title: Measuring social networks for medical research in lower-income settings.
abstract: Social networks are believed to affect health-related behaviors and health. Data to examine the links between social relationships and health in low- and middle-income country settings are limited. We provide guidance for introducing an instrument to collect social network data as part of epidemiological surveys, drawing on experience in urban India. We describe development and fielding of an instrument to collect social network information relevant to health behaviors among adults participating in a large, population-based study of non-communicable diseases in Delhi, India. We discuss basic characteristics of social networks relevant to health including network size, health behaviors of network partners (i.e., network exposures), network homogeneity, network diversity, strength of ties, and multiplexity. Data on these characteristics can be collected using a short instrument of 11 items asked about up to 5 network members and 3 items about the network generally, administered in approximately 20 minutes. We found high willingness to respond to questions about social networks (97% response). Respondents identified an average of 3.8 network members, most often relatives (80% of network ties), particularly blood relationships. Ninety-one percent of respondents reported that their primary contacts for discussing health concerns were relatives. Among all listed ties, 91% of most frequent snack partners and 64% of exercise partners in the last two weeks were relatives. These results demonstrate that family relationships are the crux of social networks in some settings, including among adults in urban India. Collecting basic information about social networks can be feasibly and effectively done within ongoing epidemiological studies.
authors.affiliation: Graduate Group in Demography, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Laura
authors.initials: L
authors.lastname: Kelly
authors.affiliation: Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Shivani A
authors.initials: SA
authors.lastname: Patel
authors.affiliation: Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America.
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.affiliation: Center for Chronic Disease Control, New Delhi, India; Chronic Disease Epidemiology, Public Health Foundation of India, New Delhi, India.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America.
authors.forename: Solveig A
authors.initials: SA
authors.lastname: Cunningham
mesh_terms: D035843:Biomedical Research; D005191:Family Characteristics; D006801:Humans; D007194:India; D011203:Poverty; D060756:Social Networking; D012940:Social Problems