The association between neighbourhood social cohesion and hypertension management strategies in older

Public Health, CUNY School of Public Health at Hunter College, 425 East 25th Street, New York, NY 10010-2590, USA.
Age and Ageing (Impact Factor: 3.64). 12/2011; 41(3):388-92. DOI: 10.1093/ageing/afr163
Source: PubMed
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Available from: Marianne Fahs
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    • "In spite of good knowledge of diabetes self-care recommendations , people with diabetes might struggle to maintain a healthy lifestyle when their efforts are not valued by their community. Evidence suggests that social cohesion also relates to healthy behaviors such as adherence to treatment [42]. Social cohesion represents the ties, solidarity and connectedness among individuals living in the neighborhood . "
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    ABSTRACT: Diabetes-specific distress is an important psychological issue in people with diabetes. The neighborhood environment has the potential to be an important factor for diabetes distress. This study investigates the associations between neighborhood characteristics and diabetes distress in adults with type 2 diabetes. We used cross-sectional data from a community-based sample of 578 adults with type 2 diabetes from Quebec, Canada. Information on perceived neighborhood characteristics and diabetes distress was collected from phone interviews. We used factor analysis to combine questionnaire items into neighborhood factors. Information on neighborhood deprivation was derived from census data. We performed linear regressions for diabetes distress and specific domains of diabetes distress (emotional, regimen-related, physician-related and interpersonal distress), adjusting for individual-level variables. Factorial analysis uncovered 3 important neighborhood constructs: perceived order (social and physical order), culture (social and cultural environment) and access (access to services and facilities). After adjusting for individual-level confounders, neighborhood order was significantly associated with diabetes distress and all specific domains of distress; neighborhood culture was specifically associated with regimen-related distress; and neighborhood access was specifically associated with physician-related distress. The objective measure of neighborhood material deprivation was associated with regimen-related distress. Neighborhood characteristics are associated with diabetes distress in people with type 2 diabetes. Clinicians should consider the neighborhood environment reported by their patients with diabetes when assessing and addressing diabetes-specific distress.
    Full-text · Article · Aug 2013 · Journal of psychosomatic research
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    ABSTRACT: Purpose: The purpose of this study was to develop and test a hypothetical model which explains health behavior adherence in elderly people with prehypertension. The model was based on self-determination theory (SDT). Methods: Data were collected from June 21 to July 15, 2010, using self-report questionnaires. The participants were 140 elders with prehypertension who lived in D Metropolitan City. Collected data were analyzed using PASW 18.0 for descriptive statistics and correlation analysis and AMOS 5.0 for covariance structure analysis. Results: It appeared that the overall fit index was good with a score of 13.23 (p
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    ABSTRACT: Background The positive effect of social cohesion on well-being in older adults has been well documented. However, relatively few studies have attempted to understand the mechanisms by which social cohesion influences well-being. The main aim of the current study is to identify social pathways in which social cohesion may contribute to well-being. Methods The data for this study (taken from 1,880 older adults, aged 60 years and older) were drawn from a national survey conducted during 2008–2009. The survey employed a two-stage stratified sampling process for data collection. Structural equation modeling was used to test mediating and moderating analyses. Results The proposed model documented a good fit to the data (GFI =98; CFI =0.99; RMSEA =0.04). The findings from bootstrap analysis and the Sobel test revealed that the impact of social cohesion on well-being is significantly mediated by social embeddedness (Z=5.62; P<0.001). Finally, the results of a multigroup analysis test showed that social cohesion influences well-being through the social embeddedness mechanism somewhat differently for older men than women. Conclusion The findings of this study, in addition to supporting the importance of neighborhood social cohesion for the well-being of older adults, also provide evidence that the impact of social cohesion towards well-being is mediated through the mechanism of social embeddedness.
    Full-text · Article · May 2014 · Clinical Interventions in Aging
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