Skip to main content
Top
Published in: Journal of General Internal Medicine 11/2019

01-11-2019 | Care | Original Research

Perceived Adequacy of Tangible Social Support and Associations with Health Outcomes Among Older Primary Care Patients

Authors: Rachel O’Conor, PhD, MPH, Julia Yoshino Benavente, MPH, Marina Arvanitis, MD, Laura M. Curtis, MS, Kamal Eldeirawi, PhD, RN, Romana Hasnain-Wynia, PhD, Alex D. Federman, MD, MPH, Jeni Hebert-Beirne, PhD, MPH, Michael S. Wolf, PhD, MPH

Published in: Journal of General Internal Medicine | Issue 11/2019

Login to get access

Abstract

Background

The availability and adequacy of tangible social support may be critical to older adults managing multiple chronic conditions, yet few studies have evaluated the perceived adequacy of needed tangible support and its relation to health outcomes.

Objective

We investigated the association between unmet, tangible social support needs, health status, and urgent healthcare use among community-dwelling older adults.

Design

Cross-sectional analysis.

Participants

English-speaking older adults (n = 469) who participated in the Health Literacy and Cognitive Function cohort study.

Main Measures

Perceived adequacy of tangible social support was measured using a brief, validated scale that determined (1) if an individual needed assistance managing his or her health, and (2) if yes, whether this need was met. Health status was measured using physical function, depression, and anxiety PROMIS short-form instruments. Urgent healthcare utilization (emergency department and hospitalization) was self-reported for the past 12 months.

Key Results

Participants’ mean age was 69 years; 73% were women and 31% were African American, and 16% identified unmet support needs. Unmet support needs were associated with worse physical (β − 6.32; 95% CI − 8.31, − 4.34) and mental health (anxiety: β 3.84; 95% CI 1.51, 6.17; depression: β 2.45; 95% CI 0.32, 4.59) and greater urgent healthcare utilization (ED: OR 2.86; 95% CI 1.51, 5.41; hospitalization: OR 3.75; 95% CI 1.88, 7.50).

Conclusions

Perceived unmet support needs were associated with worse health status and greater urgent healthcare use. Primary care practices might consider screening older patients for unmet tangible support needs, although appropriate responses should first be established if unmet needs are identified.
Literature
1.
go back to reference Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, et al. Multiple Chronic Conditions Chartbook. AHRQ Publications No. Q14–0038. Rockville, MD: Agency for healthcare Research and Quality; 2014. Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, et al. Multiple Chronic Conditions Chartbook. AHRQ Publications No. Q14–0038. Rockville, MD: Agency for healthcare Research and Quality; 2014.
2.
go back to reference Ward BW. Prevalence of Multiple Chronic Conditions among US Adults: Estimates from the National Health Interview Survey, 2010. Prev Chronic Dis 2013;10. Ward BW. Prevalence of Multiple Chronic Conditions among US Adults: Estimates from the National Health Interview Survey, 2010. Prev Chronic Dis 2013;10.
3.
go back to reference Gallant MP. The Influence of Social Support on Chronic Illness Self-Management: A Review and Directions for Research. Health Educ Behav 2003;30(2):170–95.CrossRef Gallant MP. The Influence of Social Support on Chronic Illness Self-Management: A Review and Directions for Research. Health Educ Behav 2003;30(2):170–95.CrossRef
4.
go back to reference DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol 2004;23(2):207.CrossRef DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol 2004;23(2):207.CrossRef
5.
go back to reference Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med 2010;7(7):e1000316.CrossRef Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med 2010;7(7):e1000316.CrossRef
6.
go back to reference Holt-Lunstad J, Uchino BN. Social Support and Health. In: Glanz K, Rimer BK, Viswanath K, eds. Health Behavior: Theory, Research, and Practice. John Wiley & Sons; 2015:183–242. Holt-Lunstad J, Uchino BN. Social Support and Health. In: Glanz K, Rimer BK, Viswanath K, eds. Health Behavior: Theory, Research, and Practice. John Wiley & Sons; 2015:183–242.
7.
go back to reference Valtorta NK, Moore DC, Barron L, Stow D, Hanratty B. Older Adults’ Social Relationships and Health Care Utilization: A Systematic Review. Am J Public Health 2018;108(4):e1-e10.CrossRef Valtorta NK, Moore DC, Barron L, Stow D, Hanratty B. Older Adults’ Social Relationships and Health Care Utilization: A Systematic Review. Am J Public Health 2018;108(4):e1-e10.CrossRef
8.
go back to reference National Academies of Sciences, Engineering, MedicineAccounting for Social Risk Factors in Medicare Payment: Identifying Social Risk Factors. Washington, DC: National Academies Press; 2017. National Academies of Sciences, Engineering, MedicineAccounting for Social Risk Factors in Medicare Payment: Identifying Social Risk Factors. Washington, DC: National Academies Press; 2017.
9.
go back to reference Woloshin S, Schwartz LM, Tosteson AN, Chang CH, Wright B, Plohman J, et al. Perceived adequacy of tangible social support and health outcomes in patients with coronary artery disease. J Gen Intern Med 1997;12(10):613–8.CrossRef Woloshin S, Schwartz LM, Tosteson AN, Chang CH, Wright B, Plohman J, et al. Perceived adequacy of tangible social support and health outcomes in patients with coronary artery disease. J Gen Intern Med 1997;12(10):613–8.CrossRef
10.
go back to reference Song Y, Song H-J, Han H-R, Park S-Y, Nam S, Kim MT. Unmet Needs for Social Support and Effects on Diabetes Self-care Activities in Korean Americans With Type 2 Diabetes. Diabetes Educ 2012;38(1):77–85.CrossRef Song Y, Song H-J, Han H-R, Park S-Y, Nam S, Kim MT. Unmet Needs for Social Support and Effects on Diabetes Self-care Activities in Korean Americans With Type 2 Diabetes. Diabetes Educ 2012;38(1):77–85.CrossRef
11.
go back to reference Wolf MS, Curtis LM, Wilson EA, Revelle W, Waite KR, Smith SG, et al. Literacy, cognitive function, and health: results of the LitCog study. J Gen Intern Med 2012;27(10):1300–7.CrossRef Wolf MS, Curtis LM, Wilson EA, Revelle W, Waite KR, Smith SG, et al. Literacy, cognitive function, and health: results of the LitCog study. J Gen Intern Med 2012;27(10):1300–7.CrossRef
12.
go back to reference O’Conor R, Smith SG, Curtis LM, Benavente JY, Vicencio DP, Wolf MS. Mild Visual Impairment and Its Impact on Self-Care Among Older Adults. J Aging Health 2016. O’Conor R, Smith SG, Curtis LM, Benavente JY, Vicencio DP, Wolf MS. Mild Visual Impairment and Its Impact on Self-Care Among Older Adults. J Aging Health 2016.
13.
go back to reference Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care 2002;40(9):771–81.CrossRef Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care 2002;40(9):771–81.CrossRef
14.
go back to reference Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol 2010;63(11):1179–94.CrossRef Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol 2010;63(11):1179–94.CrossRef
15.
go back to reference Yost KJ, Eton DT, Garcia SF, Cella D. Minimally important differences were estimated for six Patient-Reported Outcomes Measurement Information System-Cancer scales in advanced-stage cancer patients. J Clin Epidemiol 2011;64(5):507–16.CrossRef Yost KJ, Eton DT, Garcia SF, Cella D. Minimally important differences were estimated for six Patient-Reported Outcomes Measurement Information System-Cancer scales in advanced-stage cancer patients. J Clin Epidemiol 2011;64(5):507–16.CrossRef
16.
go back to reference Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med 1995;10(10):537–41.CrossRef Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med 1995;10(10):537–41.CrossRef
17.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189–98.CrossRef Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189–98.CrossRef
18.
go back to reference Lubben J, Blozik E, Gillmann G, Iliffe S, von Renteln Kruse W, Beck JC, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist. 2006;46(4):503–13.CrossRef Lubben J, Blozik E, Gillmann G, Iliffe S, von Renteln Kruse W, Beck JC, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist. 2006;46(4):503–13.CrossRef
19.
go back to reference Lubben JE. Assessing social networks among elderly populations. Fam Community Health 1988;11(3):42–52.CrossRef Lubben JE. Assessing social networks among elderly populations. Fam Community Health 1988;11(3):42–52.CrossRef
20.
go back to reference Wolff JL, Feder J, Schulz R. Supporting Family Caregivers of Older Americans. N Engl J Med 2016;375(26):2513–5.CrossRef Wolff JL, Feder J, Schulz R. Supporting Family Caregivers of Older Americans. N Engl J Med 2016;375(26):2513–5.CrossRef
21.
go back to reference House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241(4865):540.CrossRef House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241(4865):540.CrossRef
22.
go back to reference Solar O, Irwin A. A Conceptual Framework for Action on the Social Determinants of Health. Geneva: World Health Organization. 2010. Solar O, Irwin A. A Conceptual Framework for Action on the Social Determinants of Health. Geneva: World Health Organization. 2010.
23.
go back to reference McPherson M, Smith-Lovin L, Cook JM. Birds of a feather: Homophily in social networks. Annu Rev Sociol 2001;27(1):415–44.CrossRef McPherson M, Smith-Lovin L, Cook JM. Birds of a feather: Homophily in social networks. Annu Rev Sociol 2001;27(1):415–44.CrossRef
24.
go back to reference Cornwell B. Social Disadvantage and Network Turnover. J Gerontol B Psychol Sci Soc Sci 2015;70(1):132–42.CrossRef Cornwell B. Social Disadvantage and Network Turnover. J Gerontol B Psychol Sci Soc Sci 2015;70(1):132–42.CrossRef
25.
go back to reference Diez Roux AV, Katz M, Crews DC, Ross D, Adler N. Social and Behavioral Information in Electronic Health Records: New Opportunities for Medicine and Public HealthAm J Prev Med 2015;49(6):980–3.CrossRef Diez Roux AV, Katz M, Crews DC, Ross D, Adler N. Social and Behavioral Information in Electronic Health Records: New Opportunities for Medicine and Public HealthAm J Prev Med 2015;49(6):980–3.CrossRef
26.
go back to reference Garg A, Boynton-Jarrett R, Dworkin PH. Avoiding the unintended consequences of screening for social determinants of health. JAMA. 2016;316(8):813–4.CrossRef Garg A, Boynton-Jarrett R, Dworkin PH. Avoiding the unintended consequences of screening for social determinants of health. JAMA. 2016;316(8):813–4.CrossRef
27.
go back to reference Given B, Sherwood PR, Given CW. What knowledge and skills do caregivers need? J Soc Work Educ 2008;44(sup3):115–23.CrossRef Given B, Sherwood PR, Given CW. What knowledge and skills do caregivers need? J Soc Work Educ 2008;44(sup3):115–23.CrossRef
28.
go back to reference Reinhard SC, Levine C, Samis S. Home alone: Family caregivers providing complex chronic care: AARP Public Policy Institute Washington, DC; 2012. Reinhard SC, Levine C, Samis S. Home alone: Family caregivers providing complex chronic care: AARP Public Policy Institute Washington, DC; 2012.
29.
go back to reference Revenson T, Griva K, Luszczynska A, Morrison V, Panagopoulou E, Vilchinsky N, et al. Caregiving in the Illness Context: Palgrave Macmillian; London; 2016.CrossRef Revenson T, Griva K, Luszczynska A, Morrison V, Panagopoulou E, Vilchinsky N, et al. Caregiving in the Illness Context: Palgrave Macmillian; London; 2016.CrossRef
30.
go back to reference Rowe JW, Fulmer T, Fried L. Preparing for better health and health care for an aging population. JAMA. 2016;316(16):1643–4.CrossRef Rowe JW, Fulmer T, Fried L. Preparing for better health and health care for an aging population. JAMA. 2016;316(16):1643–4.CrossRef
31.
go back to reference Wolinsky FD, Miller TR, An H, et al. Hospital episodes and physician visits: the concordance between self-reports and medicare claims. Med Care 2007;45(4):300–307.CrossRef Wolinsky FD, Miller TR, An H, et al. Hospital episodes and physician visits: the concordance between self-reports and medicare claims. Med Care 2007;45(4):300–307.CrossRef
32.
go back to reference Uchino BN. Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspect Psychol Sci 2009;4(3):236–55.CrossRef Uchino BN. Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspect Psychol Sci 2009;4(3):236–55.CrossRef
Metadata
Title
Perceived Adequacy of Tangible Social Support and Associations with Health Outcomes Among Older Primary Care Patients
Authors
Rachel O’Conor, PhD, MPH
Julia Yoshino Benavente, MPH
Marina Arvanitis, MD
Laura M. Curtis, MS
Kamal Eldeirawi, PhD, RN
Romana Hasnain-Wynia, PhD
Alex D. Federman, MD, MPH
Jeni Hebert-Beirne, PhD, MPH
Michael S. Wolf, PhD, MPH
Publication date
01-11-2019
Publisher
Springer US
Keyword
Care
Published in
Journal of General Internal Medicine / Issue 11/2019
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-019-05110-7

Other articles of this Issue 11/2019

Journal of General Internal Medicine 11/2019 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.