Recent research coming from Boston University suggests our traditional one-on-one behavioral interventions with patients may not be the best for long-term preventive behaviors. In fact, researcher Brenda Heaton, an assistant professor of health policy and health services research at Boston University’s Henry M. Goldman School of Dental Medicine offers information that may change the way information is dispersed throughout communities in order to have larger, long-term effect.
Heaton specializes in social epidemiology with a focus on oral health. In 2008, she, along with other members of BU’s Center for Research to Evaluate & Eliminate Dental Disparities, began a new line of research, focused on understanding oral health and disease among residents in Boston public housing. The majority of the work to date has focused on whether or not “motivational interviewing” can influence how women care for their children’s diet and oral health—specifically, the impact on kids with dental caries (also known as tooth decay). There is mounting evidence that one-on-one behavioral interventions, like motivational interviewing, may change short-term behavior, but the effects don’t last long. “We started to get a sense that there may be more influences that we need to acknowledge beyond just the individual,” says Heaton. She found that social networks—not Facebook and Twitter, but networks of friends, family, and acquaintances—may play an overlooked role in oral health care.
Since 2008, her team has interviewed close to 200 women living in Boston public housing and identified nearly 1,000 individuals who were influential. Heaton is using those network maps to find similarities about how information flows through these communities.
The ultimate goal, she says, is to use the map to introduce health information and resources into a community in ways that change long-term behaviors.
“You can’t design those interventions until you actually have a really strong grasp of the network structure,” says Heaton. For instance, if you want to make an impact, should you look for community members with the most personal connections or for people with large influence but fewer personal ties? Should you take advantage of existing connections or seed new ones?
The power of this approach is that it focuses on prevention rather than cures, says Heaton. It might take a village, but tooth decay “is an entirely preventable health outcome.”