Powerful together with diabetes The development and evaluation of a social network based intervention for Dutch, Surinamese, Turkish and Moroccan people with type 2 diabetes living in socioeconomically deprived neighbourhoods

This thesis describes the development and evaluation of the social network based intervention Powerful Together with Diabetes (PTWD) targeted at Dutch, Turkish, Moroccan and Surinamese patients with type 2 diabetes living in socioeconomically deprived neighbourhoods. This intervention aims to increase social support for diabetes self-management (DSM) and to decrease social influences hindering DSM (e.g. peer pressure and social norms).
The intervention was evaluated in a quasi-experimental study with a control group that received a standard group based educational intervention (Know Your Sugar) and a second control group that received usual care. We aimed to evaluate the effects of the intervention on haemoglobin A1C (HbA1c), quality of life, health-related outcome measures, DSM, and intermediate outcome measures compared with the intervention for the comparison group and standard care at 3, 10, and 16 months. Further, we aimed to assess the feasibility and cost effectiveness of the intervention.
We conclude that PTWD contains promising intervention components, such as skills training and providing feedback using role-playing exercises, and involving significant others in self-management tasks by making a shared action plan. These seem to contribute to an increase in social support, and a decrease in social influences hindering DSM. We carefully conclude that the intervention improved certain aspects of DSM. Finally, we describe successful recruitment and retention strategies for this target population including sending an invitation letter from the GP, phoning participants, the positive atmosphere and social interactions between participants, taking practical barriers into account, the diplomas and adapting the intervention to the participants’ preferences.