The study compared three ways of organizing study groups and assigning student leaders to them to deliver a smoking prevention program. The most effective groups, according to the study in the November issue of the American Journal of Public Health, were those organized by a method using social networking data: Each student was assigned to work with a peer group leader he or she had personally nominated.
The method most commonly used in U.S. classrooms -- in which students are randomly assigned to student leaders elected by the entire classroom -- was shown to be less effective for teaching health promotion. Also less effective was a third method in which the teacher both selected the leaders and assigned the students.
This is one of the first studies to demonstrate the use of social network data to design a health promotion intervention, and it points to the possibility of using the network model in a variety of settings.
"Most school-based tobacco prevention programs are based on a social influences model," says Thomas W. Valente, Ph.D., associate professor of preventive medicine at the Keck School of Medicine of USC and the study's lead author, "but they haven't been structured to take full advantage of the possible positive aspects of peer influence. Previous studies have suggested that peer leaders are important components to health promotion programs; this is the first study to evaluate how these leaders should be assigned to groups."
The study was designed to test the effectiveness of the network method for identifying peer opinion leaders and constructing study groups by comparing it with two other methods: random and teacher selection. Some 1,961 sixth-graders in 16 Los Angeles-area schools took part in the smoking prevention study. In the network condition, the leaders were defined as those who had received the most nominations. By using a mathematical algorithm, they were matched to students who had nominated them, "thus recognizing that ...opinion leaders are not leaders for everyone but rather are leaders for those who nominate them as leaders," according to the study.
If a student's nominee was not chosen as a leader, he or she was assigned to a group leader nominated by his or her nominee. Peer leaders were taught how to organize and work with their groups. The aim of the programs was to change psychosocial factors involved in tobacco use such as attitudes toward smoking, self-efficacy (the belief that you can accomplish what you set out to do), refusal skills, coping skills and intention to smoke.
Students in the network groups liked the prevention program more, had improved attitudes, showed improved self-efficacy and had decreased intention to smoke when compared to students organized in the two other types of groups.
"Many adults fear that peers can have a strong influence on deviant behavior," Valente said, "but our study adds to evidence that peer influence can be harnessed in a way that benefits health promotion programs."
The article cautioned that although the results reported here were positive, the outcomes measured were attitudinal mediators and not behaviors, and it remains to be seen if behaviors will be affected.
This research was funded by the National Cancer Institute and the National Institute of Drug Abuse through the Transdisciplinary Tobacco Use Research Center of the University of Southern California (http://ipr.usc.edu/tturc).
Thomas W. Valente, Beth R. Hoffman, Anamara Ritt-Olson, Kara Lichtman and C. Anderson Johnson, Effects of a Social-Network Method for Group Assignment Strategies on Peer-Led Tobacco Prevention Programs in Schools. American Journal of Public Health, Volume 93, Number 11, November 2003.
Journal
American Journal of Public Health