Association Between Social Network Communities and Health Behavior: An Observational Sociocentric Network Study of Latrine Ownership in Rural India

Abstract

Objectives. We identified communities of interconnected people that might serve as normative reference groups for individual-level behavior related to latrine adoption. Methods. We applied an algorithmic social network method to determine the network community from respondent-reported social ties of 16 403 individuals in 75 villages in rural Karnataka, India; data were collected from 2006 to 2008. We used multilevel modeling to test the association between latrine ownership and community-level and village-level latrine ownership. We also investigated the degree to which network cohesion affected individual latrine ownership. Results. Three levels of social contacts (direct friends, social network community, and village) significantly predicted individual latrine ownership, but the strongest effect was found at the level of social network communities. In communities with high levels of network cohesion, the likelihood was decreased that any individual would own a latrine; this effect was significant only at lower levels of latrine ownership, suggesting a role for network cohesion in facilitating the nonownership norm. Conclusions. Although many international health and development interventions target village units, these results raise the possibility that the optimal target for public health interventions may not be determined through geography but through social network interactions.

Social networks and health: A systematic review of sociocentric network studies in low- and middle-income countries

“…Community-level social connectedness, as measured by several network structure characteristics, may exert different effects on various outcomes across different network types (Alatas et al, 2012; Cai et al, 2012; Entwisle et al, 2007; Shakya et al, 2014b; Zelner et al, 2012). For example, one study in China showed that take-up of weather insurance among rice-farming households was much greater in villages where households were clustered together.…”

“…In contrast, the same study showed that villages with less internal cohesion displayed more connections to outside villages and exhibited lower fertility and greater affluence. Likewise, a study of latrine ownership in India demonstrated that households were more likely to own a latrine in less cohesive network communities (Shakya et al, 2014b). Finally, a study in Indonesia showed that people in more networked villages were better at identifying which community members were poor than people in less networked villages (Alatas et al, 2012).…”

“…For example, Jaimovich (2011) showed that indicators of economic development were differently related to network information at the dyadic-, household-, and macro levels. Likewise, Shakya et al (2014b) demonstrated that the proportion of latrine ownership among an ego's immediate contacts, network-based community contacts, and village contacts were each differently related to the ego's likelihood of owning a latrine. (See Bannerjee et al, 2013 for a further example).…”

An exploratory comparison of name generator content: Data from rural India

“…Recent work has shown that when we consider the relationship between networks and behavior it is not simply the relationships between pairs of individuals that should be of interest, but we must also consider the structure of the network itself (Shakya et al, 2014, 2015). The ability for behaviors to change, diffuse, and become established within a community can greatly affect how that community is connected.…”

Social support relationships for sexual minority women in Mumbai, India: a photo elicitation interview study

“…They have been tied to a number of health-related outcomes (such as reductions in anxiety and depression (Rajandram et al 2011)). Within social support research in India, normative daily interactions (such as fetching water) were found to be significant sources of social support for women (Shakya, Christakis, and Fowler 2014;Snell-Rood 2015). Similarly, participants in this study described normative daily interactions with street vendors and service industry workers as affirming a positive worldview.…”