Community support group intervention to promote self-management of non-communicable disease in Nepal: A pilot study

Community support group interventions promote self-help, empower individuals to manage diseases and can be implemented in diverse formats. Their modality and effectiveness are influenced by broader local contexts. This pilot study aimed to explore whether conducting regular community support group meetings amongst people living with hypertension and/or diabetes, as a strategy to promote their self-management behaviours is feasible in Nepali setting. We conducted a mixed-method pilot study among adults aged ≥ 40 years living with hypertension and/or type 2 diabetes. Participants were enrolled into four groups-elderly-, marginalized-, mixed- and women's-group-that met biweekly for three months to discuss self-management practices. We recorded all meeting discussions. Changes in weight, blood pressure, diet, and exercise were assessed using quantitative pre- and post-intervention surveys. Additionally, we conducted in-depth interviews with purposively selected participants and female community health volunteers who supported the intervention. Meeting discussions and interviews were analysed thematically. Integrated analysis of the quantitative and qualitative findings informed feasibility. Assessment of acceptability, demand, practicality and implementation was guided by Bowen's framework. The study demonstrates community support group meetings as potentially feasible approach to promote self-management practices in people living with hypertension or diabetes. Over 80% of the total participants enrolled completed the study. Most expressed satisfaction with the meetings and reported that the meetings were beneficial and needed. Participation in these meetings also led to noticeable changes in self-management behaviours, particularly, dietary practices. Blood pressure and weight improved post-intervention. Members in homogeneous groups also initiated some collaborative self-management practices, such as going for walks together. To be sustainable, participants felt that such meetings should be led preferably by a resource person. Our findings suggest that regular, lifestyle-focused support group meetings can enhance NCD self-management. Homogenous group composition and expert facilitation may improve both engagement and long-term sustainability.