This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility: An educational program intended to improve maternal and child health fundamentally altered the social fabric of the rural Honduran villages where it was implemented, a new Yale-led study finds. The findings, researchers say, have implications for interventions anywhere that seek to improve people's well-being by disseminating information or changing behaviors through social contagion.
A prior study involving the same program in Honduras showed that exploiting social networks can enhance the effectiveness of public health and other interventions. This new study suggests that such initiatives also rewire existing social connections within the communities that receive them. The study, based on a randomized controlled trial involving 8,331 people in 110 remote Honduran villages, found that the educational intervention not only changed whom people engaged with for health-related advice but also affected their friend and financial networks.
"We typically think of public health interventions as simply delivering health education with the potential of improving health knowledge and behaviors, but it turns out that they also act as social institutions that may fundamentally rewire human connections," said study co-first author Laura Forastiere, associate professor of biostatistics at the Yale School of Public Health. "Our study shows that when new information is provided, the whole structure of people's relationships, especially those based on sharing information, can be altered." The new study was published on Oct. 14 in the journal Nature. Marios Papamichalis, a postdoctoral researcher at Yale's Human Nature Lab, is the co-first author with Forastiere.
The study was also co-authored by Nicholas Christakis, Sterling professor of social and natural science in Yale's Faculty of Arts and Sciences and director of the Human Nature Lab, and Edoardo M. Airoldi, a professor of statistics and data science in the Fox School of Business at Temple University. Interventions that exploit social influence to improve people's lives are common worldwide; they include efforts to address behaviors as diverse as microfinance uptake in India, iron supplementation in India, agricultural technology adoption in Malawi and school bullying in the United States.
For the new study, the researchers implemented a 22-month educational program promoting maternal, child and neonatal health in 110 villages in an isolated part of Honduras. Before and after the intervention, the research team mapped the villages' social networks and varied the percentage of households that received the educational program in each village. They categorized the villages as having "low-dose" participation in the intervention (5% to 30% of households) or "high-dose" participation (50% to 100%).
Another set of villages in which there were not any participating households in the program served as a reference group. In the "low-dose" villages, individuals who participated in the program broke ties with villagers who did not participate and whom they had previously consulted for health advice, a dynamic that left nonparticipants with fewer connections and reduced overall network connectivity, according to the study. Conversely, people who received the intervention in "high-dose" villages increased their number of social ties, raising the overall connectivity of the communities' social networks.
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