Cross-sectional social network study of adolescent peer group variation in substance use and mental wellbeing: The importance of the meso level

Adolescent health-related behaviours and outcomes are shaped by their peers through various social processes. Research using network data on friendship ties has uncovered evidence for processes such as peer influence and imitation. Much less is known about how the structure of small groups within a network, network communities that represents its meso level, affect individuals. The structure and composition of peer groups could play an important role in shaping health behaviour but knowledge of the effects of groups is limited. We used data from The Peers and Levels of Stress study, a cross-sectional social network study conducted in 2006 of 22 secondary schools in Glasgow, Scotland. Students from one year group (15-16 yrs., N = 3148; 50.8% women) provided information on socio-demographics, health behaviour and friendships via a questionnaire. Dependent variables were substance use and general mental wellbeing measured via principal components. We used a series of multilevel models with students (level 1), network communities (peer groups) identified by the Walktrap algorithm (level 2), and schools (level 3). We found substantial and moderate clustering at the peer group level for substance use and mental wellbeing, respectively. Larger and more transitive groups were associated with less substance use, but worse mental wellbeing. Addressing the methodological gap regarding the influence of the choice of group detection method on findings, we repeated our analysis using nine additional methods. The choice of the method somewhat influenced peer group variance and greatly influenced association of peer group properties with health. This study makes two key contributions to school-health improvement research. Beyond describing peer group clustering health outcomes, this is the first demonstration that structural and compositional characteristics of peer groups are associated with individual health, while highlighting the sensitivity of findings to group detection method used.