New study finds that peer-nominated influencers are more effective at bringing about health behavior change than people with the most social contacts.
If you’ve ever tried to stop smoking, drinking, or binging on sweets, you know how difficult change can be.
Sociologists, behavioral scientists, communication experts, governments, and health policy makers across the globe have been seeking effective behavior change strategies for decades. Many potential routes to change are exciting at first (billboards, coupons, both online and face-to-face social networks), only to have moderately disappointing results.
We humans construct elaborate social networks in which we live out our lives. If scientists can understand the structure and function of these social networks, we can take advantage of this understanding to turbo-charge behavioral interventions so that whole groups of people change their behavior for the better, and not just isolated individuals,
Key influencers aren’t necessarily the most popular people in a network
One reason for this may be that health behavior change campaigns tend to target specific spokespeople to disseminate their messages. Frequently, spokespeople are selected because they are highly connected in a particular community. According to the Lancet article, however, those with the most social connections are not necessarily the key influencers in a community.
In the study, researchers implemented two public health interventions—a water purification program and a multivitamin program—in 32 different villages from the Lempira region of Honduras.
They used three different methods when selecting the initial targets for the programs:
- a completely random set of villagers,
- the villagers with the most social ties,
- and one friend nominated by a random set of villagers.
Targets were given vouchers for products (either chlorine in the water purification cohort, or vitamins in the multivitamin cohort) to use themselves and to distribute among their social contacts.
Compared to the randomly selected targets, the research team found that targeting a peer-nominated friend increased adoption of the program by 12.2 percent. When they targeted the most highly connected individuals, no change in adoption was noted.
While political campaigns and homecoming courts are based on popularity—the sheer number of friends one has within a particular community—the most effective key influencers aren’t necessarily the most popular. Christakis explains:
Because highly connected people tend to be friends with one another, targeting only the best-connected people risks creating an 'echo chamber' of influence that fails to reach other parts of the network.
When spreading the message isn't enough
In 2015, I’d bet most of us think of social networks as an online, social media-enabled phenomenon. While there are similarities in the way face-to-face and online social networks can be mapped, the context and goals of a campaign may mean that real-world dissemination is more effective than social media.
…many public health interventions cannot be implemented via LinkedIn or Facebook. The diffusion of new protective knowledge and health behaviors throughout a population often requires not only cognitive awareness—which Internet messaging can provide—but physical assistance and hands-on training.
Behavior change is hard
If behavior change were easy, we’d all be at our target weights. We wouldn’t have time to smoke, drink, or watch television because we’d be busy exercising in our spare time. Bars, bakeries, and maybe even some physician practices would go out of business. But, we’re only human.
According to an experiment led by Damon Centola, PhD., Associate Professor of Communication at the University of Pennsylvania’s Annenberg School for Communication: “redundant signals significantly increased the likelihood of adoption.”
Frequent, if not daily, engagement—whether in-person or through social media—seems vital when it comes to health interventions. Disseminating messages, or changing opinions, whether face-to-face or online, seems easier than bringing about long-lasting health behavior change.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.