Tangible Support Research Articles

Use of tangible, educational and psychological support services among Chinese American dementia caregivers.

Though many studies have examined the service utilization of dementia caregivers, there is limited empirical evidence from Asian Americans in this field. Guided by Andersen's behavioral model of health services use, we aimed to understand what factors were associated with utilizing multiple types of services among Chinese American dementia caregivers. We collected survey data from 134 Chinese dementia caregivers in New York City. Logistic regression models were conducted to test the associations between predisposing, enabling, and need factors and the likelihood of using tangible (home health aide, adult daycare, respite care), educational (lectures and workshops), and psychological (peer support groups and psychological counseling) support services. Several variables conceptualized by Andersen's model, including caregiver's knowledge about services, caring tasks, length of care and burden, and care recipient's physical and cognitive deteriorations, were significantly associated with higher possibilities of using multiple types of services. Three sociocultural factors-residing in Chinatown, availability of alternative family caregivers, and diagnosis of cognitive deterioration-were also associated with higher likelihood of using educational or psychological services. The findings extend the existing literature on service utilization of caregivers by highlighting the importance of distinguishing types of services and considering sociocultural factors in future research and practice.

Does Mobile Internet Use Affect the Loneliness of Older Chinese Adults? An Instrumental Variable Quantile Analysis.

Based on the 2018 China Family Panel Studies (CFPS) data, we empirically analyze the effect, heterogeneity, quantile differences and influencing mechanisms of mobile Internet use on loneliness in the elderly. The study found that the loneliness of the elderly who used mobile Internet was 33.1% lower than that of the elderly who did not use the mobile Internet The study also passed the robustness test. There is heterogeneity in the effect of mobile Internet use on loneliness among the elderly of different ages, educational levels and marital status. Among them, the use of mobile Internet has a significant alleviating effect on the loneliness of the 60–70-year-old elderly, those of junior high school education level and below, and the elderly with a partner. The quantile regression analysis showed that the elderly group with a high level of loneliness benefited more from the use of mobile Internet. Mediation analysis further showed that mobile Internet use can improve parent–child relationship, increase offline interactions with children, and reduce children’s tangible support, which we interpret as a potential mechanism for mobile Internet use to alleviate loneliness in the elderly.

Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study.

Perceived organizational support (POS) may promote healthcare worker mental health, but organizational factors that foster POS during the COVID-19 pandemic are unknown. The goals of this study were to identify actions and policies regarding COVID-19 that healthcare organizations can implement to promote POS and to evaluate the impact of POS on physicians' mental health, burnout, and intention to leave patient care. We conducted a cross-sectional national survey with an online panel of internal medicine physicians from the American College of Physicians in September and October of 2020. POS was measured with a 4-item scale, based on items from Eisenberger's Perceived Organizational Support Scale that were adapted for the pandemic. Mental health outcomes and burnout were measured with short screening scales. The response rate was 37.8% (N = 810). Three healthcare organization actions and policies were independently associated with higher levels of POS in a multiple linear regression model that included all actions and policies as well as potential confounding factors: opportunities to discuss ethical issues related to COVID-19 (β (regression coefficient) = 0.74, p = .001), adequate access to personal protective equipment (β = 1.00, p = .005), and leadership that listens to healthcare worker concerns regarding COVID-19 (β = 3.58, p < .001). Sanctioning workers who speak out on COVID-19 safety issues or refuse pandemic deployment was associated with lower POS (β = -2.06, p < .001). In multivariable logistic regression models, high POS was associated with approximately half the odds of screening positive for generalized anxiety, depression, post-traumatic stress disorder, burnout, and intention to leave patient care within 5 years. Our results suggest that healthcare organizations may be able to increase POS among physicians during the COVID-19 pandemic by guaranteeing adequate personal protective equipment, making sure that leaders listen to concerns about COVID-19, and offering opportunities to discuss ethical concerns related to caring for patients with COVID-19. Other policies and actions such as rapid COVID-19 tests may be implemented for the safety of staff and patients, but the policies and actions associated with POS in multivariable models in this study are likely to have the largest positive impact on POS. Warning or sanctioning workers who refuse pandemic deployment or speak up about worker and patient safety is associated with lower POS and should be avoided. We also found that high degrees of POS are associated with lower rates of adverse outcomes. So, by implementing the tangible support policies positively associated with POS and avoiding punitive ones, healthcare organizations may be able to reduce adverse mental health outcomes and attrition among their physicians.

Strengthening the service experiences of women impacted by gambling-related intimate partner violence

BackgroundWhile problem gambling does not directly cause intimate partner violence (IPV), it exacerbates that violence significantly. Women experiencing both gambling harm and IPV often find themselves in challenging situations; furthermore, stigma and shame frequently act as barriers to seeking help from health and social service agencies. Despite the links between problem gambling and IPV, little is known about women’s experiences of using support services for both IPV and gambling related issues. This paper explores positive experiences of help-seeking for gambling-related IPV in Australia by adopting a strengths-based research approach.MethodsQualitative, unstructured interviews were conducted for a larger study exploring the nature of the relationship between problem gambling and IPV. To gain new insights into the service experiences of women impacted by gambling related IPV, interviews with 48 women with lived experience of IPV relating to a male partner’s gambling, and 24 women with lived experience of IPV relating to their own gambling were reanalysed using thematic analysis.ResultsThree themes emerged from the data signifying or demonstrating strength-based responses: ‘Commitment to Integrated and Collaborative Responses’; ‘Therapeutic Support’; and ‘Instrumental Support’. The themes highlight the importance of recognising the intersectionality of gambling related IPV and supporting the person ‘at the centre of the service’. Tangible and instrumental supports, such as emergency accommodation and financial assistance, were also central to the recovery process.ConclusionEffective service responses are dependent on understanding how problem gambling and IPV intersect. Importantly, service providers must recognise and address the many facets of each woman’s situation and the shame associated with resolving interdependent and complex issues. Responding to the needs of women impacted by gambling related IPV requires both individual-level awareness and organisational support; recommendations to strengthen service provision are provided.

Using Personal-Disclosure Mutual-Sharing (PDMS) with first-year undergraduate students transitioning to higher education.

Using Personal-Disclosure Mutual-Sharing (PDMS) with students transitioning to Higher Education (HE) has yet to be researched in education. In two studies, we aimed to explore the immediate effects of a Coping Oriented Personal-Disclosure Mutual-Sharing (COPDMS) intervention on first-year undergraduate students' relational and organizational identification, perceived social support availability, and self-efficacy for learning and performance. In our second study, we also aimed to examine student-perceptions of participating in a COPDMS intervention. At the beginning of induction week in both studies, first-year undergraduate students on the same degree programme at a HE provider in England received an education session where COPDMS was introduced. Students participated in a COPDMS session a few days later. During COPDMS sessions, students mutually-shared and disclosed personal information and/or stories relating to transitional experiences. Across both studies, students' relational identification with staff and perceived emotional, esteemed, and informational support availability from others on the degree programme significantly increased from pre- to post-COPDMS phases. Findings relating to relational identification with other Year 1students and perceived availability of tangible support were mixed. No significant changes occurred for organizational identification with the university and self-efficacy for learning and performance. In Study 2, five higher-order themes relating to students' perceptions of COPDMS were found: (1) emotionality; (2) personal development; (3) storytelling; (4) enhanced group processes; and (5) task appropriateness and value. Study findings provide evidence that COPDMS is a useful psychological intervention to deliver to students transitioning to HE. Practical considerations, limitations, and future research suggestions are provided.

Support Now to Care Later: Intergenerational Support Exchanges and Older Parents' Care Receipt and Expectations.

Older parents' previous support exchanges with adult children could influence which child currently provides care or which child they expect to provide care in the future. Distinguishing between support and care, we investigated how different types of past support exchanges with children were associated with care receipt and expectations from the parent's perspective. Older parents (N = 190; Mage = 79.98) reported on exchanges of tangible and nontangible support, and provision of childcare support with each of their adult children (N = 709; Mage = 52.69) in two waves of the Family Exchanges Study (2008 and 2013). Multilevel, within-family, logistic regression models were estimated to examine how past patterns of support exchanges were associated with which child the older parent receives or expects to receive care from. Parents with functional limitations at Wave 2 were more likely to receive care from children whom they received more tangible support from at the prior wave. Parents without current limitations more likely named children whom they previously provided childcare support to and received more tangible support from as their expected future caregiver. This study distinguished different types of support to examine unique pathways to received and expected care within families. Taking the older parent's perspective, these findings endorse previous studies that emphasize continuity in the transition from receiving tangible support to receiving and expecting care from adult children. The findings also suggest the importance of older parents' childcare support given to adult children, highlighting reciprocity in intergenerational care exchanges.

Reassures Me There Are People Around Who Care about Me: Analyzing Meanings of Support for People with Epilepsy

Abstract Aims The study aimed to examine the nature and outcomes of social support for the well-being and quality of life (QoL) of adults with epilepsy. Methods The Australian Epilepsy Longitudinal Survey's 5th Wave included the Medical Outcomes Study Modified Social Support Survey on four dimensions of social support and the QOLIE-31. Both numerical data and open-ended responses were analyzed quantitatively and qualitatively. A mixed method was used where quantitative analysis used t-tests, analysis of variance and block recursive regression, and qualitative analysis identified themes. Results Three-hundred thirty-two people with epilepsy (PWE) participated. The quantitative component showed that for emotional/informational support being older and living alone were key factors. These as well as household income were important in tangible support. For affectionate support living alone and household income were factors, but only income was a factor for positive social interaction. In addition, only positive social interaction predicted increased QoL. In the qualitative component of the study both positive and negative supports were identified for the emotional/informational supports. Many reported the benefits of having information, although some reported failure to have their needs taken seriously by health professionals or epilepsy associations. Inability to drive was an important feature of negative tangible support as was finding some assistive services unaffordable. Reports of positive social interaction identified being accepted as a person with epilepsy that is the primary concern. Peer support plays a role here. Discussion The findings of factors affecting the four dimensions of support in this study have supported a number of studies. This includes the effects of positive social interaction on QoL. The qualitative analysis supports these results, but it also contributes to deeper understanding of support in the lives of PWE. Conclusion Social support is a particularly important issue for PWE. The results of this study demonstrate the complexities and benefits of obtaining the appropriate forms of support. This survey took place before the coronavirus disease 2019 pandemic and it may well be that this phenomenon affects PWE's support needs.

Social activity as mediator between social support and psychological quality of life among people with rare diseases: A national repetitive cross-sectional study

BackgroundConsiderable proportion of people with rare diseases (RDs) have suffered from severe mental health problems. However, specific attention on the psychological quality of life (QoL) of people with RDs is sparse. Evidence documented the benefits of social support and social activity on recipients’ mental health and overall QoL, but no corresponding study answered how both social support and social activity work on the psychological QoL among people with RDs. This study aims to report the psychological QoL and evaluate the mediating role of social activity between social support and psychological QoL among people with RDs. MethodsData were from two national repetitive cross-sectional surveys, conducted in China in February 2016 and February 2018. In this study, eligible people were those aged 18 or above and had clinical-diagnosed RDs. Psychological QoL was measured by the subdomain of World Health Organization Quality of Life: Brief Version. Social support was measured by the Medical Outcomes Study Social Support Survey. Social activity was measured with seven items selected from the measurement on leisure activities used by the Chinese General Social Survey. Using the mediation model, we assessed the direct and indirect (via social activity) association between social support and psychological QoL, both on overall and subtypes of RDs. We controlled for a variety of potential socioeconomic and demographic confounding factors. ResultsOf the 2403 adults studied, their average score of psychological QoL was 42.49 out of 100. The psychological QoL was directly associated with received emotional/information support (coefficient = 0.159, 95% CI = [0.093, 0.231], p < 0.0001) and positive social interaction (coefficient = 0.159, 95% CI = [0.097, 0.221], p < 0.0001). The psychological QoL was indirectly (via social activity) associated with received tangible support (coefficient = −0.035, 95% CI = [-0.046, −0.025], p < 0.0001) and positive social interaction (coefficient = 0.056, 95% CI = [0.040, 0.074], p < 0.0001). Above results by subtypes of RDs were also reported. LimitationsThe causal inference was not able to be investigated due to the cross-sectional study design. ConclusionPeople with RDs suffered from a low psychological QoL. Social activity mediated the association between social support and psychological QoL, but its mediating role depended on the subscales of social support as well as the subtypes of RDs. Customized measures based on the type of RDs and support that will be provided could perhaps improve the psychological QoL of people with RDs directly and indirectly.

“I Didn’t Just Do It for Myself”: Exploring the Roles of Family in Adult Learner Persistence

Adult students and are a rapidly growing population in U.S. higher education. Yet limited scholarship has centered on the voices of adult learners and explored the complex roles that family play in their decisions to enroll and their motivations to persist in college. This study begins to fill that gap. In a grounded theory study using individual interviews with 31 adult students at a continuing education campus in the northeast United States, we documented the complicated roles family played in adult student motivation, success, and persistence. Three grounded theory categories emerged from this study: (a) family as a source of motivation, inspiration, and pride; (b) family as a source of tangible support; and (c) family as a challenge. We suggest numerous ways that higher education institutions can use these findings to foster success and persistence for adult students.

Experiences of care coordination among older adults in the United States: Evidence from the Health and Retirement Study

IntroductionThe goal of this study was to examine variation in patient experiences and perceptions of care coordination across sociodemographic and health factors. MethodsData come from the 2016 Health and Retirement Study (N = 1, 216). Three domains of coordination were assessed: 1) Perceptions (e.g., patient impressions of provider-provider communication), 2) Tangible supports (e.g., meeting with a care coordinator, being accompanied to appointments), and 3) Technical supports (e.g., use of a “patient portal”). Logistic regression was used to quantify the frequency of each domain and examine variation by racial minority status, socioeconomic status, and health status. ResultsApproximately 42% of older adults perceived poor care coordination, including 14.8% who reported receiving seemingly conflicting advice from different providers. Only one-third had ever met with a formal care coordinator, and 40% were occasionally accompanied to appointments. Although racial minorities were less likely to have access to technical supports, they were more likely to use them. Better perceived coordination was associated with higher care satisfaction (Odds Ratio: 1.43, 95% CI: 1.27–1.61). ConclusionsImportant gaps in care coordination remain for older adults. Practice implicationsProviders should consider assessing patient perceptions of care coordination to address these gaps in an equitable manner.

Transitioning to independent living: Experiences of homeless young adults in rapid rehousing

Rapid rehousing (RRH) is an intervention that is being adopted nationally to assist adolescents and emerging adults who are homeless. RRH provides short-term rental assistance for independent scattered-site housing, in addition to an array of support services for approximately 12–24 months. The aim of this study is to explore the experiences of young adults (18–23 years old) who had previously been homeless and who were enrolled in RRH programs set in two urban Northeastern cities, and their subsequent preparedness for independent living. Our sample mostly consisted of non-Hispanic Black females, many of whom identified as LGBTQ. Semi-structured interviews (n = 15) were conducted after participants had been in the program for nine months - three months prior to their initial program completion date. Thematic analysis revealed three themes: the importance of tangible support, communication among all parties: staff lead the way, and “I gotta start learning to do it on my own”. These domains provided essential assistance for young people to attain their goals and through this process they learned skills to live independently and transition into adulthood. These findings suggest that rapid rehousing programs and service providers should focus on these domains to facilitate successful transition to independent living for this population.

AIM for Teen Moms: Social Support’s Role in Contraception Use Among Young Mothers

PurposeRapid repeat pregnancy is associated with negative outcomes for teen mothers and their offspring. Contraceptive use can reduce this risk. We explored the impact of AIM for Teen Moms, a future-oriented behavioral intervention, on emotional and tangible support and the influence of this support on the attitudes, intentions, and past 3-month contraceptive use behaviors. MethodParticipants were 295 first-time moms (ages 15–19) in Los Angeles County who participated in a randomized control trial intervention to reduce rapid repeat pregnancies. Participants completed surveys at baseline and 36-months. Hypotheses were tested using multivariate and interaction analysis. ResultsTeen mothers in treatment group reported more emotional (β =.13, p < .05) and tangible support (β =.13, p < .05). Higher tangible support was positively associated with birth control attitudes (β =.13, p < .05), which, in turn, predicted intention to use birth control (β =.31, p < .001). Intention to use birth control also predicted higher past 3-month birth control use (β =.18, p < .01); there was also a direct path from attitude to 3-month birth control use (β =.35, p < .001). There was no association between emotional support and birth control attitudes, intentions, or behaviors. ConclusionAIM for Teen Mom’s effects on contraception use at 36 months was mediated by social support, specifically tangible support, which, in turn, affected birth control attitudes, intentions, and reported birth control use. Interventionists must consider how intervention content can specifically address the building of target support to meet the needs of teen mothers.

The Bidirectional Relationship between Posttraumatic Stress Symptoms and Social Support in a 9/11-Exposed Cohort: A Longitudinal Cross-Lagged Analysis.

Research on the longitudinal relationship between posttraumatic stress disorder (PTSD) and social support among survivors of large-scale trauma is limited. This study assessed bidirectional relationships between PTSD and perceived social support in a large sample of the 9/11-exposed cohort over a 14-year follow-up. We used data from 23,165 World Trade Center Health Registry (WTCHR) enrollees who were exposed to the 9/11 attacks and participated in the first four WTCHR surveys (Wave 1 (2003–2004) to Wave 4 (2015–2016)). PTSD symptoms were measured using the 17-item PTSD Checklist. Perceived social support was measured using the five-item version of the Modified Social Support Survey. We used a cross-lagged panel analysis and found an inverse relationship between PTSD symptoms and social support. PTSD at Wave 2 (W2) predicted less social support at Wave 3 (W3) (β = −0.10, p < 0.01), and PTSD at W3 predicted less social support at W4 (β = −0.05, p < 0.01). Conversely, social support at W3 buffered PTSD symptoms at W4 (β = −0.03, p < 0.05). Sub-analyses by types of perceived social support suggest greater effects of PTSD on emotional support than tangible support and in community members than rescue/recovery workers. Our findings suggest a bidirectional effect between PTSD symptoms and social support in a longitudinal study of 9/11-exposed populations.

Social support among women with genital fistula in Uganda

Resulting from prolonged obstructed labour, iatrogenic and traumatic aetiologies, female genital fistula in low-resource settings causes a significant physical and psychosocial burden. Social support is an important mechanism to build resilience to health challenges. This study aimed to understand the role of emotional, informational and tangible social support for Ugandan women affected by fistula. Thirty-three participants who had had fistula surgery 6–24 months prior to the study were recruited from Mulago Hospital in Kampala, Uganda. Data from in-depth interviews (n = 16) and 4 focus group discussions were analysed thematically using a social support framework. Various individuals were key providers of social support across the different domains. They included family, friends, community organisations, and other women affected by fistula. Social support was critical in helping women cope with fistula, access fistula care, and post-repair recovery. Women relied heavily on tangible and emotional support to meet their physical and psychological needs. Support-enhancing interventions for women and their families, particularly those offering emotional and tangible support, may be a promising strategy for improving the experiences and quality of life of women affected by fistula.

Maternal perspectives: The needs of Saudi families of children with Down's syndrome.

Down syndrome (DS) is a chromosomal condition that is affecting an increasing number of infants born in Saudi Arabia. This study investigates the needs of families with children with DS in Saudi Arabia from mothers' perspectives and in a cultural and religious context. An exploratory qualitative research design was used, and semi-structured interviews were conducted with 14 mothers of children with DS. Interview data were thematically analyzed. The most important need was found to be financial or tangible support. An increase in benefits or monthly financial allowances and social security insurance would address these concerns. Societal support is also needed; mothers want DS to be perceived differently and require more support, including better rehabilitation and education services. Informational support is needed to improve the conditions of children with DS. Recommendations for improving the quality of life of children with DS are discussed.

Instrumental support: A conceptual analysis.

The aim of this paper was to use the Walker and Avant method of concept analysis to evaluate the concept of instrumental support in the context of hospital to home care transitions. Findings from this concept analysis suggest three defining attributes of instrumental support: informal support providers, tangible support, and unmet personal needs. Antecedents identified: a strong and supportive social network, an independently functioning adult, an illness resulting in hospitalization, a change in functional status, and the patient being discharged home from the hospital. Consequences of not having adequate instrumental support: unsuccessful recovery at home, increased risk for hospital readmission, decline in physical functioning, health complications, and increased risk of mortality. Empirical referents: patient's report of successful recovery, returning to an independent level of functioning, and the lack of hospital readmission or health complication. A model and a contrary case study were developed to provide examples of clinical cases related to instrumental support. Recommendations related to clinical practice include evaluating the availability/adequacy of instrumental support before hospital discharge and including the identified instrumental support person in the discharge planning process. There are proven benefits of having people within one's social network providing instrumental support during the home recovery period.

Social Support and Physical Activity in Older Adults: Identifying Predictors Using Data From the Canadian Longitudinal Study on Aging.

This study examined which of nine forms of social support were the strongest predictors of physical activity in older adults, and to what degree these associations were moderated by eight demographic indicators of groups at increased risk of social isolation. Baseline data from 21,491 adults aged 65 and older who were participants of the Canadian Longitudinal Study on Aging were analyzed using multiple regression. Greater social network size, social contact with network members, and participation in community-related activities predicted greater physical activity, whereas being in a domestic partnership and perceiving more tangible support to be available were negatively associated. The strength and direction of these associations varied by sex, living arrangement, and income. Given the findings, various forms of social support should be incorporated in physical activity interventions but tailored to meet the needs of different segments of the aging population.

The miscarriage circle of care: towards leveraging online spaces for social support

BackgroundLack of social support during and after miscarriage can greatly affect mental wellbeing. With miscarriages being a common experience, there remains a discrepancy in the social support received after a pregnancy is lost.Method42 people who had experienced at least one miscarriage took part in an Asynchronous Remote Community (ARC) study. The study involved 16 activities (discussions, creative tasks, and surveys) in two closed, secret Facebook groups over eight weeks. Descriptive statistics were used to analyse quantitative data, and content analysis was used for qualitative data.ResultsThere were two main miscarriage care networks, formal (health care providers) and informal (friends, family, work colleagues). The formal care network was the most trusted informational support source, while the informal care network was the main source of tangible support. However, often, participants’ care networks were unable to provide sufficient informational, emotional, esteem, and network support. Peers who also had experienced miscarriage played a crucial role in addressing these gaps in social support. Technology use varied greatly, with smartphone use as the only common denominator. While there was a range of online support sources, participants tended to focus on only a few, and there was no single common preferred source.DiscussionWe propose a Miscarriage Circle of Care Model (MCCM), with peer advisors playing a central role in improving communication channels and social support provision. We show how the MCCM can be used to identify gaps in service provision and opportunities where technology can be leveraged to fill those gaps.

Physician Champions of Quality and Safety: Perspectives of MD Quality and Safety Leads to Drive Quality Innovation at an Academic Hospital.

While the importance of physician involvement in organizational quality and safety (Q&S) activities has been well established, a paucity of information exists on tangible supports needed to effectively execute this role. Interviews with 13 MD Q&S leads uncovered common enablers, including valuing Q&S work academically, hiring skilled collaborators, ensuring appropriate power and authority to advance Q&S initiatives, facilitating connections, emphasizing culture change and strong action by leadership. To operationalize these enablers and drive quality innovation, organizations should prioritize the identification and appointment of MD Q&S leads for each department/division and facilitate their assembly as a formal physician Q&S committee.

State support for small and medium-sized enterprises in the Moscow region under current conditions

The article considers the сhallenges for small and medium-sized businesses in obtaining government support during the pandemic and post-pandemic period. The reasons preventing people from obtaining support measures, as well as tangible and non-tangible state support measures for businesses in the Moscow region and the support measures provided by banks and lending institutions have been reviewed. Data from reputable source studies on identifying the difficulties caused by state and non-state support measures, in particular the problem of banks refusing to allow small and medium-sized businesses to defer accrued interest at a concessionary rate have been presented. The problem has been the distribution of support to small and medium-sized enterprises according to the type of economic activity, as not all enterprises fit the required activities. Examples have been given of sectors that have restructured their business in the new environment. A list of support measures for small and medium-sized enterprises has been proposed.