Egocentric networks and physical activity outcomes in Latinas

Understanding family functioning in mothers and daughters with obesity

PURPOSE

This study sought to understand family functioning surrounding weight in Mexican American women with obesity.

METHODS

Semi-structured in-depth interviews were conducted with mothers and adult daughters (N = 116).

RESULTS

Thematic analysis identified five themes. 1) The communication process drives perception of supportive messages. Messages perceived as non-supportive consist of directives as interventions, confirmation of faults, and critical compliments whereas supportive consist of compliments, encouragement, empathetic listening, and disclosure. 2) Acculturation differences interfere with intergenerational alliance. Differences involve dissonance in communication, behavioural expectations, and weight-related practices. 3) Maladaptive conflict responses contribute to relational strain. These responses include avoidance, withdrawal, and defensiveness. 4) Role transformations alter the generational hierarchical relationship. Daughters serve as role models, caregivers, or collaborators. 5) Low communal coping heightens psychological distress. It does so by challenging family roles, increasing social isolation, and compromising social support.

CONCLUSION

Obesity interventions for Mexican American women may benefit from targeting relational skills to improve family functioning.

Assessing Social Network Influences on Adult Physical Activity Using Social Network Analysis: A Systematic Review

OBJECTIVE

Social network analysis (SNA) can measure social connectedness and assess impact of interpersonal connections on health behaviors, including physical activity (PA). This paper aims to systematically review adult PA studies using SNA to understand important social network concepts relative to PA.

DATA SOURCE

A search was performed using PsycINFO, MEDLINE, PubMed, and Web of Science.

STUDY INCLUSION AND EXCLUSION CRITERIA

To be included in the search, articles needed to 1) include a measure of PA, 2) conduct an SNA in which specific relationships were measured, and 3) conduct an analysis between social network measures and PA.

DATA EXTRACTION

Key study elements including network design and results were extracted.

DATA SYNTHESIS

Data were synthesized to answer 2 questions: 1) how has adult PA been investigated using SNA approaches and 2) how is an adult's social network associated with PA behaviors?

RESULTS

A final sample of 28 articles remained from an initial 11 085 articles. Network size, homophily, network composition, and network exposure to PA were all associated with individual level PA across studies. Lastly, longitudinal and intervention studies showed a more complex picture of social influence and diffusion of PA behavior.

CONCLUSIONS

Adults' PA behaviors are influenced by their networks. Capitalizing on this influence, researchers should engage not just individual behavior change but also the social influences present within the person's life.

Egocentric social network characteristics and cardiovascular risk among patients with hypertension or diabetes in western Kenya: a cross-sectional analysis from the BIGPIC trial

OBJECTIVES

Management of cardiovascular disease (CVD) is an urgent challenge in low-income and middle-income countries, and interventions may require appraisal of patients' social networks to guide implementation. The purpose of this study is to determine whether egocentric social network characteristics (SNCs) of patients with chronic disease in western Kenya are associated with overall CVD risk and individual CVD risk factors.

DESIGN

Cross-sectional analysis of enrollment data (2017-2018) from the Bridging Income Generation with GrouP Integrated Care trial. Non-overlapping trust-only, health advice-only and multiplex (trust and health advice) egocentric social networks were elicited for each participant, and SNCs representing social cohesion were calculated.

SETTING

24 communities across four counties in western Kenya.

PARTICIPANTS

Participants (n=2890) were ≥35 years old with diabetes (fasting glucose ≥7 mmol/L) or hypertension.

PRIMARY AND SECONDARY OUTCOMES

We hypothesised that SNCs would be associated with CVD risk status (QRISK3 score). Secondary outcomes were individual CVD risk factors.

RESULTS

Among the 2890 participants, 2020 (70%) were women, and mean (SD) age was 60.7 (12.1) years. Forty-four per cent of participants had elevated QRISK3 score (≥10%). No relationship was observed between QRISK3 level and SNCs. In unadjusted comparisons, participants with any individuals in their trust network were more likely to report a good than a poor diet (41% vs 21%). SNCs for the trust and multiplex networks accounted for a substantial fraction of variation in measures of dietary quality and physical activity (statistically significant via likelihood ratio test, adjusted for false discovery rate).

CONCLUSION

SNCs indicative of social cohesion appear to be associated with individual behavioural CVD risk factors, although not with overall CVD risk score. Understanding how SNCs of patients with chronic diseases relate to modifiable CVD risk factors could help inform network-based interventions.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov identifier: NCT02501746; https://clinicaltrials.gov/ct2/show/NCT02501746.

Association between social network structure and physical activity in middle-aged Korean adults

PURPOSE

Evidence suggests that physical activity participation is shaped through a myriad of structural aspects of social relationships. We examined the relationship between social network structure based on egocentric social network and physical activity.

METHODS

From 6799 middle-aged Korean adults, we assessed the social network density and proportion of closed triads, using the name generator module. Self-reported physical activity for functional and leisure purposes was calculated in metabolic equivalent of task (MET)-min/week. We employed sex-stratified, multivariable linear regression to assess the association between each network structure variable and total physical activity, adjusting for age, network size, socioeconomic status, and comorbidities. We also examined the association with moderate-to-vigorous physical activity (MVPA) and wrist-worn accelerometer assessed physical activity.

RESULTS

The network members of female participants were more likely to be of same sex and family member compared to those of males. There were no sex differences in average network size. Network density based on affiliation was sex-differentially associated with physical activity (male β -346.7, p 0.2221 and female β -528.6, p 0.0002). In parallel, the proportion of closed triads was negatively associated with physical activity only in females (male β -542.6, p 0.0551 and female β -641.51, p < 0.0001). However, network density and closed triads were insignificantly yet positively associated with MVPA in male (density β 229.7, p 0.3193 and closed triad β 109.21, p 0.6333). Network structure by contact frequency or emotional closeness and accelerometer-assessed physical activity showed inconsistent results.

CONCLUSION

Understanding the role of social network structures can help to achieve ideal physical activity level in the context of primary prevention of cardiometabolic disorders.

Reproductive health decision making among nomadic pastoralists in North Eastern Kenya: a qualitative social network analysis

BACKGROUND

To our knowledge, no studies exist on the influence of nomadic pastoralist women's networks on their reproductive and sexual health (RSH), including uptake of modern family planning (FP).

METHODS

Using name generator questions, we carried out qualitative egocentric social network analysis (SNA) to explore the networks of four women. Networks were analyzed in R, visuals created in Visone and a framework approach used for the qualitative data.

RESULTS

Women named 10-12 individuals. Husbands were key in RSH decisions and never supported modern FP use. Women were unsure who supported their use of modern FP and we found evidence for a norm against it within their networks.

CONCLUSIONS

Egocentric SNA proves valuable to exploring RSH reference groups, particularly where there exists little prior research. Pastoralist women's networks likely change as a result of migration and conflict; however, husbands make RSH decisions and mothers and female neighbors provide key support in broader RSH issues. Interventions to increase awareness of modern FP should engage with women's wider networks.

Friends, physical activity, and sedentary behavior in university students: A social network analysis

Introduction: Understanding the processes of socialization during youth and their association with healthy behaviors is crucial for university education. Objective: To explore the associations of the characteristics of friendship networks with being physically active and having a sedentary behavior in university students. Materials and methods: Cross-sectional study conducted in 475 university students and based on a social network analysis. Measurements included sociodemographic, physical activity, sedentary behavior, and friendship network variables. The associations between the characteristics of friendship networks and physical activity and sedentary behavior were explored using logistic regression models. Confidence intervals (95%) were estimated and a significance level of p<0.05 was considered. Results: In women, being part of at least a cluster of friends was significantly associated with being physically active (adjusted OR [aOR]: 2.3; 95%CI: 1.2-4.6), while being popular was significantly associated with a lower probability of being physically active (aOR: 0.3; 95%CI: 0.1-0.7). Also, a ten-percentage point increase in active friends was significantly associated with a higher probability of being physically active (aOR: 9.3; 95%CI: 3.5-24.6). Regarding sedentary behavior, a ten-percentage point increase in the number of sedentary friends was significantly associated with a higher probability of being sedentary (aOR: 5.5; 95%CI: 2.5-12.3). In men, none of the studied associations were statistically significant. Conclusion: Some characteristics of social network are relevant for female university students in relation to their physical activity levels and sedentary behaviors. These findings highlight the need to consider friendship network dynamics for designing initiatives aimed at physical activity promotion and sedentary behavior reduction.

Association of Social Network Characteristics With Cardiovascular Health and Coronary Artery Calcium in South Asian Adults in the United States: The MASALA Cohort Study

Background

South Asian adults have worse cardiovascular health (CVH) and more coronary artery calcium compared with other race/ethnicities. The impact of the social environment has not been examined as a potential driver of CVH or coronary artery calcium in this population. We evaluated associations of social network characteristics with CVH and coronary artery calcium in South Asian American adults to inform strategies for CVH promotion in this at‐risk population.

Methods and Results

Using data from the MASALA (Mediators of Atherosclerosis in South Asians Living in America) cohort study, multinomial and multivariable logistic regression were used to evaluate associations of participant social network size and density, proportion of network who are kin or South Asian ethnicity and reported health of participant's identified social network members (“alters”), with participant CVH and presence of coronary artery calcium. The 699 MASALA participants included were mean age 59.2 (SD, 9.2) years and 42.9% women. After adjustment, a 1‐person larger social network size was associated with 13% higher odds of ideal CVH (odds ratio [OR], 1.13; 95% CI, 1.01–1.27). Reporting an alter with high blood pressure was associated with lower odds of ideal CVH (OR, 0.51; 95% CI, 0.29–0.88), and reporting an alter with high cholesterol was associated with lower odds of ideal CVH (OR, 0.54; 95% CI, 0.30–0.94).

Conclusions

Social network characteristics are associated with CVH in South Asian American adults. Engaging social networks may help promote CVH in this population.

Egocentric Health Networks and Cardiovascular Risk Factors in the ECHORN Cohort Study

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region.

OBJECTIVE

This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean.

DESIGN

The Eastern Caribbean Health Outcomes Research Network Cohort Study is an ongoing longitudinal cohort being conducted in the US Virgin Islands, Puerto Rico, Trinidad and Tobago, and Barbados.

PARTICIPANTS

Participants (n = 1989) were English or Spanish-speaking adults 40 years and older, who were residents of the island for at least 10 years, and who intended to live on-island for the next 5 years.

MAIN MEASURES

Logistic regression was used to examine associations between health network characteristics and CVD risk factors: physical activity, hypertension, and smoking. A baseline survey asked questions about health networks using name generator questions that assessed who participants spoke to about health matters, whose opinions on healthcare mattered, and who they would trust to make healthcare decisions on their behalf.

KEY RESULTS

Health networks were mainly comprised of family members and friends. Healthcare professionals comprised 7% of networks, mean network size was four, and 74% of health network contacts were perceived to be in "good" to "excellent" health. Persons with larger health networks had greater odds of being physically active compared with those with smaller networks (OR = 1.07, CI = 1.01-1.14).

CONCLUSIONS

Health networks may be useful to intervention efforts for CVD risk factor reduction. More studies are needed to examine health networks in Caribbean contexts and explore associations with other CVD risk factors.