Social Network Intervention Research Articles

Effectiveness of a brief social network intervention for depressive symptoms among Chinese adolescents under major chronic stress

BackgroundFriendship networks have been found to protect adolescents from depressive symptoms, yet whether adolescents’ depressive symptoms can be alleviated or reduced by altering the characteristics of their friendship networks remains unknown. ObjectivesThis study aimed to examine the effectiveness of a social network intervention among Chinese adolescents suffering from major chronic stress by evaluating the change of friendship networks and depressive symptoms. MethodsA brief social network intervention, consisting of 4 face-to-face sessions once a month lasting 90 min each, was designed to facilitate friendship network formation and to optimize peer network structures. The participants were allocated to an intervention group (n = 311) or a control group (n = 1062) and were assessed four times over six months. Latent growth curve modeling was used to examine the intervention effect on network features and depressive symptoms. ResultsLatent growth curve analyses revealed that the students in the intervention group created more ties and dissolved fewer ties during the intervention, and the steep decreases of network density and proportions of reciprocity ties were offset. The intervention group also experienced a slower increase of depressive symptoms and decrease of perceived social support during the intervention. ConclusionsOur findings suggested that a brief social network intervention could effectively act on depressive symptoms among adolescents suffering from chronic major stress. This study shows the potential of network-based interventions to prevent adolescents from experiencing a risk of depression in a stressful context.

Interventions with Social Integration Components Addressing Psychosocial Outcomes of Young- and Middle-Aged Adult Cancer Individuals: A Systematic Review.

The majority of adult cancer patients/survivors encounter social challenges (e.g., obtaining social support, maintaining social relationships, feelings of social isolation). This systematic review summarizes intervention studies addressing social integration or social connectedness issues among young- and middle-aged cancer patients/survivors. We searched the PubMed, CINAHL, and Web of Science databases (January 2000-May 2021) to identify intervention studies that addressed social integration, social connectedness, social support, and social isolation for cancer patients/survivors in young- and middle-aged adulthood (18-64.9 years) through a randomized controlled trial (RCT). We categorized the interventions as technology-based, non-technology-based, and mixed-type (technology- and non-technology-based). A total of 28 studies were identified. These interventions demonstrated improved social outcomes (e.g., increased social support, decreased loneliness), increased awareness of available cancer-related resources, and better patient-reported outcomes among patients/survivors versus controls. Specifically, the use of internet-based discussion sessions was associated with improved social cohesion and social support. Receiving social support from peers through networking sites was associated with improved physical activity. Additionally, implementing mixed-type interventions led to better social support from peer survivors, less fear of social interactions, and improved social connectedness. Using existing technology- and/or non-technology-based platforms to facilitate social connectedness among cancer patients/survivors in young- or middle-aged adulthood can help them cope with stressful life circumstances and improve quality-of-life. Further interventions targeting social integration (e.g., social network interventions) are needed to improve the complex social integration challenges experienced by cancer patients and survivors.

Conceptualizing the peer contribution in Open Dialogue practice.

In English mental health services, people with their own experience of mental distress have trained as Open Dialogue practitioners and have been employed as peer practitioners, co-working as equals alongside workers with professional backgrounds in Network Meetings. The conceptual underpinnings of the peer practitioner role have been drawn from the principles and relational approach of Intentional Peer Support. These have significant similarities with Open Dialogue, in terms of philosophical and theoretical orientations, with a particular focus on what happens in the "between" of a relational encounter. However, there are also significant differences in how practice principles are conceptualized, particularly around areas such as mutuality and self-disclosure. This article offers an analysis of this conceptual territory drawing on the relevant literature. This is then taken forward with the teasing out of specific practice principles that capture the unique contribution that peer practitioners can bring to Open Dialogue practice. These are derived through discussions that took place in an Action Learning Set for peer practitioners who have been involved in delivering Open Dialogue services in mainstream mental health service settings. This was part of a wider research study entitled Open Dialogue: Development and Evaluation of a Social Network Intervention for Severe Mental Illness (ODDESSI). The principles address how peer practitioners may be particularly well-placed to offer attunement, validation, connection and mutuality, and self-disclosure - and hence how they may be able to contribute an additional dimension to dialogical practice.

The effectiveness of an additive informal social network intervention for forensic psychiatric outpatients: results of a randomized controlled trial.

A supportive social network is associated with better mental health and wellbeing, and less criminal behavior. Therefore, this study examined the effectiveness of an additive informal social network intervention to treatment as usual (TAU) among forensic psychiatric outpatients. An randomized controlled trial (RCT) was conducted in forensic psychiatric care, allocating eligible outpatients (N = 102) to TAU with an additive informal social network intervention or TAU alone. Participants receiving the additive intervention were matched to a trained community volunteer over 12 months. TAU consisted of forensic care (e.g., cognitive behavioral therapy and/or forensic flexible assertive community treatment). Follow-up assessments were conducted at 3, 6, 9, 12, and 18 months after baseline. The primary outcome was the between-group effect on mental wellbeing at 12 months. Between-group effects on secondary outcomes (e.g., general psychiatric functioning, hospitalization, criminal behavior) were explored. Intention-to-treat analyses showed non-significant between-group effects on mental wellbeing on average over time and at 12 months. However, significant between-group effects were found on hospitalization duration and criminal behavior. Specifically, TAU participants were hospitalized 2.1 times more days within 12 months and 4.1 more days within 18 months than participants in the additive intervention. Furthermore, TAU participants reported 2.9 times more criminal behaviors on average over time. There were no significant effects on other outcomes. Exploratory analyses revealed that sex, comorbidity, and substance use disorders moderated effects. This is the first RCT examining the effectiveness of an additive informal social network intervention in forensic psychiatric outpatients. Although no improvements were found on mental wellbeing, the additive intervention was effective in reducing hospitalization and criminal behavior. The findings suggest that forensic outpatient treatment can be optimized by collaborating with informal care initiatives aimed at improving social networks within the community. Future research is warranted to determine which specific patients might benefit from the intervention and if effects can be improved by extending the intervention duration and enhancing patient compliance.Clinical Trial Registration: [https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7163], identifier [NTR7163].

Non-pharmacotherapeutic Management of Alcohol Use Disorder in the Alaska Native Population: A Narrative Review.

Alcohol use disorder (AUD) is a leading preventable cause of death in the United States and has had a greater health impact on Alaska Natives than on any other racial group. To date, AUD in these communities has had wide-reaching negative impacts contributing to high rates of suicide, homicide, and accidents. A variety of genetic, experiential, social, and cultural factors have been associated with this trend. For decades, the Alaska Native subgroup has received inadequate treatment. The purpose of this review is to evaluate current trends in effective interventions and to help answer the question: What may comprise a successful non-pharmacotherapeutic interventional strategy to treat and prevent AUD in Alaska Natives?A database literature search was performed in September 2022 using the PubMed library. Search terms included (alcohol use disorder) AND ((Alaska OR Alaskan) Native). Inclusion criteria included full-text articles, a focus on specific non-pharmacotherapeutic treatment strategies, and a publication date after 2005. Studies that did not evaluate non-pharmacotherapeutic interventions, evaluated a population other than Alaska Natives, evaluated a disorder other than AUD,were written in a language other than English, or were editorials or opinion pieces were excluded. The selected studies were assessed for bias utilizing the Newcastle-Ottawa Scale (NOS). Twelve studies were included in this review. This review found that early social network intervention, incentive-driven programs, culturally-driven programs, and motivational interviewing are promising non-pharmacotherapeutic interventions in the treatment of AUD in Alaska Native communities. Evidence suggests that a shift in focus to the accentuation of protective factors and the mitigation of isolation as a risk factor, rather than on the reduction of more intractable risk factors, may be associated with improved outcomes in treating AUD. The literature also suggests that successful prevention strategies should be driven by indigenous knowledge and grounded in community and culture. This study has its limitations. These include a lack of direct comparisons between studies, a lack of pooled statistical analysis or synthesis, and a lack of quantitative analysis. Instead, the majority of data is gathered from more bias-prone cross-sectional studies and, thus, should be used to provide insight into potential risk factors and non-pharmacologic therapies effective in this population rather than as strong evidence in favor of one therapeutic regimen over another. For this, there is a need for more clinical trials evaluating treatments for AUD in this population.This review received support from the University of South Florida Department of Psychiatry. There were no sources of funding for this work from any institution. There are no competing financial or non-financial interests that may be interested in this work. This review is not registered. This review does not have a prepared protocol.

Patients’ and volunteer coaches’ experiences with an informal social network intervention in forensic psychiatric care: a qualitative analysis

Background:Improving supportive social networks in forensic psychiatric patients is deemed important due to the protective effects of such networks on both mental health problems and criminal recidivism. Informal interventions targeted at social network enhancement by community volunteers showed positive effects in various patient and offender populations. However, these interventions have not specifically been studied in forensic psychiatric populations. Therefore, forensic psychiatric outpatients’ and volunteer coaches’ experiences with an informal social network intervention were explored in this study.Methods:This qualitative study was based on semi-structured interviews conducted alongside an RCT. Forensic outpatients allocated to the additive informal social network intervention, and volunteer coaches, were interviewed 12 months after baseline assessment. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to identify and report patterns in the data.Results:We included 22 patients and 14 coaches in the study. The analysis of interviews revealed five main themes reflecting patients’ and coaches’ experiences: (1) dealing with patient receptivity, (2) developing social bonds, (3) receiving social support, (4) achieving meaningful change, and (5) using a personalized approach. Patient receptivity, including willingness, attitudes, and timing, was a common reported barrier affecting patients’ engagement in the intervention. Both patients’ and coaches’ experiences confirmed that the intervention can be meaningful in developing new social bonds between them, in which patients received social support. Despite, experiences of meaningful and sustainable changes in patients’ social situations were not clearly demonstrated. Coaches’ experiences revealed broadened worldviews and an enhanced sense of fulfillment and purpose. Finally, a personalized, relationship-oriented rather than goal-oriented approach was feasible and preferable.Conclusion:This qualitative study showed positive experiences of both forensic psychiatric outpatients and volunteer coaches with an informal social network intervention in addition to forensic psychiatric care. Notwithstanding the limitations, the study suggests that these additive interventions provide an opportunity for forensic outpatients to experience new positive social interactions with individuals in the community, which can initiate personal development. Barriers and facilitators to engagement are discussed to improve further development and implementation of the intervention.Trial registration:This study is registered at the Netherlands Trial Register (NTR7163, registration date: 16/04/2018).

A peer-led, school-based social network intervention for young people in the UK, promoting sexual health via social media and conversations with friends: intervention development and optimisation of STASH

BackgroundThe quality of school-based sex and relationships education (SRE) is variable in the UK. Digitally-based interventions can usefully supplement teacher-delivered lessons and positively impact sexual health knowledge. Designed to address gaps in core SRE knowledge, STASH (Sexually Transmitted infections And Sexual Health) is a peer-led social network intervention adapted from the successful ASSIST (A Stop Smoking in Schools Trial) model, and based on Diffusion of Innovation theory. This paper describes how the STASH intervention was developed and refined.MethodsDrawing on the Six Steps in Quality Intervention Development (6SQuID) framework, we tested a provisional programme theory through three iterative stages -: 1) evidence synthesis; 2) intervention co-production; and 3) adaptation - which incorporated evidence review, stakeholder consultation, and website co-development and piloting with young people, sexual health specialists, and educators. Multi-method results were analysed in a matrix of commonalities and differences.ResultsOver 21 months, intervention development comprised 20 activities within the three stages. 1) We identified gaps in SRE provision and online resources (e.g. around sexual consent, pleasure, digital literacy), and confirmed critical components including the core ASSIST peer nomination process, the support of schools, and alignment to the national curriculum. We reviewed candidate social media platforms, ruling out all except Facebook on basis of functionality restrictions which precluded their use for our purposes. 2) Drawing on these findings, as well as relevant behaviour change theories and core elements of the ASSIST model, we co-developed new content with young people and other stakeholders, tailored to sexual health and to delivery via closed Facebook groups, as well as face-to-face conversations. 3) A pilot in one school highlighted practical considerations, including around peer nomination, recruitment, awareness raising, and boundaries to message sharing. From this, a revised STASH intervention and programme theory were co-developed with stakeholders.ConclusionsSTASH intervention development required extensive adaptation from the ASSIST model. Although labour intensive, our robust co-development approach ensured that an optimised intervention was taken forward for feasibility testing. Evidencing a rigorous approach to operationalising existing intervention development guidance, this paper also highlights the significance of balancing competing stakeholder concerns, resource availability, and an ever-changing landscape for implementation.Trial registrationISRCTN97369178.

(986) Hyper Personalized Educational Social Network Intervention to Improve Health Equity in Transplantation

(986) Hyper Personalized Educational Social Network Intervention to Improve Health Equity in Transplantation

Social processes during recovery: an expansion of Kelly and Hoeppner’s biaxial formulation of recovery

Recent conceptualizations frame addiction recovery as a complex process involving changes across behavioral, physical, psychological, and social domains. These broad conceptualizations can be difficult to apply directly to research, making detailed models of individual dimensions necessary to guide empirical work and subsequent clinical interventions. We used Kelly and Hoeppner’s biaxial formulation of recovery as a basis for a detailed examination of social processes in recovery using social network approaches. We delineated how appraisal of situational risks and social network resources result in coping actions, and how repeated iterations of this process change a person’s social recovery capital over time. In addition, we incorporated the experience of interpersonal trauma and structural oppression and demonstrated how the model accommodates the complex issues often encountered during recovery. We present a measurable framework that can guide empirical testing of how social processes and social recovery capital change over time during recovery. The model presented here illuminates key factors in the recovery process that have the potential to support trauma- and social-network-informed interventions. We call for research that empirically tests this model in ways that will result in practical, trauma-informed social network interventions for people in recovery.

Assessing the Awareness of the Staff of a University of Medical Sciences about Organ Donation Following Brain Death

Background: Organ donation is fast becoming an important bioethical issue from a social perspective, because it is a humanitarian act with the goal of saving human lives and deliverance from suffering. Donation may be for research or, more often, healthy transplantable organs and tissues may be donated to be transplanted into another person. Organ donors are usually dead at the time of donation, though sometimes may be alive. The purpose of this study is to assess the awareness of the employees of a university of medical sciences, Tehran- Iran, about organ donation following brain death. Methods: A questionnaire containing ten questions regarding participant's knowledge about “organ donation” was filled. To evaluate the reliability of the questionnaire Cronbach's alpha method test was used. SPSS software was used for statistical analysis of the data. Findings: Out of 70 participants (those who answered the questionnaire), 61 were male (87.1%) and 9 were female (12.9%). Based on the education, most of the participants (36 people) were general practitioner with MBBS degree, masters and medical student (51.4%). Analyses of the collected data indicate that 60% of the 70participants are "familiar" with organ donation (P> 0.05). 72.9% of the participants expressed interest in having more information about organ donation. Conclusion: Motivating people to donate organ is a multi-approach task. It involves applying effective methods of teaching and learning, social network interventions and exposing educational content about organ donation for social media users.

Abstract P650: Addressing Cardiovascular Disease Inequities: Qualitative Process Evaluation From a Co-Investigation With Im/Migrants Exploring How to Sustain a Community-Driven, Social Network Intervention Using a Racism-Conscious Approach

Introduction: Health promotion programs focused on cardiovascular disease are underutilized with im/migrants. The one-time referral to group-based interventions model ignores (1) the complex sociocultural influences on behavior change and (2) the socio-historical context of migration, racialization of immigrants and refugees, and the roles these play in differential social integration of refugees. One solution may be to apply community-based participatory research (CBPR) and Public Health Critical Race Praxis (PHCRP) to social network interventions with opinion leaders. Yet, these interventions are challenging to scale. There is a critical need to understand how to scale community-driven social network interventions to effectively address cardiovascular disease inequities resulting from systemic racism experienced by im/migrant populations. Developed using CBPR and informed by PHCRP, this work builds upon Healthy Immigrant Community (HIC), a collaborative effort between Latinx and Somali im/migrant partners and Rochester Healthy Community Partnership. Our aim is to explore opinion leader recruitment, their characteristics, and expectations for HIC scale-up. Qualitative Hypothesis: Learning more about the opinion leaders’ background and experience in the Healthy Immigrant Community social network intervention will prepare us for a future efficacy study. Methods: We conducted a process evaluation by: (1) interviewing community partners who recruited opinion leaders (n=8) and (2) conducting three pre-intervention focus groups with opinion leaders (Latinx n=4; Somali women n=8; Somali men n=8). We used PHCRP to deductively form codes yet allowed for new ideas that arose from the data by inductively generating additional codes. Results: Interview participants described their decision-making process, qualities considered, recruitment strategies, and expectations for an implementation study. Focus group participants discussed their personal motivations for participation, how they hoped the study would help their community, and the barriers to health they experience because of structural determinism (macro-level forces that sustain inequities). Conclusions: This work will enhance our ability to translate HIC to other communities by expanding our knowledge of opinion leader characteristics that are important in a community-driven, social network intervention. Because social network interventions have been demonstrated to cause positive behavior change, further adapting these interventions in a community setting would be expected to provide a more effective approach compared to individually targeted behavior change strategies. Additionally, selecting OLs is neither time nor resource intensive and could enhance organizational strategies for implementing health promotion programming.

"Each Day We Lose a Little More": Visual Depictions of Family Caregiving for Persons with Dementia.

More than 11 million Americans provide unpaid care for people with dementia (PWD) and need emotional, financial, and physical support. This study explored how participants in Caregiver Speaks, a social networking and image-based storytelling intervention designed to help caregivers make meaning of caregiving, described their caregiving experiences and needs. Strategies of thematic analysis were used to identify patterns in 28 different caregivers' images (N = 59) and text interactions on social media. Caregivers identified as white (71.4%), as women (92.9%), and as an adult child or child-in-law of the PWD (85.7%). Through images and text, caregivers explained interrelated changes in their behaviors (e.g., managing dual roles), thoughts (e.g., realizing severity of illness), and feelings (e.g., trapped) throughout the caregiving process. Findings reiterate that caregiving changes significantly over time, that visual storytelling helps to concretely capture those changes, and that interventions are needed to respond to caregivers' hardships across the caregiving time span.

The effect of a multi-component school-based social network intervention on children’s body mass index: a four-arm intervention study

Objective: Schools are considered an important setting for stimulating healthy weight. The current study is unique in examining effects of a multi-component school-based social network intervention on children’s body mass index z-scores (zBMI). Methods: Four schools were randomly allocated to one of four conditions: a social network intervention using influence agents focusing on water consumption, physical activity, a combination of the two, or a passive control condition. Participants included a total of 201 6- to-11-year-old children (53.7% girls; M age = 8.51, SD age = 0.93). At baseline, 149 (76.0%) participants had a healthy weight, 29 (14.8%) had overweight and 18 (9.2%) had obesity. Results: Linear mixed effect models indicated that a multi-component school-based social network intervention targeting both water consumption and physical activity was most effective in decreasing children’s zBMI. Conclusion: This study suggests that schools can contribute to the intervention of childhood obesity—even without involving the parents—by targeting both children’s water consumption and physical activity through influential peers, but more research is needed to identify mechanisms of change.

Understanding Changes in Social Cannabis Use among Young Adults During the COVID-19 Pandemic: A Social Network Analysis.

As the COVID-19 pandemic has caused historic morbidity and mortality and disrupted young people's social relationships, little is known regarding change in young adults' social cannabis use following social distancing orders, or other factors associated with such changes before and during the pandemic. 108 young adult cannabis users in Los Angeles reported on their personal (egocentric) social network characteristics, cannabis use, and pandemic-related variables before (July 2019 - March 2020) and during the COVID-19 pandemic (August 2020 - August 2021). Multinomial logistic regression identified factors associated with increasing or maintaining the number of network members (alters) participants used cannabis with before and during the pandemic. Multilevel modeling identified ego- and alter-level factors associated with dyadic cannabis use between each ego and alter during the pandemic. Most participants (61%) decreased the number of alters they used cannabis with, 14% maintained, and 25% increased. Larger networks were associated with a lower risk of increasing (vs. decreasing); more supportive cannabis-using alters was associated with a lower risk of maintaining (vs. decreasing); relationship duration was associated with a greater risk of maintaining and increasing (vs. decreasing). During the COVID-19 pandemic (August 2020 - August 2021), participants were more likely to use cannabis with alters they also used alcohol with and alters who were perceived to have more positive attitudes towards cannabis. The present study identifies significant factors associated with changes in young adults' social cannabis use following pandemic-related social distancing. These findings may inform social network interventions for young adults who use cannabis with their network members amid such social restrictions.

The Effect of a Peer Social Support Network Intervention on Self-management of the Elderly With Type 2 Diabetes

Background: Participation in peer social groups could be used in health promotion programs for the elderly. The current study investigates the effectiveness of participation in a peer social support network intervention on the self-management of the elderly with type 2 diabetes. Methods: This research is a quasi-experimental study with a pre-test-pos-ttest design with a control group conducted in 2019. Two health centers were selected as research settings from a single district in Qom Province, Iran. From each center, 46 subjects were randomly selected. Subjects in the intervention group participated in a peer social support network for 3 months (12 sessions), and the control group received only usual care. The outcome variable was self-management. The components of this variable include the level of hemoglobin A1C (HbA1C), diabetes distress (measured with Diabetes Distress Scale), awareness (measured with Davoodi’s knowledge of diabetes questionnaire), attitude (measured with diabetes attitude scale [DAS-3]), self-efficacy (measured with diabetes empowerment scale, [DES-28]), weight and blood pressure. Subjects were evaluated at baseline and at a 6-month follow-up. The obtained data were analyzed using t-test, Chi-Square, and Fisher test in SPSS software, version 22. The significance level was set at less than 0.5. Results: The change in mean HbA1C of the intervention and control groups at baseline and 6-month follow-up was -0.7 and 0.1, respectively, which was significant (P≤0.0001). Moreover, the difference in changes in the mean values of diabetes distress (P=0.008), self-efficacy (P≤0.0001), and attitude (P≤0.0001) were significant. No significant changes were found in knowledge, weight, systolic and diastolic blood pressure (P>0.05). Conclusion: The formation of social support groups may help control blood sugar in the elderly with type 2 diabetes. Seemingly, social groups can mainly impact through psychological factors such as distress control, attitude improvement, and self-efficacy enhancement.

Understanding social network support, composition, and structure among cancer caregivers.

We examined the social network support, composition, and structure of pediatric cancer caregivers. We used a self-report survey to collect egocentric social network data from 107 caregivers of pediatric cancer patients and calculated descriptive statistics to examine cancer-related support network composition, function, and structure. We then ran logistic regressions to examine the relationships between network characteristics and overall satisfaction with social support. Family members were the most common source of emotional support and logistical support, and health care providers were the most common source of informational support. Participants perceived the "most helpful" forms of support as being: (1) emotional support from family and health care providers; (2) informational support from health care providers and other cancer caregivers; and (3) logistical support from family. Overall, caregivers wished that 9.8% of their network ties had provided more support, with family members being the most common alter type to disappoint caregivers and offer less support than needed/expected. Caregivers who reported higher network disappointment (having network members who offered less support than needed/expected) were significantly less satisfied with emotional support than those with lower network disappointment (Odds Ratio=0.18, p=0.02), and caregivers with higher network disappointment were significantly less satisfied with logistical support compared to those with lower network disappointment (Odds Ratio=0.14, p=0.01). Our results show differences in the nature of social support provided by different types of network members. These findings have implications for tailoring social network interventions to improve caregiver and family outcomes.

Demographic and HIV status diversities as mechanisms of social integration and segregation among Black sexual and gender minorities enrolled in a community-based social network intervention

Drawing on a social integration and intersectionality framework, this study advances a dynamic network understanding of the mechanisms that enable differential patterns of within-group social integration and segregation among Black sexual and gender minorities (BSGM). Specifically, in a cohort of BSGM (18–35 years of age, n = 340) participating in a community-based network intervention for HIV prevention, we examine how sexual, gender, age, and HIV status diversities contribute to friendship formation and maintenance patterns over the 12-month study enrollment period. We found attenuated social integration (or social activity) among non-gay-identified and older BSGM and evidence of social segregation (or homophily) on the basis of sexual identity and age similarities. Accounting for the moderating effects of the intervention revealed that the attenuated integration of non-gay-identified and older BSGM were stronger for participants who received the peer leadership training, and integration challenges were also found for transgender BSGM who received the peer leadership training. Meanwhile, BSGM living with HIV who received the peer leadership training were significantly more integrated than their counterparts in the control arm. These findings help us understand the complicated social fabric among BSGM and the dynamics that interventions for this community may have to contend with or alter.

Does mentoring improve the health of people in the community? A realist evaluation

Summary Mentoring is an intervention aimed at strengthening social networks of individuals by providing one-to-one support to develop a social network. While there is a lack of insight into how the social network intervention “mentoring” affects health outcomes, we used a realist evaluation approach to find out for whom and under what circumstances mentoring affects health. The study was conducted in the Netherlands. In phase 1, an initial program theory of mentoring was developed based on a group interview with participants and professionals engaged in mentoring, complemented by documents (previous studies, descriptions of interventions). In phase 2, the program theory was tested using interviews with 23 participants before and 16 after mentoring. Findings Mentoring strengthened the social network when two conditions were met. Firstly, mentoring coaches needed to be trained. Secondly, participants needed to have a pre-existing—albeit small—network and need to have some social skills. If the social network was strengthened, mentoring increased self-esteem and self-confidence and decreased experiences of depression and loneliness of participants through three mechanisms: (1) participants were acknowledged and their individual needs were accepted; (2) individual coping resources were improved; (3) capabilities to initiate the search for a social network and to be involved in a social network were realized. Applications Mentoring is a useful intervention to increase self-esteem and self-confidence and decrease experiences of depression and loneliness of participants if the two conditions are met. Therefore, mentors should be carefully trained to acknowledge and respond to participants’ individual needs for social bonds.

A Protocol of a Pilot Experimental Study Using Social Network Interventions to Examine the Social Contagion of Attitudes Towards Childhood Vaccination in Parental Social Networks

Increasing vaccination hesitancy that burdens global health and safety can be attributed to multiple reasons. Individuals’ social environment seems to be the catalyst for vaccination hesitancy perpetuation, thus it is important to examine the influence of different social network mechanisms in vaccination attitudes’ contagion. The proposed pilot experiment will examine the social contagion of childhood vaccination attitudes within a parental community using social network interventions. By identifying centrally-located people or groups of like-minded individuals from a parents’ community, we will examine whether the position of a person within a social group can have a greater impact in spreading positive vaccination messages to other community members. Parents will be recruited from social media and will be randomly assigned into three groups. Firstly, each group will participate in an online game to map their social networks and identify members with certain network position, who will then receive a short training about valid vaccination information provisions. All groups’ members will participate in daily vaccination discussion groups for one week, where the selected members will spread positive vaccination attitudes to others. We hypothesize that centrally located individuals and like-minded group of people will more likely cause a change on the childhood-vaccination attitudes and will sustain a long-term change at 3 months follow-up, compared to randomly located people.

Personal Social Networks and Relapses in Women With Substance Dependence: Application of the Theory of Planned Behavior.

Establishing positive network resources and rebuilding drug free networks are key components of recovery process for women with substance use disorder (SUDs). Theory of planned behavior (TPB) posits that behaviors are determined by behavioral intentions, which are determined by three factors: attitude toward the behavior, perceived behavioral control, and subjective norms. The current study applied TPB to examine whether women's personal social network characteristics (as subjective norms) were related to intentions towards, and/or a substance use relapse using prospective research design. Longitudinal data from 300 American women with SUD who received treatment at three county-funded, women-only intensive treatment programs was utilized for the current study. Bayesian estimation path analyses indicated that attitude and abstinence self-efficacy at intake were not related to intention at the 6-month follow-up, but abstinence self-efficacy was directly related to substance use relapse by 12 months. Personal social network characteristics, number of treatment related persons in personal social network and sobriety support were significantly associated with intention at 6 months. The interaction between the numbers of treatment related persons and density was found on intention, suggesting that density strengthens the relationship between treatment related persons in network and intention. Intention to use substance was associated with relapse to substance use behavior. Our findings support that personal social network characteristics can be considered as subjective norms in the TPB model. Personal social network interventions focusing on rebuilding consistent social norms against drug-using behaviors may decrease intention to use substance, which will lead to abstinence.