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Do your friends influence your oral health?

August 30, 2016

In the early 1980s, a TV commercial showed a woman so happy with her shampoo that she told two friends, and they told two friends, and so on and so on, as her face replicated on the screen. The ad illustrated the power of viral marketing long before the online social networks of Facebook, Twitter and Instagram, with one person influencing the purchasing decisions of a network of people.

At the Indiana University School of Dentistry and the Indiana University Network Science Institute, researchers will study the influence of social networks on oral health decisions in underserved communities in the Midwest U.S.. They are applying network science methods to track multilayered social networks and discover the people of influence who are promoting and disseminating norms – whether accurate or not – about oral health and dental care.

“The most effective intervention may be changing the minds of the most influential people in a network,” said principal investigator Dr. Gerardo Maupomé, professor of cariology, operative dentistry, and dental public health at the IU School of Dentistry.

Maupomé and the School of Dentistry received a five-year, $3.6 million National Institute of Dental and Craniofacial Research RO1 grant to map the evolution of the complex network dimensions that may prevent people from seeking and receiving adequate oral health care. The grant partners the school with the IU Network Science Institute, the Department of Sociology, the Fairbanks School of Public Health and others. Brea Perry and Bernice Pescosolido of IUNI are primary co-investigators on the grant.

“We are adding new tools to dental research by using a social-network approach to study behaviors, norms and attitudes, with the goal of creating effective public policy and culturally sensitive clinical care for poor communities,” said Maupomé.

“Understanding patterns of oral health and dental care utilization in underserved communities lies within the networks of friends, family, peers and professionals on whom people rely for help and with whom they discuss health matters,” Maupomé said. He and his colleagues hypothesize that if they can pinpoint the handful of influential people in a community, such as a parish priest or midwife, and then educate them about proper oral health practices, these people may have a greater impact on changing social norms and improving oral health within their community compared to dental professionals, who may be viewed as outsiders.

“One cultural norm we often find in underserved communities is the belief that baby teeth don’t matter, that there is no need to brush them or care for them,” Maupomé said. “Another prominent norm is that diet does not affect teeth. Or, if people believe they will lose all their teeth just like everyone else in their community, they are much more apt to eat sugary foods and not brush their teeth.”

IU is an international hub for social-network research, more recently strengthened through the IUNI. Social-network analysis applies mathematical models to establish the characteristics of people affecting exchanges and identify the people who are the epicenters of influence within networks. Network methods hinge upon systematically collecting data about the links among individuals and then applying mathematical and computational tools to process and graphically depict complex data.

“Dr. Maupomé’s research is developing new and practical knowledge to understand how social influence flows through networks and affects views about oral health and dental care,” said Pescosolido, IUNI co-director. “Applying network science to the daily dental problems of individuals, especially in disadvantaged and understudied groups, represents the cutting edge of prevention.”

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