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Value of social network analysis for developing and evaluating complex healthcare interventions: a scoping review

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Objectives Most complex healthcare interventions target
a network of healthcare professionals. Social network
analysis (SNA) is a powerful technique to study how social
relationships within a network are established and evolve.
We identified in which phases of complex healthcare
intervention research SNA is used and the value of
SNA for developing and evaluating complex healthcare
interventions.
Methods A scoping review was conducted using the
Arksey and O’Malley methodological framework. We
included complex healthcare intervention studies using
SNA to identify the study characteristics,level of complexity
of the healthcare interventions, reported strengths
and limitations, and reported implications of SNA. The
Preferred Reporting Items for Systematic Reviews and
Meta-Analyses
Extension for Scoping Reviews 2018 was
used to guide the reporting.
Results Among 2466 identified studies, 40 studies were
selected for analysis. At first, the results showed that
SNA seems underused in evaluating complex intervention
research. Second, SNA was not used in the development
phase of the included studies. Third, the reported
implications in the evaluation and implementation phase
reflect the value of SNA in addressing the implementation
and population complexity. Fourth, pathway complexity
and contextual complexity of the included interventions
were unclear or unable to access. Fifth, the use of a
mixed methods approach was reported as a strength,
as the combination and integration of a quantitative and
qualitative method clearly establishes the results.
Conclusion SNA is a widely applicable method that
can be used in different phases of complex intervention
research. SNA can be of value to disentangle and
address the level of complexity of complex healthcare
interventions. Furthermore, the routine use of SNA within
a mixed method approach could yield actionable insights
that would be useful in the transactional context of
complex interventions.


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