Effects of Public Health Interventions on Aged Adults in Village Social Networks

摘要 在传统环境中，老年人在形成和维持社会关系方面发挥着核心作用。大有可为 观察和实验工作表明，健康影响可以在这种社会关系中传播， 影响到老年人自身和其他人的健康。人们对此知之甚少的是是否以及如何 外源性干预可能重建社会关系，从根本上改变老年人在他们的生活中所扮演的角色 并可能导致他们被孤立或损害他们的社会相关性或健康。在一个 在洪都拉斯农村176个村庄的30,862名年龄在12岁至93岁之间的人中，我们正在评估“社会 网络定向算法“，以最大限度地传播公共卫生干预措施。每个村庄都是随机的 分配给不同百分比的居民(从0到100%)接受干预。在建议的 工作中，我们希望评估引入(通过实验变化的外显)公共卫生 干预可能会改变村庄的社会结构，特别是老年人的社会结构，重点是 4,589名受试者≥为50岁。父RCT提供了构建当前项目的理想平台， 收集新数据，提出新问题，进行新分析。我们有四个具体目标。首先，我们 将重新绘制176个村庄30,862人的完整面对面网络图，构成第三个 网络测绘的浪潮，大约在我们2019年完成第二次浪潮的两年后。结果将是 这是一个非常不同寻常的数据集，它捕捉到了现实世界社交网络的结构和老龄化的位置 他们中的成年人会随着时间的推移而变化，以回应随机暴露于正式公共卫生干预的情况。 我们的第二个目标是在两年内量化整个村级社会网络结构的变化 时间间隔。使用表征网络结构的各种统计(例如，度分布，传递性， 网络主题)，我们将评估村庄网络的稳定性。我们还将研究老年人的社会 村庄内部的联系，特别是与健康有关的社会联系，受到不同形式的 (跨村)公共卫生干预的剂量。正式机构的引入可能是 预计将削弱以前服务于相同目的的非正式机构，导致 潜在的社会孤立和这些社区中老年成年人的相关性较低。我们的第三个目标是 描述老年村民自我层面网络的变化，基于他们的社会关系 接受(或采用)公共卫生干预。我们的第四个目标是评估外源性的影响 网络位置的变化对老年人后续身心健康的影响。总的来说， 我们的工作将使我们能够通过实验探索老年人的社会关系是否以及如何 老年人在与健康有关的网络中的作用，这些人的健康在正式情况下会发生变化 与健康相关的机构被外在地引入一个社会系统。

ABSTRACT Aging adults play a central role in the formation and maintenance of social ties in traditional settings. Much observational and experimental work has demonstrated that health effects can spread across such social ties, affecting the health of the aging adults themselves and also others. Less well understood is whether and how exogenous interventions might restructure social ties, fundamentally altering the role aging adults play in their communities and potentially leading to their isolation or compromising their social relevance or health. In an existing RCT involving 30,862 people aged 12-93 in 176 villages in rural Honduras, we are assessing “social network targeting algorithms” to maximize the diffusion of public health interventions. Each village is randomly assigned to have a different percentage of its inhabitants (from 0-100%) get the intervention. In the proposed work, we wish to evaluate how the introduction (with experimentally varied penetrance) of a public health intervention might alter the social fabric of the villages, especially among the older adults, focusing on the 4,589 subjects ≥50 years old. The parent RCT provides an ideal platform on which to build the current project, collecting new data, asking new questions, and performing new analyses. We have four specific aims. First, we will re-map the complete face-to-face networks of the 30,862 people in the 176 villages, constituting the third wave of network mapping, roughly 2 years after the completion of our second wave in 2019. The result will be a very unusual dataset, capturing how the structures of real-world social networks, and the position of aging adults in them, change over time, in response to randomized exposure to a formal public health intervention. Our second aim is to quantify changes in the structure of the whole-village-level social networks over a 2-year interval. Using various statistics that characterize network structure (e.g., degree distribution, transitivity, network “motifs”), we will assess the stability of village networks. We will also study how aging adults’ social ties, and in particular health-related social ties, within the villages are affected by the introduction of varying doses (across villages) of the public health intervention. The introduction of formal institutions might be expected to attenuate the informal institutions that had previously served the same purpose, leading to potential social isolation and less relevance of aging adults in these communities. Our third aim is to characterize changes in the ego-level networks of aging villagers, based on whether their social connections received (or adopted) the public health intervention. Our fourth aim is to evaluate the impact of exogenously induced changes in network position upon the subsequent physical and mental health of the elderly. Overall, our work will allow us to explore experimentally whether and how the social connections of aging adults, the role of aging adults in networks related to health, and the health of those individuals change when formal health-relevant institutions are exogenously introduced into a social system.