Social Support and Hindrance for Intervention Tasks

Abstract

The Social Support and Hindrance for Intervention Tasks (SSHIT) scale, developed by Van Denburg et al. (2025), is a specialized 16-item instrument designed to quantify the perceived levels of social support and hindrance offered by significant individuals to patients engaged in behavioral interventions for chronic pain. This measure focuses particularly on the support dynamics surrounding active participation in Pain-Coping Skills Training (PCST).

The instrument was initially validated within a randomized controlled trial involving adults suffering from hip or knee osteoarthritis and associated pain. Participants in the study underwent an eight-session, internet-based PCST program (e.g., painTRAINER). The scale’s development integrates established theoretical concepts of social support (e.g., Cutrona & Russell, 1990) with contemporary psychosocial pain management frameworks (Keefe & Somers, 2010; Kroon et al., 2014). The psychometric properties, including reliability and factor structure, have been reported, confirming its utility for assessing interpersonal influences on treatment engagement.

Keywords

Behavioral Intervention, Chronic Pain, Pain-Coping Skills Training, Social Support, Hindrance, Significant Others, Psychosocial Pain Management, Osteoarthritis.

Authors

Van Denburg, Alyssa N., Porter, Laura S., Somers, Tamara J., Keefe, Francis J., Rini, Christine.

Purpose

The core purpose of the Social Support and Hindrance for Intervention Tasks scale is to systematically quantify the environmental and interpersonal factors—specifically support and hindrance—originating from significant others, that may influence an individual’s engagement and success during behavioral interventions for chronic pain.

By assessing these variables both before (expectations) and after (experiences) the intervention, the scale provides crucial insights into how the social environment modulates treatment adherence and outcomes, particularly in skill-based programs like PCST. This data helps researchers and clinicians understand barriers and facilitators to treatment completion.

Construct

The SSHIT measures a multidimensional construct encompassing the patient’s perception of how their primary significant other (spouse, partner, or close confidant) influences their participation in specific therapeutic tasks. The scale is structured around two primary, distinct subscales: Support for learning and practicing pain-coping skills, and Hindrance to learning and practicing pain-coping skills.

The total measure consists of 16 items. The support subscale captures helpful behaviors (e.g., motivational encouragement, logistical assistance, problem-solving), while the hindrance subscale captures unhelpful behaviors (e.g., criticism, making time difficult, expressing doubt about the program’s value). These items collectively provide composite measures of the quality of the social environment relative to treatment engagement.

Validity

No data is Available. Further research is necessary to fully establish the scale’s predictive and concurrent validity within diverse clinical populations.

Reliability

The internal consistency of the SSHIT scales was rigorously assessed and found to be high across both measurement points (pre- and post-intervention). The reliability was calculated using Cronbach’s alpha, demonstrating excellent consistency for the support subscale and good to excellent consistency for the hindrance subscale.

Specifically, the Cronbach’s alpha values for the Support for learning and practicing pain-coping skills scale ranged from .97 (pre-intervention) to .92 (post-intervention). For the Hindrance to learning and practicing pain-coping skills scale, the alpha values ranged from .87 (pre-intervention) to .93 (post-intervention). These high reliability coefficients suggest that the items within each subscale consistently measure the intended underlying construct.

Factor Analysis

An exploratory factor analysis (EFA) was performed to confirm the hypothesized two-factor structure of the 16 items. The extraction method employed was principal axis factoring, and the rotation method utilized was oblique (direct oblimin), which is appropriate when factors are expected to be correlated.

The results of the EFA supported the segregation of items into their respective scales (Support and Hindrance). All items demonstrated strong loadings onto their intended factor, with factor loadings consistently reported at .60 or above, confirming the robust structural integrity of the instrument and its underlying dimensions.

Instrument

Test Type: Original

Format: Inventory/Questionnaire. Responses are gathered using a 6-point Likert-type scale, ranging from 1 (strongly disagree) to 6 (strongly agree). Raw item scores are subsequently averaged to derive composite measures.

Language Available: English

Population Group: Human; Male; Female

Age Group: Adulthood (18 years & older)

Population Details: The scale was initially developed and tested on a sample of individuals in the United States who were diagnosed with hip or knee osteoarthritis and experienced associated chronic pain, participating in an internet-based PCST program.

Test Methodology: The validation study incorporated a range of psychometric properties assessments, including test reliability analysis, internal consistency assessment, factor analysis, and exploratory factor analysis.

Keywords

Psychometrics, Randomized Controlled Trial, Internal Consistency, Cronbach’s Alpha, Factor Loadings, Exploratory Factor Analysis, PainTRAINER, PainCOACH.

Authors

Author ORCID Identifier: http://orcid.org/0000-0003-4380-3869 (Van Denburg, Alyssa N.)

Affiliation Email addresses: [email protected] (Van Denburg, Alyssa N.)

Correspondence Address: Van Denburg, Alyssa N.: Northwestern Medicine, Lake Forest Hospital, Canning Thoracic Institute, 1000 North Westmoreland Road, Level 1, Pavilion B, Lake Forest, Illinois, United States, 60045.

Permissions & Fee and Test Year

The scale may be used for research and teaching purposes. No fee is required for academic or research use. The scale was formally published in 2025 and is not approved for commercial use.

Reference’s

Van Denburg, A. N., Porter, L. S., Somers, T. J., Keefe, F. J., & Rini, C. (2025). Significant other support and hindrance for intervention tasks: Implications for interventions to improve health and well-being. Couple and Family Psychology: Research and Practice. Advance online publication. https://doi.org/10.1037/cfp0000271

Items of the Social Support and Hindrance for Intervention Tasks

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

This measure consists of 16 items which are worded slightly differently for pre- and post-intervention test administrations. The items assess two subscales: Support for learning and practicing pain-coping skills and Hindrance to learning and practicing pain-coping skills.Test items are available.

Part 1: Pre-Intervention Assessment (Expectations regarding painTRAINER)

Instructions: These questions ask about your “significant other”. This is the same person you answered questions about in the first questionnaire you completed today. That is:

• Your spouse or romantic partner, if you have one

• OR, if you do not have a spouse or partner, the one person you interact with on a regular basis who you are most likely to confide in and who you feel emotionally close to

Please think about this significant other as you answer the following questions.

We are interested in knowing how your significant other may respond to your participation in the painTRAINER study. The next questions ask about helpful things your significant other may do as you learn and practice pain-coping skills using painTRAINER.

For each question, check one box to indicate how much you disagree or agree that your significant other is likely to respond in these ways.

Response Scale:
1: Disagree strongly
2: Disagree
3: Disagree a little
4: Agree a little
5: Agree
6: Agree strongly

As I learn and practice pain-coping skills, I expect that my significant other will…

Item	1	2	3	4	5	6
Be supportive of what I am doing
Help me understand things I need to do
Ask me what he/she can do to help
Help me make time to do these activities
Offer helpful suggestions
Say or do things to reassure me
Help me solve any problems that arise
Help keep me motivated
Make it easier for me to do the program

The next questions ask about unhelpful things your significant other may do as you learn and practice pain-coping skills using the painTRAINER program.

For each question, check one box to indicate how much you disagree or agree that your significant other is likely to respond in these ways.

Response Scale:
1: Disagree strongly
2: Disagree
3: Disagree a little
4: Agree a little
5: Agree
6: Agree strongly

As I learn and practice pain-coping skills, I expect that my significant other will…

Item	1	2	3	4	5	6
Make it hard for me to find time to do these activities
Give me unwanted advice
Criticize the things I am doing
Make fun of the things I am doing
Think the program is a waste of time
Get irritated with me
Make it harder for me to do the program

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Part 2: Post-Intervention Assessment (Experiences regarding PainCOACH)

Instructions: These questions ask about your “significant other”—the same person you answered questions about in the first questionnaire you completed today. That is:

• Your spouse or romantic partner, if you have one

• OR, if you do not have a spouse or partner, the one person you interact with on a regular basis who you are most likely to confide in and who you feel emotionally close to

Please think about this significant other as you answer the following questions.

The following questions ask about helpful things your significant other may have done as you learned and practiced pain-coping skills in PainCOACH.

For each question, check one box to indicate how much you disagree or agree that your significant other responded in these ways.

Response Scale:
1: Disagree strongly
2: Disagree
3: Disagree a little
4: Agree a little
5: Agree
6: Agree strongly

My significant other…

Item	1	2	3	4	5	6
Was supportive of what I was doing
Helped me understand things I needed to do
Asked me what he/she could do to help
Helped me make time to do these activities
Offered helpful suggestions
Said or did things to reassure me
Helped me solve any problems that arose
Helped keep me motivated
Made it easier for me to do the program

The next questions ask about unhelpful things your significant other may have done as you learned and practiced pain-coping skills in PainCOACH.

For each question, check one box to indicate how much you disagree or agree that your significant other responded in these ways.

Response Scale:
1: Disagree strongly
2: Disagree
3: Disagree a little
4: Agree a little
5: Agree
6: Agree strongly

My significant other…

Item	1	2	3	4	5	6
Made it hard for me to find time to do these activities
Gave me unwanted advice
Criticized the things I was doing
Made fun of the things I was doing
Acted like he/she thought the program was a waste of time
Got irritated with me
Made it harder for me to do the program