Researchers in the making:
Social network analysis: a new way to build community capacity?
Story by Tara Narwani/Photos by Laughing Dog Photography
Ambitious new public policy or interventions can have a significant impact on how a society functions and operates. To determine whether a particular policy or intervention is working, it's important to evaluate its effectiveness. It's also valuable to understand the process by which a policy or intervention is implemented to inform its future shape and direction.
For the past two years, postdoctoral fellow Kate Storey has been doing just that. She's been working on a community evaluation of the chronic disease prevention project called Healthy Alberta Communities (HAC).
With the knowledge that chronic diseases, such as diabetes and cancer, are the leading causes of death worldwide, HAC began in 2005 with the goal of "making healthy choices easier."
Coordinators were hired for four communities across the province: Medicine Hat, St. Paul, Bonnyville, and Edmonton-Norwood. First, the coordinators worked with the communities to identify appropriate initiatives for each community in the areas of nutrition, physical activity and tobacco reduction. Then, the coordinators began the task of building capacity within the communities to ensure the success and sustainability of each initiative. Building capacity refers to the development of an environment that facilitates and supports initiatives and includes things like establishing institutions and promoting human resources.
Dr. Storey says, "In the end, with or without the coordinator, the communities need the capacity to continue these initiatives, to truly create a supportive environment for healthy living."
To measure any changes that occurred in the communities as a result of HAC, an initial assessment was done in 2006 (to get "before" statistics), and an outcome evaluation was run in 2009 (to get "after" statistics). Random phone surveys in each community were used to collect individuals' self-reported height and weight, as well as accounts of nutrition and physical activity. Individuals were also asked to visit a clinic to collect various health statistics, such as measured height and weight and blood pressure. In Medicine Hat, individuals were also asked to provide blood samples.
In addition to the outcome evaluation, Dr. Storey began working on a different type of evaluation in 2008, a community evaluation, to understand how HAC was implemented. This included holding focus groups with community coordinators as well as collecting and analyzing activity tracking forms and community capacity building tools for each community. "This information could inform continuing intervention development and also helps us, in the end, figure out what worked and what didn't," she explains.
As part of the community evaluation, Dr. Storey led a social network analysis (SNA). She wanted to understand how the chronic disease prevention organizations in each community were connected to each other.
"If you want to disseminate resources or understand how your community network works, SNA can give you an idea of who the key players are in each network," Dr. Storey explains.
To fit each organization into a network, Dr. Storey used an approach called reputational sampling. Each organization was sent a survey that asked how often they met each of the other organizations in their community, what types of information were exchanged, and if they shared resources or had partnerships, among other questions.
Organizations receive individualized reports that do not include the names of the other groups in the community so they can anonymously know where they are in the network. According to Dr. Storey, supplying this type of information could have a positive impact. "The organization can say, 'Oh look. We're only connected to two other organizations.' If they realize that they're not overly connected within the network, that information can promote capacity within each community."
The SNA revealed some interesting patterns. Networks in two of the communities contain organizations that likely act as key gatekeepers. In the future, they could be effective conduits of information and resources to the rest of the community.
These results demonstrate the value of implementing an SNA for health promotion. "It's a novel way to get an objective view of community capacity building for something like chronic disease prevention and the promotion of healthy weights. To be able to go into a community and have a tool to use can be invaluable for communities," say Dr. Storey.