Social Connectedness and Diabetes Self-Management Across the COVID-19 Pandemic: A Mixed Methods Study

Introduction: Structural social connectedness is the structure and size of a person’s social network, including whether persons live with or have regular contact with others. The COVID-19 pandemic disrupted structures that facilitate social connectedness. This study investigated how a person’s structural social connectedness influenced diabetes self-management strategies through the COVID-19 pandemic. Method: The study followed an explanatory sequential mixed methods design. First, quantitative data were collected via surveys of 54 patients living with diabetes (67% female, Mage of 60 [12] years) in 2021. Then in 2022, we interviewed 25 patients (64% female, Mage of 62 [9] years) as a follow-up to the survey to help explain quantitative findings. Longitudinal mixed methods analysis integrated both phases to offer a holistic view of the factors influencing diabetes self-management. Results: A full-factorial analysis of covariance tested home and workplace social connectedness effects onto glycemic control and four self-management measures. In integrated analysis, researchers categorized patients into four groups by level of home and workplace social connectedness. Individuals with home social connectedness were more likely to over-come pandemic-related self-management challenges than those without home social con-nectedness. Although the workplace provided social connectedness, it imposed structural barriers to self-management. Discussion: Structural social connectedness influenced how patients navigated diabetes self-management challenges through the COVID-19 pandemic. Results suggest clinicians should consider how home and workplace connectedness interact to facilitate or impede patient self-management.