Change in social networks, information -seeking, and contraceptive adoption among women in rural Nepal

There is growing evidence that women's social networks regarding family planning are influential in their decisions to use a contraceptive method. It is unclear, however, how discussions with peers facilitate contraceptive use or what role information-seeking strategies may play in determining the composition of these networks. Identifying the reciprocal influences between individuals and their social environment may foster a greater understanding of the process by which innovations diffuse throughout a community and may inform community-based approaches to behavior change.;The present study examined changes in the composition of women's family planning discussion networks over time to assess both the role of discussion networks in promoting contraceptive use and the role of individual motivations in constructing one's social environment. Data were collected at two points in time from women living in three villages in Dang District, Nepal using structured surveys (N = 281) and semistructured in-depth interviews (N = 12). Sociometric data were collected to identify discussion networks. Cross-sectional and longitudinal logistic regression models were used to test the research questions.;Adoption of family planning was associated with positive changes in the composition of one's social network. Women who added a long-term user or recent contraceptive adopter or who had dropped a non-user from their network were all more likely to have adopted a contraceptive method. The use of these multiple pathways to contraceptive adoption suggested that a number of mechanisms mediate the relationship between social interaction and individuals' behavior.;Individual-level characteristics were associated with these changes. Women with low levels of knowledge were more likely to have added long-term users to their network. Women with positive attitudes towards family planning were often more likely to have made positive changes to their network. Perceptions of spousal disapproval and son preference were associated with a lower use of Positive changes strategies. Cognitive dissonance was used to explain the role of these changes as strategies to minimize one's exposure to information dissonant with one's existing attitudes and beliefs.;The present findings support current the use of family planning programs focusing on community-based activities aimed at women's empowerment.