It is generally assumed that social support has a favorable impact on the maintenance of health and on coping with illness. However, results are inconsistent and even conflicting. This is partly due to conceptual and methodological shortcomings. In order to overcome these problems and to guide further research, we present a taxonomy of social relationships and a causal process model. Social integration, cognitive social support and behavioral social support are distinguished and related to personality, stress, coping and the pathogenic process. In the causal model we propose that social support is depicted both as mediating the effects of stress on illness as well as directly affecting illness. A meta analysis was conducted that related social support and social integration to morbidity and mortality based on eighty empirical studies, including more than 60,000 subjects. Data subsets revealed disparate patterns of results that give rise to intriguing theoretical questions. Evidently, social support operates in complex ways. Several causal models are specified which represent alternative pathways of social support processes. Where social support was associated with less illness, a direct effect model was proposed. In cases where more support was seemingly paradoxically associated with illness it is assumed that a mobilization of support has taken place. In conclusion, some recent research examples that help illustrate future directions untangling the social support-illness relationship are presented.

The outbreak of severe acute respiratory syndrome in 2003 and the subsequent emergence of the H5N1 virus have highlighted the threat of a global pandemic influenza outbreak. Planning effective public health control measures for such a case will be highly dependent on sound theory-based research on how people perceive the risks involved in such an event. The present article aims to review theoretical models and concepts underlying current empirical research on pandemic influenza risk perception. A review was conducted based on 28 empirical studies from 30 articles which were published between 2003 and 2007. Concepts of risk perception mostly seemed more pragmatic than theory-based and were highly heterogeneous, for instance, in terms of conceptualizing risk perception as an exclusively cognitive or as a cognitive and emotional phenomenon or whether the concept was dominated by expectancy or expectancy and value components. Similarly, the majority of studies investigating risk perceptions and protective behaviors were not model-based. The current body of knowledge can only provide preliminary insights. Unlike the reviewed studies, which were mostly launched as a rapid response to outbreak situations, future research will have to invest more strongly into theoretical work to provide sounder evidence.

In the last decade a great deal of research has been devoted to the question whether social support has a favorable impact on the maintenance of physical health and on coping with illness. It is claimed that social support can either generally prevent negative health consequences or can serve as a buffer in specific stress situations. The literature, however, yields inconsistent findings. We have compiled 55 studies on this topic including a total sample size of N=32,739 subjects. Forty one of the studies were published after 1981. A total of 83 effect sizes (correlations), based on independent samples, were identified. The correlations between social support and poor health (including mortality) ranged from r=-0.60 to +0.23. The meta-analysis focussed on several data subsets generated by potential moderators such as gender, kind of support, and specific health variables.

Behavioral factors such as (excessive) alcohol consumption play a major role in the explanation of social inequalities in health. The unequal distribution of health risk behaviors among socio-economic groups has important consequences for both the current and future health status of the younger generation. However, little is known about socio-economic differences in unhealthy lifestyles during adolescence. The purpose of the present study is to investigate socio-economic differences in adolescent drinking behaviour among 11-15 year old adolescents in Europe and North America. Data was obtained from the Health Behaviour in School-aged Children (HBSC) study 2001/02, a cross-national survey conducted in collaboration with the World Health Organization. The present analysis is based on 69249 male and 73619 female students from 28 countries. The effect of parental occupation and family affluence on episodes of drunkenness was assessed using separate logistic regression models controlling for age. Socio-economic circumstances of the family had only a limited effect on repeated drunkenness in adolescence. For girls only in one out of 28 countries a significant association between family affluence and repeated drunkenness was observed, while boys from low and/or medium affluent families in nine countries faced a lower risk of drunkenness than boys from more affluent families. Regarding parental occupation, significant differences in episodes of drunkenness were found in nine countries for boys and in six countries for girls. Compared to family affluence, which was positively related to risk of drunkenness, a decreasing occupational status predicted an increasing risk of drunkenness. This pattern was identified within a number of countries, most noticeably for boys. Parental socio-economic status is only of limited importance for episodes of drunkenness in early adolescence, and this very limited role seems to apply for girls more than for boys and for parental occupation more than family affluence. For future studies it might be important to look at the effects of socio-economic status within the context of other peer, family and school related factors in order to assess to what extent those factors might mediate the effects of social class background.

Background: The adoption rate of digital health in the health care sector is low in many countries. A facilitating factor for successful implementation and adoption of digital health is acceptance by current and future health care professionals. Objective: This study was conducted to identify factors associated with willingness to use digital health tools in patient care among health care professionals and students. Methods: This was a quantitative cross-sectional survey study conducted among health care professionals and students at a university hospital in Riyadh, Saudi Arabia. A nonprobability convenience sampling procedure was used to recruit participants. Data were collected using a self-completed e-questionnaire that was distributed by email. Chi-square tests, t tests, and logistic regression were used to analyze the data. Results: We found that 181 out of 218 health care professionals (83.0%; 75.6% [59/78] physicians; 87.1% [122/140] nurses) and 115 out of 154 students (74.7%; 80.0% [76/95] medical students and 66.1% [39/59] nursing students) were willing to use digital tools in patient care. Willingness to use digital tools was significantly associated with attitude (Adjusted Odds Ratios [AOR] 1.96; 95% CI 1.14-3.36) and self-efficacy (AOR 1.64; 95% CI 1.17-2.30) among health care professionals, and with current year of study (AOR 2.08; 95% CI 1.18-3.68) and self-efficacy (AOR 1.77; 95% CI 1.17-2.69) among students. No significant difference in willingness to use digital tools was found between physicians and nurses (P=.113), and between medical and nursing students (P=.079). Conclusions: The findings of this study should encourage policy makers and hospital managers to implement relevant eHealth interventions within routine health care systems in Saudi Arabia. For successful implementation, digital health education programs should be implemented simultaneously, so that current and future health care professionals are able to develop required positive attitudes as well as practical skills and competencies.