TY - JOUR
T1 - Social networks and risk of delayed hospital arrival after acute stroke
AU - Dhand, Amar
AU - Luke, Douglas
AU - Lang, Catherine
AU - Tsiaklides, Michael
AU - Feske, Steven
AU - Lee, Jin Moo
N1 - Funding Information:
We were supported by National Center for Medical Rehabilitation Research (K23HD083489, PI: Dhand), American Heart Association (14CRP20080001, PI: Dhand), National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, PI: Corkey), National Institute of Neurological Disorders and Stroke (R01NS085419, PI: Lee), and the Football Players Health Study at Harvard University. The Football Players Health Study is funded by a grant from the National Football League Players Association. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Medical School, Harvard University or its affiliated academic health care centers, the National Football League Players Association, or Brigham and Women’s Hospital. We also wish to acknowledge Angela H. Kim, Karen Li, Abby Halm, and Liam McCafferty for aiding in manuscript preparation.
Publisher Copyright:
© 2019, The Author(s).
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Arriving rapidly to the hospital after a heart attack or stroke is critical for patients to be within time windows for treatment. Prior research in heart attacks has suggested a paradoxical role of the social environment: those who arrive early are surrounded by nonrelatives, while those who arrive late are surrounded by spouses or family members. Here, we used network methods to more deeply examine the influence of social context in stroke. We examined the relationship of personal social networks and arrival time in 175 stroke patients. Our results confirmed the paradox by showing that small and close-knit personal networks of highly familiar contacts, independent of demographic, clinical, and socioeconomic factors, were related to delay. The closed network structure led to constricted information flow in which patients and close confidants, absent outside perspectives, elected to watch-and-wait. Targeting patients with small, close-knit networks may be one strategy to improve response times.
AB - Arriving rapidly to the hospital after a heart attack or stroke is critical for patients to be within time windows for treatment. Prior research in heart attacks has suggested a paradoxical role of the social environment: those who arrive early are surrounded by nonrelatives, while those who arrive late are surrounded by spouses or family members. Here, we used network methods to more deeply examine the influence of social context in stroke. We examined the relationship of personal social networks and arrival time in 175 stroke patients. Our results confirmed the paradox by showing that small and close-knit personal networks of highly familiar contacts, independent of demographic, clinical, and socioeconomic factors, were related to delay. The closed network structure led to constricted information flow in which patients and close confidants, absent outside perspectives, elected to watch-and-wait. Targeting patients with small, close-knit networks may be one strategy to improve response times.
UR - http://www.scopus.com/inward/record.url?scp=85062965981&partnerID=8YFLogxK
U2 - 10.1038/s41467-019-09073-5
DO - 10.1038/s41467-019-09073-5
M3 - Article
C2 - 30872570
AN - SCOPUS:85062965981
SN - 2041-1723
VL - 10
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 1206
ER -