• Availability of social support resources and survival strategies among African American grandmother caregivers

      Simpson, Gaynell Marie Salina; Cornelius, Llewellyn Joseph, 1959- (2002)
      While the literature has explored the positive relationship between social supports, coping and mental health well-being, there has been minimal exploration of this relationship among African American grandmother caregivers. The purpose of this qualitative field study was to describe available resources (social supports and coping) used by grandmother caregivers and to explore how their use of social supports and coping related to caregiver well being. This study was guided by a Womanist Perspective to explore social supports, coping and caregiver well-being. The aim was not to compare African American grandmother caregivers to the dominant group but to gain an understanding of African American grandmother caregivers from their own cultural framework, which encompassed issues related to racism, sexism and classism. Data were collected through 14 semi-structured interviews gathered from seven participants. The constant comparative method was employed to build working hypotheses that became the 'grounded theory.' Findings revealed that grandmother caregivers experienced significant losses in their informal social support network, which were experienced as a drain or depletion on their informal social support resources. These losses represented social conditions (e.g. drug abuse, incarceration and poverty) which affected the type and degree of support remaining in their informal social support networks. Despite the depletion in resources, grandmother caregivers had at least one person they could rely upon in times of need. Grandmother caregivers' coping strategies were primarily influenced by the availability of supportive resources remaining in their informal and formal social support structures. In the context of their social support structures, grandmother caregivers employed the necessary adaptive strategies to meet their caregiving role expectations. Implications of these findings are significant for direct practice (micro and macro), research and social policy. Direct micro practice suggests that a strengths-based, case-management approach, which includes culturally competent clinical tools and is built upon an interdisciplinary and empowerment approach, is essential to providing services to African American grandmother caregivers. On the macro level, social workers need to politically advocate with regards to the impact of social and economic conditions on African Americans' traditions of relying upon their extended kin.
    • EAP and COVID-19: Worker Alcohol Abuse: Employers Can Help

      Sonnenstuhl, William J., 1946- (Cornell University, IRL School, 2020-04-11)
    • The effect of the provision of inhome services on the elderly person's informal support network

      McFarland, Margaret Lauren; Gelfand, Donald E. (1991)
      This study examined the effect that the provision of formal services had on the informal support network as it related to the care of the elderly. Interviews were conducted with 107 persons over the age of sixty, who lived alone and who were scheduled to start receiving at least two services from a home health agency. The survey instrument included data on the types and frequency of tasks provided by each member of the informal support network, the level of functioning of the elderly person, and the relationship with the primary caregiver. A follow up interview was conducted two months later to determine if there were any changes in time spent by the informal support network in providing instrumental tasks, affective tasks, or those tasks needing specialized skills. This research also studied whether changes in the affective relationship between the elderly person and the informal support system occurred after formal services were provided. It was found that the informal support system decreased the amount of time spent on instrumental tasks or those tasks that did not necessitate emotional involvement. A decrease in time was also found for those tasks requiring specialized skills and affective tasks requiring emotional involvement. The decrease in the provision of affective tasks or the strength of the informal support network did not change the affective relationship between the primary caregiver and the elderly person. Studying the impact that the provision of formal services has on the informal support network allows us the opportunity to determine how the two systems can work together to more effectively meet the needs of the growing number of elderly. Policy planners who are concerned about the substitution effect of formal services need to plan for a balanced and effective mix of care for the elderly person, where the caregiver is given support and respite, and the costs for long term care are controlled.
    • Independent living among community-based elderly: The impact of social support and sense of coherence

      Lewis, Judith Salter; Hegar, Rebecca L. (1993)
      This research began with an interest in enhancement of independent functioning among community based elderly. As the population ages, increasing numbers of older people, though not in need of institutional care, may need a variety of supports to maintain independence. Housing residents and administrators are faced with complex challenges as problems related to advanced aging occur, and independent functioning is threatened. In the interest of careful planning to maintain the best person-environment fit, and maintain maximum independence, systematic research can build knowledge that contributes to meeting these goals. This research involved assessing the factors of social support and sense of coherence as they relate to independent living ability among a group of 128 elderly residents of a metropolitan senior housing complex. Cross-sectional data were gathered using a pre-coded questionnaire in individual in-person interviews with a nonprobability sample of consenting residents. Independent living ability was measured by ADL and IADL scales from the OARS multidimensional assessment questionnaire. Social support was measured using the Norbeck Social Support Questionnaire (Norbeck, et al., 1983), and Antonovsky's Sense of Coherence Questionnaire (1979) was used to measure sense of coherence. Data were analyzed using multiple regression. Hypotheses predicted relationships between each of the independent variables (social support and sense of coherence) and independent living ability after controlling for five demographic variables (age, education, income, number of living children, length of time at the complex). Findings did not support the predicted models. Since substantive knowledge lends some credibility to the connection between social support, sense of coherence, and well-being among the elderly, explanations for study findings are attributed to design and methodological factors. Low reliability of the dependent measure for this study may be explained by limited sample variability in ADL/IADL tasks. Random sampling and the use of a more varied sample is advisable in replication of this study.
    • The Interrelationships of Adverse Childhood Experiences (ACEs), Alcohol use in Adulthood, and Intimate Partner Violence (IPV) Perpetration Among Black Men in the United States

      Lee, Kerry-Ann; Bright, Charlotte Lyn (2020)
      Historically, Black men have been found to perpetrate IPV at higher rates in comparison to other ethnic groups; however, studies of IPV perpetration have largely focused on samples of White individuals. There is a paucity of empirical research related to the interrelationships among ACEs, IPV perpetration, and alcohol use among Black men. This study used data from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions. Study aims were: (1) to examine the interrelationships of ACEs, alcohol use, and IPV perpetration; to investigate whether alcohol use moderates the relationship between ACEs and IPV perpetration; and whether interpersonal social support moderates the relationships between ACEs and IPV perpetration and between alcohol use and IPV perpetration; (2) to determine if higher cumulative ACE score is associated with increased alcohol use and IPV perpetration; (3) to determine if racial discrimination is significantly associated with increased alcohol use and IPV perpetration; and (4) to identify how subgroups of ACEs (individually or in combination) are associated with alcohol use and IPV perpetration among Black men in adulthood. The sample consisted of 2,326 Black men aged ≥ 20 years. Bivariate results indicated an interrelationship among ACEs, alcohol use, and IPV perpetration. Regression analyses showed that alcohol use exacerbated the ACEs and IPV perpetration relationship for men with no ACEs; but for men who had a history of ACEs, the effect of alcohol on IPV was less substantial. Contrary to study hypotheses, higher interpersonal social support was found to buffer the relationship between ACEs and IPV perpetration for men with three ACEs, but exacerbated the alcohol use and IPV perpetration relationship. Higher cumulative ACE score was significantly associated with alcohol use and IPV perpetration. Racial discrimination was not significantly associated with study outcomes. Latent class analysis yielded three classes. Membership in classes 1 and 2 was associated with IPV perpetration; however, only class 1 membership was associated with alcohol use when compared to class 3 membership. Findings revealed factors that may contribute to IPV perpetration among a sample of Black men. Future research with Black men should aid in the development of culturally-appropriate interventions.
    • Multiple Challenges in Kinship Families: How Are They Associated with Children’s Behavioral Health in Kinship Care?

      Xu, Yanfeng; Bright, Charlotte Lyn (2019)
      The use of kinship care has increased in the United States. This dissertation, comprised of three papers, aims to understand multiple challenges in kinship care and their associations with children’s behavioral health using data from the second National Survey of Child and Adolescent Well-being (NSCAW II). Paper 1 developed a new kinship typology based on financial assistance and examined factors associated with receiving Temporary Assistance for Needy Families (TANF) and foster care payments. Results from logistic regression models showed that child maltreatment, children’s externalizing problems, and receiving social services were significantly associated with receiving foster care payments. Living in poverty and a single-adult household were associated with receiving TANF. The results of paper 1 imply that child welfare workers need to increase kinship caregivers’ awareness of financial resources and to make the right resources accessible for them. Paper 2 examined longitudinal relations among economic hardship, economic pressure, TANF, foster care payments, and children’s behavioral problems in kinship care and non-relative foster care. Results of multi-level mixed-effects generalized linear models indicated that economic pressure was associated with children’s internalizing and externalizing problems, as was receiving TANF. Receiving foster care payments was associated with lower externalizing problems. Significant interaction terms showed that foster care payments had positive effects on children’s behavioral health among families without economic hardship and families with economic pressure. The results of paper 2 imply that assessing caregivers’ subjective economic experiences is important to promoting child wellbeing. Findings point to the hardships of families that receive TANF and suggest providing financial and non-financial services to these families. Paper 3 examined the association between neighborhood disorder and children’s behavioral problems and tested the mediating role of social support and the moderating role of race/ethnicity. Results of moderated mediation regression models showed that neighborhood disorder was associated with lower social support, while more social support predicted lower children’s internalizing and externalizing problems. Social support mediated the relation between neighborhood disorder and children’s behavioral problems, but race/ethnicity did not significantly moderate the pathways. The findings of paper 3 imply that interventions are needed to enhance kinship caregivers’ social support and neighborhood quality.
    • Quality of life, perceived social support and adherence to fluid restriction and treatment schedule among hemodialysis patients

      Schneider, Robert Andrew; Goldmeier, John (1995)
      Issues of quality-of-life and social support are important to nephrology social workers in delivering psychological and concrete services to dialysis patients. However, the patients are often non-compliant with a restriction of fluid gain and their regular treatment schedules. The result of this non-adherence is likely to be excess weight gain leading to hospitalization or even death from pulmonary edema and/or congestive heart failure. There were two aims of the study. One was to associate measures of compliance to both fluid restriction and adherence to treatment schedules with quality-of-life measures, as operationalized by the Medical Outcomes Study SF-36 scales. Secondly, the study sought to examine whether social support was independently associated with quality-of-life or whether it would buffer the ill effects of fluid gain. The hypotheses also tested the association between quality-of-life and social support while controlling for compliance measures. Social support was measured by two instruments, an existing perceived social support scale, and another similar instrument designed by the author. A pilot test of the latter, the Perceived Social Support-Dialysis Scale, yielded a high alpha coefficient (.81). The construct of social support was also confirmed in a LISREL analysis. Fluid-gain data were recorded from patients' charts. The sample consisted of fifty-eight hemodialysis outpatients from an inner-city dialysis site in Baltimore. After correcting for multiple statistical tests, none of the hypothetical associations was supported in the regression analyses although some associations were close to significance. Explanations for lack of positive findings and an interpretation of trends, including a discussion of the potential usefulness of the dialysis social support instrument are addressed. For example, it was noted that the associations between age and the SF-36 scales, while not truly significant, indicated a trend of decreased quality-of-life with age.
    • Relationship Between Caregiver Social Support, Depressive Symptoms, and Child Asthma Outcomes in Low-Income, Urban, African American Families

      Margolis, Rachel; Bellin, Melissa H; Dababnah, Sarah (2020)
      Caregiver depressive symptoms are prevalent and put low-income, urban, African American children with asthma at risk for poor asthma medication adherence and control. Caregiver social support may improve medication adherence and asthma control directly or buffer against the negative effects of caregiver depressive symptoms. In Paper 1, I systematically reviewed the literature and identified nine studies examining the relationship between caregiver social support and child asthma outcomes. Most studies measured informal social support using self-report instruments and evaluated clinical indicators of asthma morbidity in ethnically diverse school-age children. Studies were limited by referral and recall bias. A pattern of significant results suggested that more caregiver social support is associated with better child asthma outcomes; however, due to the variety in asthma outcomes and the heterogeneity in their measurement, further research is needed to draw more definitive conclusions. In Paper 2, I examined the factor structure of the five-item Medication Adherence Report Scale (MARS), in a sample of caregivers of low-income, urban, African American children with uncontrolled asthma. Confirmatory factor analysis indicated that a five-item one-factor model marginally fit the data. The MARS demonstrated acceptable internal reliability. MARS was associated with caregiver-reported inhaled steroid adherence, but not with Asthma Medication Ratio, asthma control, or caregiver perception of asthma control in the regression model. These results suggest it may be more productive for clinicians to engage in consistent, non-judgmental communication with families about asthma medication rather than using the MARS. In Paper 3, I used generalized estimating equations and ordered logistic regression to investigate the longitudinal relationships among caregiver social support and depressive symptoms and two asthma outcomes: (a) medication adherence and (b) asthma control in the above sample. The analyses revealed that caregiver social support did not have an effect on either outcome, nor did it moderate the relationship with depressive symptoms in either model. Medication adherence and asthma control improved over time. Caregiver depressive symptoms predicted decreased medication adherence. Severe and moderate baseline asthma, very low income, and season (fall) were predictors of poorer asthma control. Clinicians should target depressive symptoms as a modifiable factor associated with child asthma outcomes.
    • The social support needs of persons with HIV and AIDS: The case of clients with buddies at the Health Education Resource Organization (HERO)

      Woodroffe, Annette Angela; Greif, Geoffrey L. (1993)
      An orientational qualitative inquiry was conducted to explore and describe the problems and social support needs of people with HIV and AIDS who have buddies, and the extent to which those needs are met, especially by buddies. Semi-structured interviews were conducted with thirty clients from an agency in Baltimore City that provides social support to people with HIV and AIDS. The sample consisted of gay clients, clients with histories of injecting drug use (IDU), and partners of IDUs. Findings revealed that all informants need emotional support; social support involving the sharing of pertinent information about the disease by professionals and the buddy; perceived available support from buddies, friends, and relatives; and social support that encourages them to share experiences as persons living with HIV and AIDS. Clients with histories of IDU needed strong role models and participated in many formal social support groups such as Methadone Maintenance support groups and HIV/AIDS support groups. Overall, findings suggest that social support provided by buddies is unique largely because informants want to be assured at all times that there is someone available for them who will not turn them away.
    • Socio-demographic Factors, Social Supports, and Quality of Life among People Living with HIV/AIDS in Ghana

      Abrefa-Gyan, Tina; Cornelius, Llewellyn Joseph, 1959-; Okundaye, Joshua Nosakhare (2014)
      This study aimed to determine whether quality of life and social support differ by socio-demographic factors and whether socio-demographic characteristics and social support are associated with quality of life in individuals diagnosed with HIV/AIDS in Ghana. This study utilized concepts from the intersection domains of social capital, social network, and social support theories. Using a cross sectional design, survey data were collected from 300 participants selected because they attend support groups meetings, are a convenient sample, and also have experience in participating in research studies. The Medical Outcome Studies (MOS) HIV Health Survey and the MOS Social Support Survey (MOS-SSS) instruments were used to assess quality of life and social support respectively. A demographic questionnaire developed by this researcher was also used to gather demographic information about the respondents. The study used independent sample t-tests to determine possible differences in quality of life and social supports among individuals across socio-demographic factors, Multiple regression was used to determine if socio-demographic factors moderated the relationship between social support and quality of life, and to also identify factors associated with quality of life. Social support was higher for men, married individuals, and those with more than 12 years of education while the reports on quality of life was higher for men. There was a positive association between overall social support and overall quality of life (r = .51). Sex contributed most to quality of life. Males reported poorer quality of life at low social support but better quality of life at higher social support. Females, on the other hand reported lower quality of life compared to the males but their reports of quality of life were approximately the same at both low and high social support. Similarly, those who have children reported slightly better quality of life than those who do not have children but these two groups reported about the same quality of life at high social support. Overall, the findings from this study indicate that the combination of socio-demographic factors and social support related to quality of life. Implications of the findings for practice, research, and policy in Ghana were discussed.