Social Networks and Social Support Influencing Health-Promoting Behaviors among Thai Community-Dwelling Elderly

This study aimed to examine whether a proposed conceptual model can explain mechanisms by which social networks and social support influence health-promoting behaviors among Thai community-dwelling elderly. Four hundred and sixty-nine elders from Nan Province, Thailand, were recruited by multi-stage random sampling. Berkman's work on social relations related to health provided the theoretical framework of this study. Structural equation modeling, using LISREL, was used to examine the causal relationships in the hypothesized model. The results suggesting the final model had a good fit with the data and could explain 74% of the variance in health-promoting behaviors. Kinship networks, through kinship support and sense of well-being, were found to have indirect effects on health-promoting behaviors. Kinship support, through a sense of well-being, also was found to have an indirect influence on health-promoting behaviors. Friendship networks and friendship support demonstrated both direct and indirect influences on health-promoting behaviors. Interestingly, friendship networks and support were found to influence support for the elderly person by family members. Elderly persons' sense of well-being demonstrated a strong positive direct effect on health-promoting practices. The findings indicated that kinship support had a clear direct influence on the elderly person's sense of well-being, whereas friendship networks had a noticeable effect on health-promoting behaviors. To enhance the elderly person's health-promoting behaviors, nurses and multidisciplinary healthcare providers should design intervention programs to foster social relations, especially by promoting familial support and the elderly person's psychological well-being. This should also be done by facilitating friendship network activities in communities.