Research Findings

Use of social network analysis in the development, dissemination, implementation, and sustainability of health behavior interventions for adults: A systematic review.

Shelton RC, Lee M, Brotzman LE, Crookes DM, Jandorf L, Erwin D, Gage-Bouchard EA.
Social Science & Medicine, 2018 Oct 19

Abstract: Interest in conceptualizing, measuring, and applying social network analysis (SNA) in public health has grown tremendously in recent years. While these studies have broadened our understanding of the role that social networks play in health, there has been less research that has investigated the application of SNA to inform health-related interventions. This systematic review aimed to capture the current applied use of SNA in the development, dissemination, implementation, and sustainability of health behavior interventions for adults. We identified 52 articles published between 2004 and 2016. A wide variety of study settings were identified, most commonly in the US context and most often related to sexual health and HIV prevention. We found that 38% of articles explicitly applied SNA to inform some aspect of interventions. Use of SNA to inform intervention development (as opposed to dissemination, implementation, or sustainability) was most common. The majority of articles represented in this review (n = 39) were quantitative studies, and 13 articles included a qualitative component. Partial networks were most represented across articles, and over 100 different networks measures were assessed. The most commonly described measures were network density, size, and degree centrality. Finally, very few articles defined SNA and not all articles using SNA were theoretically-informed. Given the nascent and heterogeneous state of the literature in this area, this is an important time for the field to coalesce on terminology, measures, and theoretical frameworks. We highlight areas for researchers to advance work on the application of SNA in the design, dissemination, implementation and sustainability of behavioral interventions.

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Two Cheers for Air Pollution Control: Triumphs and Limits of the Mid-Century Fight for Air Quality.

Chowkwanyun M.
Public Health Reports, 2019 Mar 21

Abstract: This article analyzes the early years of 20th-century air pollution control in Los Angeles. In both scholarship and public memory, mid-century efforts at the regional level were overshadowed by major federal developments, namely the Clean Air Act and creation of the US Environmental Protection Agency in 1970. Yet the mid-century local experience was highly consequential and presaged many subsequent challenges that persist today. The article begins with an exploration of the existential, on-the-ground misery of smog in Los Angeles during the 1940s and 1950s. The article examines the role that scientific evidence on smog did and did not play in regulation, the reasons smog control galvanized support across various constituencies in the region, and, finally, some of mid-century air pollution's limits.

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How Alcohol, Space, and Time Influence Young People's Sexual Encounters in Tanzania: A Qualitative Analysis.

Sommer M, Parker R, Msacky G, Kajula L, Kaaya S.
Archives of Sexual Behavior, 2019 Jan 10.

Abstract: A significant under-addressed issue in the global adolescent health agenda is the interaction between alcohol use and sexual encounters among adolescent boys and girls in sub-Saharan Africa. The aim of this study was to explore the structural and environmental factors influencing young people's access to and use of alcohol, and subsequent engagement in safe or unsafe sexual behaviors in such contexts, from the perspective of young people themselves. We used qualitative and participatory methodologies to explore the experiences and perspectives of 177 adolescent girls and boys in and out of school in four sites across Dar es Salaam, Tanzania. Findings suggest that alcohol use intersects with a spatial dimension in relation to where youths are consuming alcohol and subsequently engaging in sex. This in turn influences young people's likelihood of using condoms and practicing safer sex. The spatial dimension was found to be influenced by time, gender, age, economics, and social norms around the carrying of and use of condoms. Interventions are needed that both address the gendered and social sanctioning of youth carrying condoms in Tanzania and that increase the availability of condoms where alcohol is sold and consumed.

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Sex club/party attendance and STI among men who have sex with men: results from an online survey in New York City.

Meunier É, Siegel K.
Sexually Transmitted Infections, 2019 Mar 13

Objective: Prior studies have shown that men who have sex with men (MSM) who attend sex clubs or parties are at higher risk for HIV and other STIs than those who do not. We sought to provide data about MSM who attend sex clubs/parties in New York City (NYC) in the era of biomedical HIV prevention.

Methods: We conducted an online survey among MSM in NYC (n=766) in 2016–2017 and investigated differences between those who reported never attending a sex club/party (non-attendees 50.1%), those who had attended over a year ago (past attendees 18.0%) and those who attended in the prior year (recent attendees 30.1%). We also conducted multivariable analyses to explore associations with past-year STI diagnosis.

Results: Recent attendees were not more likely to be HIV positive than non-attendees. Among participants never diagnosed with HIV, recent attendees were more likely to use pre-exposure prophylaxis (PrEP, 32.6%) than non-attendees (14.5%) and past attendees (18.8%; p<0.001). Recent attendees reported the highest numbers of recent sex partners, including partners with whom they had condomless anal sex. Significantly more recent attendees reported an STI diagnosis in the prior year (27.9%) compared with non-attendees (14.0%) and past attendees (16.5%; p<0.001). However, 13.8% of non-attendees and 11.5% of past attendees reported having never tested for STIs, significantly more than recent attendees (6.0%, p=0.010). Multivariable analysis showed recent attendees to have 2.42 times the odds (compared with non-attendees) of reporting past-year STI diagnosis (95% CI 1.52 to 3.87, p<0.001).

Conclusions: Compared with those who had not done so, MSM who attended sex clubs/parties in NYC in the prior year were not only more likely to report past-year STI diagnoses but also more likely to report PrEP use or recent HIV/STI testing. Sexual health promotion among MSM who attend sex clubs/parties should address STI risk and prevention.

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