Development of a Conceptual Framework for Social Connection and T2D Management

Diabetes self-management is below target among American adults, and novel, person-centered approaches to diabetes management are needed. A person-centered approach necessitates a thorough understanding of the social setting in which an individual is managing type 2 diabetes, as daily self-care behaviors such as exercising, eating healthfully, and taking medications occur in social settings. Social connection is the umbrella term which includes the structure (or context), function (or support), and quality of an individual’s social settings. While the function and quality of social connection have been associated with diabetes self-management behaviors and outcomes, this work seeks to develop a conceptual model including all aspects of social connection with diabetes self-management behaviors, diabetes self-efficacy, and diabetes outcomes to understand which aspects of social connection are associated with which behaviors and outcomes, as well as identify any antagonistic or synergistic effects. Leveraging an ongoing randomized controlled trial recruiting adults with type 2 diabetes across the mid-South as well as primary data collection to increase the generalizability of the sample, this project will collect self-report measures of social connection, diabetes self-management behaviors, diabetes self-efficacy, and diabetes outcomes, including hemoglobin A1c, at baseline from all RCT participants and repeated measures from RCT control participants and P&F participants at 4- and 8-months follow up. Aim 1 will use structural equation models to explore relationships among variables of interest. Aim 2 will employ longitudinal structural equation models to explore relationships and develop a conceptual model for these constructs. Exploratory Aim 3 will explore which measures of social connection are the most potent predictors to guide future measure selection. The results of this work will serve as pilot data to (1) validate the conceptual model and (2) inform intervention design to get the right social support to the right person in order to improve diabetes self-management.