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Supporting people with type 2 diabetes mellitus through the REDE D+ social prescribing program: feasibility of a
Dulce Oliveira1,2,3,4, Adriana Henriques1,4,5, Paulo Nogueira1,4,5,6
1Nursing Research Innovation and Development Center of Lisbon (CIDNUR), School of Nursing (ESEUL), Universidade de Lisboa, Lisboa, Portugal.
Background:
REDE D+, a social prescribing (SP) program, offers a complementary approach to traditional T2DM management by connecting people to community activities designed to support them in self-care behaviors and health literacy (HL). This study aims to assess the feasibility of a pilot study by evaluating recruitment, adherence and retention rates among people with T2DM, health professionals (nurses), community stakeholders, while exploring preliminary results in improvements on self-care behaviors and HL.
Methods:
This 12-week non-randomized pilot cohort study, conducted in primary and community healthcare settings in accordance with the guidelines of the Medical Research Council, involved a personalized assessment during a diabetes nursing consultation, followed by the prescription of community-based activities. Subsequently, a social prescriber nurse acts as a liaison between the two settings through structured follow-up, ensuring the continuity of the prescribed community-based activities. Primary outcomes were feasibility (recruitment, adherence, and retention rates). The secondary outcomes included anthropometric values [weight, body mass index (BMI), and abdominal perimeter], clinical values [glycated hemoglobin A1c (HbA1c)], measures of self-care, HL, diabetes knowledge, quality of life, and wellbeing. Descriptive and exploratory inferential analyses were conducted to examine preliminary patterns. Magnitude of effect was estimated via Cohen's d, allowing for a standardized assessment of improvements across the secondary outcomes.
Results:
The REDE D+ program revealed an 87.8% recruitment rate across the three participant groups, a 90% retention rate, and a good level of adherence to group community-based activities (94.4%). The secondary results suggest a small effect size of the SP intervention on weight, BMI, abdominal circumference, and HbA1c, and some improvements in HL and self-care behavior with a medium effect. The indicators related to physical activity and quality of life were the domains that showed the most statistically significant effects.
Conclusions:
The REDE D+ program has proven to be feasible, yielding positive results in terms of recruitment, retention, and adherence among people with T2DM. Preliminary secondary results suggest that has the potential to support the improvement of self-care behaviors and promote HL. However, future research is needed to evaluate its effectiveness and cost-effectiveness in large-scale studies.
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