Social Network Interventions in Rural Honduras

Study Overview
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Brief Summary
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This project will examine the spread of health interventions with a randomized control trial design by introducing public health interventions in 32 villages in the Honduran Department of Lempira. Based on identified public health needs in the region, namely improved drinking water and diet, this study will provide training on the use of chlorine (sodium hypochlorite) for water purification and multivitamins for nutritional supplementation. In some villages, individuals selected for their social connectedness will be trained and given coupons that can be redeemed for either chlorine bleach or multivitamins, and these persons will be asked to spread this information and distribute coupons to four people of their choosing. In other villages, individuals selected at random will receive the same training, materials, and instructions. A second wave of coupon distribution will provide coupons to those who received a coupon from the original seed groups so that they may disperse these coupons further out in the social networks. Over the following months, study investigators will look at how knowledge of these health practices, and uptake or and adherence to the practices, spreads throughout the villages. More specifically, the investigators will examine the speed and extent of spreading of these new health practices after introducing them to three different initial seed groups: (1) people chosen on the basis of being named as a friend by many people in their village, (2) people chosen based on being named as a friend by a randomly chosen individual, and (3) a group of randomly chosen individuals. It is hypothesized that spread will occur faster and/or to a greater extent when the intervention is started in groups 1 and 2 versus group 3 (control group).

Official Title
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Diffusion of Health Interventions Across Social Networks in Honduran Villages

Conditions
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Malnutrition, Dysentery, Social Transmission of Health Behaviors

Intervention / Treatment
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* Behavioral: exposure to vitamin use
* Behavioral: exposure to water chlorination
* Behavioral: high in-degree
* Behavioral: nominated by random


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residents of Targeted Communities, ages 15 and up Exclusion Criteria: Children younger than age 15

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Random-Cloro<br>exposure to water chlorination | Behavioral: exposure to water chlorination<br>* Seed individuals in village are given Clorox bleach for water purification, with training on use and general information on water hygiene, along with coupons to distribute to others in village<br>* Other names: Clorox;|
| Active Comparator: Random-Vitamin<br>exposure to vitamin use | Behavioral: exposure to vitamin use<br>* Seed individuals in village are given daily adult multivitamin, with training on use and general nutrition information, along with coupons to distribute to others in village<br>* Other names: Medox Forte;|
| Experimental: Indegree-Cloro<br>high in-degree, exposure to water chlorination | Behavioral: exposure to water chlorination<br>* Seed individuals in village are given Clorox bleach for water purification, with training on use and general information on water hygiene, along with coupons to distribute to others in village<br>* Other names: Clorox;Behavioral: high in-degree<br>* Seed individuals for starting intervention are chosen on the basis of high (social network) in-degree<br>|
| Experimental: Indegree-Vitamin<br>high in-degree, exposure to vitamin use | Behavioral: exposure to vitamin use<br>* Seed individuals in village are given daily adult multivitamin, with training on use and general nutrition information, along with coupons to distribute to others in village<br>* Other names: Medox Forte;Behavioral: high in-degree<br>* Seed individuals for starting intervention are chosen on the basis of high (social network) in-degree<br>|
| Experimental: Nominated-Cloro<br>nominated by random, exposure to water chlorination | Behavioral: exposure to water chlorination<br>* Seed individuals in village are given Clorox bleach for water purification, with training on use and general information on water hygiene, along with coupons to distribute to others in village<br>* Other names: Clorox;Behavioral: nominated by random<br>* Seed individuals for starting intervention are chosen on the basis of being named as a friend/alter of a randomly selected individual<br>|
| Experimental: Nominated-Vitamin<br>nominated by random, exposure to vitamin use | Behavioral: exposure to vitamin use<br>* Seed individuals in village are given daily adult multivitamin, with training on use and general nutrition information, along with coupons to distribute to others in village<br>* Other names: Medox Forte;Behavioral: nominated by random<br>* Seed individuals for starting intervention are chosen on the basis of being named as a friend/alter of a randomly selected individual<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intervention Spread | Use of health product among community members will be tracked. | October 2012 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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social networks, nutrition, vitamins, chlorine