social and peer support in health: an ecological and...

Final 4/8/14

Social and Peer Support in Health: An Ecological and Global Perspective Edwin Fisher, Ph.D.

Health Behavior 756-001 University of North Carolina – Chapel Hill

Mondays, 9-11:50 AM, Room 324, Rosenau Hall Spring, 2014

Edwin B. Fisher, Ph.D. Global Director, Peers for Progress (peersforprogress.org) Professor, Department of Health Behavior Gillings School of Global Public Health University of North Carolina-Chapel Hill [email protected]; 919 966 6693

To schedule meetings, please contact: Jennifer B. Robinette, MS Program Administrator 335 Rosenau Hall [email protected] (919) 966-3918

Overview This course has four broad purposes.

1. Review key features of social support, a very powerful but not well understood aspect of human behavior and experience.

2. Review applications of social support to health promotion.

3. Consider these issues from a global and cross-cultural perspective.

4. Through the group project and term paper, provide the student the opportunity to contribute to an application of peer support and examine how (a) fundamental features of and research on social support inform that application, as well as how (b) the process of application heightens understanding of fundamental features of and research on social support.

The course is divided into two sections. From January 13 through March 3, we will review foundational and research literature on social support. From March 17 to the end of the semester, we will review applications of social support. The underlying theme of the course is that the two sections are related, understanding social support and can enhance our ability to develop effective peer support interventions.

Social and Peer Support in Health Spring, 2014

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Student Project and Term Paper During our first class on January 13, we will discuss a number of current topics in peer support for which students might develop a document, report, or other “product.” These include, just as a short list of possibilities: • Economic or business cases for peer support programs • Addressing mental health/behavioral health through peer support • Peer support and the elderly • Peer support for rural populations • How to manage, supervise, and provide back-up to peer supporters • The roles of instrumental and emotional support in peer support • Comparison of peer support across different kinds of health problems, e.g., diabetes

management vs HIV/AIDS • Peer support in specific country or cultural settings • “Reverse innovation” or “Twinning”; transferring lessons from developing to developed

countries • Exploring the tension between lay persons and health professionals, including, e.g.,

paradigm shift in modern medicine and health care, evolution vs revolution, roots in social activism, empowerment of minority groups

• New ways of measuring impact of peer support programs, e.g., positive psychology, happiness index

We will continue this discussion in our 2nd class, on January 27. At the conclusion of this, students will choose a specific topic on which they would like to develop some document or “product” that may be useful to the field. They will be free to do this individually or in small groups of 2 – 4. The document or “product” can be anything from a manual or report for the field to a research proposal or review of existing research. At the end of the semester, these may be selected for promotion through Peers for Progress such as through its website or newsletters, etc. We will discuss these student projects every week or so in class to compare notes and provide some guidance in students’ development of the projects. In our last class (April 21), students will present their product or document. Term Paper – Reflecting on the product or document which you (and your group, if applicable) have developed during the semester, describe how (a) fundamental features of and research on social support inform your work, as well as how (b) the process of application heightens understanding of fundamental features of and research on social support. Due Friday, May 2, 5 pm by hard and electronic copy, 12-point, Times New Roman, 0.75 in. top and bottom margins, 1.0 in. side margins, maximum = 15 pp. Mid-Term Assignment – As preparation for the Term Paper, describe one example of each of how (a) fundamental features of and research on social support inform the work you are doing for your project, as well as how (b) the process of application heightens understanding of fundamental features of and research on social support. Due Friday, March 7, 5 pm by electronic copy to [email protected] and to [email protected], 12-point, Times New Roman, 0.75 in. top and bottom margins, 1.0 in. side margins, Maximum = 5 pp. Grading Scheme Assignment of final grades will be guided by the following:

Term Paper 35% Mid-Term Assignment 20% Class Participation 35% Project (Document or Product for the field) 10%


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Section 1 – Foundations and Research on Social Support (January 13 – March 3) In this first section of the course, we will review classic and current literature on social support, what it is, how it enters into health, and how it works. 1/13 What is social support? Where does it fit within an ecological view of health and health

behavior?

1/20 MLK Day – No Class

1/27 Fundamentals Fisher, E.B., Zhong, X., Kowitt, S., & Nan, H. (2013). The Importance of Contexts and

the Roles of Community and Peer Support Programs in Bridging Gaps among Contexts, Self-Management Interventions, and Clinical Care. In J. Rodriguez-Saldana (Ed.), Quality of Health Care: Challenges, Evidence and Implementation.

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Med, 7(7), e1000316.

Uchino, B. N. (2006). Social Support and Health: A Review of Physiological Processes Potentially Underlying Links to Disease Outcomes. Journal of Behavioral Medicine, 29 (4): 377-387.

Harlow, H.F., & Harlow, M. (1966) Learning to love. American Scientist 54 (3), 244-272.

Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM Jr. (1997). Social ties and susceptibility to the common cold. JAMA 277(24):1940-1944.

Francis, D.D., Champagne, F.A., Liu, D. & Meaney, M.J. (1999). Maternal care, gene expression, and the development of individual differences in stress reactivity. Annals of the New York Academy of Sciences. 896: 66-84.

For Reference – Not Assigned: House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health.

Science, 241, 540-544. Sallis, J. F., Owens, N., & Fisher, E. B. (2008). Ecological Models of Health Behavior.

In K. Glanz, B. K. Rimer, & V. Viswanath (Eds.) Health Behavior and Health Education: Theory, Research and Practice (4th Edition). San Francisco, CA: Jossey Bass.

2/3 Social Networks & Environmental Determinants of Social Support:

Christakis, N.A., & Fowler, J.H. Connected. 2009. New York: Little Brown. Chapters 1 and 2.

Putnam, R.C. 1995. Bowling Alone: America’s declining social capital. 1995. Journal of Democracy, 6: 65-78

Sander, T.H. & Putnam, R.C. 2010. Still bowling alone? The post-9/11 split. Journal of Democracy, 21: 9-16.

Leyden, K. M. (2003). Social capital and the built environment: the importance of walkable neighborhoods. American journal of public health, 93(9), 1546-1551.

Brown, S. C., Mason, C. A., Lombard, J. L., Martinez, F., Plater-Zyberk, E., Spokane, A. R., et al. (2009). The relationship of built environment to perceived social support and psychological distress in Hispanic elders: the role of "eyes on the street". The journals of gerontology. Series B, Psychological sciences and social sciences, 64(2), 234-246.

Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the


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National Academy of Sciences of the United States of America, 110(15), 5797-5801. doi: 10.1073/pnas.1219686110

2/10 Attachment

Bowlby, J. (1988). A Secure Base. Basic Books. Lecture 1: Caring for Children, pp. 6-19. Lecture 7: The Role of Attachment in Personality Development, pp. 119-136.

Hazan, C., Gur-Yaish, N., and Campa, M. What does it mean to be attached?, pp. 55-85. In W.S. Rholes & J.A. Simpson (Eds), Adult Attachment: Theory, Research, and Clinical Implications. New York: Guilford, 2004.

Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524.

Mak, M. C. K., Bond, M. H., Simpson, J. A., & Rholes, W. S. (2010). Adult attachment, perceived support, and depressive symptoms in Chinese and American cultures. Journal of Social and Clinical Psychology, Vol. 29, No. 2, 2010, pp. 144-165, 29(2), 144-165.

Assignment: Bring a Valentines Day card or copy of one! Optional: Green , B.L., Furrer, C.J., & McAllister, C.L. (2011): Does attachment style influence

social support or the other way around? A longitudinal study of Early Head Start mothers. Attachment & Human Development, 13:1, 27-47

2/17 Psychosocial studies of social support and social influence

Psychosocial Studies of Social Support Fisher, E. B., Todora, H., & Heins, J. (2003). Social support in nutrition counseling. On

the cutting edge: Diabetes care and education, 24(4), 18-20. Gabriele, J. M., Carpenter, B. D., Tate, D. F., & Fisher, E. B. (2010). Directive and

Nondirective E-Coach Support for Weight Loss in Overweight Adults. Ann Behav Med.

Rini, C., Dunkel-Schetter, C., Hobel, C.J., Glynn, L.M. & Sandman, C.A. (2006). Effective social support: Antecedents and consequences of partner support during pregnancy. Personal Relationships, 13 (2006), 207–229.

2/24 What is universal? What is specific? Cross-cultural perspectives on social support

Regarding social support and peer support in different cultures: Review: Mak, M. C. K., Bond, M. H., Simpson, J. A., & Rholes, W. S. (2010). Adult

attachment, perceived support, and depressive symptoms in Chinese and American cultures. Journal of Social and Clinical Psychology, Vol. 29, No. 2, 2010, pp. 144-165, 29(2), 144-165.

Kim, H.S., Sherman, D.K., & Taylor, S.E. (2008). Culture and social support. American Psychologist. 63(6): 518-526.

Kowitt, S., Emmerling, D., Tanasugarn, C., & Fisher, E. (in preparation) Community health workers as agents of health promotion: Analyzing Thailand’s Village Health Volunteer program

Chuengsatiansup, K. Health Volunteers in the Context of Changes: Assessing the Roles and Potentials of Village Health Volunteer in Thailand. Society and Health Institute, Ministry of Public Health, Thailand


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Dutton, Y. E. (2012). Butting in vs. being a friend: cultural differences and similarities in the evaluation of imposed social support. [Comparative Study]. The Journal of social psychology, 152(4), 493-509.

Nishigaki, M., Tokunaga-Nakawatase, Y., Nishida, J., & Kazuma, K. (2014). The Effect of Genetic Counseling for Adult Offspring of Patients with Type 2 Diabetes on Attitudes Toward Diabetes and its Heredity: A Randomized Controlled Trial. J Genet Couns. doi: 10.1007/s10897-013-9680-5

Section 2 – Social and Peer Support Interventions (March 3 – April 28) In this section of the course, we turn toward practical applications of social support in prevention, health, and health care. 3/3 Examples of Successful Peer Support

Interventions – Diabetes, Mental Health, Asthma, Maternal & Child Health, HIV/AIDS Perry, H. B., Zulliger, R., & Rogers, M. M.

(2014). Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annual review of public health, 35, in press.

Singh, P., & Sachs, J. D. (2013). 1 million community health workers in sub-Saharan Africa by 2015. Lancet, 382(9889), 363-365. doi: 10.1016/S0140-6736(12)62002-9

Read and come to class prepared to describe what you think is most interesting about your choice of two of the following regarding diabetes, mental health, and asthma, maternal and child health, and HIV/AIDS::

Diabetes: Heisler, M., Vijan, S., Makki, F., & Piette, J. D. (2010). Diabetes control with reciprocal

peer support versus nurse care management: a randomized trial. Ann Intern Med, 153(8), 507-515.

Ghorob, A., Vivas, M. M., De Vore, D., Ngo, V., Bodenheimer, T., Chen, E., et al. (2011). The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial. BMC Public Health, 11, 208. Also, read “Abstract of Thom et al. and Moskowitz et al.”: Thom, D.H., Ghorob, A., Hessler, D., De Vore, D., Chen, E., & Bodenheimer, T. (in press). Peer health coaching improves glycemic control in low-income patients with diabetes: a randomized controlled trial. Annals of Family Medicine. Moskowitz, D., Thom, D. H., Hessler, D., Ghorob, A., & Bodenheimer, T. (2013). Peer Coaching to Improve Diabetes Self-Management: Which Patients Benefit Most? Journal of general internal medicine.

DePue, J. D., Rosen, R. K., Batts-Turner, M., Bereolos, N., House, M., Held, R. F., et al. (2010). Cultural translation of interventions: diabetes care in American Samoa. [Research Support, N.I.H., Extramural]. American journal of public health, 100(11), 2085-2093. Also read “Abstract of DePue et al.”: DePue, J. D., Dunsiger, S., Seiden, A. D., Blume, J., Rosen, R. K., Goldstein, M. G., et al. (2013). Nurse-Community Health Worker Team Improves Diabetes Care in American Samoa: Results of a randomized controlled trial. Diabetes Care.

Thanh, D. T. N., Deoisres, W., Keeratiyutawong, P., & Baumann, L. C. (2013).


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Effectiveness of a Diabetes Self-Management Support Intervention in Vietnamese Adults with Type 2 Diabetes. Journal of Science, Technology, and Humanities., 11(1), 41-79.

Mental Health: Rahman, A. (2007). Challenges and opportunities in developing a psychological

intervention for perinatal depression in rural Pakistan--a multi-method study. Arch Womens Ment Health, 10(5), 211-219. Also, read abstract of: Rahman, A., Malik, A., Sikander, S., Roberts, C., & Creed, F. (2008). Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomized controlled trial. Lancet, 372(9642), 902-909. (Full Paper Optional) And Also Read Editorial: Patel, V., & Kirkwood, B. (2008). Perinatal depression treated by community health workers. Lancet, 372(9642), 868-869.

Dennis, C. L., Hodnett, E., Kenton, L., Weston, J., Zupancic, J., Stewart, D. E., et al. (2009). Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial. BMJ, 338, a3064.

Forchuk, C., Martin, M. L., Chan, Y. L., & Jensen, E. (2005). Therapeutic relationships: from psychiatric hospital to community. Journal of psychiatric and mental health nursing, 12(5), 556-564.

Patel, V., Weiss, H. A., Chowdhary, N., Naik, S., Pednekar, S., Chatterjee, S., . . . Kirkwood, B. R. (2011). Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months. The British journal of psychiatry : the journal of mental science, 199(6), 459-466. doi: 10.1192/bjp.bp.111.092155

Asthma, Maternal & Child Health, HIV/AIDS: Fisher EB, Strunk RC, Highstein GR, Kelley-Sykes R, Tarr KL, Trinkaus K, Musick J.

(2009). A randomized controlled evaluation of the effect of community health workers on hospitalization for asthma: the Asthma Coach. Archives of Pediatrics and Adolescent Medicine. Mar; 163 (3), 225-232.

Bhutta, Z. A., Soofi, S., Cousens, S., Mohammad, S., Memon, Z. A., Ali, I., et al. (2011). Improvement of perinatal and newborn care in rural Pakistan through community-based strategies: a cluster-randomised effectiveness trial. Lancet, 377(9763), 403-412.

Chang, L. W., Kagaayi, J., Nakigozi, G., Ssempijja, V., Packer, A. H., Serwadda, D., et al. (2010). Effect of peer health workers on AIDS care in Rakai, Uganda: a cluster-randomized trial. PLoS One, 5(6), e10923.

3/10 Spring Break 3/17 Practical Challenges in Developing and Managing Peer Support Interventions

Fisher, E. B., Earp, J. A., Maman, S., & Zolotor, A. (2010). Cross-cultural and international adaptation of peer support for diabetes management. Family Practice, 27 Suppl 1, i6-16.

Fisher, E. B., Boothroyd, R.E., Coufal, M.M., Baumann, L.C., Mbanya, J.C., Rotheram-Borus, M.J., Sanguanprasit, B., & Tanasugarn, C. (2012). Peer support for self-management of diabetes improved outcomes in international settings. Health Affairs, 31(1): 130-139.

Fisher, E.B., Zhong, X., Kowitt, S., & Nan, H. (2013). The Importance of Contexts and the Roles of Community and Peer Support Programs in Bridging Gaps among Contexts, Self-Management Interventions, and Clinical Care. In J. Rodriguez-Saldana (Ed.), Quality of Health Care: Challenges, Evidence and Implementation. Previously assigned, 1/28/13. Re-read section on peer support program in Anhui


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Province, China, pp. 15-17. National Council of La Raza and Peers for Progress (2014). Peer Support in Health –

Evidence to Action: An Expert Report of the National Peer Support Collaborative Learning Network.

3/24 Successes and Failures: Reaching the Hardly Reached, and Learning from Failure: Lessons Learned, Failure Factors, and Success Factors

Moskowitz, D., Thom, D. H., Hessler, D., Ghorob, A., & Bodenheimer, T. (2013). Peer

Coaching to Improve Diabetes Self-Management: Which Patients Benefit Most? Journal of General Internal Medicine, 28, 938-942.

Rogers, E. A., Hessler, D. M., Bodenheimer, T. S., Ghorob, A., Vittinghoff, E., & Thom, D. H. (2014). Diabetes peer coaching: do "better patients" make better coaches? Diabetes Educ, 40(1), 107-115.

Smith SM, Paul G, Kelly A, Whitford DL, O'Shea E, O'Dowd T. Peer support for patients with type 2 diabetes: cluster randomised controlled trial. BMJ. 2011 Feb 15;342:d715. doi: 10.1136/bmj.d715. Read Abstract and Methods

Fisher, E. & Boothroyd, R. Response to Smith et al. and Smith et al., Rejoinder Fisher, E. B., Jr. (1997). Two approaches to social support in smoking cessation:

Commodity Model and Nondirective Support. Addictive Behaviors, 22, 819-833. Fisher et al., Systematic Review of the Effects of Peer Support Interventions for

Complex Health Behaviors (in preparation) Section on Unsuccessful Studies. 3/31 Network Approaches

Readings: Emrick, C.D. (1987). Alcoholics Anonymous: Affiliation Processes and Effectiveness

as Treatment. Alcoholism: Clinical and Experimental Research. 11: 416-423. Nápoles-Springer AM, Ortíz C, O'Brien H, Díaz-Méndez M. (2009). Developing a

Culturally Competent Peer Support Intervention for Spanish-speaking Latinas with Breast Cancer, Journal of Immigrant and Minority Health,11:268–280.

4/7 Channels of peer support: Email, Web Guest Speaker: Valarie Clark Worthy, Sisters’ Network

Visit the Sisters Network website (http://www.sistersnetworkinc.org) and website of Sisters Network Triangle (http://www.sisterstriangle.org/)

Assignment: See the movie, Her Readings: Schneider, S. The Philosophy of ‘Her.’ The Stone, New York Times, March 2, 2014. Seltzer, L. J., Prososki, A. R., Ziegler, T. E., & Pollak, S. D. (2012). Instant messages

vs. speech: hormones and why we still need to hear each other. Evolution and Human Behavior. 33(1), 42-45.

Wang, Z., Walther, J. B., Pingree, S., & Hawkins, R. P. (2008). Health information, credibility, homophily, and influence via the Internet: Web sites versus discussion groups. Health communication, 23(4), 358-368.

Review (originally assigned 2/17): Gabriele, J. M., Carpenter, B. D., Tate, D. F., & Fisher, E. B. (2010). Directive and Nondirective E-Coach Support for Weight Loss in Overweight Adults. Ann Behav Med.

Workshop on Developing a Peer Support Program Peers for Progress. (2010). Peer Support in Health and Health Care: A Guide to Program Development and Management.


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4/14 Primary Care, the Patient-Centered Medical Home, and Peer Support Guest Presenters:

Samuel Cykert, MD, Professor of Medicine, Associate Director of Medical Education for the North Carolina Area Health Education Centers program (NC AHEC) Diana Urlaub, MPH, Program Manager, Peers for Progress Program Development Center.

Readings: Bielaszka-DuVernay, C. (2011). Vermont's Blueprint for medical homes, community

health teams, and better health at lower cost. Health affairs, 30(3), 383-386. Friedberg, M. W., Schneider, E. C., Rosenthal, M. B., Volpp, K. G., & Werner, R. M.

(2014). Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care. JAMA, 311(8), 815-825.

4/21 Retrospect and Student Presentations Class Presentations, 4/21: Students will circulate ahead of time* and bring 8 copies of their product for all class members to class on April 21. There will be 5 products. We will take 15-20 min for each which will include the student’s presentation of the product (about 5 min) and then the class’ general discussion of it. * Send current draft of product to [email protected] and [email protected] by end of day, Thursday, 4/17. This of course does not preclude further work over the following several days. Bring 8 copies of revised version to class on 4/21. Reading: Fisher, E. B., Coufal, M. M., Parada, H., Robinette, J. B., Tang, P., Urlaub, D.,

Castillo, C., Guzman-Corrales, L.M., Hino, S., Hunter, J., Katz, A., Symes, Y.R., Worley, H.P., & Xui, C. (2014). Peer Support in Health Care and Prevention: Cultural, Organizational and Dissemination Issues. In J. Fielding, R. C. Brownson & L. Green (Eds.), Annual review of public health (Vol. 35). Palo Alto: Annual Reviews.

Fisher, E.B., Chan, J.C.N., Kowitt, S., Nan, H., Sartorius, N. & Oldenburg, B. (In Press). Conceptual Perspectives on the Co-occurrence of Mental and Physical Disease: Diabetes and Depression as a Model. In: N. Sartorius, M. Maj, & R. Holt (Eds.), Comorbidity of Mental and Physical Disorders. Basel: Karger

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