title: Social Network Type and Long-Term Condition Management Support: A Cross-Sectional Study in Six European Countries.
abstract: BACKGROUND
  Network types and characteristics have been linked to the capacity of inter-personal environments to mobilise and share resources. The aim of this paper is to examine personal network types in relation to long-term condition management in order to identify the properties of network types most likely to provide support for those with a long-term condition.
  
  
  METHODS
  A cross-sectional observational survey of people with type 2 diabetes using interviews and questionnaires was conducted between April and October 2013 in six European countries: Greece, Spain, Bulgaria, Norway, United Kingdom, and Netherlands. 1862 people with predominantly lower socio-economic status were recruited from each country. We used k-means clustering analysis to derive the network types, and one-way analysis of variance and multivariate logistic regression analysis to explore the relationship between network type socio-economic characteristics, self-management monitoring and skills, well-being, and network member work.
  
  
  RESULTS
  Five network types of people with long-term conditions were identified: restricted, minimal family, family, weak ties, and diverse. Restricted network types represented those with the poorest self-management skills and were associated with limited support from social network members. Restricted networks were associated with poor indicators across self-management capacity, network support, and well-being. Diverse networks were associated with more enhanced self-management skills amongst those with a long-term condition and high level of emotional support. It was the three network types which had a large number of network members (diverse, weak ties, and family) where healthcare utilisation was most likely to correspond to existing health needs.
  
  
  CONCLUSIONS
  Our findings suggest that type of increased social involvement is linked to greater self-management capacity and potentially lower formal health care costs indicating that diverse networks constitute the optimal network type as a policy in terms of the design of LTCM interventions and building support for people with LTCs.
authors.affiliation: NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Health Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
authors.forename: Ivaylo
authors.identifier: http://orcid.org/0000-0002-2206-8247
authors.initials: I
authors.lastname: Vassilev
authors.affiliation: NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Health Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
authors.affiliation: NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Health Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
authors.forename: Anne
authors.initials: A
authors.lastname: Kennedy
authors.affiliation: University Hospital Heidelberg, Department of General Practice and Health Services Research, Im Neuenheimer Feld, Marsilius Arkaden, Turm West, Heidelberg, Germany.
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.affiliation: Aarhus University, Department of Public Health, Bartholins Alee 2, 8000, Aarhus C, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Koetsenruijter
authors.affiliation: NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Health Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Orlando
authors.affiliation: NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Health Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Portillo
authors.affiliation: NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Health Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Culliford
mesh_terms: D000328:Adult; D002031:Bulgaria; D002908:Chronic Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology; D000066498:Emotional Adjustment; D005260:Female; D006115:Greece; D006304:Health Status; D006801:Humans; D008297:Male; D009426:Netherlands; D009664:Norway; D012648:Self Care / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors; D013030:Spain; D006113:United Kingdom