Department of Population & Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
BMC Public Health. 2022 May 16;22(1):985. doi: 10.1186/s12889-022-13372-w.
Peer-led interventions for adolescents are effective at accelerating behavioral change. The Sources of Strength suicide preventive program trains student peer change agents (peer leaders) in secondary schools to deliver prevention messaging and conduct activities that increase mental health coping mechanisms. The program currently has school staff select peer leaders. This study examined potential for more efficient program diffusion if peer leaders had been chosen under network-informed selection methods.
Baseline assessments were collected from 5,746 students at 20 schools. Of these, 429 were selected by adults as peer leaders who delivered intervention content through the school year. We created theoretical alternate peer leader sets based on social network characteristics: opinion leadership, centrality metrics, and key players. Because these sets were theoretical, we examined the concordance of these sets with the actual adult-selected peer leaders sets and correlated this metric with diffusion of intervention modalities (i.e., presentation, media, communication, activity) after the first year.
The sets of adult-selected peer leaders were 13.3%-22.7% similar to theoretical sets chosen by other sociometric methods. The use of friendship network metrics produced peer leader sets that were more white and younger than the general student population; the Key Players method produced more representative peer leader sets. Peer opinion leaders were older and more white than the general population. Schools whose selected peer leaders had higher overlap with theoretical ones had greater diffusion of intervention media and peer communication.
The use of network information in school-based peer-led interventions can help create more systematized peer leader selection processes. To reach at-risk students, delivery of an indirect message, such as through a poster or video, may be required. A hybrid approach where a combination of visible, respected opinion leaders, along with strategically-placed key players within the network, may provide the greatest potential for intervention diffusion.
同伴主导的干预措施对青少年加速行为改变是有效的。力量之源自杀预防计划培训中学生同伴变革代理人（同伴领袖），在中学中传递预防信息，并开展活动，增加心理健康应对机制。该计划目前由学校工作人员选择同伴领袖。本研究探讨了如果同伴领袖是根据网络知情选择方法选择的，该计划是否具有更大的扩散潜力。
从 20 所学校的 5746 名学生中收集基线评估数据。其中，429 名学生被成年人选为同伴领袖，他们在整个学年中通过学校提供干预内容。我们根据社会网络特征创建了理论上的替代同伴领袖群体：意见领袖、中心性指标和关键人物。由于这些群体是理论上的，我们检查了这些群体与实际由成年人选择的同伴领袖群体的一致性，并将这一指标与第一年之后干预模式（即演示、媒体、沟通、活动）的扩散相关联。
成年人选择的同伴领袖群体与其他社会计量方法选择的理论群体的相似性为 13.3%-22.7%。使用友谊网络指标产生的同伴领袖群体比一般学生群体更白、更年轻；关键人物方法产生了更具代表性的同伴领袖群体。同伴意见领袖比一般人群更年长、更白。选择的同伴领袖与理论群体重叠度较高的学校，干预媒体和同伴沟通的扩散程度较大。
在基于学校的同伴主导干预中使用网络信息可以帮助创建更系统的同伴领袖选择过程。为了接触到高风险学生，可能需要通过海报或视频等间接信息进行传递。一种混合方法，结合了可见的、受尊敬的意见领袖，以及网络中的战略关键人物，可能为干预传播提供最大的潜力。
