SELF-REPORTED HEALTH AND DEPRESSION AMONG EIRA COHORT: A MODERATED MEDIATION MODEL OF SEX AND PERCEIVED SOCIAL SUPPORT

Raquel Sánchez Recio^1,2Bárbara Oliván-Blázquez^3*Fátima Méndez-López^4,5,6Santiago Gascon^3,5Ruth Martí-Lluch^5,7,8,9Edurne Zabaleta-Del-Olmo^10,11,12Olaya Tamayo-Morales^13,14,5Jose Angel Maderuelo-Fernandez^13,14,5Marc Casajuana¹¹Tomàs López-Jiménez¹¹Emma Motrico^15,5Irene Gómez Gómez^16,5Álvaro Sánchez-Pérez^17,18,5Maria Luisa Rodero-Cosano¹⁶Joan Llobera-Canaves^19,20,5Juan Angel Bellon^21,22,23,5Patricia Moreno-Peral^24,5Bonaventura Bolíbar^11,5,9Jose I Recio-Rodriguez^13,5Rafel Ramos^25,26,5,7Ana Clavería^27,5

• ¹Zaragoza Penitentiary Center, Zaragoza, Spain
• ²Research Group on Health Services in Aragon (GRISSA), Institute for Health Research Aragon (IIS Aragón), Zaragoza, Aragon, Spain
• ³Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
• ⁴Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
• ⁵Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
• ⁶GAIAP Research Group, Zaragoza, Aragon, Spain
• ⁷Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l'Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
• ⁸Parc Hospitalari Martí Julià, Institute of Biomedical Research of Girona, Girona, Catalonia, Spain
• ⁹Autonomous University of Barcelona, Barcelona, Catalonia, Spain
• ¹⁰Nursing Department, University of Girona, Girona, Catalonia, Spain
• ¹¹Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Cornellà de Llobregat, Spain
• ¹²Catalan Health Institute (ICS), Barcelona, Catalonia, Spain
• ¹³Primary Care Research of Salamanca, Salamanca Primary Care Management, Salamanca, Spain
• ¹⁴Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, Spain
• ¹⁵Departamento de Psicología Evolutiva y de la Educación, Sevilla University, Seville, Andalucia, Spain
• ¹⁶Universidad de Loyola, Sevilla, Spain
• ¹⁷Grupo de Investigación en ciencias de la diseminación e implementación en servicios de salud, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
• ¹⁸Unidad de Investigación Atención Primaria de Bizkaia. Subdirección para la Coordinación de la Atención Primaria, Dirección General Osakidetza, Bizkaia, Spain
• ¹⁹Primary Care Research Unit of Mallorca, Balearic Public Health Service, Palma, Spain
• ²⁰GrAPP-caIB, Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Balearic Islands, Spain
• ²¹Biomedical Research Institute of Malaga, University of Malaga, Málaga, Andalusia, Spain
• ²²El Palo Health Centre, Andusian Health Service, Seville, Andalucia, Spain
• ²³Department of Public Health and Psychiatry, University of Malaga, Málaga, Andalusia, Spain
• ²⁴University of Malaga, Málaga, Andalusia, Spain
• ²⁵Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
• ²⁶Primary Care Services, Catalan Health Institute (ICS), Barcelona, Catalonia, Spain
• ²⁷Galicia South Health Research Institute, Vigo, Spain

Background: The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim: This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods: A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results: 3,062 people (54.9% women) participated in the study. Men reported experiencing more social support and self-perceived health (p<0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, postintervention, those women (bsimple=-2.9867, p<0.001) and males (bsimple=-1.4337, p<0.001) who scored lower in depression reported higher social support.In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population's health, especially in adults and more specifically in women. Trial registration ClinicalTrials.gov, NCT03136211. Registered 2 May 2017, "retrospectively registered".