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1.
Eval Program Plann ; 103: 102410, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38367350

ABSTRACT

In this study we use personal network analysis to examine the social relationships taking place throughout programme implementation. Previous literature on psychosocial intervention has used network analysis techniques to examine: (a) the interaction between participants, (b) the facilitators' link to the intervention target group, (c) the transfer of knowledge between experts and facilitators, and (d) the interaction of facilitators with each other. However, there has been little research on how facilitators connect with other figures in their organisational context, impacting both intervention fidelity and the fit of the programme to the local context. In this study we combine the analysis of personal networks with qualitative interviews with 102 teachers in 72 schools in Barranquilla (Colombia), with whom we describe the implementation of the psychoeducational programmes Pisotón and Metodologías Flexibles. The results show that programme implementation networks not only rely on facilitators but also on the contribution of the schools' director of studies, the coupling with the regular classroom teachers, and occasional collaborations from the rest of the school staff. After conducting a cluster analysis, we detected the existence of two types of personal networks, some based on the functioning of highly cohesive teams and others with a greater level of centralisation around the head of studies. Implementation networks not only enable the implementation of programme activities, but also the integration of the programme into educational organisations. In the discussion we reflect on how the analysis of facilitators' personal networks can be used to improve the process of programme implementation.


Subject(s)
Educational Personnel , Humans , Program Evaluation , Schools
2.
J Appl Res Intellect Disabil ; 37(2): e13192, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38361391

ABSTRACT

BACKGROUND: Previous studies show that the personal support networks of people with intellectual disability are smaller and less diverse than those of people without intellectual disability. This article aims to compare the characteristics of the personal networks of young people with and without intellectual disability. METHOD: The Personal Network Analysis (McCarty, Revista Hispana Para El Análisis de Redes Sociales, 2010, 19, 242-271) was applied. The participants comprised 51 young people aged between 13 and 19, of whom 27 had an intellectual disability. The Egonet programme was used to compile information, and SPSS v.27 for the statistical analysis. RESULTS: Young people with intellectual disabilities have smaller personal networks than people without disability, while they also comprise more people with disability and fewer 'friends' and support people. CONCLUSIONS: The full social inclusion of people with intellectual disability requires schools, families, the community and the individual to work together to develop activities that help them initiate and maintain relationships, prioritising mainstream contexts.


Subject(s)
Disabled Persons , Intellectual Disability , Humans , Adolescent , Young Adult , Adult , Social Support , Research Design , Schools
3.
JMIR Public Health Surveill ; 10: e45429, 2024 Feb 06.
Article in English | MEDLINE | ID: mdl-38319703

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the social fabric. OBJECTIVE: We evaluated the associations between personal social networks and neurological function in people with multiple sclerosis (pwMS) and controls in the prepandemic and pandemic periods. METHODS: During the early pandemic (March-December 2020), 8 cohorts of pwMS and controls completed a questionnaire quantifying the structure and composition of their personal social networks, including the health behaviors of network members. Participants from 3 of the 8 cohorts had additionally completed the questionnaire before the pandemic (2017-2019). We assessed neurological function using 3 interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale-Revised (MSRS-R), and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function. We identified the network features associated with neurological function using paired 2-tailed t tests and covariate-adjusted regressions. RESULTS: In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 controls during the pandemic, having a higher percentage of network members with a perceived negative health influence was associated with worse disability in pwMS (MSRS-R: ß=2.181, 95% CI 1.082-3.279; P<.001) and poor physical function in controls (PROMIS Physical Function: ß=-5.707, 95% CI -7.405 to -4.010; P<.001). In the longitudinal analysis of 230 pwMS and 136 controls, the networks of all participants contracted, given an increase in constraint (pwMS-prepandemic: mean 52.24, SD 15.81; pwMS-pandemic: mean 56.77, SD 18.91; P=.006. Controls-prepandemic: mean 48.07, SD 13.36; controls-pandemic: mean 53.99, SD 16.31; P=.001) and a decrease in network size (pwMS-prepandemic: mean 8.02, SD 5.70; pwMS-pandemic: mean 6.63, SD 4.16; P=.003. Controls-prepandemic: mean 8.18, SD 4.05; controls-pandemic: mean 6.44, SD 3.92; P<.001), effective size (pwMS-prepandemic: mean 3.30, SD 1.59; pwMS-pandemic: mean 2.90, SD 1.50; P=.007. Controls-prepandemic: mean 3.85, SD 1.56; controls-pandemic: mean 3.40, SD 1.55; P=.01), and maximum degree (pwMS-prepandemic: mean 4.78, SD 1.86; pwMS-pandemic: mean 4.32, SD 1.92; P=.01. Controls-prepandemic: mean 5.38, SD 1.94; controls-pandemic: mean 4.55, SD 2.06; P<.001). These network changes were not associated with worsening function. The percentage of kin in the networks of pwMS increased (mean 46.06%, SD 29.34% to mean 54.36%, SD 30.16%; P=.003) during the pandemic, a change that was not seen in controls. CONCLUSIONS: Our findings suggest that high perceived negative health influence in the network was associated with worse function in all participants during the pandemic. The networks of all participants became tighter knit, and the percentage of kin in the networks of pwMS increased during the pandemic. Despite these perturbations in social connections, network changes from the prepandemic to the pandemic period were not associated with worsening function in all participants, suggesting possible resilience.


Subject(s)
COVID-19 , Multiple Sclerosis , Phenylenediamines , Humans , COVID-19/epidemiology , Case-Control Studies , Cross-Sectional Studies , Multiple Sclerosis/epidemiology , Pandemics
4.
Am J Med Genet C Semin Med Genet ; 196(1): e32064, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37740458

ABSTRACT

Research continues to demonstrate that the characteristics of one's social network could have an impact on the development of Alzheimer's disease. Given the predisposition of people with Down syndrome to develop Alzheimer's disease, analysis of their social networks has become an emerging focus. Previous pilot research demonstrated that the personal networks of people with DS could be quantitatively analyzed, with no difference between self-report and parent-proxy report. This manuscript focuses on a 12-month follow-up period with the same original participants (24 adults with Down syndrome). Their social networks demonstrated sustainability, but not improvement, as reported by people with DS (mean network size: 8.88; mean density: 0.73; mean constraint: 0.44; mean effective size: 3.58; mean max degree: 6.04; mean degree: 4.78) and their proxies (mean network size: 7.90; mean density: 0.82; mean constraint: 53.13; mean effective size: 2.87; mean max degree: 5.19; mean degree: 4.30). Intentional and continued efforts are likely needed in order to improve the social network measures of people with Down syndrome.


Subject(s)
Alzheimer Disease , Down Syndrome , Adult , Humans
5.
Soc Sci Med ; 329: 115968, 2023 07.
Article in English | MEDLINE | ID: mdl-37329720

ABSTRACT

Medical crowdfunding is an accessible alternative for individuals to meet their unaffordable health needs. This study explores the role of personal networks in medical crowdfunding performance from the perspective of tie strength and whether gender inequality persists in the returns of personal networks in this survival context, using bilateral data of both the ego and the alters collected from a large representative medical crowdfunding platform in China. It is found that kin ties play a fundamental and predominant role while pseudo-kin ties, being less strong than kin ties in terms of mutual sentiment and reciprocal obligations to help each other, play an accumulative role and are more influential in increasing crowdfunding performance, and neighbour and other role relations have the weakest effect and contribution. Importantly, women are not discriminated against when mobilizing personal networks for medical crowdfunding as they enjoy the same returns of most personal ties as men do.


Subject(s)
Crowdsourcing , Male , Humans , Female , Healthcare Financing , China
6.
Soc Networks ; 73: 114-129, 2023 May.
Article in English | MEDLINE | ID: mdl-36960419

ABSTRACT

Increasing research highlights heterogeneity in patterns of social network change, with growing evidence that these patterns are shaped in part by social structure. The role of social and structural neighborhood conditions in the addition and loss of kin and non-kin network members, however, has not been fully considered. In this paper, we argue that the residential neighborhood context can either facilitate or prevent the turnover of core network relationships in later life - a period of the life course characterized by heightened reliance on network ties and vulnerability to neighborhood conditions. Using longitudinal data from the National Social Life, Health, and Aging Project linked with data from the American Community Survey, we find that higher levels of neighborhood concentrated disadvantage are associated with the loss of older adults' kin and non-kin network members over time. Higher levels of perceived neighborhood social interaction, however, are associated with higher rates of adding non-kin network members and lower rates of adding kin network members over time. We suggest that neighborhood conditions, including older adults' perceptions of neighborhood social life, represent an underexplored influence on kin and non-kin social network dynamics, which could have implications for access to social resources later in the life course.

7.
Am J Med Genet A ; 191(3): 690-698, 2023 03.
Article in English | MEDLINE | ID: mdl-36437642

ABSTRACT

Studies in the neurotypical population have demonstrated that personal social networks can mitigate cognitive decline and the development of Alzheimer disease. To assess whether these benefits can also be extended to people with Down syndrome (DS), we studied whether and how personal networks can be measured in this population. We adapted a personal networks instrument previously created, validated, and implemented for the neurotypical population. We created two versions of the survey: one for participants with DS, ages 25 and older, and another for their study partners, who spent a minimum of 10 h/wk in a caregiver role. Participants with DS gave concordant data to those of study partners. Their personal networks included a median network size of 7.50, density 0.80, constraint 46.00, and effective size 3.07. Personal networks were composed of 50% kin, 80% who live within 15 miles, and 80% who eat a healthy diet. In this proof-of-principle study, we demonstrated that the personal networks of people with DS can be quantitatively analyzed, with no statistical difference between self-report and parent-proxy report. Future research efforts can now evaluate interventions to enhance personal networks for preventing Alzheimer disease in this population.


Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Down Syndrome , Humans , Adult , Down Syndrome/epidemiology , Down Syndrome/psychology , Alzheimer Disease/epidemiology , Caregivers , Social Networking
8.
Netw Sci (Camb Univ Press) ; 11(4): 632-656, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38223900

ABSTRACT

The social networks surrounding intimate couples provide them with bonding and bridging social capital and have been theorized to be associated with their well-being and relationship quality. These networks are multidimensional, featuring compositional (e.g., the proportion of family members vs. friends) and structural characteristics (e.g., density, degree of overlap between spouses' networks). Most previous studies of couple networks are based on partners' global ratings of their network characteristics or network data collected from one member of the dyad. This study presents the analysis of "duocentric networks" or the combined personal networks of both members of a couple, collected from 207 mixed-sex newlywed couples living in low-income neighborhoods of Harris County, TX. We conducted a pattern-centric analysis of compositional and structural features to identify distinct types of couple networks. We identified five qualitatively distinct network types (wife family-focused, husband family-focused, shared friends, wife friend-focused, and extremely disconnected). Couples' network types were associated with the quality of the relationships between couples and their network contacts (e.g., emotional support) but not with the quality of the couples' relationship with each other. We argue that duocentric networks provide appropriate data for measuring bonding and bridging capital in couple networks.

9.
Front Psychol ; 13: 848774, 2022.
Article in English | MEDLINE | ID: mdl-35519652

ABSTRACT

Anorexia is a serious threat to young women's wellbeing worldwide. The effectiveness of mental health intervention and treatment is often evaluated on the basis of changes in the personal networks; however, the development of such measures for young women with anorexia is constrained due to the lack of quantitative descriptions of their social networks. We aim to fill this substantial gap. In this paper, we identify the basic properties of these women's personal networks such as size, structure, and proportion of kin connections. The empirical analysis, using a concentric circles methodology, is based on 50 ego networks constructed on data drawn from interviews with Russian-speaking bloggers who have been diagnosed with anorexia and write about this condition. We conclude that young women with anorexia tend to support a limited number of social ties; they are prone to select women as alters, but do not have a preference to connect to their relatives. Further research is needed to elucidate whether these personal network characteristics are similar among women with anorexia who belong to different age, ethnic, cultural, and income groups.

10.
Soc Sci Res ; 102: 102643, 2022 02.
Article in English | MEDLINE | ID: mdl-35094768

ABSTRACT

Adult children are key confidants for their aging parents, often providing emotional and advisory supports. Still, adult children are not a guaranteed presence in older people's core discussion networks. Geographical distance is a leading explanation for why some children are excluded from the confidant network, but we hypothesize that certain parent- and dyadic-level factors make these intergenerational ties more or less resilient to distance. Using wave six of the Survey of Health, Ageing, and Retirement in Europe, we identified whether a living adult child was also a member of the parent's egocentric confidant network. We found that fifty-eight percent of children were excluded from a parent's network and that such network exclusion was more common the greater the distance between parent and child. Random slope logit models indicate that parents with higher education were less sensitive to longer distances when listing a child as a confidant, whereas poor parental health exacerbated distance consequences. We also observed regional differences, with Northern Europeans being more impervious to geographical distance than older adults living in areas of the continent considered most familistic. Together, results point to the contingency of distance, as a number of demographic factors and personal and social resources contribute to the elasticity of parent-child ties across geographic space.


Subject(s)
Adult Children , Social Support , Adult Children/psychology , Aged , Humans , Parents , Social Networking , White People
11.
PNAS Nexus ; 1(4): pgac195, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36714861

ABSTRACT

Culture and social structure are not separated analytical domains but intertwined phenomena observable in personal networks. Drawing on a personal networks dataset of migrants in the United States and Spain, we show that the country of origin, a proxy for diverse languages and cultural institutions, and religion may be predicted by specific combinations of personal network structural measures (closeness, clustering, betweenness, average degree, etc). We obtain similar results applying three different methods (a multinomial logistic regression, a Random Forest algorithm, and an artificial neural network). This finding is explained within the framework of the Grid/Group theory that has long posed the interdependence of social structural and cultural features of human groups.

12.
Genus ; 77(1): 17, 2021.
Article in English | MEDLINE | ID: mdl-34465924

ABSTRACT

The policies for containing the spread of the SARS-CoV2 virus include a number of measures aimed at reducing physical contacts. In this paper, we explore the potential impact of such containment measures on social relations of both young adults and the elderly in Italy. We propose two ego-centered network definitions accounting for physical distance in light of the COVID-19 containment measures: the easy-to-reach network, that represents an accessible source of support that can be activate in case of new lockdown; the accustomed-to-reach network, which includes proximity and habit to meet in person. The approach used for constructing personal (ego-centered) networks on data from the most recent release of Families and Social Subject survey allows us to bring to the foreground people exposed to relational vulnerability. The analysis of the most vulnerable individuals by age, gender, and place of residence reveals that living alone is often associated with a condition of relational vulnerability for both the elderly and for young adults.

13.
Soc Sci Med ; 283: 114204, 2021 08.
Article in English | MEDLINE | ID: mdl-34271369

ABSTRACT

Social isolation and international migration have potentially adverse effects on physical and mental health, and may compound each other when migrants have limited access to supportive social networks. This problem may be particularly serious in older age groups, who are more vulnerable to illness and isolation. We analyze population representative data from a detailed survey of social networks and health in the San Francisco Bay Area, U.S., to compare access to different types of social support and health outcomes among first-generation migrants, second-generation migrants, and nonmigrants between 50 and 70 years old (N = 674). We find that first-generation migrants report systematically lower levels of social support and poorer self-rated health compared to nonmigrants, even after controlling for sociodemographic characteristics. While social support is strongly and positively associated with health in the general population, this relationship is null or, in some cases, reversed among migrants in the first and second generations. These results provide further evidence that migration operates as an adverse social determinant of health, and suggest an isolation paradox: migrants are healthier than nonmigrants only at very low levels of social support, and they do not experience the same beneficial health effects of social support as nonmigrants.


Subject(s)
Transients and Migrants , Aged , Emigration and Immigration , Humans , Mental Health , Middle Aged , Population Dynamics , Social Support
14.
Health Place ; 69: 102545, 2021 05.
Article in English | MEDLINE | ID: mdl-33714179

ABSTRACT

BACKGROUND: While considerable research on adult binge drinking has focused on social influences, the potential role of social capital has been largely overlooked. This study examines the role of social capital, assessed in terms of both neighborhood and social network characteristics, in understanding adult binge drinking. METHODS: Adults ages 30-80 were randomly drawn from the RAND American Life Panel and completed an online survey (analytic sample n = 1383). The main predictor variables were neighborhood cohesion, neighborhood order, and social network density. Associations of social capital with past month binge drinking (any, number of days) were examined, controlling for demographic characteristics. RESULTS: Zero-inflated negative binominal regression analysis indicated that any binge drinking was more likely among adults who lived in highly ordered neighborhoods and who had denser social networks but was negatively associated with neighborhood cohesion. However, binge drinking was more frequent among those who lived in neighborhoods lacking order and who had sparser social networks, but had no association with neighborhood cohesion. Age was not found to moderate associations of social capital with binge drinking. CONCLUSIONS: Given that the associations of social capital with adult binge drinking behavior appear to differ by level of influence and type of drinking behavior, there is a need to gain a more nuanced understanding of these complex associations, including the mechanisms through which they operate.


Subject(s)
Binge Drinking , Social Capital , Adult , Aged , Aged, 80 and over , Binge Drinking/epidemiology , Humans , Middle Aged , Residence Characteristics , Social Support , Surveys and Questionnaires
15.
Soc Networks ; 64: 99-108, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32952277

ABSTRACT

Although it is widely accepted that personal networks influence health and illness, network recall remains a major concern. This concern is heightened when studying a population that is vulnerable to cognitive decline. Given these issues, we use data from the Social Network in Alzheimer Disease project to explore similarities and discrepancies between the network perceptions of focal participants and study partners. By leveraging data on a sample of older adults with normal cognition, mild cognitive impairment, and early stage dementia, we explore how cognitive impairment influences older adults' perceptions of their personal networks. We find that the average individual is more likely to omit weaker, peripheral ties from their self-reported networks than stronger, central ties. Despite observing only moderate levels of focal-partner corroboration across our sample, we find minimal evidence of perceptual differences across diagnostic groups. We offer two broad conclusions. First, self-reported network data, though imperfect, offer a reasonable account of the core people in one's life. Second, our findings assuage concerns that cognitively impaired older adults have skewed perceptions of their personal networks.

16.
Front Public Health ; 9: 770965, 2021.
Article in English | MEDLINE | ID: mdl-35004583

ABSTRACT

The COVID-19 pandemic and its related restrictions have affected the everyday life of older people. Advanced age is a significant predisposing factor for a more severe COVID-19 infection, increasing the risk for hospitalization and mortality. Even though restrictions have been, thus, well-grounded, they may also have had detrimental effects on the social well-being of older people. Personal networks and social activity are known protective factors against the premature decline in health and functioning, and it is widely acknowledged that social isolation increases feelings of loneliness, poor quality of life, and even the risk for diseases and disabilities among older adults. This qualitative study investigated changes in personal networks among community-dwelling oldest-old individuals (persons aged 80 and over) during the first and second waves of the COVID-19 pandemic in Finland. The data is part of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE85+) study, which is an ongoing large longitudinal population-based study in Finland. In this qualitative sub-study, we analyzed fifteen in-depth telephone interviews using directed content analyses and identified five types of changes in personal social networks during the pandemic. In type 1, all social contacts were significantly reduced due to official recommendations and fear of the virus. Type 2 included modified ways of being socially active i.e., by deploying new technology, and in type 3, social contacts increased during the lockdown. In type 4, personal social networks were changed unexpectedly or dramatically due to a death of a spouse, for example. In type 5, we observed stable social networks, which had not been affected by the pandemic. At an individual level, one person could have had different types of changes during the pandemic. These results highlight the heterogeneity of the oldest olds' personal social networks and changes related to them during the exceptional times of the COVID-19 pandemic. Social activity and personal networks play an important role in the well-being of the oldest old, but individual situations, needs, and preferences toward personal social networks should be taken into account when planning social activities, policies, and interventions.


Subject(s)
COVID-19 , Pandemics , Aged , Aged, 80 and over , Communicable Disease Control , Humans , Independent Living , Quality of Life , SARS-CoV-2 , Social Networking
17.
Ann Behav Med ; 55(5): 446-459, 2021 05 06.
Article in English | MEDLINE | ID: mdl-32970789

ABSTRACT

BACKGROUND: Sleep is an important, restorative behavior for health, yet many adults report troubled sleep. The existence of a support network may be beneficial for sleep quality, including as a buffer for stressful events, yet few studies have examined these relationships longitudinally. PURPOSE: To examine the causal effect of changes in personal network support on sleep quality both directly and as a buffer of negative life events among young and older adults. METHODS: The UC Berkeley Social Network survey collected data from young (21-30 year old, n = 475) and late middle-age (50-70 year old, n = 637) adults across three waves between 2015 and 2018. Participants reported on personal network characteristics, negative life events, and number of nights with trouble falling and staying asleep. Fixed effects models are used to examine causal relationships among each age cohort. RESULTS: Direct effects of network support on sleep quality were observed among older adults. Insufficient practical support predicted higher rates of trouble falling asleep (incident rate ratio [IRR] = 1.40, p < .01), while a desire for more social companions predicted lower rates of trouble staying asleep (IRR = 0.81, p < .01). Buffering effects of network support on sleep quality were observed among young adults. Changes in partnership status buffer the negative effects of the death of a close tie on trouble falling asleep (IRR = 0.75, p < .01) and persistent difficulties paying bills on trouble staying asleep (IRR = 0.45, p < 0.001) among young adults. CONCLUSIONS: This study provides evidence for the direct and buffering role of network support on sleep quality. Our results indicate that efforts to improve sleep quality should address personal networks and the support they provide, perhaps especially during times of stress for younger adults.


Subject(s)
Interpersonal Relations , Sleep , Social Networking , Adult , Aged , Causality , Female , Humans , Logistic Models , Longitudinal Studies , Male , Middle Aged , Poisson Distribution , Young Adult
18.
Soc Networks ; 63: 201-212, 2020 Oct.
Article in English | MEDLINE | ID: mdl-33100488

ABSTRACT

Capturing dynamics in high-risk personal networks is essential for preventing HIV transmission. Online social networking data offer incentive to augment traditional selfreported approaches for network enumeration. To explore what online networks reveal about dynamics among high-risk associates, we examine the relationship between egocentric confidant and sex networks and personal Facebook friendship networks of a cohort of young Black men who have sex with men. Although overlap exists between self-reported and Facebook associates, the stabilities of each were unrelated. Confidants who were also Facebook friends with a respondent were, however, more likely to be retained. Thus, Facebook networks contain stable confidants.

19.
J Gerontol B Psychol Sci Soc Sci ; 75(7): 1573-1584, 2020 08 13.
Article in English | MEDLINE | ID: mdl-30888040

ABSTRACT

OBJECTIVES: Integration into social networks reduces stress during adverse life events and improves coping with disability in late life. The aim was to investigate whether social network closure (frequent contact among ties) and balance (positive contact among ties) are associated with perceived stress. We expect lowest stress for older adults with highly closed and balanced networks. METHOD: Panel data on self-reported egocentric networks stem from the population-based Chicago Health, Aging, and Social Relations Study. Five waves were collected between 2002 and 2006, with 708 observations from 160 participants aged 50-68 years at baseline. Data include information on the participants' social relationships, that is, interaction frequency and relationship quality, for ego-alter ties and alter-alter ties, and participants' perceived stress. The analytical strategy used fixed- and random-effects models. RESULTS: Participants reporting the highest number of balanced relationships (positive ties among alters) experience least stress. This effect holds independently of sociodemographic confounders, loneliness, and network size. DISCUSSION: The absence of a stress-reducing effect from network closure suggests that balance matters more. Future research would benefit from considering balance when examining the characteristics of social networks that impinge on mental health outcomes in older adults.


Subject(s)
Social Networking , Stress, Psychological/epidemiology , Aged/psychology , Chicago/epidemiology , Female , Humans , Interpersonal Relations , Longitudinal Studies , Male , Middle Aged , Social Integration , Social Support , Socioeconomic Factors , Stress, Psychological/psychology
20.
BMC Public Health ; 19(1): 1520, 2019 Nov 14.
Article in English | MEDLINE | ID: mdl-31727032

ABSTRACT

BACKGROUND: Studies have shown that social networks influence health behaviors, including the adoption of health innovations. This study explored the potential for early adopters of community health worker-delivered injectable contraceptives (CHWDIC) to influence the uptake of this innovation by women in their social networks. METHODS: This Social Network Analysis (SNA) study was conducted in Gombe, Nigeria. Twenty women who were early adopters of the CHWDIC were recruited. Each participant (ego) listed ten women of reproductive age (alters) with whom they related. An interviewer-administered questionnaire was used to collect from each ego, data about the nature of her relationship with each alter (ego-alter relationship), whether she talked about CHWDIC with each alter, and whether her listed alters talked to each other about CHWDIC (alter-alter relationship). Data were also collected on age, marital status and education level for each ego and alter. Data were analyzed with UCINET social network analysis software. Variables of interest include homophilia (similarity), density (number of ties as a proportion of possible ties), degree (popularity) and betweeness (frequency of connecting actor pairs who otherwise might not communicate). RESULTS: There were 20 egos and 200 alters. Between two thirds (alters) and three quarters (egos) of the women were 30 years or older. All of the egos and 196 (98%) of alters were married. Most of the networks had similar (homophilic) actors according to certain sociodemographic characteristics - ethnicity, age, education and type of marriage. More than 90% of the networks had density greater than 50%, suggesting high cohesion in most networks. The majority of actors in these networks used injectable contraceptives. In some of the networks, few actors with the highest prominence (betweeness centrality) were not users of injectable contraceptives. CONCLUSION: The study illustrates the application and feasibility of ego SNA in identifying champions and opinion leaders among women of reproductive age group. It also shows the influence of social networks on the diffusion of community-based injectable contraceptives, and how homophilic and dense networks may have positive health externality. The interrelatedness of network members' decision to adopt a health innovation was also demonstrated by the findings of this study.


Subject(s)
Community Networks , Contraception Behavior , Contraceptive Agents , Diffusion of Innovation , Health Behavior , Patient Acceptance of Health Care , Social Networking , Adult , Community Health Workers , Decision Making , Delivery of Health Care/methods , Female , Health Services , Humans , Interpersonal Relations , Leadership , Nigeria , Social Support , Surveys and Questionnaires
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