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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 October 2018) | Viewed by 77496

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Special Issue Editors

Dr. Ivaylo Vassilev

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Guest Editor

Faculty of Health Sciences, University of Southampton, Southampton, UK
Interests: long-term condition management; sociology of health and illness; capabilities approach; critical realism; development, evaluation and implementation of interventions

Dr. Pilar Marques-Sanchez

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Guest Editor

University of Leon, Campus de Ponferrada, s/n, 24401, Ponferrada, León, Spain
Interests: health policy; public health; management on health organisations; sociocentric structures; networks and emotions

Mr. Nestor Serrano-Fuentes

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Guest Editor

Faculty of Health Sciences, University of Southampton, Southampton, UK
Interests: global health; chronic illness; sociology of health; nursing; history of nursing

Special Issue Information

Dear Colleagues,

We would like to invite papers to this Special Issue of the International Journal of Environmental Research and Public Health, which will explore the application of Social Network Analysis (SNA) to applied health research. We welcome the submission of theoretical, methodological, empirical, and review papers using a range of social network methodologies and with clear implications for policy. We are particularly interested in research using mixed methods and ego-net analysis. Some of the themes that the papers could address include:

Health and well-being
Illness management in everyday life
Online and offline personal communities
Changing health behaviours and social practice
Interactions between healthcare, social care, and community support
Public policy and enabling environments
New technologies and changes in healthcare delivery
Development, implementation and evaluation of interventions

Dr. Ivaylo Vassilev
Dr. Pilar Marques-Sanchez
Mr. Nestor Serrano-Fuentes
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

illness management
online and offline personal communities
healthcare delivery
interventions

Published Papers (14 papers)

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Research

18 pages, 4521 KiB

Open AccessArticle

Morbi-Mortality of the Victims of Internal Conflict and Poor Population in the Risaralda Province, Colombia

by Rafael Rentería-Ramos, Rafael Hurtado-Heredia and B Piedad Urdinola

Int. J. Environ. Res. Public Health 2019, 16(9), 1644; https://doi.org/10.3390/ijerph16091644 - 11 May 2019

Cited by 5 | Viewed by 4191

Abstract

This work studies the health status of two populations similar in most social and environmental interactions but one: the individuals from one population are victims of an internal armed conflict. Both populations are located in the Risaralda province, Colombia and the data for this study results from a combination of administrative records from the health system, between 2011 and 2016. We implemented a methodology based on graph theory that defines the system as a set of heterogeneous social actors, including individuals as well as organizations, embedded in a biological environment. The model of analysis uses the diagnoses in medical records to detect morbidity and mortality patterns for each individual (ego-networks), and assumes that these patterns contain relevant information about the effects of the actions of social actors, in a given environment, on the status of health. The analysis of the diagnoses and causes of specific mortality, following the Social Network Analysis framework, shows similar morbidity and mortality rates for both populations. However, the diagnoses’ patterns show that victims portray broader interactions between diagnoses, including mental and behavioral disorders, due to the hardships of this population. Full article

(This article belongs to the Special Issue Social Networks and Health)

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15 pages, 1305 KiB

Open AccessArticle

Gender Differences in Social Support Received by Informal Caregivers: A Personal Network Analysis Approach

by María Nieves Rodríguez-Madrid, María Del Río-Lozano, Rosario Fernandez-Peña, Jaime Jiménez-Pernett, Leticia García-Mochón, Amparo Lupiañez-Castillo and María del Mar García-Calvente

Int. J. Environ. Res. Public Health 2019, 16(1), 91; https://doi.org/10.3390/ijerph16010091 - 31 Dec 2018

Cited by 40 | Viewed by 6211

Abstract

Social support is an important predictor of the health of a population. Few studies have analyzed the influence of caregivers’ personal networks from a gender perspective. The aim of this study was to analyze the composition, structure, and function of informal caregiver support networks and to examine gender differences. It also aimed to explore the association between different network characteristics and self-perceived health among caregivers. We performed a social network analysis study using a convenience sample of 25 female and 25 male caregivers. A descriptive analysis of the caregivers and bivariate analyses for associations with self-perceived health were performed. The structural metrics analyzed were density; degree centrality mean; betweenness centrality mean; and number of cliques, components, and isolates. The variability observed in the structure of the networks was not explained by gender. Some significant differences between men and women were observed for network composition and function. Women received help mainly from women with a similar profile to them. Men’s networks were broader and more diverse and they had more help from outside family circles, although these outcomes were not statistically significant. Our results indicate the need to develop strategies that do not reinforce traditional gender roles, but rather encourage a greater sharing of responsibility among all parties. Full article

(This article belongs to the Special Issue Social Networks and Health)

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17 pages, 2221 KiB

Open AccessArticle

Measuring Relevant Information in Health Social Network Conversations and Clinical Diagnosis Cases

by Albert Moreira, Raul Alonso-Calvo, Alberto Muñoz and José Crespo

Int. J. Environ. Res. Public Health 2018, 15(12), 2787; https://doi.org/10.3390/ijerph15122787 - 09 Dec 2018

Viewed by 2632

Abstract

The Internet and social media is an enormous source of information. Health social networks and online collaborative environments enable users to create shared content that afterwards can be discussed. The aim of this paper is to present a novel methodology designed for quantifying relevant information provided by different participants in clinical online discussions. The main goal of the methodology is to facilitate the comparison of participant interactions in clinical conversations. A set of key indicators for different aspects of clinical conversations and specific clinical contributions within a discussion have been defined. Particularly, three new indicators have been proposed to make use of biomedical knowledge extraction based on standard terminologies and ontologies. These indicators allow measuring the relevance of information of each participant of the clinical conversation. Proposed indicators have been applied to one discussion extracted from PatientsLikeMe, as well as to two real clinical cases from the Sanar collaborative discussion system. Results obtained from indicators in the tested cases have been compared with clinical expert opinions to check indicators validity. The methodology has been successfully used for describing participant interactions in real clinical cases belonging to a collaborative clinical case discussion tool and from a conversation from a health social network. This work can be applied to assess collaborative diagnoses, discussions among patients, and the participation of students in clinical case discussions. It permits moderators and educators to obtain a quantitatively measure of the contribution of each participant. Full article

(This article belongs to the Special Issue Social Networks and Health)

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9 pages, 301 KiB

Open AccessArticle

Recruitment of Healthcare Staff to Social Network Studies: A Case Study Exploring Experiences, Challenges, and Considerations

by Aoife De Brún and Eilish McAuliffe

Int. J. Environ. Res. Public Health 2018, 15(12), 2778; https://doi.org/10.3390/ijerph15122778 - 07 Dec 2018

Cited by 6 | Viewed by 3460

Abstract

Social network analysis (SNA) is a term that describes a set of methodologies to understand and depict social relations or ties. SNA is different from other research methods in several ways that have important ethical implications, as well as specific considerations for study design. Recruitment of participants and attrition during the study, where there are several data collection time points, pose significant challenges. Furthermore, there are implications of non-participation in studies, whereby gaps in network maps may result in an inaccurate representation of how a network is working and this, in turn, means the results may be of lesser value in terms of informing policy and practice. Given the widely noted challenge of recruiting healthcare staff to research, this paper adopts a case study approach to discussing considerations for researchers, as well as offering recommendations and insights from our own research and from the published literature about how to tackle these issues. This paper examines data sourcing, decision-making about defining the network for data collection, and ethical considerations and their implications for the recruitment of healthcare staff to social network studies. We use a case study example exploring leadership in a hospital group network to illustrate techniques and challenges in the recruitment of healthcare staff. Full article

(This article belongs to the Special Issue Social Networks and Health)

18 pages, 1644 KiB

Open AccessArticle

Personal Network Analysis in the Study of Social Support: The Case of Chronic Pain

by Rosario Fernández-Peña, José Luis Molina and Oliver Valero

Int. J. Environ. Res. Public Health 2018, 15(12), 2695; https://doi.org/10.3390/ijerph15122695 - 29 Nov 2018

Cited by 21 | Viewed by 4880

Abstract

In the context of chronic illness, the individual’s social and relational environment plays a critical role as it can provide the informal support and care over time, beyond healthcare and social welfare institutions. Social Network Analysis represents an appropriate theoretical and methodological approach to study and understand social support since it provides measures of personal network structure, composition and functional content. The aim of this mixed method study is to present the usefulness of Personal Network Analysis to explore social support in the context of chronic pain. Personal and support network data of 30 people with chronic pain (20 alters for each ego, 600 relationships in total) were collected, obtaining measures of personal network structure and composition as well as information about social support characteristics. Also, semi-structured interviews with participants were conducted to identify the context of their experience of pain, their limitations as regards leading an autonomous life, their social support needs and other aspects concerning the effect of pain on their social and relational lives. This approach shows the importance of non-kin social support providers and the significant role of non-providers in the personal networks of people suffering chronic pain. Full article

(This article belongs to the Special Issue Social Networks and Health)

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15 pages, 3058 KiB

Open AccessArticle

A Semantic Social Network Analysis Tool for Sensitivity Analysis and What-If Scenario Testing in Alcohol Consumption Studies

by José Alberto Benítez-Andrades, Alejandro Rodríguez-González, Carmen Benavides, Leticia Sánchez-Valdeón and Isaías García

Int. J. Environ. Res. Public Health 2018, 15(11), 2420; https://doi.org/10.3390/ijerph15112420 - 31 Oct 2018

Cited by 7 | Viewed by 3644

Abstract

Social Network Analysis (SNA) is a set of techniques developed in the field of social and behavioral sciences research, in order to characterize and study the social relationships that are established among a set of individuals. When building a social network for performing an SNA analysis, an initial process of data gathering is achieved in order to extract the characteristics of the individuals and their relationships. This is usually done by completing a questionnaire containing different types of questions that will be later used to obtain the SNA measures needed to perform the study. There are, then, a great number of different possible network-generating questions and also many possibilities for mapping the responses to the corresponding characteristics and relationships. Many variations may be introduced into these questions (the way they are posed, the weights given to each of the responses, etc.) that may have an effect on the resulting networks. All these different variations are difficult to achieve manually, because the process is time-consuming and error-prone. The tool described in this paper uses semantic knowledge representation techniques in order to facilitate this kind of sensitivity studies. The base of the tool is a conceptual structure, called “ontology” that is able to represent the different concepts and their definitions. The tool is compared to other similar ones, and the advantages of the approach are highlighted, giving some particular examples from an ongoing SNA study about alcohol consumption habits in adolescents. Full article

(This article belongs to the Special Issue Social Networks and Health)

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13 pages, 6891 KiB

Open AccessArticle

Social Network Analysis and Resilience in University Students: An Approach from Cohesiveness

by Cristina Liébana-Presa, Elena Andina-Díaz, María-Mercedes Reguera-García, Iván Fulgueiras-Carril, David Bermejo-Martínez and Elena Fernández-Martínez

Int. J. Environ. Res. Public Health 2018, 15(10), 2119; https://doi.org/10.3390/ijerph15102119 - 26 Sep 2018

Cited by 10 | Viewed by 5447

Abstract

The Social Network Analysis offers a view of social phenomena based on interactions. The aim of this study is to compare social reality through the cohesion variable and analyse its relationship with the resilience of university students. This information is useful to work with the students academically and to optimise the properties of the network that have an influence in academic performance. This is a descriptive transversal study with 90 students from the first and third year of the Nursing Degree. Cohesion variables from the support and friendship networks and the level of resilience were gathered. The UCINET programme was used for network analysis and the SPSS programme for statistical analysis. The students’ friendship and support networks show high intra-classroom cohesion although there are no differences between the support networks and friendship or minimal contact networks in both of the courses used for the study. The network cohesion indicators show less cohesion in the third year. No correlations were found between cohesion and resilience. Resilience does not appear to be an attribute related to cohesion or vice versa. Full article

(This article belongs to the Special Issue Social Networks and Health)

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17 pages, 1651 KiB

Open AccessArticle

Socioeconomic Status in Adolescents: A Study of Its Relationship with Overweight and Obesity and Influence on Social Network Configuration

by Natalia Arias, María Dolores Calvo, José Alberto Benítez-Andrades, María José Álvarez, Beatriz Alonso-Cortés and Carmen Benavides

Int. J. Environ. Res. Public Health 2018, 15(9), 2014; https://doi.org/10.3390/ijerph15092014 - 15 Sep 2018

Cited by 17 | Viewed by 5909

Abstract

Socioeconomic status (SES) influences all the determinants of health, conditioning health throughout life. The aim of the present study was to explore the relationship between socioeconomic status and obesity in adolescence through an analysis of the patterns of contact between peers as a function of this parameter. A cross-sectional study was performed, analyzing a sample of 235 students aged 14 to 18 and 11 class networks. Social network analysis was used to analyze structural variables of centrality from a sociocentric perspective. We found that adolescents with a medium-low SES presented a two-fold higher probability of being overweight, but we did not detect any differences in the configuration of their social networks when compared with those of normal-weight adolescents. However, we did find significant differences in the formation of networks according to SES in the overall sample and disaggregated by gender, whereby adolescents with a high SES in general presented a higher capacity to form wider social networks. Elucidating the relationship between SES and overweight and its influence on social network formation can contribute to the design of preventative strategies against overweight and obesity in adolescents, since their social environment can provide them with several resources to combat excess weight. Full article

(This article belongs to the Special Issue Social Networks and Health)

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12 pages, 1570 KiB

Open AccessArticle

The Influence of Adolescents’ Social Networks on Alcohol Consumption: A Descriptive Study of Spanish Adolescents Using Social Network Analysis

by Enedina Quiroga, Arrate Pinto-Carral, Isaías García, Antonio J. Molina, Tania Fernández-Villa and Vicente Martín

Int. J. Environ. Res. Public Health 2018, 15(9), 1795; https://doi.org/10.3390/ijerph15091795 - 21 Aug 2018

Cited by 11 | Viewed by 4867

Abstract

In adolescence, friends are important due to their influence on the acquisition of habits such as alcohol consumption. However, there is a lack of studies that describe the structural context of adolescents, which would be useful to implement prevention strategies. Therefore, our research question was how adolescent friendship networks influence alcohol consumption. Our goal was to determine the structural profile of adolescent at-risk alcohol users and their relational context in the classroom. We designed a descriptive cross-sectional study based on social network analysis to analyze structural patterns. We recruited 195 students. Social-network and alcohol-consumption variables were analyzed using the UCINET and STATA programs. Some 86.67% of participants had consumed alcohol at some time in their lives and the prevalence of at-risk alcohol use was higher in females (50.48% vs. 49.52%; OR: 1.84; CI 95%: 0.99–3.43%; p = 0.036). The lower the intensity of friendship, the more contacts adolescent at-risk alcohol users had within the network, and the easier it was for them to access their peers. Consequently, we conclude that the structure of a class is a key factor that merits further research. Full article

(This article belongs to the Special Issue Social Networks and Health)

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17 pages, 3587 KiB

Open AccessFeature PaperArticle

The Importance of External Contacts in Job Performance: A Study in Healthcare Organizations Using Social Network Analysis

by Pilar Marqués-Sánchez, María F. Muñoz-Doyague, Yolanda V. Martínez, Martin Everett, Nestor Serrano-Fuentes, Peter Van Bogaert, Ivaylo Vassilev and David Reeves

Int. J. Environ. Res. Public Health 2018, 15(7), 1345; https://doi.org/10.3390/ijerph15071345 - 27 Jun 2018

Cited by 12 | Viewed by 5756

Abstract

There is evidence that relations between physicians and nurses within healthcare institutions might be shaped by informal aspects of such relations and by links to people external to the organization, with an impact on work performance. Social network analysis is underutilized in exploring such associations. The paper aims to describe physicians’ and nurses’ relationships outside their clinical units and to explore what kind of ties are related to job performance. A network analysis was performed on cross-sectional data. The study population consisted of 196 healthcare employees working in a public hospital and a primary healthcare centre in Spain. Relational data were analysed using the UCINET software package. Measures included: (i) sample characteristics; (ii) social network variables; and (iii) team performance ratings. Descriptive statistics (means, medians, percentages) were used to characterize staff and performance ratings. A correlational analysis was conducted to examine the strength of relationships between four different types of ties. Our findings suggest that external ties only contribute to improving the performance of physicians at both the individual and team level. They are focused on the decision-making process about the therapeutic plan and, therefore, might need to seek advice outside the workplace. In contrast, external ties are not relevant for the work performance of nurses, as they need to find solutions to immediate problems in a short period of time, having strong ties in the workplace. Social network analysis can illuminate relations within healthcare organizations and inform the development of innovative interventions. Full article

(This article belongs to the Special Issue Social Networks and Health)

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12 pages, 326 KiB

Open AccessArticle

Differences in the Perception of Social Support Among Rural Area Seniors—A Cross-Sectional Survey of Polish Population

by Paweł Chruściel, Teresa Kulik, Klaudia Jakubowska and Dorota Nalepa

Int. J. Environ. Res. Public Health 2018, 15(6), 1288; https://doi.org/10.3390/ijerph15061288 - 19 Jun 2018

Cited by 8 | Viewed by 3992

Abstract

Introduction and objective: Social support constitutes an important determinant of an elderly person’s health and of functioning in his or her living environment. It depends on available support networks and the type of help received. Measurement of social support should encompass both its structure and the functions it fulfills, which enables detailed assessment of the phenomenon. The aim of the study was to compare the perception of social support among rural area seniors provided with institutional care with those living in a home setting. Material and method: Using the diagnostic survey method and the technique of the distribution of a direct questionnaire, 364 respondents from rural areas were examined: those living in an institutional environment (n = 190) and those living in their home (natural) environment (n = 174). The respondents were selected on the basis of a combined sampling method: proportionate, stratified, and systematic. Variables were measured with the following questionnaires: Courage Social Network Index (CSNI) and Social Support Scale (SSS). Results: The living environment has been proved to differentiate average values of support both in the structural and functional dimensions in a statistically significant way (p < 0.001). An untypical phenomenon was higher average values pertaining to emotional bonds, frequency of direct contacts, and help received in the group of respondents living in an institutional environment. Conclusions: The living environment and demographic variables affect the perception of social support among elderly people. Full-time institutional care of a senior citizen leads to the deterioration of social support; therefore, keeping an elderly person in a home environment should be one of the primary goals of the senior policy. Full article

(This article belongs to the Special Issue Social Networks and Health)

14 pages, 1430 KiB

Open AccessArticle

Research Trend Visualization by MeSH Terms from PubMed

by Heyoung Yang and Hyuck Jai Lee

Int. J. Environ. Res. Public Health 2018, 15(6), 1113; https://doi.org/10.3390/ijerph15061113 - 30 May 2018

Cited by 34 | Viewed by 13770

Abstract

Motivation: PubMed is a primary source of biomedical information comprising search tool function and the biomedical literature from MEDLINE which is the US National Library of Medicine premier bibliographic database, life science journals and online books. Complimentary tools to PubMed have been developed to help the users search for literature and acquire knowledge. However, these tools are insufficient to overcome the difficulties of the users due to the proliferation of biomedical literature. A new method is needed for searching the knowledge in biomedical field. Methods: A new method is proposed in this study for visualizing the recent research trends based on the retrieved documents corresponding to a search query given by the user. The Medical Subject Headings (MeSH) are used as the primary analytical element. MeSH terms are extracted from the literature and the correlations between them are calculated. A MeSH network, called MeSH Net, is generated as the final result based on the Pathfinder Network algorithm. Results: A case study for the verification of proposed method was carried out on a research area defined by the search query (immunotherapy and cancer and “tumor microenvironment”). The MeSH Net generated by the method is in good agreement with the actual research activities in the research area (immunotherapy). Conclusion: A prototype application generating MeSH Net was developed. The application, which could be used as a “guide map for travelers”, allows the users to quickly and easily acquire the knowledge of research trends. Combination of PubMed and MeSH Net is expected to be an effective complementary system for the researchers in biomedical field experiencing difficulties with search and information analysis. Full article

(This article belongs to the Special Issue Social Networks and Health)

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15 pages, 1278 KiB

Open AccessArticle

Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations

by Padmore Adusei Amoah, Joseph Edusei and David Amuzu

Int. J. Environ. Res. Public Health 2018, 15(5), 973; https://doi.org/10.3390/ijerph15050973 - 13 May 2018

Cited by 24 | Viewed by 6885

Abstract

Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare. Full article

(This article belongs to the Special Issue Social Networks and Health)

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14 pages, 2097 KiB

Open AccessFeature PaperArticle

Hygiene and Health: Who Do Mothers in Vanuatu Communicate with about Health?

by Karen File, Thomas Valente and Mary-Louise McLaws

Int. J. Environ. Res. Public Health 2018, 15(3), 443; https://doi.org/10.3390/ijerph15030443 - 03 Mar 2018

Cited by 4 | Viewed by 4731

Abstract

Health information-seeking behaviour of mothers with children five years of age and younger in Vanuatu was examined using the structural properties of social networks. Data were collected from a rural village from two islands and an urban settlement in the capital, Port Vila, by face-to-face interviews using a structured questionnaire. Sociometric data on the structure of the network, the characteristics of key informants, and associations with outside sources of health information were analysed as interpersonal predictors of health promotion and behavior change. Rural mothers preferred the health advice of biomedical practitioners for diarrheal disease over traditional custom practitioners. Interpersonal connections were restricted in the urban mother network indicating that mothers were merely acquaintances or do not seek health advice from each other. Our findings suggest that biomedical practitioners are the best option for diffusing health and hygiene information for rural and urban mothers. Traditional healers and paraprofessionals could be strategically used to complete the missing links in network connectedness to optimally spread new information. The novel use of cross-sectional social network data can create a baseline evaluation to purposefully frame a health intervention. Our study provided a unique explanation of how network analysis offers insight into how key players can be identified and the circumstances in which they are likely to be able to influence hygiene practices of their peers. Full article

(This article belongs to the Special Issue Social Networks and Health)

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