Aims: CUSTOM is a culturally sensitive diabetes self-management education and support programme tailored to Urdu, Turkish and Arabic-speaking people in Denmark. The aim of this study was twofold: first, to examine the functional social support perceived by CUSTOM participants before and after the intervention; and, second, to explore how participants' structural social support affected the physical and mental health benefits of the intervention.
Methods: The participants were people with type 2 diabetes whose primary language was Urdu, Arabic or Turkish (n = 73). Outcomes included A1C, body fat percentage, diabetes distress, well-being and functional social support. Changes were observed between baseline and six months after participation in a single-group pre-test/post-test design. The Cochran-Armitage trend test was used to assess pre-post differences in functional social support. The role of structural social support was assessed using moderation regression analysis.
Results: Participants reported higher availability of functional social support after the programme (p < 0.05), although the change in loneliness was not significant. In addition, cohabitating with adult children increased the average body fat percentage reduction achieved following the programme, while living with a partner lowered the average body fat percentage reduction achieved. The intervention was particularly successful in improving diabetes distress among those with weak structural social support.
Conclusions: Culturally sensitive diabetes self-management education and support can improve social support among people with an ethnic minority background. The structure of social relations may influence the benefit of culturally sensitive diabetes self-management education and support. Future programmes should include family members and other social relations more actively, drawing attention to both positive and negative aspects of social relations.
Keywords: Ethnic and racial minorities; cultural competency; emigrants and immigrants; family relations; psychosocial intervention; social support.