A systematic review and meta-analysis of trials of social network interventions in type 2 diabetes

Gabriela Spencer-Bonilla, Oscar J. Ponce, Rene Rodriguez-Gutierrez, Neri Alvarez-Villalobos, Patricia J. Erwin, Laura Larrea-Mantilla, Anne Rogers, Victor Manuel Montori

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Abstract

OBJECTIVES: In the care of patients with type 2 diabetes, self-management is emphasised and studied while theory and observations suggest that patients also benefit from social support. We sought to assess the effect of social network interventions on social support, glycaemic control and quality of life in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS: We searched Ovid MEDLINE, Ovid EBM Reviews, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO and CINAHL through April 2017 for randomised clinical trials (RCTs) of social network interventions in patients with type 2 diabetes. Reviewers working independently and in duplicate assessed eligibility and risk of bias, and extracted data from eligible RCTs. We pooled estimates using inverse variance random effects meta-analysis.

RESULTS: We found 19 eligible RCTs enrolling 2319 participants. Social network interventions were commonly based on individual behaviour change rather than social or interpersonal theories of self-management, were educational, and sought to engage social network members for their knowledge and experience. Interventions improved social support (0.74 SD (95% CI 0.32 to 1.15), I2=89%, 8 RCTs) and haemoglobin A1c at 3 months (-0.25 percentage points (95% CI -0.40 to -0.11), I2=12%, 9 RCTs), but not quality of life.

CONCLUSIONS: Despite a compelling theoretical base, researchers have only minimally studied the value of interventions targeting patients' social networks on diabetes care. Although the body of evidence to date is limited, and based on individual behaviour change theories, the results are promising. This review challenges the scientific community to design and test theory-based interventions that go beyond self-management approaches to focus on the largely untapped potential of social networks to improve diabetes care.

PROSPERO REGISTRATION: CRD42016036117.

Original languageEnglish (US)
Pages (from-to)e016506
JournalBMJ Open
Volume7
Issue number8
DOIs
StatePublished - Aug 21 2017

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Keywords

  • General Diabetes
  • Public Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Spencer-Bonilla, G., Ponce, O. J., Rodriguez-Gutierrez, R., Alvarez-Villalobos, N., Erwin, P. J., Larrea-Mantilla, L., Rogers, A., & Montori, V. M. (2017). A systematic review and meta-analysis of trials of social network interventions in type 2 diabetes. BMJ Open, 7(8), e016506. https://doi.org/10.1136/bmjopen-2017-016506