"The purpose of this dissertation is to examine the relationship between social support and self-management behaviors of medication adherence and diet modification among emerging adults (ages 18-29) with Inflammatory Bowel Disease (IBD). Manuscript one is a systematic review of the relationship between social support and self-management behaviors among adults with IBD. The review of literature identified 430 articles; seven articles met review inclusion criteria of adults (age 18 or older) with a diagnosis of IBD and measured social support and self-management behaviors. Articles with significant findings reported a positive relationship between social support and self-management behaviors. As age decreased, self-management behaviors also decreased. These findings informed the emphasis on emerging adults in manuscripts two and three. Manuscripts two and three used a convenience sample of emerging adults (ages 18-29) with a health care provider diagnosis of ulcerative colitis or Crohn's disease. All participants were recruited through Research Match, Facebook, and word of mouth. Participants were excluded if they were pregnant or lived outside of the United States. Sixty-one emerging adults met study criteria; the majority of participants were female (n=55, 90%), single (n=47, 77%), and diagnosed with Crohn's disease (n=39, 64%). Manuscript two examines the individual, condition-specific, and emerging adulthood factors influencing received social support among emerging adults with IBD. Increased total received social support was associated with decreased age (p = 0.001), being married (p = 0.039) and having employment full-time compared to being unemployed or a student (p = 0.007). Increased emotional support was associated with decreased age (p = 0.033) and being married (p = 0.001). For condition-specific factors, the use of immunomodulators (p < 0.001), biologics (p = 0.002) and the interaction between immunomodulators and biologics (p < 0.001) was associated with increased tangible social support when controlling for time since diagnosis and symptom frequency. Finally, emerging adulthood factors were not associated with received social support. Manuscript three examines the relationship between received social support and self-management behaviors of medication adherence and diet modification and examines how perceived availability of social support may moderate this relationship. Seventy-three percent of participants reported medication adherence and sixty-four percent reported modifying their diet. Low informational received social support was associated with medication non-adherence compared to high informational received social support (p = 0.023). Perceived availability of social support did not moderate the relationship between social support and self-management behaviors. Received social support was not associated with diet modification. The findings from these manuscripts advance science by demonstrating the need to improve self-management behaviors among emerging adults with IBD. Results can assist healthcare providers in identifying emerging adults who may receive less social support. Also, interventions aimed at improving informational received social support may improve medication adherence. Future research should examine received social support among emerging adults with IBD who are experiencing more frequent symptoms or increased symptom severity and those who are recently diagnosed. Additional research is needed to determine the factors which influence self-management behaviors of medication adherence and diet modification among emerging adults with IBD."--Pages ii-iii.
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