# Social Network Analysis and Social Support Intervention for Rural Dwelling Older Adults with T2DM

> **NIH NIH K01** · UNIVERSITY OF KENTUCKY · 2020 · $122,556

## Abstract

7. PROJECT SUMMARY/ABSTRACT
 Approximately 29.1 million (9.3%) adults in the US have type 2 diabetes (T2DM).1 T2DM is associated
with significant complications including premature coronary artery disease, kidney disease, stroke, and
blindness.1 Estimates show that prevalence of T2DM is 17% higher in rural dwellers compared to their urban
counterparts.2 For example, the prevalence of T2DM for adults in Kentucky's rural Appalachian counties is
13.6%,3 compared to the overall state prevalence of 10.6% 3. Appropriate self-care behaviors are necessary for
optimal clinical outcomes in T2DM 4-6 and account for 90% of the variance in glycemic control 7. Yet, self-care
among T2DM is notoriously poor in general and even worse in rural-dwellers. Without attention to improving
self-care in this population, we are facing an epidemic of T2DM complications in rural areas of the US.
 The impact of living with T2DM in rural communities is compounded in the aging population. The
prevalence of T2DM increases with age and an estimated 25% of older adults (≥65 years) have T2DM 8. Older
adults living with T2DM have more difficulty than younger people adhering to self-care regimens and
social/environment factors account for up to 85% of their self-care nonadherence.6,9-13 Notable
social/environment factors include competing social demands, lack of social support (SS), and stress.14-17 Social
support plays a particularly significant role in older adults with T2DM. The extent and type of SS available in
rural communities can positively or negatively impact self-care in those diagnosed with T2DM. 18-25
 To better understand the effects of the social environment in communities where older rural dwelling
adults reside and to lay the foundation for interventions, social network analysis (SNA) will be used to determine
social support network structures. By using SNA, social support structures can be developed and relationships
between individuals within a social network can be evaluated. 26 The overall objective of this study is to improve
T2DM self-care regimens in older rural dwelling adults by training influential community members to be
community health workers and provide social support strategies within an older adults' existing social network
that promotes T2DM self-care.
The proposed study seeks to:
 Aim 1—Use social network analysis to identify key players in a rural community to serve as community
health workers for those living with T2DM.
Aim 2—Use mixed methods to evaluate the impact of social support on T2DM self-care and clinical
outcomes and evaluate social networks in rural dwelling older adults with T2DM.
Aim 3—Test the feasibility and preliminary effectiveness of a 6-week intervention administered by
community health workers with the support of members of older adults' individual social network.

## Key facts

- **NIH application ID:** 9838747
- **Project number:** 5K01DK116923-02
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Brittany L. Smalls
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $122,556
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9838747

## Citation

> US National Institutes of Health, RePORTER application 9838747, Social Network Analysis and Social Support Intervention for Rural Dwelling Older Adults with T2DM (5K01DK116923-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9838747. Licensed CC0.

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