Acceptability of a social prescribing program (REDE D+) for self-care and health literacy among people with type 2 diabetes mellitus-a qualitative study.

BACKGROUND

Social prescribing (SP) interventions have been increasingly developed to improve wellbeing, promote healthier behaviors, and support the management of chronic diseases such as type 2 diabetes mellitus (T2DM). This study aims to explore the REDE D+ program, a complex SP intervention designed to promote self-care and health literacy among people with T2DM from the perspective of users in the primary health care context.

METHODS

A qualitative study was conducted following the implementation of a non-randomized pilot cohort study (REDE D+ program), carried out in primary health care and the community. Acceptability was assessed through two focus groups involving 18 people living with T2DM who had engaged with the SP intervention. The semi-structured interviews were transcribed and analyzed using a reflexive thematic analysis, following the six-phase approach proposed by Braun and Clarke. Five main themes emerged from the analysis: acceptance of the intervention, benefits, barriers and challenges, facilitators, and overall satisfaction. The perceived barriers were analyzed through the lens of the COM-B model from the Behavior Change Wheel theory.

RESULTS

The REDE D+ program demonstrated a high level of acceptance and satisfaction among individuals living with T2DM. The main benefits were highlighted by the adoption of healthier behaviors, such as healthy eating and physical activity, improvements in the level of knowledge and awareness about the disease, and the promotion of health literacy. Participants also reported improvements in their quality of life, including better social interaction and reduced feelings of loneliness. Regarding barriers and challenges, physical capability was related to age and osteoarticular pain, as well as difficulties in understanding; reflective motivation was related to previous preconceived ideas.

DISCUSSION: The REDE D+ program suggested that it can contribute to better self-care behaviors in T2DM and support health-related decision-making by improving health literacy. The intervention has proven to be a valid and impactful approach, with strong potential for future integration into primary health care services to support the monitoring and management of individuals with T2DM.