Social network characteristics and type 2 diabetes self-management among Black/African American men: A cross-sectional analysis of support quality and communication patterns

Objective: Social networks and social support are critically important for Black/African American men managing Type 2 diabetes (T2D). This study aims to examine how social network characteristics are associated with T2D self-management among Black/African American men. Methods: Cross-sectional survey data were collected from Black/African American men with T2D (n = 1225) from February to June 2024. Network composition included percentages of spouses, children, parents, siblings, friends, extended family, and healthcare providers. Network interaction measures included communication frequency, support quality, and perceptions of network members' health behaviors. Self-care activities were measured using the Summary of Diabetes Self-Care Activities scale across diet, physical activity, blood sugar testing, and foot care domains. Multiple regression analyses examined associations between network characteristics and each self-management domain while controlling for demographics. Results: Diabetes-specific communication frequency was consistently positively associated with all self-care activities (β from 0.09 to 0.18,p < .05). Having very supportive network members was positively associated with diet (β = 0.17,p < .01) and physical activity (β = 0.20,p < .01), though mean social network support showed negative associations with these behaviors (β = −0.13,p = .03; β = −0.14,p = .03). Higher percentages of children were associated with better dietary behaviors (β = 0.06,p = .04), while having spouses (β = 0.06,p = .04), friends (β = 0.06,p = .03), and siblings (β = 0.06,p = .04) was associated with better foot care. Conclusions: The quality and content of network interactions appear more important than network size for T2D self-management among Black/African American men. Interventions should focus on fostering quality, disease-specific support rather than expanding social networks. Future programs should leverage existing relationships while considering how different network members influence specific aspects of diabetes management.