International Cooperative Study of Social Support
Principal Investigator: Edwin Fisher PhD

Summary:
Epidemiological research indicates that the absence of social support, or social isolation, may have impacts on mortality akin to that of smoking one pack of cigarettes a day.
Efforts to identify specific types of support have included the differentiation of instrumental and emotional and several other types of support. Cutrona has articulated matching of type of support and type of challenge, suggesting for example that emotional support may be more appropriate for acute stress that is unavoidable but that instrumental support is more appropriate for stressors that may be altered. Dr. Fisher and his colleagues at Washington University have developed a distinction between Directive Support ("taking over" responsibility and telling recipients what they should feel and choose) and Nondirective Support (cooperating without taking control, accepting recipients' choices and feelings).

There has been little research on the personality, family, and social circumstances surrounding social support. Current work on social capital or community assets suggests that communities characterized by trust, cooperation, and a sense of security a may create circumstances hospitable to social support among their members. Broader cultural factors, such as emphases on individualism versus family and community may also influence social support and its role in health.

Through colleagues in the International Society of Behavioral Medicine, Dr. Fisher has assembled an international group to study social and cultural contexts of social support, types of support and associated effects on key health indicators.

The project will entail administration of surveys to adults in countries representing diverse cultures - Finland, Sweden, Thailand, and the US. Study participants will be population samples of adults between the ages of 50 and 70 recruited either through community studies of health promotion or provider groups or equivalent provider care structures in the four countries.

The study will evaluate (1) the contexts of support, (2) different types of support, (3) individual characteristics, and (4) relationships with risk behaviors, overall health, and quality of life. For this initial study, no data requiring face-to-face assessment or audit of medical records will be included, although these would be included in subsequent studies.

Contexts of Support Measures in this area will include Family characteristics; Living circumstances; Social networks; Measures of social capital and community assets; Attachment style. Type of Support will include measures of tangible, informational, and emotional support and measures of Nondirective Support and Directive Support. Individual Characteristics will include styles of coping and personal coherence. Health Measures will include major risk behaviors (smoking, alcohol consumption, fat and vegetable consumption); Body Mass Index and abdominal circumference; Ratings of overall health status; and Quality of Life and Depression.

The expected number of completed surveys will be at least 800, supporting sophisticated multivariate analyses of relationships among the variables assessed and the ways in which those relationships vary across different countries/cultures.