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Table 3 Data-Driven Themes abstracted from quotes and text of the articles

From: Social network influences and the adoption of obesity-related behaviours in adults: a critical interpretative synthesis review

Data-Driven Themes Quotes and Text From Findings
Meso-micro network processes Q1(+). “Several participants suggested external health promoters could provide additional encouragement: ‘Somebody coming in from outside, say doing half an hour at lunchtime just doing a presentation about it or, you know, longer and getting people there and talking about that and saying ‘and we have our in-house person who you know if you want to talk to him, d’you wanna get encouragement from him/her’ that would be great but I think somebody coming in from outside actually would be a good idea.” [58] Q2(+). “That’s why I think the group would be kind of cool to get together with… to get together as a group and just share some ideas ...” [55] T1(+). “During follow-up visits all but one woman in the study agreed that men and women were not active together. In contrast, women reported discussing exercise with other women and joining all-female exercise groups.” [48] Q3(+). “I probably would pass somebody from my gym somewhere on the streets [… It’s] motivational in the sense that if you don’t go […to the gym] and pass a girl that I haven’t seen in a while ‘hey why I don’t see you in the gym? What’s going on with you?’ and I guess guilt people into coming back. So yeah it’s motivation.” [48] Q4(−). “However, if I go back to the village where my husband comes from, they are country people and they love to bake, cook and it’s lovely. It’s gorgeous and because they know you’re coming for afternoon tea, they’ll have made you the apple pie and they’ll have made you the cakes and if you went in there and tried to start explaining that you don’t eat any of that… In that sort of culture, it just would not be understood, and also you’re interfering with the social norms and you don’t want to do that.” [51] T2(+). “WhatsApp groups comprised of women in the same exercise class could make this social pressure and social support even stronger.” [48] Q5(+). “We have people in my neighbourhood that you can be leaving out at five in the morning, and they’re walking. You can come in at six in the afternoon and there’s another group walking…We have a monthly HOA [homeowners association] meeting— and sometimes in those meetings people just go, “Hey, I saw you walking. Can I join your group?” [53] Q6(+). “Overall the promoters found their booklet ‘was well set out’ and helped them approach participants: ‘It was informative and useful and helped me set out what I needed to do, promote walking to work to the colleagues, and how to approach them and stuff, I thought it was quite good.” [58] T3(+). “In contrast, having tight social networks was viewed as beneficial if friends were “health-conscious” and acted as positive role models.” [55] T4(+). “In the case of body size, a descriptive norms effect can work through direct comparison so that a person compares himself to others in his social reference group and makes decisions regarding his own status according to that metric.” [45] Q7(+). “My husband insists that I shouldn’t eat large quantities or any starchy food. My mum always scolds me, but this doesn’t help; she just gets on my nerves. As soon as she sees me eating even the smallest amount of sweets, she’ll start complaining. I can’t say my daughters are indifferent. They’ll remark when I overeat something. Everyone is focused on my diet.” [51] T5(−). “Social events involving food were areas where maintaining normal social ties were often more important than attempting to force attention on dietary needs.” [49] Q8(+). “I used to eat a lot of vegetables when I was at home, cause my wife was an extremely good cook, so we ate really well, I don’t mean gluttony I mean just healthy food.” [56] Q9(+). “We are trying to exercise together, all of us… We aim to create a large group and include family and kids and socialize very often, so it becomes a big group and better habits.” [49]
T6(+). “More precisely, women and their most important eating companions tended to be similar in diet-related factors such as diet quality and eating styles as well as in BMI.” [62] Q10(+). “…found myself you know doing the walking home without having written it down and you know having told several people – I mean telling people that that’s what you’re doing actually makes you hold to it even more than if you, if I’d written it down.” [58] T7(−). “Several elderly women also discussed the negative consequences of living alone on their diets. Without family members around, eating decisions were primarily based on convenience and several participants reported having no incentive to make dietary improvements at their advanced age.” [55]
Contextual and individual factors Q11(−). “Close to my house, there are no sidewalks. And I feel like I don’t want to get in the car and drive somewhere and get out and walk and get back in the car… I used to walk a lot, but I lived somewhere else so it made it very simple.” [50] Q12(+). “I’m looking for more, all the time… I’m getting ideas at the moment because when I go to the sports centre they’ve got loads of activities for older people like me and other illnesses, not just diabetes, they cover everything there.” [49] Q13(−). “When the weather is cold I walk, but it is difficult to walk in summer.” [52] T8(+). “Participants described food-centric social events as a primary constraint to eating well. Limited entertainment options in these rural communities meant that most activities involved getting together for a snack or meal. Food provision was regarded as a sign of “hospitality” and people felt obligated to eat whatever was offered in social settings (e.g., church, senior centers).” [55] Q14(−). “Walking is not culturally acceptable. My husband will not allow me to walk in the street but if it is a closed place [gym] he has no problem.” [52] Q15(+). “Going to the gym the motivation is, well obviously it would be generally to lose weight, but going by the gym is relatively small so you know everybody that is there so it’s kind of a family type atmosphere.” [48] Q16(+). “My grandmother… when I was 13… I was the sole witness to her coronary occlusion which killed her on the spot and I never quite dealt with that so it has left me with a bit of a fear of heart disease and heart problems and seeing how violently they can end your life.” [56] Q17(+). “There is some type of apprehension in the back of my mind, and I’m trying to figure out why, but I really need to say, “Go ahead, start doing it.” I guess I feel that if I start, I’m going to have to continue. It’s going to change my routine. [And that] Moves me out of my comfort zone.” [53] Q18(−). “I have the control to change things I just don’t change them, and I don’t know why. It’s ridiculous.” [54] Q19(−). “The food we eat is not healthy because of the way we cook it and because we do not know enough about healthy food.” [52] Q20(−). “I think people [study participants] have the intentions of walking … but, because their character is, just they don’t know how to live without the car.” [58] T9(−). “During treatment, participants lost an average of 4.4% of initial body weight, and social influence factors were adversely associated with weight loss outcomes. Having more casual friends who were overweight at baseline and being part of a social network with stronger social norms for unhealthy eating predicted poorer weight losses (p’s < .023).” [27] Q21(−). “I look after my husband, the house, everything. I don’t look after myself as much as I used to. In the past, I would cook something for myself and something for the others to eat… I have to cook meals that my children and grandchildren like because my daughter works, and so I eat from these as well, so I don’t miss out.” [51]
T10(−). “This man emphasizes the need to occasionally not adhere to the diet, especially at parties and when with friends.” [51] Q22(−). “Without the help of my children, I wouldn’t be able to cope. My pension is 140 leva—[not enough] for following a diet and buying drugs.” [51] Q23(−). “I worked as […] a cashier at a supermarket until 2009 and you know a cashier sits down ain’t much activity in that and then in 2009 to 2011 I did secretarial work – so that’s even worse but then […] I got this new job that I totally love cause since I really can’t get the exercise that I want to put in…” [48] T11(+). “Specifically, people who reported good self-management skills were more likely to have a diverse network, to be older, to be in relatively good health, to have high levels of income and education, and to live in the wealthier of the six countries (Norway, UK, Netherlands, Spain). High levels of self-monitoring were also associated with high education and relatively good health.” [59] T12(+). “In these small rural towns, social interaction appeared to be an important facilitator of active lifestyles, particularly for women. Organized group activities, such as walking, were viewed as an opportunity to socialize with friends and connect with the community. Building these networks increased enjoyment and gave people more incentive to engage in activity.” [55] Q24(−). “Sometimes the walk is be good you know exercise but if I have my car I wouldn’t walk at all only when I don’t have do I walk cause everything closer in town [Bridgetown] that ya could walk to instead of wasting the gas but as for out here [St. Philip]… the closest shop there … nah… now that is daytime no way! Ain’t walking. Too hot!” [48] T11(+). “Specifically, people who reported good self-management skills were more likely to have a diverse network, to be older, to be in relatively good health, to have high levels of income and education, and to live in the wealthier of the six countries (Norway, UK, Netherlands, Spain). High levels of self-monitoring were also associated with high education and relatively good health.” [67] T13(−). “People with type 2 diabetes were less physically active, less likely to follow recommended diet (men), had fewer contacts with family and friends and were less certain of counting on help in case of severe illness than people with type 1 diabetes.” [67]
Types of ties Q3(+). “I probably would pass somebody from my gym somewhere on the streets [… It’s] motivational in the sense that if you don’t go […to the gym] and pass a girl that I haven’t seen in a while ‘hey why I don’t see you in the gym? What’s going on with you?’ and I guess guilt people into coming back. So yeah it’s motivation.” [48] T14(+). “In Bulgaria compared to elsewhere, health professionals’ advice was taken more seriously and sought more frequently.” [49] Q4(+). “We have people in my neighbourhood that you can be leaving out at five in the morning, and they’re walking. You can come in at six in the afternoon and there’s another group walking… We have a monthly HOA [homeowners association] meeting— and sometimes in those meetings people just go, "Hey, I saw you walking. Can I join your group?” [53] T15(+). “Attending community organizations was positively related to physical activity, however only for patients with a low income (OR = 1.53).” [18] Q25(+). “…my health…[is] my family…My children and husband, and our whanau whanui (tribal family) … our wellbeing is whanau (family)…[when] someone else is not well in our family, that has an impact…on our health…I’m connected to those people and our children…the heavier we are collectively, the better off we are individually…” [57]
Q26(−). “No, my family doesn’t help me. I am responsible for health issues at home… I ask them to support me a bit more, taking the cakes out of my sight, but they’re all tomboy-like and take little care of me. They don’t see a disease in my diabetes.” [49] T16(+). “Whether the target was a friend moderated these effects. When engaging in an upward comparison to a friend, participants had more thoughts of exercising compared to when the target of the upward comparison was not a friend (Y = 1.03, P = 0.031). When engaging in a downward comparison to a friend, participants also reported more thoughts of dieting (Y = 2.68, P = 0.006) and exercising (Y = 2.13, P = 0.024) as compared to when targets were nonfriends.” [66] T9(−). “During treatment, participants lost an average of 4.4% of initial body weight, and social influence factors were adversely associated with weight loss outcomes. Having more casual friends who were overweight at baseline and being part of a social network with stronger social norms for unhealthy eating predicted poorer weight losses (p’s < .023).” [27] Q27(−). “Our weights increase because we have housemaids and we depend on them a lot.” [52] T17(+). “In a multivariable regression model, greater weight loss was associated with help from a child with eating goals (p = .0002) and co-worker help with physical activity (p = .01).” [64] T18(+). “For several participants, pets provided much needed companionship and reason to be active. Pets appeared to be especially important motivators of physical activity for elderly individuals living alone.” [55]
Properties of social networks T19. “Lower frequencies of family contact were associated with lower fruit variety scores and rare/no contact was similarly negative for both genders. By contrast, decreasing family contact seemed to have limited association with vegetable variety in men whereas weekly contact had a 0.56 unit difference (p ¼ 0.001) in score in women compared with daily family contact.” [61] T20. “The degree to which this behaviour is shared is modulated by the strength of the relationship between the two individuals, with a greater probability of engaging in these behaviours observed when the relationship with the nominated peer is strong relative to when the relationship is weak.” [63] T21. “Moreover, having more friends is associated with an improvement in health, while being healthy and prosocial is associated with closer relationships. Specifically, a unit increase in health is associated with an expected 0.45 percentage-point increase in average closeness, while adding a prosocial activity is associated with a 0.46 percentage-point increase in the closeness of one’s relationships.” [60] T22. “Participants reporting social contact with 6 or 7 friends on a weekly basis had a 24% lower mortality risk than those in contact with ≤1 friend (HR 0.76, 95% CI 0.58–0.98).” [65] T9. “During treatment, participants lost an average of 4.4% of initial body weight, and social influence factors were adversely associated with weight loss outcomes. Having more casual friends who were overweight at baseline and being part of a social network with stronger social norms for unhealthy eating predicted poorer weight losses (p’s < .023).” [27] T23. “Whereas increasing social distance appeared to decrease the effect of an alter on an ego, increasing geographic distance did not. The obesity of the most geographically distant alters correlated as strongly with an ego’s obesity as did the obesity of the geographically closest alters. These results suggest that social distance plays a stronger role than geographic distance in the spread of behaviours or norms associated with obesity.” [68]