Diabetes 2013 July-31

The distribution of physical activity in an after-school friendship network.

Pediatrics. 2012 Jun;129(6):1064-71.

Gesell SB, Tesdahl E, Ruchman E.

Department of Pediatrics, Vanderbilt University School of edicine, Nashville, Tennessee 37212, USA. sabina.gesell@vanderbilt.edu

Abstract

OBJECTIVE: To examine whether a child’s friendship network in an afterschool program influences his/her physical activity.

METHODS: Three waves of data were collected from school-aged children participating in aftercare (n = 81; mean [SD] age, 7.96 [1.74] years; 40% African American, 39% white, and 19% Latino) a name generator survey was used to map each child’s social network, and accelerometers were used to measure physical activity. We applied stochastic actor-based modeling for social networks and behavior.

RESULTS: Children did not form or dissolve friendships based on physical activity levels, but existing friendships heavily influenced children’s level of physical activity. The strongest influence on the amount of time children spent in moderate-to-vigorous activity in the afterschool hours was the activity level of their immediate friends. Children consistently made adjustments to their activity levels of 10% or more to emulate the activity levels of their peers (odds ratio [OR] = 6.89, P < .01). Age (OR = 0.92, P < .10) and obesity status (OR = 0.66, P < .10) had marginally significant and relatively small direct effects on the activity. Gender had no direct effect on activity.

CONCLUSIONS: These results suggest that friendship ties play a critical role in setting physical activity patterns in children as young as 5 to 12 years. Children’s activity levels can be increased, decreased, or stabilized depending on the activity level of their immediate social network during a 12-week afterschool program. Network-based interventions hold the potential to produce clinically significant changes to children’s physical activity.

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Supplemental Text:

Although obesity has stabilized in some US populations, it is still at epidemic proportions with 23 million children classified as overweight or obese. The cascade of adverse health effects associated with childhood overweight and obesity includes type 2 diabetes, hypertension, hyperlipidemia, abnormal glucose tolerance, cardiovascular disease, and psychosocial problems such as weight prejudice, depression, social isolation, poor self-esteem, and poor academic performance. Prevention efforts must start early in life but to this point in time anti-obesity interventions have generally failed. New approaches to obesity prevention are urgently needed.

An innovative approach to public health interventions has been proposed by scientists studying social networks. Social networks are the webs of social relationships that us to each other. We now know that social networks influence our health. Social networks play a significant role in adult and adolescent obesity. The role of social networks in child obesity has not been examined prior to this study. Social network interventions warrant our attention.

If healthy lifestyle behaviors can be facilitated through children’s social ties, such that when one child engages in physical activity, those children with whom he or she is connected will be more likely to engage in physical activity, then we could develop novel intervention strategies that leverage power of social networks.

This study advances the science by demonstrating that (1) friendship ties may play a critical role in setting physical activity patterns in children as young as 5 to 12 years and (2) a child’s physical activity level can be increased, decreased, or stabilized depending on the activity level of his/her immediate social network during a 12-week afterschool program. These findings warrant the development of novel interventions that leverage the social influences of children’s friendship networks to increase and maintain physical activity at a young age. Social network interventions after school hours hold the potential to produce clinically significant changes to children’s physical activity.

 

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