Who counts as supportive? A social network analysis of perceived support among Black/African American men with type 2 diabetes

Black/African American men experience a disproportionate burden of Type 2 Diabetes (T2D), yet little is known about which people in their lives they actually experience as supportive. This study used personal (egocentric) network analysis with 1,181 Black/African American men with T2D, who together described 6,899 relationships. Multilevel modeling examined what makes a man perceive an individual person in his network as supportive. Because each man described several relationships, the analysis separates differences between men from differences among the people within a single man’s network. Advice mattered most: network members who gave advice were rated more supportive than those who provided practical help or a confiding relationship. Contrary to the assumption that more is better, members who provided several kinds of support were rated no higher than those who gave advice alone. Healthcare providers and family members were rated most supportive, friends less so. Members who also had T2D were rated more supportive, pointing to the value of shared experience. Being named as someone who made diabetes harder lowered ratings regardless of other support that person provided. Men with more varied networks rated their members more supportive, while men with larger networks rated them slightly lower, though this decline was detectable only in networks of more than ten people. These findings suggest that interventions should focus on cultivating a small number of effective advisors rather than encouraging any one person to do everything.