A social network approach to demonstrate the diffusion and change process of intervention from peer health advocates to the drug using community.

Project RAP (Risk Avoidance Partnership) trained 112 active drug users to become peer health advocates (PHAs). Six months after baseline survey (N(bl) = 522), 91.6% of PHAs and 56.6% of community drug users adopted the RAP innovation of giving peer intervention, and 59.5% of all participants (N(6m) = 367) were exposed to RAP innovation. Sociometric network analysis shows that adoption of and exposure to RAP innovation was associated with proximity to a PHA or a highly active interventionist (HAI), being directly linked to multiple PHAs/HAIs, and being located in a network sector where multiple PHAs/HAIs were clustered. RAP innovation has diffused into the Hartford drug-using community.