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Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels

OBJECTIVES: The purpose of this study is to test the hypothesis that the link between socioeconomic status (SES) and resilience is mediated by reserve-building activities. DESIGN: Cross-sectional observational study. Structural equation modelling (SEM) was used to test the mediation hypothesis. SETT...

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Autores principales: Schwartz, Carolyn Emily, Zhang, Jie, Stucky, Brian Dale, Michael, Wesley, Rapkin, Bruce David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549651/
https://www.ncbi.nlm.nih.gov/pubmed/31154302
http://dx.doi.org/10.1136/bmjopen-2018-025602
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author Schwartz, Carolyn Emily
Zhang, Jie
Stucky, Brian Dale
Michael, Wesley
Rapkin, Bruce David
author_facet Schwartz, Carolyn Emily
Zhang, Jie
Stucky, Brian Dale
Michael, Wesley
Rapkin, Bruce David
author_sort Schwartz, Carolyn Emily
collection PubMed
description OBJECTIVES: The purpose of this study is to test the hypothesis that the link between socioeconomic status (SES) and resilience is mediated by reserve-building activities. DESIGN: Cross-sectional observational study. Structural equation modelling (SEM) was used to test the mediation hypothesis. SETTING: Web-based survey. PARTICIPANTS: Participants with a chronic medical condition were recruited from Rare Patient Voice. PRIMARY AND SECONDARY OUTCOME MEASURES: DeltaQuest Reserve-Building Measure; demographic variables to capture SES; Centers for Disease Control Healthy Days Core Module; Self-Administered Comorbidity Questionnaire. Resilience was operationalised using residual modelling. RESULTS: The study sample included 442 patients (mean age 49, 85% female). SES was modelled as a bifactor model composed of general SES and specific factors for personal finance and parent’s education. A series of simple mediation models predicting resilience led to the selection of three reserve-building activities for subsequent SEM-based mediation models: Active in the World, Outdoor and Exercise. The full SEM model supported the hypothesis that the relationships from both general SES and personal finance to resilience were mediated by engaging in the three reserve-building activities. In addition, the number of comorbidities partially mediated the relationship between personal finance and reserve-building. Those with more comorbidities generally had lower levels of resilience. CONCLUSIONS: This study provides suggestive evidence that reserve-building activities may be one pathway by which SES is associated with resilience: people of higher SES are more likely to engage in reserve-building activities that are intellectually stimulating, involve Outdoor pursuits and include physical Exercise. These reserve-building activities are not costly to pursue. These findings may empower patients to introduce more such reserve-building activities into their lives.
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spelling pubmed-65496512019-06-21 Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels Schwartz, Carolyn Emily Zhang, Jie Stucky, Brian Dale Michael, Wesley Rapkin, Bruce David BMJ Open Public Health OBJECTIVES: The purpose of this study is to test the hypothesis that the link between socioeconomic status (SES) and resilience is mediated by reserve-building activities. DESIGN: Cross-sectional observational study. Structural equation modelling (SEM) was used to test the mediation hypothesis. SETTING: Web-based survey. PARTICIPANTS: Participants with a chronic medical condition were recruited from Rare Patient Voice. PRIMARY AND SECONDARY OUTCOME MEASURES: DeltaQuest Reserve-Building Measure; demographic variables to capture SES; Centers for Disease Control Healthy Days Core Module; Self-Administered Comorbidity Questionnaire. Resilience was operationalised using residual modelling. RESULTS: The study sample included 442 patients (mean age 49, 85% female). SES was modelled as a bifactor model composed of general SES and specific factors for personal finance and parent’s education. A series of simple mediation models predicting resilience led to the selection of three reserve-building activities for subsequent SEM-based mediation models: Active in the World, Outdoor and Exercise. The full SEM model supported the hypothesis that the relationships from both general SES and personal finance to resilience were mediated by engaging in the three reserve-building activities. In addition, the number of comorbidities partially mediated the relationship between personal finance and reserve-building. Those with more comorbidities generally had lower levels of resilience. CONCLUSIONS: This study provides suggestive evidence that reserve-building activities may be one pathway by which SES is associated with resilience: people of higher SES are more likely to engage in reserve-building activities that are intellectually stimulating, involve Outdoor pursuits and include physical Exercise. These reserve-building activities are not costly to pursue. These findings may empower patients to introduce more such reserve-building activities into their lives. BMJ Publishing Group 2019-06-01 /pmc/articles/PMC6549651/ /pubmed/31154302 http://dx.doi.org/10.1136/bmjopen-2018-025602 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Public Health
Schwartz, Carolyn Emily
Zhang, Jie
Stucky, Brian Dale
Michael, Wesley
Rapkin, Bruce David
Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
title Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
title_full Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
title_fullStr Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
title_full_unstemmed Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
title_short Is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
title_sort is the link between socioeconomic status and resilience mediated by reserve-building activities: mediation analysis of web-based cross-sectional data from chronic medical illness patient panels
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549651/
https://www.ncbi.nlm.nih.gov/pubmed/31154302
http://dx.doi.org/10.1136/bmjopen-2018-025602
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