Strategies and opportunities for social network interventions that promote healthy weight in youth: preliminary findings of a scoping review
Tracie Barnett, Lisa Kaefer, Elena Tresierra-Farbridge, Jack Moncado, Ariane Bélannger-Gravel, Johanne Saint-CharlesGiven the limited success of traditional interventions targeting weight-related outcomes for youth, calls have been made to consider the importance of social relationships in school and youth life and to devise interventions that incorporate social networks. We conducted a scoping review according to Arksey and O’Malley’s framework in order to glean preliminary insight on promising healthy weight promotion interventions for youth (ages 5-17 years) that leverage social networks. Preliminary findings are described herein. Our search strategy originally identified 1659 retrieves. After exclusion of duplicates and studies that did not meet inclusion criteria based on screening of title and abstract, only 67 were found to address social network interventions. There was a notable lack of clarity in terminology with respect to describing social network interventions. After a second round of screening including full text review, only 5 met our methodological criteria. Years ranged from 2009 to 2018, and studies were conducted either in Europe or in North America. Sample sizes ranged from 40 to 928. Outcomes included weight status, physical activity, sedentary behaviour, dietary behaviour, and perceived social support for physical activity. Interventions were generally school-based; 3 focused on ego-centric networks, and most were founded in behavioural and other theoretical frameworks. Targeted social network features included influence (in-degree), centrality, homophily, and closeness. Selecting change agents was a common approach but no clear characteristics of key actors emerged. Effective and/or promising interventions included those that were multi-level; incorporating both environmental and individual level influences; those that targeted specific behaviours; those that articulated behaviour change theories including social support; and those that adapted interventions to the personal social networks in anticipation of specific unfavourable influences. Enhancing skills for providing social support appears to be universally favourable, but further investigation is needed to translate this evidence in order to impact health outcomes. Manipulation of network structure appears promising and is supported by simulation approaches, but real-world demonstrations are lacking and to date, these approaches do not appear easily transferable to population contexts. Moreover, almost no studies have conducted large scale investigations in youth outside of school settings, and ego-centric social network interventions remain to be further potentiated. More generally, effective interventions should consider the characteristics of the target population, the desired behaviour change, and the compositional features of the social networks.