Making the Connection: Understanding the dynamic social connections impacting type 2 diabetes management among Black/African American men

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PROJECT SUMMARY This study is designed to address the alarmingly low rate of disease self-management that has resulted in the current disproportionate chronic illness, specifically type 2 diabetes (T2D), burden borne by Black/African American males. Black/African American males have the highest mortality rates from preventable conditions due, in part, to a low rate of health care utilization. Following the social ecological model, it is vital to understand the social influences and social networks that impact T2D self-management. Strengthening relationships and creating behavior reinforcement loops has improved T2D self-management and social measures such as coping and self-efficacy. Broader social networks play a significant role in chronic disease management, yet a gap remains in the literature regarding the identification of these networks, and understanding how these networks evolve over time, specifically among Black/African American males. Therefore, there is a critical need to identify the aspects of social networks that are associated with T2D self-management and support among Black/African American males. Such newfound knowledge about the influence of interpersonal, community, and societal sociocultural environments can result in the development of novel, effective strategies to improve T2D self- management compliance and health outcomes in Black/African American males. Our long-term goal is to develop culturally- and socially-relevant dyadic relationship intervention points to improve T2D self-management among Black/African American men with T2D. Our overall objectives in this application are to establish the aspects of social networks related to healthy self-management practices as well as characterize their formation and evolution. To accomplish these objectives, we will use a convergent mixed methods approach to determine significant aspects of social networks identified by using social network analysis and in-depth qualitative interviews. First, we will recruit a nationally representative sample of 1,200 Black/African American males with T2D using Qualtrics research panels to determine significant associations between T2D management their social relationships. Next, a cohort of 65 Black/African American males from the national sample will be asked to participate in longitudinal qualitative interviewing regarding their social networks with two follow-ups at six months and one year. The rationale for this project is that determining the aspects of one’s network that promotes self-management will provide the groundwork for intervention studies to improve T2D self-management within a population with health disparities. To achieve our long-term goal and objectives, the following specific aims will be pursued: 1) Identify specific aspects of dyadic relationships within select domains (family, friends, neighbors, church, other) among Black/African American male social networks related to T2D self-management adherence; 2) Characterize the formation and evolution of dyadic relationships that result in improved T2D self-maintenance strategy adherence among Black/African American males.