Neighborhood Organization for Pediatric Asthma Management in the Neighborhood Asthma Coalition: Programatic Strategies Social Support and Informal Networks

Research indicates that African Americans may be especially responsive to social support for behaviors such as disease management and risk reduction. For instance, a survey of residents of St. Louis conducted as a basis for evaluation of “Neighbors for a Smoke Free North Side,” a program we developed in the same neighborhoods prior to the Neighborhood Asthma Coalition, found differences between African Americans and whites in their responses to an item asking, “How important would the support of your family and friends be to you in quitting smoking?” After controlling for age, education, income, and smoking status, African American respondents indicated greater importance of social support for quitting than did whites (/?=.12, p<0.002). Also, research indicates supportive relationships may be especially helpful to those beset by social and economic disadvantages. Thus, support from family and neighbors may be especially helpful to African Americans attempting to do things like quitting smoking while coping with other problems such as unemployment and severe economic hardship. In addition to the importance of social support, research indicates that African Americans are relatively isolated from formal channels of information such as provided by physicians and other professionals. Rather, they may be more influenced by informal networks of friends and family. Information may be very effectively exchanged within such networks. African Americans appear to utilize their extended kin network for social support more than do whites. Unfortunately, these informal networks may isolate African Americans from formal health education and media and contribute to the reduced utilization of formal and professional health services noted above.’ However, community organization’s emphasis on organizing and implementing campaigns through peers may recruit such informal networks into supporting program goals. Additionally, as informal networks are key sources of social support, reaching them brings this additional force to bear on program targets. A number of the considerations noted above have led us to pursue a community organization approach to programs for asthmatic children. Community organization approaches have several advantages in reaching informal networks. Creating roles for neighbors on steering committees and work groups creates ties between the program and neighborhood residents’ informal networks. As more members of target audiences take roles within the program, they become links between it and their own informal networks. As these linkages increase, the number of informal networks connected to the program increases and the extent to which these networks may each have several such links to the program also increases.

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