Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review

BACKGROUND

The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents.

METHODS

The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method.

RESULTS

Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings.

CONCLUSIONS

The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).

Socially Acquired Nocebo Effects Generalize but Are Not Attenuated by Choice

BACKGROUND

Socially observing a negative treatment-related experience has been shown to modulate our own experience with the same intervention, leading to worsened health outcomes. However, whether this social learning generalizes to similar but distinct interventions has not been explored nor what manipulations can reduce these effects.

PURPOSE

To determine whether socially acquired nocebo effects can be generated by observing a negative experience with a similar, but distinct intervention, and whether choice can reduce these effects.

METHODS

Across three experiments, a community sample of healthy adults (N = 336) either watched a confederate report cybersickness to the same Virtual Reality (VR) activity they were assigned to (Social Modeling: Consistent); a similar, but different VR activity (Social Modeling: Inconsistent); or did not view the confederate (No Social Modeling). Participants were either given choice over the VR (Choice) or assigned by the experimenter (No Choice).

RESULTS

Across the experiments, there was significantly greater cybersickness in both Social Modeling groups relative to No Social Modeling, while the two Social Modeling groups did not differ. There was no significant effect of Choice or a Choice by Social Modeling interaction. Social Modeling elicited greater anxiety and expectancies for cybersickness. Furthermore, these mechanisms mediated the association between social modeling and cybersickness.

CONCLUSIONS

Socially acquired side-effects were demonstrated to generalize to similar, but distinct interventions, highlighting the diffuse and robust effect social modeling can have on our experiences. However, choice did not attenuate the experience of cybersickness, highlighting the need for alternative methods to counteract the effect of social modeling.

Influence of social-normative information on the modeling of food-related decisions

Social modeling is a powerful influence on people's food intake: When there is a clear and consistent norm, people eat more when eating with someone who eats a lot and eat less when eating with someone who eats only a little. In three studies, the present research examined how clear versus ambiguous social-normative information influences the modeling of food-related decisions. Using a novel online decision-making paradigm, female participants (total N = 1042) were provided with information about how many cookies previous participants had supposedly selected (no information was provided in the control condition), and then decided how many cookies they would choose for a snack. When there was a clear and consistent norm, the typical social modeling effect was observed. When there was a small number of "dissenters" whose responses conflicted with the norm set by the majority, participants' cookie selection still conformed to the behaviour of the majority (Studies 1 and 2). It was only when the behaviour of the previous participants was highly ambiguous that participants behaved as if they had been given no normative information (Study 3). By demonstrating that, except in extreme cases, people use the available information to discern a social norm that influences their behaviour, these findings highlight the power of social norms related to food-related decisions.

Social modeling of food choices in real life conditions concerns specific food categories

The social context of eating has a profound effect on consumption choices. Social modeling, that involves using others' behavior as a guide for appropriate consumption, has been well documented for food intake, but less is known about social modeling of food choices. Moreover, social modeling has mainly been studied in laboratory settings. We conducted an observational study in a self-service canteen to examine whether the food choices of an individual were influenced by the choice of the person ahead in the queue. We recorded food choices of 546 individuals (333 men and 211 women) and those of the person in front of them in the queue along a linear buffet. Starters were sub-categorized into salads, mixed starters (e.g. avocado shrimp mayonnaise), and cold meat starters, and desserts were sub-categorized into fruits, dairy products and pastries. There was a significantly higher probability of taking a starter in general (OR = 1.65, IC = 1.06-2.57, p = 0.03), a salad (OR = 1.78, CI = 1.08-2.93, p = 0.02), a mixed starter (OR = 2.98, CI = 1.42-6.05, p < 0.01), but not a cold meat, if the person ahead in the queue also took one compared to when the person ahead did not take one. No significant modelling was found for desserts which may be because almost all participants took a dessert. These results highlight that social modeling influences food choices, and that this phenomenon can be observed in a real life setting. These data also suggest that some food categories, such as starters, could be more susceptible to social modeling than are others. Finally, we observed modeling both between familiar and unfamiliar participants, which suggests that social norms could be used to promote healthier eating in a range of settings including friendship groups.

Social influence fosters the use of a reusable takeaway box

The severe ecological and economic consequences of disposable takeaway containers call for the implementation of effective interventions: namely, the use of reusable takeaway boxes. The present field study examined how social influence determined whether customers chose a reusable or a disposable takeaway box at a takeaway restaurant. We unobtrusively recorded the takeaway packaging choices (reusable vs. disposable) of customers over lunchtimes during a period of four weeks. We operationalized social influence in two ways. First, we manipulated social norms. For half of the field days, we added a normative message to the existing informational material on the counter of the takeaway outlet. Second, we observed social modeling by recording whether the takeaway packaging choice took place in the presence of other customers using a reusable takeaway box. The results were mixed: On one hand, we found no effect from the manipulated social norm, which we discuss in the light of past interventions using social norm messages. On the other hand, we found an effect of the observed social modeling: witnessing others using a reusable takeaway box increased the odds of choosing one oneself. This finding demonstrates the importance of getting customers to perform the desired behavior, to serve as social role models for others.