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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Physical Activity.

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Strategy. Social Network/Peer Influence in School

Approach. Use in-person or technology-based social influence student groups (e.g., peer mentoring, peer leadership) to encourage and increase physical activity in or out-of-school

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Overview. Studies indicate that using social influence groups through in-person or technology-based interaction can increase the physical activity in children and adolescents during in or out-of-school time. The intervention may include class competitions to increase participation and may involve family members to support physical activity during out-of-school time.[1,2]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Student group participation and leadership rosters
  • Peer-led activity tracking logs
  • School climate/culture surveys

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Social Marketing (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of students recruited and trained as peer mentors for peer leaders to promote physical activity. (Measures the capacity building and engagement of influential youth)
  • Number of social influence groups for initiatives formed, both in-person and technology-based, to encourage physical activity among students. (Quantifies the reach and scale of the intervention)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of peer mentors and peer leaders who represent the student population and are influential across different social groups and networks. (Assesses the involvement of multiple perspectives and credibility of the youth leadership)
  • Percent of social influence group activities and communications that are designed and delivered using evidence-based behavior change techniques and best practices for youth engagement. (Measures the quality and effectiveness of the intervention strategies)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of schools that adopt and institutionalize social influence approaches as a core component of their physical activity promotion efforts. (Measures the systemic integration and sustainability of the intervention)
  • Number of student-led promotion campaigns for policy initiatives launched to create supportive environments and resources for physical activity, inspired by the social influence groups. (Shows the empowerment and leadership development of youth to drive systems-level change)
  • Number of schools that demonstrate sustained increases in student physical activity levels and reductions in sedentary behavior, as measured by longitudinal assessments following the implementation of social influence interventions. (Assesses the long-term impact and maintenance of the behavior change)
  • Number of districts for regions that replicate and scale up successful social influence models for physical activity, based on the evidence and best practices generated by local initiatives. (Measures the diffusion and spread of the intervention approach)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of social influence group leadership and membership that reflects key characteristics of the student body and community. (Measures the representativeness of the intervention)
  • Percent of social influence strategies and messages that are relevant, appropriate, and responsive to the unique needs and assets of student populations. (Assesses the competence and tailoring of the intervention)
  • Percent reduction in gaps in physical activity participation and outcomes between students of different key characteristics involved in social influence initiatives. (Measures the impact on advancing health outcomes and reach)
  • Percent of students from various groups who assume leadership roles, gain new skills, and build social capital through their participation in physical activity-focused social influence efforts. (Shows the empowerment and capacity-building of youth)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Harrington DM, Davies MJ, Bodicoat DH, Charles JM, Chudasama YV, Gorely T, Khunti K, Plekhanova T, Rowlands AV, Sherar LB, Tudor Edwards R, Yates T, Edwardson CL. Effectiveness of the 'Girls Active' school-based physical activity programme: A cluster randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity. 2018 Apr 25;15(1):40

2 Van Woundenberg TJ, Bevelander KE, Burk WJ, Smit CR, Buijs L, Buijzen M. A randomized controlled trial testing a social network intervention to promote physical activity among adolescents. BMC Public Health. 2018;18(1), 542.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.