community-level characteristic associated with MOUD uptake. However, more research is needed examining multilevel predictors, to help with developing interventions addressing barriers to MOUD use at multiple levels of influence.

CHANGE IN OLDER ADULTS’ SELF-EFFICACY TO HANDLE DISASTERS AFTER A PREPAREDNESS PROGRAM: ROLE OF SOCIAL NETWORKS

Abstract Social support networks provide a context within which older adults maintain their safety and well-being. Preparing for disasters and emergency situations can help older adults stay safe independent after a disaster. Self-efficacy to prepare for and handle disaster situations can influence how older adults proactively prepare and protect themselves. Fifty-four older adults 61 to 92 years of age in Eastern Iowa were interviewed before and after participating in an intervention program that helped them develop personalized disaster management plans. Participants reported seven support network members on average, ranging from one to 23. About one-third of the network members were participants’ children and grandchildren, 11% were their siblings and parents, and 58% were non-family members such as friends and neighbors. Out of 549 network members identified, 245 were selected as someone participants can depend on during emergency situations; 47% were family whereas 43% were non-family members. Participants who reported higher numbers of network members whom they can depend on in emergency situations at baseline showed more increase in self-efficacy to manage disasters one-month after receiving the intervention (p=0.02). Having social support network members whom older adults feel they can turn to during emergency situations may help boost their confidence in handling and preparing for disasters through participating in a disaster preparedness program. Participants indeed identified additional members whom they could depend on in disaster situations after the intervention. Future studies may test strategies to enhance social support networks to increase confidence among older adults to prepare for and handle disasters.

CONVOYS OF CARE

Abstract Many existing Alzheimer’s disease (AD) caregiving interventions focus narrowly on thechallenges and needs of a primary caregiver rather than the family systems in which they areembedded. We advance a family systems framework by invoking convoys of caregiving to adaptan existing AD caregiver intervention to Middle Eastern/Arab American families in metroDetroit (N=56). The composition of caregiving networks is described, followed by assessment ofcare burden, depressive symptoms, care satisfaction and family conflict. Results show thatsiblings and children are the predominate support network members who accompanied theprimary caregiver to the program. Paired t-tests show that care burden and family conflictdecreased while caregiving satisfaction increased following program participation. Depressivesymptoms did not change. Findings illuminate how convoys of care may serve as valuablesupport resources, yet may also be the source of stress and conflict.

Family Conflict Non-negotiation and HIV Disclosure Associated With ART Adherence in a Disadvantaged Population

Adherence to antiretroviral therapy (ART) is vital for reducing racial and gender disparities in morbidity and mortality among people living with HIV/AIDS (PLWH). Little research attention has been given to aspects of family functioning affecting ART adherence among PLWH vulnerable to disparities. Data were from n = 313 participants (93% African American) in the BEACON study, which recruited injection-drug-using PLWH on ART. Using factor analysis and longitudinal structural equation modeling, we found that current substance use and negative family conflict tactics (i.e., non-negotiation) predicted PLWH's lower probability of ART adherence at 12-month follow-up; and greater HIV disclosure to support network members predicted a higher probability of adherence. These findings suggest the importance of family and other support network members in this vulnerable population's ART adherence. Social network-focused interventions promoting prosocial response to conflict and negotiation skills are important for improving vulnerable PLWH's HIV outcomes and reducing health disparities.

The Role of Church Support Networks in the Relationship between Discrimination and Psychiatric Disorders among Older African Americans.

Few studies have examined the effects of discrimination on mental health specifically among older African Americans despite it being a common experience in this population. Further, knowledge on social resources, such as social relationships, that could mitigate the effects of discrimination is limited in this population. Given the historical and contemporaneous importance of the Black church in African American communities, church members are important support network members and a major source of social support for older African Americans. To address these knowledge gaps, this study will (1) examine the association between racial discrimination and psychiatric disorders; and (2) determine whether church relationships moderate the impact of racial discrimination on psychiatric disorders. Data from African American respondents aged 55 and older were drawn from the National Survey of American Life (N = 837). Church relationship variables included receipt of emotional support from, frequency of contact with, and subjective closeness to church members. Regression analyses were used to test the study aims. Analyses indicated that more frequent experiences of racial discrimination were associated with meeting criteria for any DSM-IV disorder and a greater number of DSM-IV disorders. Significant interactions revealed that frequency of contact with and subjective closeness to church members mitigated the association between discrimination and meeting criteria for any 12-month disorder and number of 12-month disorders. Altogether, these findings support the literature on the detrimental effects of discrimination on the mental health of older African Americans and provide a more nuanced understanding of the role of church members in the lives of older African Americans. The study findings suggest that church relationships are effective stress coping resources for older African Americans dealing with discrimination. Given the importance and relevance of church members, initial clinical assessments should assess clients' level of religious involvement and relationships with church members.

Relationships of adolescents with suicidal behavior with social support networks.

To identify the relationships of adolescents with suicidal behavior established with social support networks. Qualitative study addressing ten adolescents with suicidal behavior cared for by a psychosocial care center attending children and adolescents located in southern Brazil. Semi-structured interviews were held in July 2020 via WhatsApp during the COVID-19 pandemic, and data were analyzed according to Minayo's thematic analysis. Two categories emerged: Dynamics of the relationships established in the family support network and Relationships established with the remaining social support network members, which revealed a weak social support network established with friends and at the school context. This study enabled identifying how relationships are established in the social support networks and how these reflected on the adolescents' development.

A Dyadic View on the Post-separation Network of Single Mothers

Many empirical studies have focused on the quantitative changes in the social networks of divorced and separated people. In this qualitative study, we use interviews with dyads to construct a two-sided view of the support network after separation. The aim of the study is to gain insight into the needs for support after a relational breakup. Including a network member in the analysis enables a more detailed view on the interaction at hand in the bond between these women and their supportive network members. The results show that personal coping resources are left untouched. Giving advice on ones daily activities is counter-productive. This is better understood by non family members compared to the women’s parents (especially the mother). With respect to the reciprocity in these relationships, network members do not expect a return in the period after the separation.

Validation of a tool to assess effectiveness of peer-recruitment for hepatitis C testing and linkage to care among people who inject drugs

ObjectivePeople who inject drugs (PWID) have high hepatitis C virus (HCV) infection prevalence but low rates of HCV treatment uptake. To better harness the potential of peer-led social network-based interventions to increase HCV treatment uptake among PWID, simple tools that can help identify individuals with the potential to function effectively as peer-mentors who support network members to get HCV tested and linked to care are needed. MethodsData from a survey administered to index PWID enrolled in a social network-based intervention, in which they were invited to recruit drug use network members for HCV testing and linkage to care, was analyzed. Constructs derived from exploratory factor analysis were validated through confirmatory factor analysis (CFA). We used logistic regression analysis to assess the association between scores in identified constructs and subsequent effectiveness in the peer mentor role, defined as recruiting at least one network member for HCV testing and linkage to care in the 12 weeks following survey completion. ResultsAmong 100 PWID with median age 53 years, 74% male, and 71% Black, CFA resulted in a multidimensional three-factor survey with 4 questions related to opinion leadership, 3 questions related to perceived HCV-related stigma, and 3 questions related to HCV communication comfort and care support willingness. Only self-designated opinion leadership was associated with effectiveness in the peer mentor role (adjusted odds ratio 3.76 (95% Confidence interval CI 1.01, 14.0)). ConclusionWe developed and validated a simple tool with potential to ease and improve the efficiency of peer-led social network interventions.

The potential role of network-oriented interventions for survivors of sexual and gender-based violence among asylum seekers in Belgium

BackgroundSocial support and social network members have been identified as an important factor in mitigating the effects of sexual and gender-based violence (SGBV) and improving the coping process for many survivors. Network oriented strategies have been advocated for among domestic violence survivors, as they help build on improving social support and addressing factors that alleviate repeat victimization. There are opportunities to implement such strategies among asylum seekers who are survivors of SGBV in asylum centres, however, this has not been fully explored. This study sought to identify key strategies and opportunities for developing peer-led and network-oriented strategies for mitigating the effects of SGBV among asylum seekers at these centres.MethodsTwenty-seven interviews, were conducted with service providers (n = 14) / asylum seekers (n = 13) at three asylum centres in Belgium. A theoretical model developed by the research team from a literature review and discussions with experts and stakeholders, was used as a theoretical framework to analyse the data. An abduction approach with qualitative content analysis was used by the two researchers to analyse the data. Data triangulation was done with findings from observations at these centres over a period of a year.ResultsMany of the asylum seekers presented with PTSD or psychosomatic symptoms, because of different forms of SGBV, including intimate partner violence, or other trauma experienced during migration. Peer and family support were very influential in mitigating the effects and social costs of violence among the asylum seekers by providing emotional and material support. Social assistants were viewed as an information resource that was essential for most of the asylum seekers. Peer-peer support was identified as a potential tool for mitigating the effects of SGBV.ConclusionInterventions involving asylum seekers and members of their network (especially peers), have the potential for improving physical and mental health outcomes of asylum seekers who are SGBV survivors.

Personal Support Networks of Older Adults in Relation to Their Perceptions About Disaster Management

Personal support networks are essential in ensuring the health and well-being of older adults especially in handling disaster situations. This study assessed the characteristics of personal support networks of older adults in relation to their perceptions about disaster management. Adults between ages 63 and 88 from Eastern Iowa participated in a survey prior to receiving a disaster preparedness education program. About half (47%) were living alone, 66% were female, and 53% had a high school diploma or fewer years of education. Forty-seven participants identified 308 support network members, with an average network size of 6.55 members ranging from 2 to 17. A greater number of network members with whom participants discussed disaster/emergency plans was associated with higher perceived response efficacy (preparation/planning “will help handle the situation better”; r=0.45, p=0.002), lower perceived barriers (preparation is “difficult to do”; r=-0.34, p=0.021), and higher self-efficacy to handle disaster situations (r=0.32, p=0.030). Having more members who would help “if something went wrong” was associated with higher self-efficacy to prepare (r=0.44, p=0.002) and to handle disaster situations (r=0.34, p=0.021). Fatalistic perception that nothing can help handle disaster situations was associated with having fewer people who provide emotional support (r=-0.559, p=.003) and who participants trust (r=-0.46, p=.018). Older adults’ social support network members may partly determine their perceptions regarding the importance of and their ability to prepare for emergency and disaster situations. Future studies may evaluate whether activating network member support and discussion would lead to increased motivation and preparedness among older adults.

Social network support and harm reduction activities in a peer researcher-led pilot study, British Columbia, Canada

BackgroundPeople who smoke drugs (PWSD) are at high risk of both infectious disease and overdose. Harm reduction activities organized by their peers in the community can reduce risk by providing education, safer smoking supplies, and facilitate access to other services. Peers also provide a network of people who provide social support to PWSD which may reinforce harm reducing behaviors. We evaluated the numbers of supportive network members and the relationships between received support and participants’ harm-reducing activities.MethodsInitial peer-researchers with past or current lived drug use experience were employed from communities in Abbotsford and Vancouver to interview ten friends from their social networks who use illegal drugs mainly through smoking. Contacts completed a questionnaire about people in their own harm reduction networks and their relationships with each other. We categorized social support into informational, emotional, and tangible aspects, and harm reduction into being trained in the use of, or carrying naloxone, assisting peers with overdoses, using brass screens to smoke, obtaining pipes from service organizations and being trained in CPR.ResultsFifteen initial peer researchers interviewed 149 participants who provided information on up to 10 people who were friends or contacts and the relationships between them. People who smoked drugs in public were 1.46 (95% CI, 1.13-1.78) more likely to assist others with possible overdoses if they received tangible support; women who received tangible support were 1.24 (95% CI; 1.02-1.45) more likely to carry and be trained in the use of naloxone. There was no relationship between number of supportive network members and harm reduction behaviors.ConclusionsIn this pilot study, PWSD who received tangible support were more likely to assist peers in possible overdoses and be trained in the use of and/or carry naloxone, than those who did not receive tangible support. Future work on the social relationships of PWSD may prove valuable in the search for credible and effective interventions.

Advice messages and helpful behaviors emerging adults receive during transitions from higher education: associations with dispositional and contextual hope

ABSTRACT One of the most meaningful life transitions is from school to full-time employment. Emerging adults embarking on this transition to adulthood often face many financial, identity, and relational challenges. Hopefulness, encouragement, and advice from personal networks can play an important role in the way emerging adults process and navigate these challenges following graduation from college. A content analysis of 226 emerging adults’ responses to questions about this transition revealed typologies of advice messages and helpful behaviors received from personal network members. Findings revealed that emerging adults with higher levels of hope reported more encouraging messages and identity-specific support than those lower in hope, while also reporting more helpful behaviors from supportive network members than from sources outside their close personal network.

Comparisons of Social Support and Social Networks in Homeless and Vulnerably Housed Women

Social support is closely connected to mental health and well-being as well as experiences of housing vulnerability. This study explored differences between homeless and vulnerably housed women in their experiences of social support. Forty-nine homeless and 43 vulnerably housed women completed 3 measures to assess their social networks, social support networks, and global social support. Vulnerably housed women reported fewer social support network members than homeless women. Social support network size was found to be a predictor of global social support score. These findings suggest that housing status impacts social support in homeless and vulnerably housed women, which may have implications for their well-being.

How the personal support networks of people with intellectual disability promote participation and engagement

Background: Social inclusion has been defined as an interaction between major life domains, including interpersonal relationships and community participation among other factors. Understanding the manner in which these life domains may inter-connect could inform efforts to promote social inclusion. This paper explores the role of personal support network members in establishing and maintaining community participation of a person with an intellectual disability. Method: An ethnographic research design allowed exploration of network interactions over a three-year period. In-depth interviews and participant observations were undertaken with nine people with an intellectual disability and their network members. Results: The networks promoted participation using various strategies. The person and their network gathered and shared information to determine what was meaningful to the person. Information about success was used to adapt developing strategies, enhance support, and build on existing gains. Conclusions: Personal networks provided insight into the practical and relational aspects of participation, and the importance of balancing risk and autonomy, vulnerability and freedom. Respect for the personhood, importance and dignity of each person at the centre of the network influenced this work.

How the personal support networks of people with intellectual disability promote participation and engagement

Background: Social inclusion has been defined as an interaction between major life domains, including interpersonal relationships and community participation among other factors. Understanding the manner in which these life domains may inter-connect could inform efforts to promote social inclusion. This paper explores the role of personal support network members in establishing and maintaining community participation of a person with an intellectual disability.Method: An ethnographic research design allowed exploration of network interactions over a three-year period. In-depth interviews and participant observations were undertaken with nine people with an intellectual disability and their network members.Results: The networks promoted participation using various strategies. The person and their network gathered and shared information to determine what was meaningful to the person. Information about success was used to adapt developing strategies, enhance support, and build on existing gains.Conclusions: Personal networks provided insight into the practical and relational aspects of participation, and the importance of balancing risk and autonomy, vulnerability and freedom. Respect for the personhood, importance and dignity of each person at the centre of the network influenced this work.