Health literacy is the ability to obtain and utilize health information to make health-related decisions and to navigate health systems. Although health literacy has traditionally been understood as an individual-level construct, current research is revealing the impact that social networks can have on health literacy. To date, no studies have examined associations between health literacy and social networks among people with serious mental illness (PWSMI), who are at high risk of physical illness and premature mortality. To begin to fill this gap, this study explores associations between health literacy, relationships with health discussion partners, and self-reported health outcomes in a racially diverse sample of Clubhouse members in Hawai‘i. Clubhouses are community mental health centers that promote recovery from mental illness through destigmatization, meaningful activity, and strong social relationships. Health literacy was assessed using two single-item screeners (SILS). In a sample of 163 members, 56.2% reported adequate ability to understand health-related instructions or pamphlets, and 43.3% reported adequate confidence filling out medical forms independently. This is consistent with other health literacy studies with PWSMI in the United States, and indicates lower health literacy within this group than is reported in national averages. Multivariate logistic regression revealed a larger Clubhouse staff social network and completing high school were significantly associated with requiring less help to read materials. Higher age, male gender, and being Native Hawaiian and/or Pacific Islander were associated with less confidence filling out medical forms, while higher self-efficacy was associated with higher confidence filling out medical forms. This study provides preliminary evidence that relationships fostered within Clubhouses are associated with health literacy among PWSMI, and highlights the need for more research to examine how social networks and health literacy interventions can be leveraged in community mental health settings to improve health outcomes within this vulnerable population.
Objective: Social support is an important component of recovery-based interventions for individuals living with severe mental illness (IWSMI). Clubhouses are local community centers that facilitate the development of meaningful relationships among IWSMI through an empowering structure and engagement with the work-ordered day. This review synthesizes research on social networks in Clubhouses to provide insights on the role of supportive relationships in mental illness recovery, including the size and features of social networks of Clubhouse members, methodological trends and gaps, and the associations between social networks and demographic variables, recovery, health, and perceived social support. Method: Research on social networks within Clubhouses were identified and analyzed following a systematic six-stage scoping review design. Results: Twelve articles across six studies were included. Results revealed considerable variation in social network interview methods and network size and features. Overall findings suggest that network size is not consistently associated with reported loneliness, social support, recovery, or quality of life. A deep relationship with at least one supportive person, level of perceived affiliation with Clubhouses, or positive comments from network members may be more or equally valuable than a larger network. Some studies found that types of relationships were associated with unique benefits. Stronger peer networks were associated with relationship satisfaction, while increased connections with health care professionals and family were associated with reduced hospitalizations. Conclusions and Implications for Practice: Future research should diversify research designs, expand the use of social network analysis and visualization, measure additional outcomes including recovery and health, and increase sample diversity. Impact and ImplicationsThis review highlights relationship characteristics and associations with recovery within Clubhouses, a unique community mental-health model. Findings support Clubhouses' role in facilitating the wellbeing of members through increasing social capital and fostering a context for recovery. Furthermore, findings suggest that deepening relationships or enhancing positive connection may be more or equally important than increasing the size of a social network, and individual characteristics within a network impact recovery outcomes.
Acceptance and commitment therapy (ACT) is a process-based, transdiagnostic approach to treatment that seeks to increase values-based, adaptive functioning (i.e., engaged living [EL]) in part through attenuating the impact of experiential avoidance (EA). The present case-series study examined EL and EA as mechanisms of change within a 10-week course of individual ACT delivered via a telehealth platform. Participants were two adult women with mental health concerns associated with clinically elevated EA. Throughout the study, we collected (a) daily self-monitored clinically relevant behaviors, (b) daily and weekly measures of EL and EA, and (c) pre-, mid-, post-treatment, and 3-month follow-up measures of psychopathology, quality of life, and ACT-related outcome variables. Results showed support for the efficacy of ACT, with both participants demonstrating slight improvements in clinically relevant behaviors, along with expected improvements in EL and EA. These favorable results were most pronounced for Participant 1. Results are discussed in the context of COVID-19-related adaptations (including telehealth), and within the framework of process-based ACT and its transdiagnostic applicability to a range of mental health concerns.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.