title: Development of an unsupportive social interaction scale for patients with diabetes.
abstract: OBJECTIVE
  The positive aspects of social support and its impact on health have been studied extensively. However, there may also be negative effects of social environments on the diabetic patient. This study developed and validated a new diabetic unsupportive social interaction scale (USIS), including two subscales: interference and insensitivity.
  
  
  METHODS
  A list of 22 items depicting unsupportive interactions associated with management of diabetes was developed. A telephone survey was administered to 764 Israelis with diabetes. The questionnaire included the USIS and questions about social networks, social support, health behaviors, and health. The characteristics, validity, and reliability of the scale were tested.
  
  
  RESULTS
  A principal component analysis was performed for extraction of two factors describing unsupportive social interaction concepts: interference and insensitivity. Cronbach's alpha for the full 15-item scale was 0.84, indicating internal consistency. The two subscales were calculated to have Cronbach's alphas of 0.85 and 0.73, respectively. The USIS showed construct validity as it was associated with social support, some measures of social networks, subjective measures of health, and health behaviors. Arabs, older respondents, those defining themselves as more religious, and the less educated reported higher rates of unsupportive interactions.
  
  
  CONCLUSIONS
  This study suggests a new concept of unsupportive interactions including interference and insensitivity. These unsupportive interactions may adversely affect patients' ability to adhere to treatment and may undermine their health in various ways. Identifying these problems may enable clinicians to help patients cope with their unsupportive environments.
authors.affiliation: School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Baron-Epel
authors.affiliation: Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel ; Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Anthony David
authors.initials: AD
authors.lastname: Heymann
authors.affiliation: Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Nurit
authors.initials: N
authors.lastname: Friedman
authors.affiliation: Psychosocial Aspects of Health, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Giora
authors.initials: G
authors.lastname: Kaplan
keywords: development of scale; insensitivity; interference; social support; unsupportive social interactions; validity