'Powerful together against diabetes'. A Social network intervention for type 2 diabetics with a low socioeconomic status.

The prevalence of type 2 diabetes is higher among people with a lower
socio-economic status, including migrants. This group has a poorer metabolic
control and experiences more diabetes-related complications than diabetics with
a higher socio-economic status. The amount of social support, diabetics receive
from their direct social environment has a major influence on the way they
manage their diabetes. However, interventions aimed at increasing social
support for diabetics often have limited effects on diabetes self-management.
This can be explained by the temporary nature of the social support offered in
these interventions. After the end of these interventions, there is usually no
further contact between the participants: the newly acquired social support
comes to an end. Without permanent social support, it seems difficult for most
diabetics to maintain an optimal diabetes self-management. A second explanation
could be the limited focus of these interventions. These interventions often
offer the participants social support from other diabetics (peer support), but
disregard the participants* existing social environment. Providing patients
with social support without addressing existing social influences on their
diabetes self-management seems less effective. In this project we study the
effectiveness of an intervention for low socio-economic groups (*Powerful
Together against Diabetes*) which aims to create permanent social support. The
focus of this intervention is the participants' whole social network, including
the participants* existing social environment and the influences this
environment exerts on their diabetes self-management.

The aim of this study is to evaluate the effect of the intervention *Powerful
Together against Diabetes* on metabolic control, health related outcome
measures, diabetes related behaviour, psycho-social outcome measures and
intermediate outcome measures of diabetics with a low socio-economic status.

This study is an randomised controlled trial. We compare 300 patients that
participated in the intervention with 300 patients that participated in the
control group. Measurements will take place at baseline, 6,12 and 24 months.

*Powerful Together against Diabetes* is a group intervention that consists of
three parts. Firstly group meetings will be organised consisting of 10
diabetics. These groups will meet frequently for a period of two years. The
participants will exchange experiences about coping with diabetes, support each
in maintaining a healthy lifestyle and undertake activities to improve their
lifestyle. A part of these groupmeetings is a social learning intervention in
which the participants will be stimulated to mobilize social support within
their direct social environment and at the same time learn to deal with social
influences from their direct social environment that negatively influence their
diabetes self-management. Thirdly we will organize a social network
intervention in which we invite the direct social environment of the
participants to learn about diabetes and discuss obstacles with the diabetic
patient in order to stimulate their social support.

As far as we know, there are no risks associated with participation in this
study.