The practitioners’ perspective on the upside and downside of applying social capital concept in therapeutic settings

Social capital, and more particularly the social networks that define its existence, is said to benefit health and well‐being. In individuals recovering from alcohol and drug addiction, social capital accruing from social networks support treatment, recovery and maintenance. Therefore, the concept of social capital is important for public health practitioners working in recovery interventions. This qualitative study seeks to explore what practitioners perceive as the importance of social capital and how they apply the concept in interventions to support individuals recovering from drug and alcohol addiction. Eight public health practitioners involved in drug and substance abuse interventions in West Yorkshire, England, were interviewed. The results of the interview were then deductively coded using two priori themes of perceived impact of social capital on health outcomes and application of social capital theory in recovery interventions. The findings reveal that practitioners understand the impact of social capital as the effects of social networks on recovery and apply the concept in their interventions. However, the nature of interventions created based on similarities in condition (alcohol and substance addiction) and intended outcome (recovery) create bonding social capital with mixed outcomes. This paper argues that the wider benefits to service users are unintentionally inhibited by the overwhelming downsides of bonding social capital. For instance, closed support groups comprised of individuals with high similarities further exclude the already socioeconomically deprived service users from integrating and accessing resources outside their groups.     

Mothers experiencing homelessness: mental health, support and social care needs

Little is known about the experiences of mothers who become homeless. The numbers of women with children in this situation are growing, most becoming homeless following domestic or neighbour abuse, or the breakdown of family relationships. This qualitative study aimed to describe mothers' experiences of homelessness in relation to their mental health, support and social care needs. Twenty-eight homeless women with dependent children residing in hostels were interviewed. The experience of homelessness was stressful, but viewed as a respite for many of the participants because they had experienced violence and harassment prior to their stay in the hostels. Many described poor mental health, which they related to the conditions in hostels and traumas that they had experienced before becoming homeless. Their experiences and perceptions of the services available were mixed. Some valued the support offered by staff and other residents, but the majority felt that there was a lack of resources to address their needs. Many women had difficulty coping with homelessness, and several said that support from other homeless women was an important source of help. Services need to work together to meet the multiple health, social, psychological and housing needs of these women.     

Learning the ropes together: assimilation and friendship development among first-year male medical students

This study explores the mutual influences of friendship development and organizational assimilation processes among first-year male medical students. Interviews and observations were used to examine the ways students constructed and enacted their friendships with male classmates during the process of assimilating into medical school. The study also examined how the male friends viewed the influence of their friendships on their assimilation into medical school and how the assimilation process simultaneously influenced their developing friendships. Thematic analysis revealed that although the men perceived their medical school friendships as "not yet close," the friendships provided them with valuable tangible and socio-emotional support during the rigorous assimilation process and that the assimilation process paradoxically facilitated as well as hindered the development of friendships. Implications for practice and future research are discussed.     

Friendship After a Friends with Benefits Relationship: Deception, Psychological Functioning, and Social Connectedness

Friends with benefits (FWB) relationships are formed by an integration of friendship and sexual intimacy, typically without the explicit commitments characteristic of an exclusive romantic relationship. The majority of these relationships do not transition into committed romantic relationships, raising questions about what happens to the relationship after the FWB ends. In a sample of 119 men and 189 women university students, with a median age of 19 years and the majority identified as Caucasian (63.6 %), we assessed relationship adjustment, feelings of deception, perception of the FWB relationship and friendship, social connectedness, psychological distress, and loneliness. Results demonstrated that the majority of FWB relationships continued as friendships after the sexual intimacy ceased and that about 50 % of the participants reported feeling as close or closer to their FWB partner. Those who did not remain friends were more likely to report that their FWB relationship was more sex- than friendship-based; they also reported higher levels of feeling deceived by their FWB partner and higher levels of loneliness and psychological distress, but lower levels of mutual social connectedness. Higher levels of feeling deceived were related to feeling less close to the post-FWB friend; also, more sex-based FWB relationships were likely to result in post-FWB friendships that were either more or less close (as opposed to unchanged). FWB relationships, especially those that include more attention to friendship based intimacy, do not appear to negatively impact the quality of the friendship after the “with benefits” ends.     

Peer Influence on Marijuana Use in Different Types of Friendships

PurposeAlthough several social network studies have demonstrated peer influence effects on adolescent substance use, findings for marijuana use have been equivocal. This study examines whether structural features of friendships moderate friends' influence on adolescent marijuana use over time.MethodsUsing 1-year longitudinal data from the National Longitudinal Study of Adolescent Health, this article examines whether three structural features of friendships moderate friends' influence on adolescent marijuana use: whether the friendship is reciprocated, the popularity of the nominated friend, and the popularity/status difference between the nominated friend and the adolescent. The sample consists of students in grade 10/11 at wave I, who were in grade 11/12 at wave II, from two large schools with complete grade-based friendship network data (N = 1,612).ResultsIn one school, friends' influence on marijuana use was more likely to occur within mutual, reciprocated friendships compared with nonreciprocated relationships. In the other school, friends' influence was stronger when the friends were relatively popular within the school setting or much more popular than the adolescents themselves.ConclusionsFriends' influence on youth marijuana use may play out in different ways, depending on the school context. In one school, influence occurred predominantly within reciprocated relationships that are likely characterized by closeness and trust, whereas in the other school adopting friends' drug use behaviors appeared to be a strategy to attain social status. Further research is needed to better understand the conditions under which structural features of friendships moderate friends' influence on adolescent marijuana use.     

The relationship between friendship factors and adolescent girls' body image concern, body dissatisfaction, and restrained eating

OBJECTIVE: This study examined whether poorer friendship relations predict weight concerns and dietary restraint in adolescent girls. METHOD: Questionnaires were administered to 131 Year 9 and Year 10 girls to assess the relationship between acceptance by friends, perceived social support, friendship intimacy, and perceived impact of thinness on male (PITOF-M) and female (PITOF-F) friendships on the one hand, and body image concern, body dissatisfaction, and restrained eating on the other. RESULTS: Friendship variables contributed significantly to the prediction of body image concern, body dissatisfaction, and restrained eating. The largest unique contribution to prediction was from the PITOF-M. Poor acceptance by friends significantly predicted the PITOF-M and PITOF-F. Whereas heavier girls were more likely to believe being thinner would improve their friendships, they did not experience poorer friendships. DISCUSSION: Results suggest sociocultural risk factors for disordered eating and underline the importance of perceived peer affiliation on girls' body image concern and dieting.     

Friendship,sexual intimacy and young people’s negotiations of sexual health

Abstract

This paper examines how young people’s friendships influence safer sexual practices. Through a thematic discourse analysis, interviews with Sydney-based young people (aged 18–25 years) and Australian-based sexual health websites for young people are considered. Interview data illustrate how friendships can support young people's sexual experiences, concerns and safeties beyond the practice of ‘safe sex’ (condom use). This is evident in friends’ practices of sex and relationship advice, open dialogue, trust and sharing experiential knowledge, as well as friend-based sex. Meanwhile, friendship discourse from selected Australian sexual health websites fails to engage with the support offered by friendship, or its value to a sexual health agenda. Foucault’s account of friendship as a space of self-invention is considered in light of these data, along with his argument that friendship poses a threat to formal systems of knowing and regulating sex. Whether sexual or not, many close friendships are sexually intimate given the knowledge, support and influence these offer to one’s sexual practices and relations. This paper argues that greater attention to friendship among sexual health promoters and researchers would improve professional engagements with young people’s contemporary sexual cultures, and better inform their attempts to engage young people through social media.     

Homophily and Contagion as Explanations for Weight Similarities Among Adolescent Friends

Purpose

To determine whether weight-based similarities among adolescent friends result from social influence processes, after controlling for the role of weight on friendship selection and other confounding influences.

Methods

Four waves of data were collected from a grade 8 cohort of adolescents (N = 156, mean age = 13.6 years) over their initial 2 years of high school. At each wave, participants reported on their friendship relations with grade-mates and had their height and weight measured by researchers to calculate their body mass index (BMI). Newly developed stochastic actor-oriented models for social networks were used to simultaneously assess the role of weight on adolescents' friendship choices, and the effect of friends' BMIs on changes in adolescent BMI.

Results

Adolescents' BMIs were not significantly predicted by the BMI of their friends over the 16 months of this study. Similarities in the weights of friends were found to be driven predominantly by friendship selection, whereby adolescents, particularly those who were not overweight, preferred to initiate friendships with peers whose weight status (overweight/nonoverweight) was the same as their own.

Conclusions

Weight-based similarities among friends were largely explained by the marginalization of overweight adolescents by their peers, rather than by the “contagion” of excess weight among friends. These findings highlight the importance of adequately modeling friendship selection processes when estimating social influence effects on adiposity.     

Self‐reported health,healthcare service use and health‐related needs: A comparison of older and younger homeless people

The number of older homeless people with a limited life expectancy is increasing. European studies on their health‐related characteristics are lacking. This study compared self‐reported health, healthcare service use and health‐related needs of older and younger homeless people in the Netherlands. It is part of a cohort study that followed 513 homeless people in the four major Dutch cities for a period of 2.5 years, starting from the moment they registered at the social relief system in 2011. Using cross‐sectional data from 378 participants who completed 2.5‐year follow‐up, we analysed differences in self‐reported health, healthcare service use, and health‐related needs between homeless adults aged ≥50 years (N = 97) and <50 years (N = 281) by means of logistic regression. Results show that statistically significantly more older than younger homeless people reported cardiovascular diseases (23.7% versus 10.3%), visual problems (26.8% versus 14.6%), limited social support from family (33.0% versus 19.6%) and friends or acquaintances (27.8% versus 14.6%), and medical hospital care use in the past year (50.5% versus 34.5%). Older homeless people statistically significantly less often reported cannabis (12.4% versus 45.2%) and excessive alcohol (16.5% versus 27.0%) use in the past month and dental (20.6% versus 46.6%) and mental (16.5% versus 25.6%) healthcare use in the past year. In both age groups, few people reported unmet health‐related needs. In conclusion, compared to younger homeless adults, older homeless adults report fewer substance use problems, but a similar number of dental and mental problems, and more physical and social problems. The multiple health problems experienced by both age groups are not always expressed as needs or addressed by healthcare services. Older homeless people seem to use more medical hospital care and less non‐acute, preventive healthcare than younger homeless people. This vulnerable group might benefit from shelter‐based or community outreach programmes that proactively provide multidisciplinary healthcare services.     

Communication and interpretation of emotional distress within the friendships of young Irish men prior to suicide: a qualitative study

The potential for young men in crisis to be supported by their lay networks is an important issue for suicide prevention, due to the under‐utilisation of healthcare services by this population. Central to the provision of lay support is the capability of social networks to recognise and respond effectively to young men's psychological distress and suicide risk. The aim of this qualitative study was to explore young men's narratives of peer suicide, in order to identify how they interpreted and responded to behavioural changes and indications of distress from their friend before suicide. In‐depth qualitative interviews were conducted during 2009/10 with 15 Irish males (aged 19–30 years) who had experienced the death by suicide of a male friend in the preceding 5 years. The data were analysed using a thematic approach. Through the analysis of the participants’ stories and experiences, we identified several features of young male friendships and social interactions that could be addressed to strengthen the support available to young men in crisis. These included the reluctance of young men to discuss emotional or personal issues within male friendships; the tendency to reveal worries and emotion only within the context of alcohol consumption; the tendency of friends to respond in a dismissive or disapproving way to communication of suicidal thoughts; the difficulty of knowing how to interpret a friend's inconsistent or ambiguous behaviour prior to suicide; and beliefs about the sort of person who takes their own life. Community‐based suicide prevention initiatives must enhance the potential of young male social networks to support young men in crisis, through specific provisions for developing openness in communication and responsiveness, and improved education about suicide risk.     

Disappearing acts: the social networks of formerly homeless individuals with co-occurring disorders

Studies of the social lives of men and women living with co-occurring disorders (substance abuse and serious mental illness) suggest that social networks critically influence recovery. In this paper, we examine some of the reasons that the social networks of individuals with co-occurring disorders are small, and the impact of small networks for this population. Using a social capital framework with cross-case analysis, we analyze 72 in-depth qualitative interviews with 39 formerly homeless mentally ill men and women who were substance abusers. All were participants in the New York Services Study (NYSS), a federally funded study of mentally ill adults in New York City. The patterns suggest that networks shrunk because (1) social network members died prematurely, (2) study participants withdrew or pushed others away, and (3) friends and family members faced so many obstacles of their own that they could not provide resources for the study participants. We suggest that as networks diminished, some participants responded by attempting to rebuild their networks, even if the networks provided negative social capital, and others isolated themselves socially to escape the pressures and disappointments of interaction.     

Mechanisms through which drug, sex partner, and friendship network characteristics relate to risky needle use among high risk youth and young adults

Drug injector social networks are a primary social space in which risky needle use behaviors associated with HIV transmission occur, but the mechanisms through which these social networks influence risky needle use are unclear. This study investigated two mechanisms, social support and social regulation, through which injection drug users' social networks might relate to risky needle use behaviors. We investigated how these mechanisms work in three types of social networks, namely, drug user, sex partner, and friendship networks. Data are from a study of HIV risk and protective behaviors of youth and young adults, ages 14-43, in the United States who were injection drug users and/or the sexual partners of users (N = 277). The three types of networks were constructed based on information respondents provided about their drug use partners, sexual partners, and friends. The networks were characterized by structural (i.e., size and density) and interactional (i.e., multiplexity and closeness) characteristics. We conducted tests for mediation using ordered probit models and multiple linear regression. In the drug networks, social regulation partially meditated the relationship between multiplexity and risky needle use (p<.10). In the sex partner networks, emotional support partially mediated the relationship between network size and risky needle use (p<.001), fully mediated the relationship between network closeness and risky needle use (p<.001), and partially mediated the relationship between multiplexity and risky needle use (p<.01). Mediators were not identified in the friendship networks. The findings demonstrate that network mechanisms explaining risky needle use differ for drug user and sex partner networks in ways consistent with the functional nature of each type of network tie.     

Health status and utilisation of the healthcare system by homeless and non‐homeless people in Vienna

This case–control study describes the health situation, internal and external resources, and utilisation of healthcare facilities by a marginalised population consisting of homeless people in Vienna, Austria, compared with a non‐homeless control population. Among the homeless group, participants lived in halfway houses (70%) or permanent housing (30%) in Vienna. Personal interviews were conducted in July 2010 with 66 homeless individuals, and their data were compared with data from non‐homeless subjects from the Austrian Health Interview Survey using conditional logistic regression. Compared with the control group, homeless persons suffered more often from chronic diseases (P < 0.001) and rated their health considerably lower than the comparison group (P < 0.001). Homeless people suffered significantly more often from psychiatric disorders, respiratory diseases, hypertension (P < 0.001), digestive system diseases (P = 0.002) and heart diseases (P = 0.015) in comparison with the control group. Additionally, among homeless and non‐homeless individuals, the former more often consulted a general practitioner in a period of 28 days (P = 0.002). A significantly greater proportion of homeless people did not have any teeth (P = 0.024) and smoked significantly more (P = 0.002). The results demonstrate deficits in the areas of health, health behaviour, and individual and social resources of homeless people, even though homeless people seek medical care at a higher rate than controls. Continuing health promotion projects for this high‐risk group and the strengthening of social resources are recommended.     

Sleeping at the margins: a qualitative study of homeless drug users who stay in emergency hostels and shelters

A growing social science literature demonstrates that sleep is not merely a personal matter but also a political problem and a public health issue. Taking this as a point of departure, our article presents an analysis of sleeping practices amongst homeless drug users (HDUs) who make use of emergency hostels and night shelters in England. Data generated by way of qualitative interviews undertaken with 29 men and 11 women reveal that, as we might expect, securing sleep for this group is by no means easy. The strategies they pursue to find places to sleep are described, as are the threats and barriers to their sleeping. Emergency hostels and night shelters can afford a lifeline; providing warmth, water, food and access to support services. But if these are inadequately resourced they can be experienced as volatile environments and inimical to sleeping. It is argued here that although sleep is an essential prerequisite for health, for this population it can, somewhat ironically, be experienced as a risky behaviour. Vulnerable to both physical risks (e.g. inclement weather) and social threats (e.g. abuse and violence), falling asleep can exacerbate exposure to such dangers. These vulnerabilities are compounded by the social position of HDUs who live in socially and physically marginal places. It is this marginality that prevents them from being able to secure sleep that is both restful and restorative.     

Suicide and friendships among American adolescents

OBJECTIVES: We investigated the relationship between friendships and suicidality among male and female adolescents. METHODS: We analyzed friendship data on 13,465 adolescents from the National Longitudinal Survey of Adolescent Health to explore the relationship between friendship and suicidal ideation and suicide attempts. We controlled for known factors associated with suicidality. RESULTS: Having had a friend who committed suicide increased the likelihood of suicidal ideation and attempts for both boys and girls. Socially isolated females were more likely to have suicidal thoughts, as were females whose friends were not friends with each other. Among adolescents thinking about suicide, suicide attempts appear largely stochastic, with few consistent risk factors between boys and girls. CONCLUSIONS: The friendship environment affects suicidality for both boys and girls. Female adolescents' suicidal thoughts are significantly increased by social isolation and friendship patterns in which friends were not friends with each other.     

Drug use and other problems of residents in projects for the young, single homeless

One hundred people who make use of an organization housing the young, single homeless were interviewed using a semi-structured interview. There was a high prevalence of problems, including substance abuse and dependence, other mental health problems, extensive use of health services and extensive experience of crime both as victim and perpetrator. Most people said they had become homeless because they did not get on with their parents. Since becoming homeless, most had not spent more than a month sleeping rough, but most had spent time staying with friends or staying in other hostels for the homeless. It is concluded that most young, single homeless people who seek help have problems beyond a lack of permanent shelter. The extent to which the sample is representative of all homeless people is considered and implications for service provision are discussed.     

Friends don't let friends eat cookies: Effects of restrictive eating norms on consumption among friends

Social norms are thought to be a strong influence over eating, but this hypothesis has only been experimentally tested with groups of strangers, and correlational studies using actual friends lack important controls. We manipulate an eating norm in the laboratory and explore its influence within established friendships. In two studies we randomly assigned groups of three friends to a restrictive norm condition, in which two of the friends were secretly instructed to restrict their intake of appetizing foods, or a control condition, in which the friends were not instructed to restrict their eating. The third friend's consumption was measured while eating with the other two friends and while eating alone. In both studies, participants consumed less food when eating with friends who had been given restricting instructions compared to those who had not been given those instructions. In Study 2, participants who ate with restricting friends also continued to restrict their eating when alone. Experimentally manipulating social norms within established friendships is possible, and these norms can influence consumption in those social groups and carry over into non-social eating situations. These findings may suggest mechanisms through which eating behaviors may spread through social networks, as well as an environmental factor that may be amenable to change.     

Perspectives of self‐direction: a systematic review of key areas contributing to service users’ engagement and choice‐making in self‐directed disability services and supports

Self‐directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self‐directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self‐directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users’ engagement with self‐directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases – MEDLINE, CINAHL and Web of Science – were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users’ informed decision‐making. Findings concerning key areas determining engagement fell into three themes – personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision‐making yielded two themes – supporting informed decision‐making and inhibiting informed decision‐making. Literature suggests that self‐directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision‐making support, particularly around the domains of budgeting, planning and hiring. Future research must continue to investigate the perspectives of service users pertaining to their engagement, as their participation is central to the effectiveness of the approach.     

Better Health With More Friends: The Role of Social Capital in Producing Health

This paper estimates the effect of an individual's number of friends on own health outcomes. The identification strategy exploits the panel structure of the friendship data from the National Longitudinal Study of Adolescent Health to estimate individual fixed effects in the likelihood of friendship formation and then uses the fixed effect estimates as a control function in a model relating health outcomes to number of friends. Empirical results show that having a larger number of friends improves physical and mental health and also lowers the frequency of smoking cigarettes. Specifically, making one more friend increases an individual's general health measure by 6.6% of a standard deviation. This suggests that accumulating social capital through friendship interactions is beneficial to health. Copyright © 2014 John Wiley & Sons, Ltd.