Egocentric social network characteristics and cardiovascular risk among patients with hypertension or diabetes in western Kenya: a cross-sectional analysis from the BIGPIC trial.

Journal Article (Journal Article)

Objectives

Management of cardiovascular disease (CVD) is an urgent challenge in low-income and middle-income countries, and interventions may require appraisal of patients' social networks to guide implementation. The purpose of this study is to determine whether egocentric social network characteristics (SNCs) of patients with chronic disease in western Kenya are associated with overall CVD risk and individual CVD risk factors.

Design

Cross-sectional analysis of enrollment data (2017-2018) from the Bridging Income Generation with GrouP Integrated Care trial. Non-overlapping trust-only, health advice-only and multiplex (trust and health advice) egocentric social networks were elicited for each participant, and SNCs representing social cohesion were calculated.

Setting

24 communities across four counties in western Kenya.

Participants

Participants (n=2890) were ≥35 years old with diabetes (fasting glucose ≥7 mmol/L) or hypertension.

Primary and secondary outcomes

We hypothesised that SNCs would be associated with CVD risk status (QRISK3 score). Secondary outcomes were individual CVD risk factors.

Results

Among the 2890 participants, 2020 (70%) were women, and mean (SD) age was 60.7 (12.1) years. Forty-four per cent of participants had elevated QRISK3 score (≥10%). No relationship was observed between QRISK3 level and SNCs. In unadjusted comparisons, participants with any individuals in their trust network were more likely to report a good than a poor diet (41% vs 21%). SNCs for the trust and multiplex networks accounted for a substantial fraction of variation in measures of dietary quality and physical activity (statistically significant via likelihood ratio test, adjusted for false discovery rate).

Conclusion

SNCs indicative of social cohesion appear to be associated with individual behavioural CVD risk factors, although not with overall CVD risk score. Understanding how SNCs of patients with chronic diseases relate to modifiable CVD risk factors could help inform network-based interventions.

Trial registration number

ClinicalTrials.gov identifier: NCT02501746; https://clinicaltrials.gov/ct2/show/NCT02501746.

Full Text

Duke Authors

Cited Authors

  • Ruchman, SG; Delong, AK; Kamano, JH; Bloomfield, GS; Chrysanthopoulou, SA; Fuster, V; Horowitz, CR; Kiptoo, P; Matelong, W; Mugo, R; Naanyu, V; Orango, V; Pastakia, SD; Valente, TW; Hogan, JW; Vedanthan, R

Published Date

  • September 2, 2021

Published In

Volume / Issue

  • 11 / 9

Start / End Page

  • e049610 -

PubMed ID

  • 34475172

Pubmed Central ID

  • PMC8413931

Electronic International Standard Serial Number (EISSN)

  • 2044-6055

International Standard Serial Number (ISSN)

  • 2044-6055

Digital Object Identifier (DOI)

  • 10.1136/bmjopen-2021-049610

Language

  • eng