Approaches to Network Collection
                      for Internet and Health Services
                               Kri...
Table of Contents
                     • Social Networks and Health (K+B)
                     • Collecting Social Network...
Networks relate to health outcomes such
    as obesity, STIs, and even life expectancy
                           Source: ...
Health Management in Context


                                         Network
                                       Cha...
There are many types of networks




Friday, October 23, 2009                 5
Sociocognitive
                           (e.g. Recall by closeness)




Friday, October 23, 2009                         ...
Sociocognitive
                                                                                                    (e.g. R...
Sociocognitive
                                                                                                           ...
Networks
     can show
    prominence
     Generally referred to in
      centrality. There are
          many types:

   ...
Networks
     can show
    prominence
     Generally referred to in
      centrality. There are
          many types:

   ...
Whole networks cluster




                           Source: Jim Moody. Add Health data
Friday, October 23, 2009         ...
Whole networks cluster




                           Source: Jim Moody. Add Health data
Friday, October 23, 2009         ...
Different networks
                              have different
                             consequences


Friday, Octobe...
Issues with Networks I:
               Standard social network analysis is done on nodes
               of like type. Howe...
Issues with Networks II:
                               Rest

              Aspirin                 Oxycontin
            ...
Issues with Networks III:
           Individuals coping with sensitive issues such stigmatized
           and uncommon ill...
What kinds of
               networks facilitate
            information seeking
       for Health and Medical Issues?



...
Information seeking

             • Information flows through and is
               contextualized by networks.
           ...
Differentiating Health and Medical Information
                           Health information                   Medical inf...
Data: Connected Lives
         • Multi-stage research project in
              Toronto (and Northern Ontario)
            ...
Capturing Health Management

                 • Hours of Internet use
                      (general, health-specific)
    ...
Results
                “How would you classify your most recent health issue?”
              Lifestyle: n=59             ...
Searching for health information
              “Iʼm sure I Googled it, cause thatʼs become a verb now. I
                 ...
Classification of
                           Health Management Measures


                           Sick          Savvy   ...
What happens if youʼre all
               three (Sick, Savvy AND Solo)?
             • Mr. Diabetes   • Mr. Frostbite   • ...
What happens if youʼre all
               three (Sick, Savvy AND Solo)?
             • Mr. Diabetes   • Mr. Frostbite   • ...
What happens if youʼre all
               three (Sick, Savvy AND Solo)?
             • Mr. Diabetes   • Mr. Frostbite   • ...
What happens if youʼre all
               three (Sick, Savvy AND Solo)?
             • Mr. Diabetes   • Mr. Frostbite   • ...
Mr. Diabetes (343)
             • He is a 34 year old married civil engineer with 2
               young children. Has bee...
Mr. Frostbite (561)
             • He is a 42 year old married man with no children
               who moved to Canada wit...
Ms. Hep C (608)
             • She is a 58 year old woman, married no children. Lived in
               Canada 8 years, mo...
“Who in your network do you go to
                  for health information?”
              10% of those interviewed do not...
Summarizing the analysis
             • Information flows through networks and media in different
               ways. Medi...
Summarizing network techniques
             • What we learn about social structure will
               depend on the techn...
Final thoughts
             • Different network structures yield different
               outcomes and different needs.
  ...
Thank You
                    Kristen Berg
            NetLab, University of Toronto
                                     ...
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hsns09:Approaches to network collection for internet health services - Bernie Hogan,Kristen Berg

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Bernie Hogan, Oxford Internet Institute & Kristen Berg, Netlab, University of Toronto.
http://www.oii.ox.ac.uk/people/faculty.cfm?id=140

Connected Practice Symposium: Human Services in the Network Society, Changes, Challenges & Opportunities. The Institute for Advanced Studies, Glasgow, 14 September 2009.
http://connectedpractice.iriss.org.uk/

Published in: Health & Medicine, Education
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hsns09:Approaches to network collection for internet health services - Bernie Hogan,Kristen Berg

  1. 1. Approaches to Network Collection for Internet and Health Services Kristen Berg Bernie Hogan NetLab, Oxford Internet Institute University of Toronto University of Oxford Human Services in the Network Society September 14, 2009 Friday, October 23, 2009 1
  2. 2. Table of Contents • Social Networks and Health (K+B) • Collecting Social Network Data (B) • Considering Health and Wellness Information (K) • Relating Health/Wellness to Networks (K +B) • Conclusions (B then K) Friday, October 23, 2009 2
  3. 3. Networks relate to health outcomes such as obesity, STIs, and even life expectancy Source: Christakis & Fowler. N Engl J Med 2007;357:370-9. Friday, October 23, 2009 3
  4. 4. Health Management in Context Network Characteristics Social support + Information acquisition seeking (resources) Friday, October 23, 2009 4
  5. 5. There are many types of networks Friday, October 23, 2009 5
  6. 6. Sociocognitive (e.g. Recall by closeness) Friday, October 23, 2009 6
  7. 7. Sociocognitive (e.g. Recall by closeness) Summer Camp Publicly Articulated (e.g. Facebook, Undergraduate Family Bebo, Twitter) Grad school High school Professional Single event friends Professional !UK" Friday, October 23, 2009 6
  8. 8. Sociocognitive (e.g. Recall by closeness) Summer Camp Publicly Articulated (e.g. Facebook, Undergraduate Family B 4 C Bebo, Twitter) Grad school A 3 5 3 6 Trace data 1 (e.g. email, 2 DL Egoschool 4 High bulletin 1 Professional boards) 12 8 2 Single event friends D F E Professional !UK" Raw Email Network {Ego, DL, A, B, C, D, E, F} Ego’s Neighbourhood {Ego, DL, A, B, D, E} Ego’s Neighbourhood trimmed to symmetric ties with in + out > 4 messages {Ego, A, B} Friday, October 23, 2009 6
  9. 9. Networks can show prominence Generally referred to in centrality. There are many types: Degree - links in & out Betweenness - shortest paths Power - high degree friends Closeness - easily reachable Friday, October 23, 2009 7
  10. 10. Networks can show prominence Generally referred to in centrality. There are many types: Degree - links in & out Betweenness - shortest paths Power - high degree friends Closeness - easily reachable Source: Carter Butts Friday, October 23, 2009 7
  11. 11. Whole networks cluster Source: Jim Moody. Add Health data Friday, October 23, 2009 8
  12. 12. Whole networks cluster Source: Jim Moody. Add Health data Friday, October 23, 2009 8
  13. 13. Different networks have different consequences Friday, October 23, 2009 9
  14. 14. Issues with Networks I: Standard social network analysis is done on nodes of like type. However, information is flows through multiple kinds of actors, all of whom are relevant to the individual Friday, October 23, 2009 10
  15. 15. Issues with Networks II: Rest Aspirin Oxycontin Even within the standard network paradigm, we frequently assume “the strength of weak ties” and the “value of ? variety”, where accessing Weed! Paracetemol more information is useful. Job hunting (the basis of SOWT) is different from health info. Friday, October 23, 2009 11
  16. 16. Issues with Networks III: Individuals coping with sensitive issues such stigmatized and uncommon illnesses may not find adequate support from otherwise dense, supportive networks. This depends on the nature of the network as much as the structure. Here's to Blue I'm down What's with Blue! Rocks with Blue that guy? Forget it, I'm going online Friday, October 23, 2009 12
  17. 17. What kinds of networks facilitate information seeking for Health and Medical Issues? Friday, October 23, 2009 13
  18. 18. Information seeking • Information flows through and is contextualized by networks. • However, Internet-based information is appealing because of availability, interactivity, anonymity and potential to transform relationships. • Information influences relationships with self, health, medical professionals, network members. • Not all information flows in the same way or to the same people. Friday, October 23, 2009 14
  19. 19. Differentiating Health and Medical Information Health information Medical information • Information about the body and/or • Relegated to medical books and the self supplied by professionals • Historically devalued by medical • Historically privileged as source of expertise well-being. • Includes: lifestyle, wellness, and self • Includes: stigmatized concerns, care mental health, chronic issues • Issues that require “care” • Issues that requires “treatment” • Dense networks facilitate common • Dense Networks of similar type health behaviour (good and bad) support, of different type • Diverse networks allow adoption of misunderstand new health practices • Diverse networks allow local disclosure Friday, October 23, 2009 15
  20. 20. Data: Connected Lives • Multi-stage research project in Toronto (and Northern Ontario) investigating ICTs and sociability. • Data comes from East York (Toronto) surveys and interviews. • 350 households survey. Broadly comparable to census tract data. • 25% convenience sub-sample (n=86) for interviews. • Slightly older and less likely to be single than in the population at large. 16 Friday, October 23, 2009 16
  21. 21. Capturing Health Management • Hours of Internet use (general, health-specific) from survey • Health Assessment from interview • Network Data discussed above • Support data via the network 17 Friday, October 23, 2009 17
  22. 22. Results “How would you classify your most recent health issue?” Lifestyle: n=59 Chronic: n=11 Health score = 7.9 Health score = 6.6 Weight loss and exercise Arthritis, diabetes, hepatitis C 0.7 hours (home) and 0.4 hours (work) 3.7 hours (home) and 0.5 hours (work) online for information online for information 16 vc ties; 25 sc ties 18 vc ties; 22 sc ties Acute: n=3 Mental Health: n=7 Health score = 9.3 Health score = 8 Heart surgery, cancer, dental issues Depression, attention deficit disorder, 0 hours (home) and 0 hours (work) anxiety online for information 0.8 hours (home) and 0 hours (work) 5 vc ties; 11 sc ties online for information 11 vc ties; 10 sc ties Friday, October 23, 2009 18
  23. 23. Searching for health information “Iʼm sure I Googled it, cause thatʼs become a verb now. I usually type in Canada; I wouldʼve put nutrition. … I remember searching for nutritionist information once and finding Ontario Canadian Website – I think Ontario Nutritionists…. (880)” “you know probably Google or Merck Manual or something like that. You know if I have a medical condition that I know about and I just want more information about it, I would look online… (432)” “Medical things I tend to look up myself, you donʼt want your friends to think you are a hypochondriac (366)” Friday, October 23, 2009 19
  24. 24. Classification of Health Management Measures Sick Savvy Solo • Health score • Computer use • Network • Medical issue • Attitude characteristics 20 Friday, October 23, 2009 20
  25. 25. What happens if youʼre all three (Sick, Savvy AND Solo)? • Mr. Diabetes • Mr. Frostbite • Ms. Hep C (343) (561) (608) Friday, October 23, 2009 21
  26. 26. What happens if youʼre all three (Sick, Savvy AND Solo)? • Mr. Diabetes • Mr. Frostbite • Ms. Hep C (343) (561) (608) Friday, October 23, 2009 21
  27. 27. What happens if youʼre all three (Sick, Savvy AND Solo)? • Mr. Diabetes • Mr. Frostbite • Ms. Hep C (343) (561) (608) Friday, October 23, 2009 21
  28. 28. What happens if youʼre all three (Sick, Savvy AND Solo)? • Mr. Diabetes • Mr. Frostbite • Ms. Hep C (343) (561) (608) Fam Fam Fam Fam Fam Friday, October 23, 2009 21
  29. 29. Mr. Diabetes (343) • He is a 34 year old married civil engineer with 2 young children. Has been online since 1994 and uses his home based Internet computer about weekly. He searches for health information online and connects with others who have diabetes. • “Because Iʼm diabetic, so Iʼve visited seven or eight times Google. Then I write down the diabetic treatment. Friday, October 23, 2009 22
  30. 30. Mr. Frostbite (561) • He is a 42 year old married man with no children who moved to Canada within a year of the interview. He uses his Internet connected home computer about daily. • “I was just clicking on the condition, a search, and then narrowing the search, until I found a forum. Forums with people, because you find a tht a professional or a doctor, his terminology arenʼt the type of terms I might use” Friday, October 23, 2009 23
  31. 31. Ms. Hep C (608) • She is a 58 year old woman, married no children. Lived in Canada 8 years, moved from US for better medical system. Uses the Internet about daily and has been online since 2002. • Her management of a chronic health issues involved doing research online and contributing to an international database. She wants to know as much as possible and has professional mechanisms for trusting the sources and treatment options. • “I would go to any FDA site where theyʼre doing research and start in clinical trials and then from there you get your key words again” Friday, October 23, 2009 24
  32. 32. “Who in your network do you go to for health information?” 10% of those interviewed do not mention a network member that can provide information 42% of that 10% mention an external source, either their doctor, or the Internet 25% of total sample mention someone outside of their network, either a doctor or the Internet Friday, October 23, 2009 25
  33. 33. Summarizing the analysis • Information flows through networks and media in different ways. Medical and health information are sought out in different ways. • People can add to their ʻinformation gathering networkʼ from those outside the personal network when necessary. • The Internet itself is considered a unique social tie that brings with it support and information. This is especially the case for medical information. • This means we should expect different kinds of social media to facilitate different kinds of information flows, and one network (or online network site) will not fit all. 26 Friday, October 23, 2009 26
  34. 34. Summarizing network techniques • What we learn about social structure will depend on the technique and the type of relationships analyzed. –Some network types: • Whole, partial,ego-centered –Some relation types: • cognitive, trace, articulated • Networks can show clusters of activity, prominent actors and flows of information 27 Friday, October 23, 2009 27
  35. 35. Final thoughts • Different network structures yield different outcomes and different needs. • In health, these needs can refer to lifestyle/ wellness and medical information • Some people use media as a compliment to their personal network, others use it as an alternative. • We should match the network to the need, rather than assume we need a network. 28 Friday, October 23, 2009 28
  36. 36. Thank You Kristen Berg NetLab, University of Toronto ;) kristen.berg@utoronto.ca Bernie Hogan Research Fellow, OII bernie.hogan@oii.ox.ac.uk Friday, October 23, 2009 29

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