Despite socioeconomic disadvantages, less acculturated Mexican Americans tend to exhibit better mental health than their more acculturated counterparts. However, in the case of older Mexican American adults, research has demonstrated the opposite to be true (Gonzalez, Haan, & Hinton, 2001). A variable of interest potentially responsible for this difference is social support. Thus, the current study proposed to investigate the mediation and moderation effects that social support has on the relationship between acculturation and depression in older Mexican American adults age 60 or older. Data from the Health and Retirement Study (HRS) was analyzed. Results showed that the mediating effect of contact with one’s children (-.109*) and the moderating effect of total social support and contact with one’s children (-.127*; -.103*) were statistically significant in the relationship between acculturation and depression. Although these effects are small they may still hold important implications for better understanding this population.

This study examined social support landscapes of People living with HIV/AIDS (PLWHA) in Winnipeg, Manitoba through secondary analysis of the Positive Prevention Study (PPS) data. Descriptive, univariate, and multivariate analyses were utilized to investigate prospective associations between demographics, measures of positively/negatively perceived social support, sexual and substance use related transmission behaviours. The PPS (2009), a cross sectional study, interviewed 135 Manitoban PLWHA about their experiences. The majority reported at least some positively perceived social support. Ongoing transmission behaviours were reported regardless of time since diagnosis. Several key demographic variables and measures of social support were found to be associated with risk behaviours in simple and multivariate analyses. Recommendations: strengthen capacity of health care providers to continue risk prevention education beyond time of diagnosis, bolster peer led knowledge transferring prevention programs, focus upon those most at risk of continued transmission behaviour, and ensure continued existence of successful support programming. / May 2016

Thesis advisor: Margaret Lombe / Over the past several decades trauma research has expanded to recognize the heterogeneity in post-exposure reactions. Posttraumatic stress disorder, the most commonly researched mental health outcome associated with trauma, does not develop in all trauma survivors. Rather, more common trajectories of adaptation following a trauma include normative health adaptation, resilience, and posttraumatic growth. The aims of the current study were to: (1) describe and characterize post-combat adaptation profiles in a sample of Israeli male military veterans (N = 448) based on the combination of posttraumatic distress symptoms, types of coping strategies, and level of posttraumatic growth; (2) test the utility of latent class membership on predicting the quality of posttraumatic growth (i.e. constructive growth); and (3) explore the protective factors (i.e. social support and adaptive coping) that promote constructive posttraumatic growth for each profile of post-combat adaptation. The current study used latent profile mixture modeling to identify profiles of post-combat adaptation, Heckman-probit regression models, and logistic regression analysis. Demographic controls, combat related variables, type of coping strategies utilized, and baseline reports of social support were not significant predictors of constructive growth in either the resilient or struggling latent classes. However, for those in the struggling subset of the sample, reported improvement in perceived social support during the intervention increased the odds of reaching constructive growth. This relationship did not hold for the resilient subset of the sample. The study extends existing literature and theory by proposing a more complex and nuanced examination of posttrauma adaption, and specifies conditions under which protective factors may influence positive adaptation outcomes such as constructive growth. These findings highlight the importance of tailored clinical interventions that account for more complex profiles of post-combat adaptation and provide additional support for the unique effects of group intervention modalities. Further, these findings provide evidence that adaptation takes place over time and as such services should continue to be available for veterans long after combat exposure. Finally, these findings call for future research to build on existing longitudinal investigation by examining the complex temporal components of adaptation in trauma survivors. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: James Lubben / It has been shown that the effect of social networks and social support systems on health may be greater among immigrants who live away from their homeland and their natural social support systems. Despite the significance of social support systems, relevant research on minorities in the U.S. is limited. For this reason, the current cross-cultural study examined the pathways underlying different formations of social networks (kin vs. non-kin) and social support systems (emotional vs. instrumental), which affect depression symptoms and perceived general health among older Korean immigrants and non-Hispanic Caucasians in the United States. This analysis is based on the secondary data from the "Korean-American Elderly: Social Supports and Long-Term Care" study conducted in 1994. The data (n=424) were collected from non-Hispanic White Americans (n=201) and Korean immigrant elders (n=223) aged 65 and older residing in Southern California. Structural equation modeling (SEM) was used to test the proposed conceptual model designed to explain the direct and indirect relationships between social networks and social support on health outcomes. Empirical evidence from this study indicated different effect of one's social networks and social support on health by race/ethnicity. The result indicated that both kin and non-kin networks provided social support for Korean immigrants. Moreover, among social network measures, non-kin networks had a greater effect on social support for older Korean immigrants compared to kin networks. For non-Hispanic Caucasians, on the other hand, only kin network had a significant effect on social support systems. In addition, receiving instrumental support lowered the perceived general health among older non-Hispanic Caucasians. The work discussed in this paper pointed to the need to recognize the role of culture in assessing the effect of one's social networks and social support systems on health. This paper highlighted the characteristics of those older Korean-American and older non-Hispanic Caucasians who are most, as well as, least likely to benefit from social networks and social support systems. By utilizing the existing social networks and social support of diverse populations, we can improve overall health outcomes and serve the elderly community better. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: Natalia Sarkisian / A multiplicity of scholarly publications has found salutary associations between various aspects of religion and mental health, particularly depression. However, Hispanic older adults are seldom the focus of empirical studies analyzing these relationships. I fill that gap. Theories on the effects of church attendance, private prayer, religious coping, and religiosity on depression are developed and investigated. These analyses are based on a sample of older Mexican-origin individuals (N = 1,495). Data were obtained from the Hispanic Established Population for Epidemiological Studies of the Elderly (H-EPESE), a longitudinal survey. Results reveal an inverse association between moderate church attendance and depression that persists despite controls for social support, financial strain, and physical and mental impairment. An inverse association between higher levels of religiosity and depression and a direct association between higher levels of religious coping and depression also persisted beyond all controls. Findings suggest that the effects of religion on depression vary and are not always salutary. Methodological and theoretical implications, limitations, and future research directions are discussed.

Heart disease is the leading cause of death among African Americans. Despite advances in treatment modalities, based on better understanding of the disease's pathology and access to health care, African Americans continue to die from heart disease at rates significantly higher than other races. The available literature on cardiovascular disease among African Americans does not adequately explore how social support affects heart health in this group. The purpose of this study was to examine the effects of social support on cardiac recurrence among African American adults. Cohen's ISEL support system variables: tangible, appraisal, belonging, and self-esteem; and five demographic variables: age, marital status, educational level, household income, and gender provided the conceptual/methodological base for data collection and analysis. The sample consisted of 83 African American men and women ages 22 to 84 that had experienced at least one cardiac event. Chi-square analysis showed a positive correlation between marital status and cardiac recurrence. Results suggest that living alone may increase an individual's chances of having a second cardiac event. Social change implications include (a) identification of essential social support elements and tailored treatment plans for heart patient and caregiver in order to promote better heart health outcomes for African Americans living with someone or alone; and (b) policy change that fosters effective prevention and treatment.

Patients receiving dialysis treatment experience immense changes in their health and well-being, therefore receiving adequate social support services is an integral aspect of their care plan. Thus, the purpose of this study was to gain an understanding about social support services offered by social workers to patients receiving dialysis care. Furthermore, this study sought to develop awareness about additional services need to assist social workers in providing social, emotional, and physical support to patients. This qualitative study used data from a non-probability snowball sample of 10 social workers that work with patients receiving dialysis care. Findings of this study are significant to social work practice as the analysis provided insight that may enhance current practices in dialysis centers. Furthermore, the qualitative analyses gathered through the one-on-one interviews led to the emergence of seven central themes. Themes anticipated by the researchers included the perception about the ability to provide social, emotional, and physical support, as well as to highlight the role of social workers in this healthcare setting. Additional themes identified during this study focused on reasons for patients lacking social support, the scarcity of resources, and recommendations corroborated with first-hand experiences in the field to better serve patients. Recommendations included increased focus on providing therapeutic services within dialysis, additional transportation options for patients, and greater availability of resources to meet the various needs of patients.

Research exploring the relationship between social supports and resilience among hospital-based nurses and teachers has offered little to illuminate how school nurses identify and access social support and the impact it may have on their ability to manage ongoing daily stressors or develop resilience. The social networks and social support model suggest that access to social support may underscore the development of effective coping. This study explored the relationship between social supports as measured by a self-report questionnaire, and resilience as measured by the Conner-Davidson Resilience Scale (CD-RISC). It was hypothesized that a positive correlation would exist between use of personal, professional, and community social support and school nurse resilience scores. Additional hypotheses were that resilience would be positively correlated with longevity, perception of funding, and professional school nurse association activity. A convenience sample of 145 certified school nurses employed in one northeastern state's public schools completed an online survey that included a behavioral questionnaire and the CD-RISC. t tests and correlations were employed to examine the relationship between the variables. Both collaboration with multidisciplinary team members within the school setting and identification of personal and professional social support were significantly correlated with school nurse resilience. Results may influence positive social change for the individual school nurse via an improved ability to cope with workplace stressors. The bidirectional nature of resilience suggests interaction with a resilient nurse may influence the broader school community with an impact on cost, attendance, and learning.

While a growing body of evidence suggests health-related behaviors, such as problem and pathological gambling, are affected by multiple levels of influence, gambling studies using an ecological approach have not been documented. This dissertation work, that contains three studies, contributes to fill such research gap by examining gamblers' behaviors in formal treatment programs using an ecological approach. In study 1, the influences of the environmental and individual level factors on the treatment completion is examined. Previous studies have shown that treatment completion has a positive impact on the recovery path from gambling problems. In study 2 and study 3, interpersonal communication between gamblers and their social support networks is explored. More specifically, these two studies focus on understanding of the disclosure of gambling problems using the Integrated Model of Health Disclosure Decision-making. These two studies are significant because this may be the first attempt in gambling studies to explore disclosure of gambling problems. Disclosure may be a necessary step to ameliorate the negative consequences of gambling by creating or reinforcing gamblers' social support network. Each of these studies uses a distinctive dataset and methodology. Study 1 uses the Iowa Gambling Treatment Outcome system data from 2005 to 2011 from the Iowa Department of Public Health. Study 2 uses the 2011 Iowa Gambling Attitude and Experiences survey data, which included questions designed specifically for gambling disclosure. Study 3 is based on qualitative data (interviews) collected from gamblers who disclosed their gambling problems within their social support network. Results from study 1 based on a generalized linear mixed model suggest that self-reported past behavior of either reducing or quitting gambling behavior has a significant effect on treatment plan completion. Also, gamblers admitted to large treatment agencies that served mostly in urban areas are less likely to complete the treatment plan compared to gamblers admitted in any other type of agencies in urban or rural areas. In study 2, path analysis was performed to examine the disclosure of gambling problems within gamblers' social support network. Severity of gambling was the only significant predictor of disclosure. Study 3 found that the factors that affected disclosure are confrontation, gambling losses, stigma, trust, non-judgmental receivers, and close and long relationship. Outcomes expectations and past experience were also important in disclosure. Disclosures did not have substantial consequences for the size and strength of ties in their social support group, suggesting disclosures did not harm or strengthen relationships. Study 2 and study 3 both suggest that as gambling addiction become more severe, signs of gambling problems could be more visible to the members of social support groups. This may lead to disclosure of gambling problems through confrontations initiated by a friend or family member.

<p>The treatment that women get from health care staff can influence the experience of the abortion and how women manage to coping the experience emotionally. The aim of this study was to illuminate women’s experiences in connection with an abortion. The findings show that the women’s social situation led them to the decision of abortion. When the women had the pregnancy confirmed many felt unreality. Several women experienced the situation as a crisis. After the abortion most of the women experienced relief, but also guilt towards the abortion. Some knew that they had made the right decision, while others felt regret. Most of the women experienced that the nursing staff treated them well, but some women experienced that the staff was negative, insensitive and ignoring. Most of the women was satisfied with the total support from significant others. To make a satisfying nursing care possible for each woman who seeks abortion, more research is needed about women’s experiences of nursing staff’s treatment.</p>