Social network targeting to maximise population behaviour change: a cluster randomised controlled trial.
Social network targeting to maximise population behaviour change: a cluster randomised controlled trial.
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DOI：
10.1016/s0140-6736(15)60095-2
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发表时间：
2015-07-11
期刊：
影响因子：
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通讯作者：
Christakis NA
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文献类型：
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作者：
Kim DA;Hwong AR;Stafford D;Hughes DA;O'Malley AJ;Fowler JH;Christakis NA
信息和行为可以通过人际关系传播。通过以有影响力的个人为目标，利用社交网络的分布特性的卫生干预措施可能比那些不利用社交网络分布特性的卫生干预措施更有效和更有效率。在这项网络定向方法的区组随机试验中，我们向洪都拉斯农村的32个村庄(每个村庄22-541名参与者，总研究人数5773人)提供了两种不同的公共卫生干预措施：用于净水的氯和用于治疗微量营养素缺乏症的复合维生素。我们根据网络规模、社会经济地位和净水基线比率封锁了村庄。然后，我们将每个干预的村庄分别随机到三种目标方法中的一种，将干预引入5%的样本，其中包括：(1)随机选择的村民(n=9个村庄，每个干预)，(2)社会关系最密切的村民(n=9)，或(3)随机村民的指定朋友(n=9；最后一种策略利用社会网络的“友谊悖论”)。主要终点是所有人群在每种目标方法下赎回的可用产品的比例。参与者和数据收集者不知道目标确定的方法。该试验在ClinicalTrials.gov(NCT01672580)注册。对于每一次干预，9个村庄(每个村庄有1-20个初始目标个体)被随机分为三种目标方法。以人脉最广的个人为目标，并不比随机目标更多地采用干预措施。然而，与随机目标(95%CI，6.9至17.9)相比，以指定的朋友为目标的营养干预的采用率增加了12.2%。将健康干预引入随机个体的提名朋友中，可以通过利用人类社交网络的内在属性来加强这种干预的扩散。该方法具有可伸缩性的额外优势，因为它无需映射网络即可实施。通过网络定向部署某些类型的卫生干预措施，而不增加目标个人的数量或使用的资源，可能会提高这些干预措施的采用率和效率，从而改善人口健康。美国国立卫生研究院、比尔和梅林达·盖茨基金会、明星家庭基金会和加拿大卫生研究院。我们感谢Clorox公司和Tishcon公司捐赠了洪都拉斯研究中使用的用品。
Information and behaviour can spread through interpersonal ties. By targeting influential individuals, health interventions that harness the distributive properties of social networks may be made more effective and efficient than those that do not. In this block-randomised trial of network targeting methods, we delivered two dissimilar public health interventions to 32 villages in rural Honduras (22–541 participants each; total study population of 5,773): chlorine for water purification, and multivitamins for micronutrient deficiencies. We blocked villages on the basis of network size, socioeconomic status, and baseline rates of water purification. We then randomised villages, separately for each intervention, to one of three targeting methods, introducing the interventions to 5% samples composed either of: (1) randomly selected villagers (n=9 villages for each intervention), (2) villagers with the most social ties (n=9), or (3) nominated friends of random villagers (n=9; the last strategy exploiting the “friendship paradox” of social networks). Primary endpoints were the proportion of available products redeemed by the entire population under each targeting method. Participants and data collectors were not aware of the targeting methods. The trial is registered with ClinicalTrials.gov (NCT01672580). For each intervention, 9 villages (each with 1–20 initial target individuals) were randomised to each of the three targeting methods. Targeting the most highly connected individuals produced no greater adoption of the interventions than random targeting. Targeting nominated friends, however, increased adoption of the nutritional intervention by 12·2% compared to random targeting (95% CI, 6·9 to 17·9). Introducing a health intervention to the nominated friends of random individuals can enhance that intervention’s diffusion by exploiting intrinsic properties of human social networks. This method has the additional advantage of scalability because it can be implemented without mapping the network. Deploying certain types of health interventions via network targeting, without increasing the number of individuals targeted or the resources used, may enhance the adoption and efficiency of those interventions, thereby improving population health. NIH, Bill and Melinda Gates Foundation, Star Family Foundation, and the Canadian Institutes of Health Research. We thank The Clorox Company and Tishcon Corporation for their donations of supplies used in the study in Honduras.