Tapping into Social Support May be Best Way to Improve Health

When it comes to our health, drawing in more social support — particularly from close family and friends — may be a more effective strategy than increasing interaction or visits with physicians or other healthcare workers, according to a new study published in the New England Journal of Medicine.

“Most health care interventions are designed for the individual patient, but there’s a growing body of research that shows how health care organizations can use social engagement strategy to enhance health for patients who want to be involved in group activities or team competitions aimed at improving health,” said co-author Roy Rosin, MBA, chief innovation officer at Penn Medicine.

For example, the authors point to a study in which some patients with diabetes were asked to talk on the phone weekly with peers — a technique known as reciprocal mentorship — while other patients received more typical nurse-led management. The findings showed that those who worked directly with peers saw a more significant decline in glycated hemoglobin levels than those who worked with clinical staff.

The researchers believe it would be extremely helpful if health organizations arranged get-togethers with patients’ friends and family in order to draw in more social support.

“Concerns about privacy are often the reason doctors and hospitals avoid organizing social support,” said co-author David Asch, M.D., MBA, a professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania and director of the Penn Medicine Center for Health Care Innovation.

“But while privacy is very important to some patients under some circumstances, more often patients would love if their friends and family helped them manage their diabetes, and those friends and family want to help people get their health under control.”

Asch explains that people are far more heavily influenced by those they encounter on a daily basis than they are by doctors and nurses whom they see only occasionally. However, these “cost-free interactions remain largely untapped when engineering social incentives for health,” said Asch. “That’s a missed opportunity.”

“Spouses and friends are more likely to be around patients when they are making decisions that affect their health — like taking a walk versus watching TV, or what to order at a restaurant. Patients are also more likely to adopt healthy behaviors — like going to the gym — when they can go with a friend,” said Asch.

The researchers define a ladder with escalating rungs of social support ranging from no social engagement — such as when a patient is expected to take medication as part of a routine, without anyone seeing them do it or holding them accountable — to a design that relies on reputational or economic incentives, and incorporates teams or other designs that hold patients accountable for their health behaviors and habits.

“Although we don’t normally think of competition or collaboration among patients are part of managing chronic diseases like high blood pressure, heart failure, or diabetes, research shows that behavior is contagious, and programs that take advantage of these naturally occurring relationships can be very effective,” said Rosin.

Source: University of Pennsylvania School of Medicine