A Social Network Approach to Demonstrate the Diffusion and Change Process of Intervention From Peer Health Advocates to the Drug Using Community

Abstract

Project RAP (Risk Avoidance Partnership) trained 112 active drug users to become peer health advocates (PHAs). Six months after baseline survey (N_bl = 522), 91.6% of PHAs and 56.6% of community drug users adopted the RAP innovation of giving peer intervention, and 59.5% of all participants (N_6m = 367) were exposed to RAP innovation. Sociometric network analysis shows that adoption of and exposure to RAP innovation was associated with proximity to a PHA or a highly active interventionist (HAI), being directly linked to multiple PHAs/HAIs, and being located in a network sector where multiple PHAs/HAIs were clustered. RAP innovation has diffused into the Hartford drug-using community.

Keywords :

• diffusion of innovation
• social networks
• substance abuse
• HIV/AIDS
• peer interventions

THE AUTHORS

JiangHong Li, M.D., MS, is a Senior Research Scientist at the Institute for Community Research in Hartford, CT. She has been in the field of public health and social behavioral research since 1991. Dr Li is the PI of two NIDA funded research studies involving Chinese and US injection drug users. She also served as Co-PI or Data Analyst on numerous NIH funded HIV prevention studies that utilize interdisciplinary methods. Her primary interests include social cultural and network influence of HIV risk behavior, Respondent Driven Sampling, and community based multi-level, or peer intervention.

Margaret R. Weeks, Ph.D., is an anthropologist and Executive Director of the Institute for Community Research in Hartford, CT. She conducts community-based, applied social science research on HIV/AIDS prevention among drug users and women at high risk in the United States and China, and tests AIDS prevention programs in collaboration with other community research and service organizations.

Steve P. Borgatti, Ph.D., holds the Paul Chellgren Chair in Management and is Professor of Management at the Gatton College of Business and Economics at the University of Kentucky. His research interests include social networks, knowledge management, culture, and cognition. He is a past instructor and director of the NSF Summer Institute for Ethnographic Research Methods in Anthropology and the author of UCINET, the leading software package for social network analysis in the social sciences, as well as ANTHROPAC, a well-known software package for cultural domain analysis. Dr. Borgatti earned his B.A. in Anthropology from Cornell University and his Ph.D. in Mathematical Social Science from the University of California, Irvine.

Scott Clair, Ph.D., is the Director of Market Insights and Analytics at Relationship Marketing. Dr Clair has spent almost 20 years providing analytical solutions and strategic insights to a variety of heath related projects with an emphasis on HIV and hepatitis. His responsibilities have included network/diffusion modeling, ROI forecasting, among others. His prior appointments included Yale University in their Center for Interdisciplinary Research on AIDS. Dr Clair holds a Ph.D. in Social Psychology with a minor in Quantitative Methods/Statistics from the University of Houston.

Julia Dickson-Gomez, Ph.D., is a medical anthropologist, is Associate Professor of Psychiatry and Behavioral Medicine and a member of CAIR's Qualitative Core. Her primary research interests have focused on HIV prevention with active drug users, the social context of drug use and HIV risk, and structural factors that increase drug users’ risk of becoming infected with HIV. She has been Principal Investigator of a NIDA funded study on the macro- and microsocial context of crack use and HIV risk in nine communities in the San Salvador metropolitan area, El Salvador (R01DA024578). In this project, she formed a CAB with community residents and conducted multiple focus groups with active crack users in order to develop a multi-level HIV prevention intervention. She was recently awarded a competitive renewal to evaluate this intervention, which includes peer network interventions with crack users, social network HIV testing, and a variety of community wide events. She was also PI of a study to explore the effects of housing policy on drug users’ access to housing, variations in housing status, and housing options of drug users, and HIV risk (R21DA018607). This project led to a currently funded R01 (DA024578) which studies housing access, housing status/stability, and HIV risk among low-income drug using and non-drug using residents using a mix of qualitative and quantitative methods and geospatial analysis.