{"component": "clause", "props": {"groups": [{"size": 2, "snippet_links": [{"key": "protective-factors", "type": "definition", "offset": [74, 92]}, {"key": "family-reunification", "type": "clause", "offset": [126, 146]}], "snippet": "Contractor(s) must include strategies for helping clients build prosocial protective factors that will enhance the success of family reunification interventions.", "samples": [{"hash": "9TylqjXAFY5", "uri": "/contracts/9TylqjXAFY5#social-support", "label": "Standard Services Agreement", "score": 28.6848064986, "published": true}], "hash": "4c95c5f993e09789ac62798c899d85a9", "id": 2}, {"size": 2, "snippet_links": [{"key": "telephone-contact", "type": "clause", "offset": [25, 42]}, {"key": "to-verify", "type": "definition", "offset": [94, 103]}, {"key": "the-individual", "type": "clause", "offset": [109, 123]}, {"key": "client-participation", "type": "clause", "offset": [250, 270]}, {"key": "rehabilitation-programs", "type": "clause", "offset": [274, 297]}, {"key": "therapeutic-classes", "type": "definition", "offset": [299, 318]}, {"key": "and-exercise", "type": "clause", "offset": [319, 331]}, {"key": "based-on", "type": "clause", "offset": [391, 399]}, {"key": "as-designated", "type": "definition", "offset": [406, 419]}, {"key": "the-client", "type": "definition", "offset": [423, 433]}, {"key": "plan-of-care", "type": "definition", "offset": [436, 448]}, {"key": "lack-of", "type": "clause", "offset": [488, 495]}, {"key": "social-interaction", "type": "clause", "offset": [496, 514]}, {"key": "functional-capacity", "type": "clause", "offset": [688, 707]}, {"key": "title-iii", "type": "definition", "offset": [803, 812]}, {"key": "older-americans-act", "type": "definition", "offset": [820, 839]}, {"key": "the-waiver", "type": "clause", "offset": [952, 962]}, {"key": "the-service", "type": "clause", "offset": [1014, 1025]}, {"key": "in-the-community", "type": "definition", "offset": [1041, 1057]}, {"key": "private-programs", "type": "definition", "offset": [1109, 1125]}], "snippet": "(8.3): Includes periodic telephone contact, visiting or other social and reassurance services to verify that the individual is not in medical, psychological, or social crisis, or to offset isolation; expenses for activities and supplies required for client participation in rehabilitation programs; therapeutic classes and exercise classes are also provided. Such services shall be provided based on need, as designated in the client\u2019s plan of care. The MSSP has found that isolation and lack of social interaction can seriously impact some clients\u2019 capacity to remain independent. Lack of motivation or incentive or the lack of any meaningful relationships can contribute to diminishing functional capacity and premature institutionalization. These services are often provided by volunteers or through Title III of the Older Americans Act; however, these services may not be available in a particular community and do, infrequently, require purchase. The waiver will be used to purchase friendly visiting only if the service is unavailable in the community or is inadequate as provided under other public or private programs.", "samples": [{"hash": "bY2w9tzgJ7K", "uri": "/contracts/bY2w9tzgJ7K#social-support", "label": "Standard Agreement", "score": 19.6358658453, "published": true}, {"hash": "cZOtIwbrOAh", "uri": "/contracts/cZOtIwbrOAh#social-support", "label": "Standard Agreement", "score": 19.1567419576, "published": true}], "hash": "d129df50a565f2ca9f3f4061098836f9", "id": 1}, {"size": 1, "snippet_links": [{"key": "social-interaction", "type": "clause", "offset": [0, 18]}, {"key": "and-support", "type": "clause", "offset": [19, 30]}, {"key": "to-provide", "type": "definition", "offset": [47, 57]}, {"key": "health-and", "type": "clause", "offset": [87, 97]}, {"key": "older-adults", "type": "definition", "offset": [122, 134]}, {"key": "associated-with", "type": "definition", "offset": [244, 259]}, {"key": "chronic-disease", "type": "definition", "offset": [384, 399]}, {"key": "likely-to-have", "type": "clause", "offset": [497, 511]}, {"key": "lack-of", "type": "clause", "offset": [655, 662]}, {"key": "risk-factor", "type": "definition", "offset": [722, 733]}, {"key": "assessment-of-the", "type": "clause", "offset": [786, 803]}, {"key": "social-situation", "type": "clause", "offset": [804, 820]}, {"key": "the-medical", "type": "definition", "offset": [1215, 1226]}, {"key": "chronically-ill", "type": "definition", "offset": [1363, 1378]}, {"key": "individual-use", "type": "clause", "offset": [1575, 1589]}, {"key": "based-on", "type": "clause", "offset": [1659, 1667]}, {"key": "the-items", "type": "definition", "offset": [1796, 1805]}, {"key": "respondent-burden", "type": "definition", "offset": [1923, 1940]}, {"key": "to-maintain", "type": "clause", "offset": [2221, 2232]}, {"key": "structure-of-the", "type": "clause", "offset": [2249, 2265]}, {"key": "target-population", "type": "definition", "offset": [2476, 2493]}, {"key": "cognitive-impairment", "type": "definition", "offset": [2524, 2544]}, {"key": "living-in", "type": "definition", "offset": [2581, 2590]}, {"key": "social-care", "type": "clause", "offset": [2614, 2625]}, {"key": "the-community", "type": "clause", "offset": [2790, 2803]}], "snippet": "Social interaction and support have been shown to provide many benefits to the overall health and well-being of young and older adults. Social interaction and support drawn from a variety of sources (e.g., family, friends, community) have been associated with better outlook and better emotional health, especially among elderly with pre-existing life stress such as cancer and other chronic disease. Studies have also shown that older adults with adequate social interaction and support are less likely to have negative long-term effects (e.g., poor emotional health, pessimistic attitude, hospitalization, poor survival) of life stressors. Importantly, lack of social interaction and support is a potentially modifiable risk factor in older adults. But intervention requires adequate assessment of the social situation. Because of its potential for attenuating effects of life stressors, intervention, and relative ease of assessment, social support should be measured as part of the comprehensive geriatric assessment. To this end, we propose to use the \u201cMedical Outcomes Study Social Support Survey (MOS-SS)\u201d metric (Table 19). It is a 19-item, self-administered social support survey developed for patients in the Medical Outcomes Study (MOS) [61]. It was originally designed as a self-administered measure of functional social support in community dwelling chronically ill persons. The 19 items cover four domains (emotional/informational support, tangible [also called instrumental] support, positive social interaction, and affection) recommend for both combined and individual use. The questionnaire was carefully developed from previous instruments based on a sound theoretical formulation, has been demonstrated to be psycho-metrically sound, and is considered universally applicable. The items are short, simple, and easy to understand thus easy to administer to chronically ill patients of all ages. To reduce respondent burden, several more recent studies have used an eight-item modified Medical Outcomes Study Social Support Survey (mMOS-SS) [62] of the MOS-SS. The mMOS-SS has two subscales covering two domains (emotional and instrumental [tangible] social support) composed of four items each designed to maintain the theoretical structure of the MOS-SS and identify potentially modifiable social support deficits Because of its brevity, the mMOS-SS is a potentially valuable tool for use in geriatric assessment [63-65]. It is important to notice that the target population are older adults with initial cognitive impairment and possible other chronic disease, living in assisted structures of social care. Therefore their often their degree of social interaction is quite correlated with the social support that they can receive from caregivers, relatives, friends and the community where the live. Therefore we suggest the MOS- SS scale to measure their social interaction rather than scales addressing purely social interaction issues [66-69].", "samples": [{"hash": "jHle2MR9P15", "uri": "/contracts/jHle2MR9P15#social-support", "label": "Grant Agreement", "score": 22.2559890486, "published": true}], "hash": "088c1dae52460aeea870b31c8bb921f1", "id": 3}, {"size": 1, "snippet_links": [{"key": "community-asset", "type": "definition", "offset": [69, 84]}, {"key": "away-from-home", "type": "clause", "offset": [176, 190]}], "snippet": "Support given to people to actively engage in their local community, community asset building, to make friends and sustain relationships. This support is more frequently given away from home.", "samples": [{"hash": "79rynK2bvQS", "uri": "/contracts/79rynK2bvQS#social-support", "label": "General Service Agreement", "score": 24.4880219028, "published": true}], "hash": "3201daa5d33c29cc91ab154fe1ffac40", "id": 4}, {"size": 1, "snippet_links": [{"key": "the-original", "type": "definition", "offset": [63, 75]}, {"key": "strongly-disagree", "type": "clause", "offset": [215, 232]}, {"key": "strongly-agree", "type": "clause", "offset": [260, 274]}, {"key": "not-applicable", "type": "clause", "offset": [279, 293]}, {"key": "support-systems", "type": "clause", "offset": [359, 374]}, {"key": "for-students", "type": "clause", "offset": [375, 387]}, {"key": "study-team", "type": "clause", "offset": [536, 546]}, {"key": "rates-of", "type": "clause", "offset": [745, 753]}, {"key": "sexual-harassment", "type": "clause", "offset": [845, 862]}, {"key": "on-campus", "type": "definition", "offset": [863, 872]}, {"key": "for-help", "type": "definition", "offset": [900, 908]}, {"key": "members-of", "type": "clause", "offset": [1063, 1073]}], "snippet": "The 7-item social support scale was specifically developed for the original study. It measures students perceived social support following an incident of SH as victims or perpetrators. This 5-point Likert scale (1. Strongly disagree, 2. Disagree, 3. Agree, 4. Strongly agree, 5. Not applicable \u2018N/A\u2019) include questions that examine different levels of social support systems for students such as family, tribe, and friends. (Cronbach\u2019s alpha= 0.76). To understand potential influences of social support sources on bystander intentions, study team decided to investigate social support correlation with the outcomes of interest by support type (familial, friends, tribal) as dichotomous variables, except for tribal, where due to the high answer rates of \u2018N/A\u2019, this option was not recoded as missing. The three items used are: \u201cIf I experienced sexual harassment on campus, I could rely on my family for help\u201d, \u201cIf I experienced sexual harassment on campus, I could rely on my friends for help\u201d, and \u201cIf I experienced sexual harassment on campus, I could rely on members of my tribe for help.\u201d", "samples": [{"hash": "iDEojWjoJu5", "uri": "/contracts/iDEojWjoJu5#social-support", "label": "Distribution Agreement", "score": 31.5635014918, "published": true}], "hash": "0bf07d396d15f47fe6a507c1ef50fbc2", "id": 5}, {"size": 1, "snippet_links": [{"key": "one-unit", "type": "definition", "offset": [33, 41]}, {"key": "friends-and-family", "type": "definition", "offset": [211, 229]}, {"key": "demographic-variables", "type": "clause", "offset": [703, 724]}, {"key": "preference-of", "type": "clause", "offset": [831, 844]}, {"key": "middle-income", "type": "definition", "offset": [1124, 1137]}, {"key": "addition-of", "type": "clause", "offset": [1275, 1286]}, {"key": "higher-level", "type": "definition", "offset": [1458, 1470]}, {"key": "family-and-friends", "type": "definition", "offset": [1538, 1556]}, {"key": "results-of-the", "type": "clause", "offset": [1741, 1755]}, {"key": "appendix-1", "type": "clause", "offset": [1806, 1816]}, {"key": "chapter-3", "type": "definition", "offset": [1818, 1827]}, {"key": "members-of-the", "type": "clause", "offset": [3965, 3979]}, {"key": "likely-to-have", "type": "clause", "offset": [4034, 4048]}, {"key": "cardiac-rehabilitation", "type": "definition", "offset": [4067, 4089]}, {"key": "future-research", "type": "clause", "offset": [4304, 4319]}, {"key": "rehabilitation-phase", "type": "clause", "offset": [4425, 4445]}, {"key": "physical-activity", "type": "clause", "offset": [4597, 4614]}, {"key": "the-professional", "type": "clause", "offset": [4780, 4796]}, {"key": "lack-of-interest", "type": "clause", "offset": [4899, 4915]}, {"key": "physical-capabilities", "type": "clause", "offset": [5127, 5148]}, {"key": "target-population", "type": "definition", "offset": [5373, 5390]}, {"key": "given-that", "type": "clause", "offset": [5392, 5402]}, {"key": "risk-factors", "type": "definition", "offset": [5477, 5489]}, {"key": "older-people", "type": "clause", "offset": [5499, 5511]}, {"key": "social-environment", "type": "clause", "offset": [5585, 5603]}, {"key": "online-tools", "type": "definition", "offset": [5663, 5675]}, {"key": "our-results", "type": "clause", "offset": [5795, 5806]}, {"key": "personal-needs", "type": "definition", "offset": [5938, 5952]}, {"key": "with-regard-to", "type": "clause", "offset": [5980, 5994]}, {"key": "support-generally", "type": "clause", "offset": [6098, 6115]}, {"key": "other-studies", "type": "clause", "offset": [6333, 6346]}, {"key": "lower-levels", "type": "definition", "offset": [6554, 6566]}, {"key": "support-group", "type": "definition", "offset": [6754, 6767]}, {"key": "the-options", "type": "clause", "offset": [7117, 7128]}, {"key": "previous-studies", "type": "clause", "offset": [7294, 7310]}, {"key": "related-to", "type": "clause", "offset": [7407, 7417]}, {"key": "relationship-between", "type": "clause", "offset": [7584, 7604]}, {"key": "for-example", "type": "definition", "offset": [8036, 8047]}, {"key": "covid-19-pandemic", "type": "clause", "offset": [8066, 8083]}, {"key": "and-support", "type": "clause", "offset": [8281, 8292]}, {"key": "number-of-respondents", "type": "clause", "offset": [8352, 8373]}, {"key": "limitation-of", "type": "clause", "offset": [8438, 8451]}, {"key": "the-general", "type": "clause", "offset": [8575, 8586]}, {"key": "see-\u2587", "type": "clause", "offset": [8603, 8608]}, {"key": "responded-to", "type": "definition", "offset": [8691, 8703]}, {"key": "future-studies", "type": "clause", "offset": [8716, 8730]}, {"key": "digital-literacy", "type": "definition", "offset": [8889, 8905]}, {"key": "field-of", "type": "definition", "offset": [9351, 9359]}, {"key": "reliability-and-validity", "type": "clause", "offset": [9404, 9428]}, {"key": "to-develop", "type": "definition", "offset": [9461, 9471]}, {"key": "measures-to", "type": "clause", "offset": [9491, 9502]}, {"key": "type-of", "type": "definition", "offset": [9790, 9797]}, {"key": "development-and-use", "type": "clause", "offset": [10049, 10068]}, {"key": "underrepresented-groups", "type": "definition", "offset": [10121, 10144]}, {"key": "group-setting", "type": "definition", "offset": [10278, 10291]}, {"key": "changes-in", "type": "clause", "offset": [10335, 10345]}, {"key": "provision-of-a", "type": "clause", "offset": [10622, 10636]}, {"key": "the-individual", "type": "clause", "offset": [10675, 10689]}, {"key": "the-right", "type": "clause", "offset": [10774, 10783]}], "snippet": "If social support increased with one unit, likelihood of preferring being supported by a coach individually decreased with 30.1% (\u03c72(1) = 20.938, p < .001), while the likelihood of preferring being supported by friends and family increased with 39.3% (\u03c72(1) = 9.423, p = .002). We found no significant relationships between social support and being supported by a coach in a group, by a coach via an app or internet, working independently via an app or internet, having contact with CVD patients via an app or internet, or being self-supportive, without a coach, app/internet or family/friends. To check the relative importance of the predictors, we conducted multivariate logistic regressions with all demographic variables included. These analyses showed that all demographic variables were only significantly predictive for the preference of being self-supportive (\u03c72(7) = 25.476, p = .001), supported by a coach individually (\u03c72(7) = 45.185, p < .001), by a coach via an app or internet (\u03c72(7) = 31.665, p < .001), and by friends and family (\u03c72(7) = 14.813, p = .038). Men (p = .005), with a higher age (p = .017) and a middle income (compared to a low income; p = .037) were most likely to be self-supportive. This is in line with the univariate analyses, only with the addition of a middle income. Young- er patients (p < .001) with a lower level of social support (p < .001) were most likely to prefer support by a coach individually. Patients with a higher level of social support (p = .014) were most likely to prefer support by family and friends. Women (p = .001) with a younger age (p = .010) were most likely to prefer support by a coach via an app or internet. These results are all in line with the univari- ate analyses. All results of the multivariate logistic regressions can be found in Appendix 1. Chapter 3 Self- 136 43 \u03c72(1) = Exp(B) \u03c72(1) = 39 54 86 \u03c72(2) = 42 67 70 \u03c72(2) = Exp(B) \u03c72(1) = supportive (31.7%) (18.7%) 12.802, = 1.029 11.468, (29.1%) (27.6%) (26.3%) .390, p = (28.4%) (24.1%) (30.0%) 2.405, = 1.165 3.625, p < p= .823 p = p = .057 .001** .001** .300 Coach in 85 60 \u03c72(1) = Exp(B) \u03c72(1) = 20 46 78 \u03c72(2) = 33 66 46 \u03c72(2) = Exp(B) \u03c72(1) = a group (19.8%) (26.1%) 3.434, = .982 5.168, (14.9%) (23.5%) (23.9%) 4.820, p (22.3%) (23.7%) (19.7%) 1.191, p = .955 .311, p = p = = .090 = .551 p = .577 .064 .023* Coach 72 67 \u03c72(1) = Exp(B) \u03c72(1) = 27 42 69 \u03c72(2) = 37 55 47 \u03c72(2) = Exp(B) \u03c72(1) = individually (16.8%) (29.0%) 13,715, = .960 25.557, (20.1%) (21.4%) (21.1%) 0.82, p = (25.0%) (19.8%) (20.2%) 1.762, p = .695 20.938, p < p < .960 = .414 p < .001** .001** .001** Coach via 45 56 \u03c72(1) = Exp(B) \u03c72(1) = 16 30 55 \u03c72(2) = 25 48 28 \u03c72(2) = Exp(B) \u03c72(1) = an app or (10.5%) (24.3%) 22.158, = .965 15.062, (11.9%) (15.3%) (16.8%) 1.740, p (16.9%) (17.3%) (15.3%) 3.052, p = .887 1.697, internet p < p < = .419 = .217 p = .193 .001** .001** Friends and 75 24 \u03c72(1) = Exp(B) \u03c72(1) = 21 29 49 \u03c72(2) = 18 47 34 \u03c72(2) = Exp(B) \u03c72(1) = family (17.5%) (10.4%) 5.826, = 1.015 2.070, (15.7%) (14.8%) (15.0%) 0.051, p (12.2%) (16.9%) (14.6%) 1.755, p = 9.423, p = p = = .975 = .416 1.393 p = .016* .150 .002* Indepen- 54 35 \u03c72(1) = Exp(B) \u03c72(1) = 18 18 53 \u03c72(2) = 17 35 37 \u03c72(2) = Exp(B) \u03c72(1) = dently via (12.6%) (15.2%) .887, p = .989 1.143, (13.4%) (9.2%) (16.2%) 5.165, p (11.5%) (12.6%) (15.9%) 1.840, p = .845 3.060, an app or = .346 p = = .076 = .398 p = internet .285 .080 Contact with 26 (6.1%) 18 (7.8%) \u03c72(1) = Exp(B) \u03c72(1) = 9 (6.7%) 17 18 \u03c72(2) = 11 (7.4%) 23 10 \u03c72(2) = Exp(B) \u03c72(1) = CVD patients .749, p = .979 2.770, (8.7%) (5.5%) 1.969, p (8.3%) (4.3%) 3.400, = .792 3.359, via app = .387 p = = .374 p = p = .067 or internet .096 .183 * p < .05, ** p < .001 in behaviour change interventions, not only by using the direct network of the patient, but also by creating one in a digital environment (\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2015). Another explanation for the high preference for being self-supportive could be because of our sample. Members of the Harteraad panel represent a group of patients who are likely to have already underwent cardiac rehabilitation, who are more empowered and self-aware of their disease and its consequences. As they probably already learned about lifestyle management, they would be less likely to need any support. It would be interesting for future research to investi- gate whether CVD patients\u2019 lifestyle support preferences differ in the pre- and post-cardiac rehabilitation phase. Older patients also indicated to be less interested in lifestyle support from a coach, which could be explained by physical restrictions to engage in physical activity (\u2587\u2587 \u2587\u2587\u2587\u2587 et al., 2020a). As older patients might experience regular in- terventions as too physically challenging, or might have physical difficulties to even reach the professional\u2019s facilities, they could be less willing to engage in lifestyle support. Again, despite their current lack of interest, tailoring through eHealth could also be useful to promote lifestyle support among older patients (Aalbers et al., 2011). Using eHealth\u2019s tailoring capabilities to adapt programmes to older patients\u2019 individual physical capabilities could increase their accep- tance of lifestyle support, and help those older patients\u2019 who have difficulties in reaching the cardiac rehabilitation facilities. It would be worthwhile to consider offering eHealth to an older target population, given that studies show that eHealth interventions are effective in reducing cardiac risk factors among an older people (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2016). Furthermore, older people benefit from a good social environment while working on their lifestyle (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2016). Online tools could therefore be useful for them to get in touch with peers to help them engage in healthy behaviours. Nevertheless, our results indicate that there remains a need to increase the attractiveness of digital tools for an older target population to address their personal needs. Furthermore, our findings with regard to social support are in line with previ- ous studies. These show that patients with low levels of social support generally have more severe cardiac symptoms, but are also less adherent to interventions (McBrien et al., 2017; \u2587\u2587\u2587\u2587\u2587\u2587 et al., 2013). The support of a coach could therefore be particularly important for them. However, although other studies indicate that the social environment could be an important contributor to successful behaviour change (\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2018; McBrien et al., 2017; \u2587\u2587\u2587\u2587\u2587\u2587 et al., 2013), our results suggest that patients with lower levels of social support are less likely to prefer support from family and friends. This could be due to the lower availabil- ity of family and friends to do so. In that case, creating a social support group (e.g. in a digital environment) could be a solution (\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2016). It would be important though to further investigate whether patients with lower levels of social support would be interested in such forms of lifestyle interventions. Finally, with regard to the use of eHealth, it is interesting to see that there is a higher preference for the options in which a coach is involved, compared to the option in which eHealth is used either independently, or with other CVD patients. This result is in line with those of previous studies focused on eHealth interven- tions, which show that the presence of human support is positively related to intervention effectiveness and adherence (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2020; \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2018; \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 & \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2012). These findings could be due to a need of a relationship between patient and professional (\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2018), which is called the \u2018working alliance\u2019 in clinical terms (\u2587\u2587\u2587\u2587\u2587\u2587\u2587 & \u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2006). Studies show that a good working alliance is related to intervention adherence and effectiveness in face-to-face settings (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2013; \u2587\u2587\u2587\u2587\u2587\u2587 et al., 2000), but also within eHealth interventions (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al., 2018; \u2587\u2587\u2587\u2587\u2587\u2587 et al., 2012). As eHealth is becoming increasingly relevant, for example due to the recent COVID-19 pandemic (Bokolo, 2021), it is not unlikely that it will also be increasingly used within cardiac rehabilitation. However, our results show that it remains important to combine eHealth with human attention and support to meet the needs of CVD patients. Although we had a large number of respondents, and therefore a good repre- sentation of the CVD population, a limitation of our study was its digital nature. Although the gender distribution and age of our sample largely corresponds with those of the general CVD population (see \u2587.\u2587. \u2587\u2587 \u2587\u2587\u2587\u2587 et al., 2020b), it could be that mostly patients with digital affinity responded to our survey. Future studies could investigate lifestyle support preferences in face-to-face settings (e.g. rehabilitation centres), increasing the chances of including patients with low digital literacy. Furthermore, as mentioned previously, the Harteraad panel consists of CVD patients who are likely to have already underwent cardiac re- habilitation. We would advise future researchers to include CVD patients who did not start rehabilitation yet, to investigate how this might influence their life- style support preferences. Finally, although our questionnaire was developed with the expertise of researchers, professionals and experts in the field of CVD, our questions have not been tested for reliability and validity. We would advise future studies to develop valid and reliable measures to assess lifestyle support preferences. Our study contributes to the innovation of cardiac rehabilitation by not only investigating CVD patients\u2019 lifestyle support preferences, but also what demo- graphic variables predict these. Furthermore, we gained more specific knowl- edge about the type of eHealth or face-to-face intervention they would prefer. While the findings show that there is a need to increase the attractiveness of digital tools for older men, we also found that younger women are more positive about using eHealth. The increasing development and use of tele-revalidation could ensure that the needs of underrepresented groups within cardiac care (e.g. younger women) will be met by providing lifestyle support (which is often still provided face-to-face in a group setting) in a different way. Furthermore, although changes in society ask for an increasing use of eHealth (\u2587.\u2587. \u2587\u2587\u2587\u2587\u2587\u2587, 2021), our findings show that human contact remains essential during these in- novations. The findings could be applied in the provision of patient-centred care, and help collaborate patients and professionals in the provision of a lifestyle intervention that best fits the individual. For example, our findings could help professionals working in cardiac care provide the right type of lifestyle support to their patients, and eHealth developers in the innovation of lifestyle interventions that meet the needs and wishes of patients themselves. This would increase the attractiveness of lifestyle for CVD patients, leading to healthier lifestyles, and therefore a lower risk of future cardiac events.", "samples": [{"hash": "2KzegB3MX2Q", "uri": "/contracts/2KzegB3MX2Q#social-support", "label": "Human Support in Ehealth Lifestyle Interventions", "score": 24.099247091, "published": true}], "hash": "ef683cb164271c7c8346faa626510edf", "id": 6}, {"size": 1, "snippet_links": [], "snippet": "Definition", "samples": [{"hash": "jZqV3JxXdph", "uri": "/contracts/jZqV3JxXdph#social-support", "label": "Distribution Agreement", "score": 30.6611858914, "published": true}], "hash": "0b890b1926b90387673882e6ccae7fdc", "id": 7}, {"size": 1, "snippet_links": [{"key": "terms-of", "type": "definition", "offset": [205, 213]}, {"key": "associated-with", "type": "definition", "offset": [337, 352]}, {"key": "and-higher", "type": "clause", "offset": [545, 555]}, {"key": "social-networks", "type": "clause", "offset": [654, 669]}, {"key": "affected-by", "type": "definition", "offset": [688, 699]}, {"key": "over-time", "type": "clause", "offset": [728, 737]}, {"key": "significantly-higher", "type": "definition", "offset": [880, 900]}, {"key": "caring-for", "type": "definition", "offset": [917, 927]}, {"key": "maintenance-of", "type": "clause", "offset": [1241, 1255]}, {"key": "social-activities", "type": "definition", "offset": [1399, 1416]}, {"key": "the-individual", "type": "clause", "offset": [1514, 1528]}, {"key": "relate-to", "type": "definition", "offset": [1553, 1562]}, {"key": "relationships-with-others", "type": "clause", "offset": [1590, 1615]}, {"key": "consistent-with", "type": "clause", "offset": [1679, 1694]}, {"key": "type-1-diabetes", "type": "definition", "offset": [1837, 1852]}], "snippet": "The SAC framework (Lazarus & \u2587\u2587\u2587\u2587\u2587\u2587\u2587, 1984) describes social support as a resource that can modify the influence of appraisals of caregiving experience and coping ability and potentially modify outcome in terms of carer distress (\u2587\u2587\u2587\u2587\u2587 et al., 2003). \u2587\u2587\u2587\u2587\u2587 et al. (2003) studied carers of people with psychosis and found that coping was associated with social support and concluded that effective coping in caregivers of people with psychosis may improve with support from confidantes. Social support has also been associated with better health and higher life satisfaction in carers of people with psychosis (\u2587\u2587\u2587\u2587\u2587\u2587 & \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2011). However, carers\u2019 social networks can be negatively affected by their role and can diminish over time (\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, \u2587\u2587\u2587\u2587\u2587\u2587\u2587, & \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 1982; \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, \u2587\u2587\u2587\u2587\u2587\u2587\u2587, Bayer, & \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 1984). \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587 et al. (2005) found that carer burden was significantly higher among relatives caring for someone with schizophrenia who reported lower support from their social network and professionals. It is possible that carers who experience posttraumatic stress symptoms may be vulnerable to experiencing reduced social networks. Social support has been shown to be negatively correlated with the development and maintenance of PTSD (e.g., \u2587\u2587\u2587\u2587\u2587\u2587, \u2587\u2587\u2587\u2587\u2587\u2587\u2587, & \u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587\u2587, 2000). We know from the cognitive model of PTSD that people with persistent PTSD are likely to avoid social activities (\u2587\u2587\u2587\u2587\u2587\u2587 & \u2587\u2587\u2587\u2587\u2587, 2000). The \u201chere and now\u201d quality of intrusions may be interpreted as a sign by the individual that they are unable to relate to other people or that their relationships with others have permanently changed for the worse (\u2587\u2587\u2587\u2587\u2587\u2587 & \u2587\u2587\u2587\u2587\u2587, 2000). Consistent with this, \u2587\u2587\u2587\u2587\u2587\u2587 et al. (2012) found that social support was negatively associated with posttraumatic stress symptoms in mothers of children with type 1 diabetes.", "samples": [{"hash": "jc4MjJtXWyz", "uri": "/contracts/jc4MjJtXWyz#social-support", "label": "End User License Agreement", "score": 19.3880903491, "published": true}], "hash": "a20f924f7b092e36dbec6abab4442159", "id": 8}, {"size": 1, "snippet_links": [{"key": "water-treatment", "type": "definition", "offset": [83, 98]}, {"key": "in-the-case", "type": "clause", "offset": [170, 181]}, {"key": "filtered-water", "type": "definition", "offset": [203, 217]}, {"key": "where-non", "type": "clause", "offset": [324, 333]}, {"key": "product-names", "type": "clause", "offset": [367, 380]}, {"key": "associated-with", "type": "definition", "offset": [510, 525]}], "snippet": "Many communities discussed the role of social support in the adoption of household water treatment behavior. This theme was talked about from both a positive perspective in the case of neighbors sharing filtered water with those that did not have filters in the North program regions, as well as from a negative perspective where non-users called people who used the product names. Positive social support allowed people to overcome barriers such as difficulties adjusting to water treatment and the bad taste associated with chlorine-based treatment products:", "samples": [{"hash": "l2ZpJs7OeLo", "uri": "/contracts/l2ZpJs7OeLo#social-support", "label": "Distribution Agreement", "score": 24.3231642423, "published": true}], "hash": "f5e8e497ece186bf165afdda726756e4", "id": 9}, {"size": 1, "snippet_links": [{"key": "contractor-shall", "type": "clause", "offset": [0, 16]}, {"key": "protective-factors", "type": "definition", "offset": [60, 78]}, {"key": "health-care", "type": "definition", "offset": [125, 136]}, {"key": "legal-services", "type": "clause", "offset": [138, 152]}, {"key": "family-members", "type": "definition", "offset": [166, 180]}], "snippet": "Contractor shall include strategies for helping youth build protective factors such as connections with schools, employment, health care, legal services, appropriate family members and other caring adults.", "samples": [{"hash": "kEJg6FHrBUW", "uri": "/contracts/kEJg6FHrBUW#social-support", "label": "Standard Services Agreement", "score": 28.6848064986, "published": true}], "hash": "ba5e1e7cebeb0b0c96d6338fe0d82453", "id": 10}], "next_curs": "ClcSUWoVc35sYXdpbnNpZGVyY29udHJhY3RzcjMLEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2Ihdzb2NpYWwtc3VwcG9ydCMwMDAwMDAwYQyiAQJlbhgAIAA=", "clause": {"size": 17, "title": "Social Support", "children": [["", ""], ["target-population", "Target Population"], ["accidents", "Accidents"], ["independent-contractor", "INDEPENDENT CONTRACTOR"], ["insurance-and-bond", "INSURANCE AND BOND"]], "parents": [["protective-services", "PROTECTIVE SERVICES"], ["introduction", "Introduction"], ["prevailing-wages", "PREVAILING WAGES"], ["signatory", "SIGNATORY"], ["games-motivation-and-social-interaction-environment", "Games Motivation and Social Interaction Environment"]], "id": "social-support", "related": [["social-security", "Social Security", "Social Security"], ["social-media", "Social Media", "Social Media"], ["social-responsibility", "Social Responsibility", "Social Responsibility"], ["unemployment", "Unemployment", "Unemployment"], ["medicare", "Medicare", "Medicare"]], "related_snippets": [], "updated": "2025-07-07T12:37:39+00:00", "also_ask": ["What are the essential elements to include in a Social Support clause to ensure enforceability?", "How can parties strategically define the scope of 'social support' to align with their interests?", "What are the most common legal pitfalls or ambiguities in Social Support clauses?", "How do courts typically interpret and enforce Social Support obligations in similar agreements?", "How does the Social Support clause compare to related provisions in other jurisdictions or standard contracts?"], "drafting_tip": "Specify the types of social support provided to prevent misunderstandings; identify responsible parties to ensure accountability; set measurable standards to facilitate enforcement.", "explanation": "The Social Support clause outlines the obligations or provisions for providing assistance and resources to individuals or groups within the scope of an agreement. This may include access to counseling services, community programs, or other forms of support designed to promote well-being and address social needs. By specifying the types and extent of support available, the clause ensures that parties understand their responsibilities and the resources that can be accessed, ultimately fostering a supportive environment and addressing potential social challenges."}, "json": true, "cursor": ""}}