Social networks and social support: implications for natural helper and community level interventions

The convincing evidence of the relationship between social support, social networks, and health status has influenced the development of program strategies which are relevant to health education. This article focuses on the linkage between social support and social networks and health education programs which involve interventions at the network and community level. Two broad strategies are addressed: programs enhancing entire networks through natural helpers; and programs strengthening overlapping networks/communities through key opinion and informal leaders who are engaged in the process of community wide problem-solving. Following a brief overview of definitions, this article highlights several network characteristics which are often found to be related to physical and mental health status. Suggestions are made for how these network characteristics can be applied to the two program strategies. Principles of practice for the health educator, and some of the limitations of a social network approach are delineated. The article concludes with a recommendation for engaging in action research--a perspective highly consistent with both the strategies discussed and the concepts of social networks and social support. This approach not only recognizes, but also acts to strengthen indigenous skills and resources.