Human adult literature on social support and physical health is reviewed considering studies of illness onset, stress, utilization of health services, adherence to medical regimens, recovery, rehabilitation, and adaptation to illness. Only studies with actual or proxy outcome measures of physical, as opposed to psychological, health are considered. Research evidence supporting a direct link between social support and physical health is more modest than previous reviews have claimed. More complex models including clearer multidimensional conceptualizations of social support are suggested as a basis for future research. Support measures should be directly relevant to the conceptualization and outcome of interest. A framework delineating stages at which social support can mediate health outcomes is presented. Processes may differ at each stage. Social support is more than an environmental variable; person characteristics as they affect access to, development of, and utilization of social support must be considered. There is sufficient evidence to warrant further research attention by health psychologists to social support.Numerous reviews exist linking social support with many aspects of health and illness (e.g.,

Seventy-three women attending a health fair completed a questionnaire that measured demographic and health history variables, knowledge, and current practice of breast self-examination (BSE), Multidimensional Health Locus of Control (MHLC; Wallston, Wallston, & DeVellis, 1978), and components of the Health Belief Model (HBM; Rosenstock, 1974) in relation to breast cancer and BSE. These variables formed the basis of a conceptual model of BSE behavior that was examined by having each woman participate in a behavioral trial with a breast model in which her BSE technique and ability to detect simulated tumors was assessed. Regression analyses revealed that self-confidence in the efficacy of BSE was the best single predictor of proficient BSE. Powerful others HLC, knowledge of correct BSE behaviors, and chance HLC, respectively, also contributed significantly to the variance in performance. As anticipated, successful lesion detection was most strongly associated with more proficient BSE technique and higher frequency of BSE practice in the past six months. Internal HLC scores were not predictive of either behavioral measure. Similarly, except for perceived efficacy of BSE, HBM variables showed no strong relationships to observed behavior.

Women at high risk for breast cancer were compared to low risk women with respect to frequency of breast self-examination (BSE), knowledge and quality of BSE, and attitudinal variables. The women at high risk did not practice BSE more frequently than women at low risk, although they were more knowledgeable about BSE, more focused on breast cancer, and less confident in physician proficiency in conducting a breast exam. The rate of monthly BSE practice was low in both groups. Self-confidence about performing BSE was most strongly associated with BSE frequency in both groups. No other variables predicted BSE frequency in the high risk group. In the low risk group, knowledge of BSE technique and breast cancer focus were additional significant predictors.

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