Dissertation Defense Announcement

The School of Public Health announces the Final Dissertation Defense of

Shaila Strayhorn

for the Degree of Doctor of Philosophy

on June 19, 2018 at 9:00 AM in Robinson Hall, Room 217

Advisor: Brook Harmon

Racial Differences in Social Support and the Quality of Life among Individuals with Chronic Illnesses

ABSTRACT: Individuals of African descent are disproportionately affected by chronic illnesses compared to whites. Moreover, racial disparities in the quality of life (QOL) among individuals of African descent with chronic illnesses were observed in previous studies. Perceived social support has contributed to the racial differences in QOL among individuals with chronic illnesses. However, racial differences among individuals with chronic illnesses in specific factors of social support and QOL domains are unknown. The purpose of this dissertation is to examine racial differences in associations between factors of social support and four QOL domains (physical well-being, psychological well-being, social well-being, and spiritual well-being) among individuals previously diagnosed with a chronic illness. The study was guided by three study aims: 1) to examine common intrapersonal-level and interpersonal-level variables as confounders, mediators, or moderators., 2) to examine associations between sources of informal social support and QOL domains among individuals with chronic illnesses, 3) to examine associations between sources of negative and positive social support and QOL domains among individuals with chronic illnesses. A secondary data analysis of the National Survey of American Life (NSAL) was conducted. The study population was comprised of 3,285 African Americans, Caribbean Blacks, and non-Hispanic whites, who were previously diagnosed with a chronic illness. Moderation was evaluated through interaction terms, while mediation was assessed through the PROCESS MACRO bootstrapping technique in SPSS. Multivariate linear regressions assessed the racial differences between factors of social support and the QOL domains. Stress and social ties consistently moderated and mediated the relationship between factors of social support and QOL domains among individuals with chronic illnesses. Additionally, racial differences between factors of social support and the QOL domains were frequently observed among African Americans and non-Hispanic whites compared to Caribbean Blacks and non-Hispanic whites. For example, negative social support from family members was negatively associated with the social well-being among African Americans compared to non-Hispanic whites. Findings from this study can encourage future researchers to include specific factors of social support (i.e. sources of positive and negative social support) within interventions that focus on reducing the racial disparities in QOL among individuals with chronic illnesses.