Abstract
This article describes the development of the social network-based intervention Powerful Together with Diabetes which aims to improve diabetes self-management (DSM) among patients with type 2 diabetes living in socioeconomically deprived neighborhoods by stimulating social support for DSM and diminishing social influences hindering DSM (e.g., peer pressure and social norms). The intervention was specifically developed for patients with Dutch, Turkish, Moroccan, and Surinamese backgrounds. The intervention was developed according to Intervention Mapping. This article describes the first four steps of Intervention Mapping: (1) the needs assessment; (2) development of performance and change objectives; (3) selection of theory-based methods and strategies; and (4) the translation of these into an organized program. These four steps resulted in Powerful Together with Diabetes, a 10-month group-based intervention consisting of 24 meetings, 6 meetings for significant others, and 2 meetings for participants and their spouses. The IM method resulted in a tailored approach with a specific focus on the social networks of its participants. This article concludes that the IM method helped our planning team to tailor the intervention to the needs of our target population and facilitated our evaluation design. However, in hindsight, the intervention could have been improved by investing more in participatory planning and community involvement.
Highlights
People in lower socioeconomic groups, including ethnic minorities, are disproportionately affected by type 2 diabetes, they have more diabetes-related complications and higher diabetesrelated mortality compared with patients in higher socioeconomic groups [1,2,3]
Conclusions of the Needs Assessment In conclusion, patients from socioeconomically deprived neighborhoods generally have social networks that seem less beneficial to self-management because of their small size and the limited ability to acquire new information
The strong social norms these social networks impose on their members seem incongruent with self-management behaviors
Summary
People in lower socioeconomic groups, including ethnic minorities, are disproportionately affected by type 2 diabetes, they have more diabetes-related complications and higher diabetesrelated mortality compared with patients in higher socioeconomic groups [1,2,3]. To the best of our knowledge, no comparable information on glycemic control in Dutch patients in lower socioeconomic groups in the Netherlands is known. Managing type 2 diabetes requires a schedule of extensive self-management behaviors. These include an adequate use of medications, if applicable self-monitoring of blood glucose, eating healthy and being physical active, regularly checking and taking adequate care of the feet and dealing adequately with diabetes in every situation [6]. Complying with and maintaining such complex health regimens seem to be challenging, especially for socioeconomically deprived patients [7,8,9]
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