Social network diagnostics: a tool for monitoring group interventions

Sabina B Gesell, Shari L Barkin, Thomas W Valente, Sabina B Gesell, Shari L Barkin, Thomas W Valente

Abstract

Background: Many behavioral interventions designed to improve health outcomes are delivered in group settings. To date, however, group interventions have not been evaluated to determine if the groups generate interaction among members and how changes in group interaction may affect program outcomes at the individual or group level.

Methods: This article presents a model and practical tool for monitoring how social ties and social structure are changing within the group during program implementation. The approach is based on social network analysis and has two phases: collecting network measurements at strategic intervention points to determine if group dynamics are evolving in ways anticipated by the intervention, and providing the results back to the group leader to guide implementation next steps. This process aims to initially increase network connectivity and ultimately accelerate the diffusion of desirable behaviors through the new network. This article presents the Social Network Diagnostic Tool and, as proof of concept, pilot data collected during the formative phase of a childhood obesity intervention.

Results: The number of reported advice partners and discussion partners increased during program implementation. Density, the number of ties among people in the network expressed as a percentage of all possible ties, increased from 0.082 to 0.182 (p < 0.05) in the advice network, and from 0.027 to 0.055 (p > 0.05) in the discussion network.

Conclusions: The observed two-fold increase in network density represents a significant shift in advice partners over the intervention period. Using the Social Network Tool to empirically guide program activities of an obesity intervention was feasible.

Figures

Figure 1
Figure 1
Action plan for interventionist to increase small group cohesion. Based on network diagnostic tool results.
Figure 2
Figure 2
Evolution of social networks during the intervention period. (a). Advice networks at weeks four and twelve. (b). Discussion networks at weeks four and twelve. Density, the proportion of links in the network, increased from 0.082 to 0.182 in the advice network (t = 2.13, p < 0.05); and from 0.027 to 0.055 in the discussion network (t = 1.02, p > 0.05). This greater than two-fold increase represents a substantial shift in reported network partners over eight weeks of programmatic activity.
Figure 3
Figure 3
Network density for advice and discussion networks at weeks four and twelve. The density of the advice network and the density of the discussion network each increased from weeks four (wave two) to twelve (wave three). The number of reported advice partners and discussion partners increased but the density values are depressed by the four non-participants who did not provide nominations and were not nominated due to their non-participation.

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