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Social network diagnostics: a tool for monitoring group interventions

Sabina B Gesell12*, Shari L Barkin3 and Thomas W Valente4

Author Affiliations

1 Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA

2 Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA

3 Division of General Pediatrics, Department of Pediatrics, Vanderbilt School of Medicine Nashville, Nashville, TN, USA

4 Institute for Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

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Implementation Science 2013, 8:116  doi:10.1186/1748-5908-8-116

Published: 1 October 2013



Many behavioral interventions designed to improve health outcomes are delivered in group settings. To date, however, group interventions have not been evaluated to determine if the groups generate interaction among members and how changes in group interaction may affect program outcomes at the individual or group level.


This article presents a model and practical tool for monitoring how social ties and social structure are changing within the group during program implementation. The approach is based on social network analysis and has two phases: collecting network measurements at strategic intervention points to determine if group dynamics are evolving in ways anticipated by the intervention, and providing the results back to the group leader to guide implementation next steps. This process aims to initially increase network connectivity and ultimately accelerate the diffusion of desirable behaviors through the new network. This article presents the Social Network Diagnostic Tool and, as proof of concept, pilot data collected during the formative phase of a childhood obesity intervention.


The number of reported advice partners and discussion partners increased during program implementation. Density, the number of ties among people in the network expressed as a percentage of all possible ties, increased from 0.082 to 0.182 (pā€‰<ā€‰0.05) in the advice network, and from 0.027 to 0.055 (pā€‰>ā€‰0.05) in the discussion network.


The observed two-fold increase in network density represents a significant shift in advice partners over the intervention period. Using the Social Network Tool to empirically guide program activities of an obesity intervention was feasible.

Social network analysis; Behavior change; Group interventions; Obesity