Crystal Smit

Social Network Intervention vs. Mass Media Intervention 4 67 BACKGROUND The prevalence of overweight and obesity in children remains amajor global health concern (WHO, 2020). The consumption of sugar-sweetened beverages (SSB) has been identified as a significant contributor to weight gain in children (Malik, Pan, Willett, & Hu, 2013). Reducing the consumption of SSB can be an effective strategy for the prevention of childhood overweight and obesity (Hu, 2013). In particular, promoting water consumption as an alternative to SSB seems to be a promising approach (Zheng, Allman-Farinelli, et al., 2015). Mass media campaigns are widely used in the public health sector to address excessive SSB consumption (Boles, Adams, Gredler, & Manhas, 2014; Farley et al., 2017; Jordan, Taylor Piotrowski, Bleakley, &Mallya, 2012). In these campaigns, large populations are simultaneously exposed to health messages in a rapid manner through various media channels (Wakefield et al., 2010). Unfortunately, with such campaigns, the overall average behavioral change occurs in only 8% of the population (Snyder et al., 2004). A possible reason for their limited effectiveness could be that thesemass campaigns, among others, do not incorporate the strong influence of peers (Patrick & Nicklas, 2005; Salvy et al., Therefore, the current study investigated whether an approach that utilizes peer influence can be more effective in promoting healthy drinking behaviors among children. State-of-the-art intervention studies promoting other health-related behaviors, such as fruit and vegetable consumption (Story et al., 2002), physical activity (Sebire et al., 2018), condom use (Kelly et al., 1991) and smoking cessation (Campbell et al., 2008; Valente et al., 2003), revealed that utilizing peer influence can be beneficial in promoting healthy behaviors. In these so-called ‘social network interventions’, the influence of peers is utilized by selecting a subset of children as influence agents to diffuse the target health message or behavior into the children’s network (Valente, 2010, 2012). At the heart of this approach lies the diffusion of innovation theory (Rogers, 1962), which describes how new ideas and behaviors are spread among members of a social network. During the diffusion process, some individuals (i.e., influence agents) have more influence on the behavior of