Content and face validity of Workplace COVID-19 Knowledge & Stigma Scale (WoCKSS).

BACKGROUND: The COVID-19 pandemic has led to fear, rumours, and stigma, particularly against those infected with the virus. In Malaysia, the manufacturing industry is particularly vulnerable to COVID-19 clusters, making it critical to assess stigma attitudes among workers. To address this issue, The Workplace COVID-19 Knowledge & Stigma Scale (WoCKSS) was developed specifically for use in the manufacturing industry which served as the sample population for testing this scale. It was developed in the Malay language to ensure alignment with the local context. This study examines the content and face validity of WoCKSS, which can help assess the level of knowledge and stigma associated with COVID-19 among workers. METHODS: The WoCKSS was developed with 20 and 31 items for knowledge and stigma domains, respectively, based on an extensive review of COVID-19 literature. Content validation was conducted by four experts using a content validation form to assess the relevancy of each item to the intended construct. Content Validity Index (CVI) was calculated to measure the agreement between the experts on the relevance of each item to the intended construct. Face validation was then conducted by randomly selecting 10 respondents from the manufacturing industry, who rated the clarity and comprehension of each item using a face validation form. The Item Face Validity Index (I-FVI) was calculated to determine the clarity and comprehension of each question, and only items with an I-FVI ≥ 0.83 were retained. RESULTS: The WoCKSS achieved excellent content validity in both knowledge and stigma domains. Only 19 items from the knowledge domain and 24 items from the stigma domain were retained after CVI analysis. All retained items received a CVI score of 1.00, indicating perfect agreement among the experts. FVI analysis resulted in 17 items for the knowledge domain and 22 items for the stigma domain. The knowledge domain achieved a high level of agreement among respondents, with a mean I-FVI of 0.91 and a S-FVI/UA of 0.89. The stigma domain also showed high agreement, with a mean I-FVI of 0.99 and a S-FVI/UA of 0.86. CONCLUSION: In conclusion, the WoCKSS demonstrated high content and face validity. However, further testing on a larger sample size is required to establish its construct validity and reliability.

Identifying Social Network Characteristics Associated With Youth Physical Activity Skill Competency at a Summer Care Program.

While literature suggests that youth physical activity (PA) behaviors are affected by network influences, less is known about network influences on perceived skill competency, a component of physical literacy and self-efficacy. This study aims to provide an understanding of potential network characteristics which are associated with youth PA skill competency. Youth (n = 158) between the ages of 8 and 12 years recruited from two summer care programs (i.e., Boys & Girls Clubs) participated in researcher-administered surveys. Youth self-reported their age, sex, involvement in team sports, weekly PA, and skill competency assessed using a version of the PLAYself measure. Youth were also asked to report up to five people in the summer program and five out of the program with whom they interacted the most. Linear regression was used to evaluate associations between skill competency and demographics, PA, and social network characteristics. Skill competency was significantly associated (R2 = .17) with age (ß = -.06, p = .01), sex (ß = -.06, p = .01), sports team involvement (ß = .16, p < .001), and weekly PA (ß = -.20, p < .001). Skill competency was also significantly associated with the number of connections with whom the youth played frequently (ß = .09, p < .001), the number of connections that helped the youth to be active (ß = .18, p < .001), and the heterogeneity of the type of relationships within the youth's network (ß = .11, p < .001). Skill competency scores were significantly associated with both individual variables and social network composition. In addition, youth with networks comprising several types of relationships (heterogeneity) reported a significantly high skill competency. PA interventions can be most effective when considering the reinforcing aspects of networks and skill competency.

An egocentric network analysis of U.S. college students' recollection of mental health symptoms and social connections during the COVID-19 pandemic.

Objective: This study analyzes pandemic-era diminished mental health and social connections among college students. Participants: Students of a large public university completed an online survey measuring self-reported mental health symptoms for themselves and that of their closest social connections. Methods: Three regression models were used to understand if pandemic-era diminished mental health was associated with mental health characteristics present among their social networks: (1) depressive symptoms, (2) loneliness, and (3) hopelessness. Results: Students experiencing depressive symptoms (R2 = 0.13, F = 3.685, p < 0.001) perceived depressive symptoms (ß = 0.32, p = 0.01) among their social connections. Students experiencing loneliness (R2 = 0.13, F = 3.867, p < 0.001) perceived loneliness (ß = 0.39, p = 0.02) among their social connections. Students experiencing hopelessness (R2 = 0.14, F = 4.223, p < 0.001) perceived depressive symptoms (ß = 0.35, p = 0.01) among their social connections. Conclusion: Social connections may influence mental health symptoms and could be a social determinant of certain mental health outcomes.

Personal Agency and Social Supports to Manage Health Among Non-Hispanic Black and Hispanic Men With Diabetes.

The prevalence of type 2 diabetes (T2D) is increasing among non-Hispanic Black and Hispanic communities, especially among men who develop this chronic condition at earlier ages. Personal agency and social support are vital aspects to diabetes management. However, less is known about the relationship between these variables among men living with diabetes. The purposes of this study were to identify (1) levels of personal agency to manage health, (2) sources of social supports to manage health based on personal agency levels, and (3) factors associated with lower personal agency to manage health. Cross-sectional data from non-Hispanic Black (n = 381) and Hispanic (n = 292) men aged 40 years or older with T2D were collected using an internet-delivered questionnaire. Three binary logistic regression models were fitted to assess sociodemographics, health indicators, and support sources associated with weaker personal agency to manage health. About 68% of participants reported having the strongest personal agency relative to 32.1% reporting weaker personal agency. Men who relied more on their spouse/partner (odds ratio [OR] = 1.22, p = .025), coworkers (OR = 1.59, p = .008), or faith-based organizations (OR = 1.29, p = .029) for ongoing help/support to improve their health and manage health problems were more likely to have weaker personal agency. Conversely, men who relied more on their health care providers for ongoing help/support to improve their health and manage health problems were less likely to have weaker personal agency to manage health (OR = 0.74, p < .001). Findings suggest personal agency may influence men's support needs to manage T2D, which may also be influenced by cultural, socioeconomics, and the composition of social networks.

Cultivating an Active Living Plan Through a Social-Ecological Evaluation.

Physical activity (PA) social-ecological model (SEM) posits the importance of several levels of influence critical for PA promotion within communities. The purpose of this study was to examine an SEM evaluation informing a county-wide active living plan in McLennan County, Texas in the United States. Mixed-methods evaluation occurred in 4 stages: (1) county policies (n = 15) were evaluated for PA promoting strategies; (2) PA resource assessments (PARAs) were conducted via Google Maps (n = 171); (3) surveys (n = 244) included the International Physical Activity Questionnaire and interpersonal and intrapersonal factors related to PA; and (4) focus groups (n = 5) were conducted with residents (n = 30), discussing barriers and facilitators to being active. Logistic regression determined significant associations between SEM factors and meeting PA recommendations. Policy scans and PARAs identified strengths and areas of improvement (eg, equitable project selection and disparities in resource quality). Residents reporting fewer barriers (OR = 0.89, P =.01), more perceived behavioral control (odds ratio [OR] = 1.38, P = .01), more social co-participation in PA (OR = 1.20, P = .03), and living in zip codes with higher mean PARA score (OR = 1.22, P = .04) were significantly more likely to meet PA recommendations (Nagelkerke R2 = 0.32). Focus groups also discussed safety and disparities in access and quality. This study suggests the utility of the SEM when evaluating and promoting community PA.

Intramural sports social networks and implications for college student physical activity, sense of community, and retention.

Objective: This study examines associations between social networks developed through intramural sports and physical activity (PA), sense of community, and retention. Participants: College students participating in intramural sports at a large public university in the Southern United States (n = 250). Methods: Students self-reported PA, sense of community, retention, and social networks developed through intramural sports in Fall 2022. Logistic and linear regression determined significant individual and network factors associated with PA, sense of community, and retention. Results: Participants were significantly more likely to meet PA recommendations (Nagelkerke R2=.24) if they were younger, male, and reported more people in their networks were physically active often. Participants reported a greater sense of community (R2 =.28) and retention intention (R2 =.26) if they reported meeting PA recommendations, feeling closer to network members, and more relationships improving through intramurals. Conclusion: Results underline the importance of creating quality intramural experiences for college students.

Recruiting experiences of NIH-funded principal investigators for community-based health behavior interventions during the COVID-19 pandemic.

Successful recruitment into randomized trials and interventions is essential to advance scientific knowledge to improve health. This rapid assessment study explored how the COVID-19 pandemic affected participant recruitment overall, identified how it exacerbated existing challenges to recruit hard-to-reach populations, and described how NIH-funded Principal Investigators (PIs) responded to COVID-era recruitment challenges. A cross-sectional survey of NIH-funded PIs conducting interventions and trials related to health behaviors was conducted in 2022. The survey was completed by 52 PIs, most of whom were highly experienced in this type of research. Eighteen PIs reported it was very difficult to recruit participants now (39.1%) compared to before COVID-19 when only one did (2.2%). PIs reported changing recruitment and data collection methods (29.4%), increasing staff dedicated to recruitment (29.4%), and increasing participant compensation (23.5%). Recruitment methods shifted from in-person activities to social media and other electronic communications. Barriers to recruitment included reluctance to participate in research, COVID-19 protocols and precautions, overwhelmed community partners, staff burnout and turnover, and limited access to technology for some populations that were already hard to reach. Facilitators to recruitment consisted of increased access and ability to use remote technologies, use of social media, strong community ties, and wanting to be part of something positive. PIs perceived recruitment as much more difficult after the onset of COVID-19, though research teams were able to pivot to more online and remote options. These tools may have a lasting impact in modernizing recruitment, data collection, and intervention techniques in future trials.

Strategies for measuring peer alcohol use within egocentric network analysis.

OBJECTIVE: Compare different strategies for measuring perceived peer alcohol use within network research. PARTICIPANTS: College students (N = 309). METHODS: Collected demographic, personal alcohol use, and egocentric network data. Hierarchical linear regression analyses predicted egos' drinking behavior (AUDIT-C scores). RESULTS: Egos' perceptions of nominated peers' binge-drinking frequency explained a significant portion of variance in egos' AUDIT-C scores, over and above perceptions of nominated peers' frequency/typical quantity of alcohol consumption and important demographic covariates. Using more than three items to assess perceived peer alcohol use did not offer statistically significant improvements and may add unnecessary response burden. CONCLUSIONS: Utilizing the three-item approach (i.e., frequency, quantity, binge-drinking frequency) to assess perceived peer drinking explained more variance in egos' AUDIT-C scores, as opposed to one- and two-item assessments. Implementing this three-item assessment in egocentric network research can enhance programming efforts targeting reductions in binge drinking among college students within social contexts.

Evaluation of a civic engagement approach to catalyze built environment change and promote healthy eating and physical activity among rural residents: a cluster (community) randomized controlled trial.

BACKGROUND: Prior studies demonstrate associations between risk factors for obesity and related chronic diseases (e.g., cardiovascular disease) and features of the built environment. This is particularly true for rural populations, who have higher rates of obesity, cancer, and other chronic diseases than urban residents. There is also evidence linking health behaviors and outcomes to social factors such as social support, opposition, and norms. Thus, overlapping social networks that have a high degree of social capital and community cohesion, such as those found in rural communities, may be effective targets for introducing and maintaining healthy behaviors. METHODS: This study will evaluate the effectiveness of the Change Club (CC) intervention, a civic engagement intervention for built environment change to improve health behaviors and outcomes for residents of rural communities. The CC intervention provides small groups of community residents (approximately 10-14 people) with nutrition and physical activity lessons and stepwise built environment change planning workshops delivered by trained extension educators via in-person, virtual, or hybrid methods. We will conduct process, multilevel outcome, and cost evaluations of implementation of the CC intervention in a cluster randomized controlled trial in 10 communities across two states using a two-arm parallel design. Change in the primary outcome, American Heart Association's Life's Simple 7 composite cardiovascular health score, will be evaluated among CC members, their friends and family members, and other community residents and compared to comparable samples in control communities. We will also evaluate changes at the social/collective level (e.g., social cohesion, social trust) and examine costs as well as barriers and facilitators to implementation. DISCUSSION: Our central hypothesis is the CC intervention will improve health behaviors and outcomes among engaged citizens and their family and friends within 24 months. Furthermore, we hypothesize that positive changes will catalyze critical steps in the pathway to improving longer-term health among community residents through improved healthy eating and physical activity opportunities. This study also represents a unique opportunity to evaluate process and cost-related data, which will provide key insights into the viability of this approach for widespread dissemination. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05002660 , Registered 12 August 2021.

Associations Between Sexual Assault Victimization and Risky Drinking Within College Women's Personal Networks.

Within a sample of college women, this study assessed if an individual's (i.e., ego) history of sexual assault was related to her connecting with risky drinkers, and if her social contacts (i.e., alters) who had experienced sexual assault were also people who engaged in risky drinking. Results suggest ego's history of sexual assault was associated with her connecting to risky drinkers. Generally, egos reported alters who experienced sexual assault were more likely to drink in higher quantities, except when the ego and alter both had experienced sexual assault. Findings highlight the importance of social connections for survivors of sexual assault.

I CrossFit; Do You? Cross-Sectional Peer Similarity of Physical Activity Behavior in a Group High Intensity Functional Training Setting.

Physical activity (PA) is essential for physical, mental, and emotional health; however, few adults engage in enough PA. Group exercise environments such as CrossFit can promote sustained exercise habits through social influence, support, and norms. This cross-sectional study aims to provide evidence for PA social influence at CrossFit. CrossFit members (n = 62) reported PA, workout logging frequency, and members at their gym they: (1) work out with and (2) go to with personal matters. Separate linear network autocorrelation models (LNAMs) determined if individuals reported similar PA scores as those of their social ties at CrossFit that they work out with and/or those they go to for personal matters. Participants reported a mean of 2740.55 MET minutes/week (SD = 1847.08), working out with a mean of 9.89 members (SD = 6.26), and speaking to a mean of 2.66 members about personal matters (SD = 3.68). A person's PA was significantly associated with that of their ties they go to with personal matters (PEp = 0.08, SEp = 0.02), but was not associated with the PA of their ties they work out with (PEw = 0.02, SEw = 0.01). Social influence on PA levels was present when a deeper connection is made between members. Fostering and promoting deeper connections between members may help promote PA and continued exercise habits.

Exercise in the Treatment of Addiction: A Systematic Literature Review.

BACKGROUND: Exercise has been recognized as a promising and emerging treatment for individuals recovering from addiction. The purpose of this article was to systematically review scientific studies using exercise as a means to improve, sustain, or treat addictions, and to provide suggestions for the future use of exercise as a treatment method for addiction. METHODS: Using PRISMA guidelines, a database search was conducted for articles that tested the impact of exercise interventions on addiction-related outcomes. To be included, peer-reviewed experimental design studies had to use human subjects to investigate the relationship between exercise and the treatment of or recovery from addiction. Garrard's Matrix Method was used to extract data from reviewed articles (n = 53). RESULTS: Nearly three quarters of the studies reviewed documented a significant change in addiction-related outcomes (e.g., more days abstinent, reduced cravings) in response to exercise exposure, particularly while someone was receiving treatment at an in or outpatient clinic. Many studies investigated the effect of acute bouts of exercise on nicotine dependence, and many studies had small sample sizes, leaving room for future research on how exercise might benefit people recovering from substance and process addictions. CONCLUSION: Results affirm that exercise can be a helpful aspect of addiction treatment. Future researchers should investigate different exercise settings (e.g., group-based exercise vs individual) and explore exercise maintenance and the long-term outcomes following discharge from treatment facilities.

Summer Friends and Physical Activity: Social Network Effects on Child Self-Reported Physical Activity at Summer Care Programs.

Summer is a time of reduced physical activity (PA) for children; however, summer care programs (SCPs) can provide opportunities for children to be active and foster friendships. This study investigated associations between PA and friendship formation at SCPs. Children (ages 8-12 years) from two SCPs reported demographics, PA, and up to five friends at the program. Exponential random graph modeling determined significant factors associated with connections at each time point and between time points. PA was a significant factor in sending and maintaining friendship connections. A further understanding of the social dynamics which assist in the maintenance of PA behaviors during summer may improve the odds children engage in the recommended amounts of PA during this crucial time.

¿Qué Está Haciendo Papá? Mexican-Heritage Fathers' Physical Activity Networks After a Father-Focused Health Program.

Physical activity (PA) is a public health priority due to holistic health benefits; however, many adults do not meet PA guidelines. Few studies have examined Mexican-heritage fathers' social networks, specifically with whom they are physically active. This study examines changes in Mexican-heritage fathers' PA networks after participation in a father-focused, family-centered health program. Families consisting of child (aged 9-11 years), mother, and father were recruited from colonias on the Texas-Mexico border for participation in a 6-week father-focused, family-centered program concentrated on healthy eating and active living. Fathers reported up to 5 people with whom they were active most in the previous month before and after the program as well as how often they were active with the person and what activities they did most often. Multilevel regression models examined changes in networks. Fathers (n = 42; mean age = 39.07 years, SD = 7.45) were significantly more likely to report more frequent PA with others after the program as compared with before. General active play and conditional support were mentioned most frequently. This study provides context to the social networks and PA behaviors of Mexican-heritage fathers and suggests that a father-focused, family-centered health program can increase the PA frequency with social network connections.

Social Influence on Fad Diet Use: A Systematic Literature Review.

Background: A fad diet is a broad term used to describe dieting methods that recommend altering the intake of macronutrients to specific proportions or instruct people to intake or avoid particular foods, often with the goal of rapid weight loss. Previous literature reviews report social influence impacts general diet behaviour, but have yet to examine fad diets, specifically. Therefore, the purpose of this systematic review was to synthesize literature related to social influence on an individual's fad diet use and understand the sociocultural factors related to diet use. Methods: Using PRISMA guidelines, Medline, PsycInfo, Embase, CINAHL, and CENTRAL databases were searched to identify articles investigating the impact of social on fad diet use. Covidence was used to manage the review process and Garrard's Matrix Method was used to extract data from reviewed articles (n = 13). Results: A majority of reviewed studies examined interpersonal influence (62%) and reported social influence impacting a variety of fad diet behaviours (92%). Interpersonal and media influence were highlighted as motivating factors for adopting unhealthy dieting methods (54%), and studies showed interpersonal support impacted adoption and maintenance of fad diet use (23%). Also, social norms were reported to influence unhealthy weight control behaviours (15%). Discussion: This review revealed social influence is associated with the adoption, adherence, and termination of fad diets. The prevalence of fad diets in society and the lack of research on this topic warrants further examination of factors related to fad diets use and the spread among interpersonal networks.

Network analysis of a community-wide teenage pregnancy prevention initiative.

Although US teenage birth rates substantially decreased over the past two decades, it still remains the highest in the developed world. More innovative, community-wide initiatives are needed to combat the issue. In Oklahoma County, Oklahoma, the Central Oklahoma Teen Pregnancy Prevention Collaboration is utilizing the collective impact model to convene multiple organizations with the goal of making systems-level changes related to teenage pregnancy within the community. This study used an interorganizational network analysis to evaluate the current strength of relationships between organizations in the Collaboration. An interorganizational network survey assessed collaborative relationships (e.g. information sharing and joint planning) within the network. Using R software, network diagrams were developed to depict partner relationships, and network measures, including node-, group- and network-level measures, were calculated. The network depiction (n = 23) revealed that the network core was composed of organizations from multiple sectors, and the backbone organization served as the most central organization for most centrality measures. This study provides insight into how organizational relationships can be assessed in order to increase community capacity to address teenage pregnancy. Continuous monitoring of the strength of relationships is important to ensure success in achieving goals as well as collective impact.

Predicting emotional abuse among a sample of college students.

Objective This study aims to examine factors related to emotional abuse, an understudied type of intimate partner violence (IPV), among a sample of college students. Participants: 601 undergraduates from one large public university in the Midwestern United States (Spring 2017) and 756 undergraduates from one large public university in the Southern United States (Fall 2019) participated in the study. Methods: Participants completed an online survey measuring demographic information, behavioral variables (viewing porn, alcohol consumption, and hooking up), and history of violence (witnessing a father abuse his spouse, emotional abuse history). Descriptive statistics and binary logistic regression analyses predicting emotional abuse victimization were conducted. Results: Results indicate female, white, older students were more likely to report emotional abuse. Also, students witnessing their father abuse his spouse, frequent pornography use, increased alcohol use, and frequent hookups increased odds of emotional abuse. Conclusion: College campuses should consider emphasizing emotional abuse in IPV programing.

Computational analyses identify addiction help-seeking behaviors on the social networking website Reddit: Insights into online social interactions and addiction support communities.

INTRODUCTION: Although social connection to others with lived addiction experiences is a strong predictor of long-term recovery from substance use disorders (SUD), the COVID-19 pandemic greatly altered global abilities to physically connect with other people. Evidence suggests online forums for people with SUD may serve as a sufficient proxy for social connection, however efficacy of online spaces as addiction treatment adjuncts remains empirically understudied. PURPOSE: The purpose of this study is to analyze a collection of Reddit posts germane to addiction and recovery collected between March-August 2022. METHODS: We collected (n = 9,066) Reddit posts (1) r/addiction; (2) r/DecidingToBeBetter, (3) r/SelfImprovement, (4) r/OpitatesRecovery, (5) r/StopSpeeding, (6) r/RedditorsInRecovery, and (7) r/StopSmoking subreddits. We applied several classes of natural language processing (NLP) methods to analyze and visualize our data including term frequency inverse document frequency (TF-IDF) calculations, k-means clustering, and principal components analysis (PCA). We also applied a Valence Aware Dictional and sEntiment [sic] Reasoner (VADER) sentiment analysis to determine affect in our data. RESULTS: Our analyses revealed three distinct clusters: (1) Personal addiction struggle, or sharing one's recovery journey (n = 2,520), (2) Giving advice, or offering counseling based on first-hand experiences (n = 3,885), and (3) Seeking advice, or asking for support or advice related to addiction (n = 2,661). DISCUSSION & CONCLUSION: Addiction, SUD, and recovery dialogue on Reddit is exceedingly robust. Much of the content mirrors tenets for established addiction-recovery programs, which suggests Reddit, and other social networking websites, may serve as efficient tools to promote social connection among people with SUD.

Sport Participation Associations With Child Friend Selection and Physical Activity While at Summer Care Programs.

Child physical activity (PA) declines during summer reducing PA-related health benefits. Summer care programs (e.g., Boys & Girls Clubs) can promote active play while providing opportunities for friendships. Sport participation is a positive influence on PA and social development. Purpose: This article investigates the role of sport participation in PA attainment, perceived skill competency, and social connection at a summer care program. Methods: Children self-reported PA, sport participation, and the names of up to five peers whom they played with most at the program at the start (T1; n = 100; M age = 9.94 years; SD = 1.34; 47% male) and end (T2; n = 77; M age = 9.83 years; SD = 1.46; 51% male) of summer. Network autocorrelation models were used to determine if child sport participation was significantly associated with those they played with at the program. Results:Children who reported sport participation reported significantly more PA than those who did not at T1, but not T2. Child sport participation was significantly related to that of the peers they said they spent time with while at the program for T1 (ß = 0.07, p < .01), but not T2 (ß = 0.06, p = .10). Additionally, PA (ß = 0.08, p < .01; ß = 0.07, p = .01) and skill competency (ß = 0.11, p = .02; ß = 0.15, p < .01) were significantly associated with sport participation at both time points. While sports participation was a key factor in child friendships at the start of summer, the program allowed children, regardless of sport participation, to become friends outside of sports. Conclusions: These results suggest summer care programs promote PA through play and provide opportunities for children to facilitate friendships regardless of sport participation.

Assessing Social Network Influences on Adult Physical Activity Using Social Network Analysis: A Systematic Review.

OBJECTIVE: Social network analysis (SNA) can measure social connectedness and assess impact of interpersonal connections on health behaviors, including physical activity (PA). This paper aims to systematically review adult PA studies using SNA to understand important social network concepts relative to PA. DATA SOURCE: A search was performed using PsycINFO, MEDLINE, PubMed, and Web of Science. STUDY INCLUSION AND EXCLUSION CRITERIA: To be included in the search, articles needed to 1) include a measure of PA, 2) conduct an SNA in which specific relationships were measured, and 3) conduct an analysis between social network measures and PA. DATA EXTRACTION: Key study elements including network design and results were extracted. DATA SYNTHESIS: Data were synthesized to answer 2 questions: 1) how has adult PA been investigated using SNA approaches and 2) how is an adult's social network associated with PA behaviors? RESULTS: A final sample of 28 articles remained from an initial 11 085 articles. Network size, homophily, network composition, and network exposure to PA were all associated with individual level PA across studies. Lastly, longitudinal and intervention studies showed a more complex picture of social influence and diffusion of PA behavior. CONCLUSIONS: Adults' PA behaviors are influenced by their networks. Capitalizing on this influence, researchers should engage not just individual behavior change but also the social influences present within the person's life.