Article Text

Original research
Value of social network analysis for developing and evaluating complex healthcare interventions: a scoping review
  1. Linda C Smit1,
  2. Jeroen Dikken2,
  3. Marieke J Schuurmans3,
  4. Niek J de Wit4,
  5. Nienke Bleijenberg1,5
  1. 1Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands
  2. 2Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, The Hague, The Netherlands
  3. 3Education Center, UMC Utrecht Academy, University Medical Center Utrecht, Utrecht, The Netherlands
  4. 4Department of General Practice, Division Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  5. 5Department of Nursing Science, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to Linda C Smit; linda.smit{at}


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.

  • statistics & research methods
  • public health
  • epidemiology

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  • Contributors LS and JD contributed to this article by conducting the design, data collection, data analysis and by reviewing the manuscript. MJS, NJdW and NB contributed to this article by conducting the design, and by reviewing the manuscript. All authors approved the manuscript and this submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.