title: Social-ecological influences on interpersonal support in people with physical disability.
abstract: BACKGROUND
  People with physical disability report lower amounts of emotional and informational social support compared with other populations but it is unclear how influences at the broader societal level impact support in this population.
  
  
  OBJECTIVE
  To address this question, Berkman and Glass's social-ecological model was used to examine the influence of upstream factors on interpersonal support in people with physical disability. It was predicted that these factors would influence support even after controlling for the traditional measures linked to social support.
  
  
  METHODS
  331 adult participants with physical disability (43% female; mean age = 42.7; 88% White) completed an online cross-sectional survey measuring types and sources of social support, social integration, disability impact in social domains, environmental barriers, and relevant psychosocial variables such as depression.
  
  
  RESULTS
  A hierarchical linear regression analysis showed that level of disability, perceived tangible support, social integration, depressive symptoms, environmental barriers, occupational independence, and having family or friends as primary support sources were significantly associated with perceived support at the final step (R(2) = .60, F(22, 255) = 17.68, p < .001). The social-ecological measures, environmental barriers and social integration, had the largest associations with interpersonal support.
  
  
  CONCLUSIONS
  Results demonstrate the importance of measuring distinct support constructs and how the broader social environment may matter more in interpersonal support perceptions for people with disability than typical measures studied in the literature. Improving environmental factors will help improve social support.
authors.affiliation: School of Community Health Sciences, University of Nevada, Reno, USA. Electronic address: devereux@unr.edu.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Devereux
authors.affiliation: Department of Health Science and Recreation, San José State University, USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Bullock
authors.affiliation: Interdisciplinary Social Psychology Program, University of Nevada, Reno, USA.
authors.forename: Zebbedia G
authors.initials: ZG
authors.lastname: Gibb
authors.affiliation: School of Community Health Sciences, University of Nevada, Reno, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Himler
mesh_terms: D000328:Adult; D001290:Attitude; D003430:Cross-Sectional Studies; D003863:Depression; D006233:Persons with Disabilities / Q000523:psychology*; D005190:Family; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations; D010465:Perception; D012931:Social Environment; D058992:Social Participation; D012944:Social Support
keywords: Physical disability; Social support; Social-ecological model