{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:29:59Z","timestamp":1787059799251,"version":"build-2736575974"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007601","name":"European Union\u2019s Horizon 2020 research and innovation programme","doi-asserted-by":"publisher","award":["804761"],"award-info":[{"award-number":["804761"]}],"id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016386","name":"Valencian Department of Innovation, Universities, Science and Digital Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016386","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004895","name":"European Social Fund","doi-asserted-by":"publisher","award":["CIACIF\/2021\/456"],"award-info":[{"award-number":["CIACIF\/2021\/456"]}],"id":[{"id":"10.13039\/501100004895","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Social support plays an important role in the management of type 2 diabetes (T2DM), yet health promotion strategies often focus on individual behavior change while overlooking community structures that sustain supportive environments and facilitate adherence to healthy behaviors. Participatory approaches can help identify locally grounded strategies to strengthen community support networks for chronic disease management. This study aimed to co-create community-based strategies to strengthen social support networks for T2DM management. Between March and September 2024, we conducted a participatory research process with two communities in southern Quito, Ecuador. A core group composed of community leaders and academic representatives facilitated a three-phase process including situational analysis, co-creation of strategies, evaluation, and dissemination. Four community workshops engaged 152 participants. Proposed actions were prioritized through a weighted scoring system assessing feasibility, community ownership, and potential impact on social support networks. Participants generated 15 community-driven proposals. The highest-ranked proposal was the creation of a community health committee responsible for identifying socially isolated individuals, raising family awareness, and facilitating accompaniment to medical appointments. Additional initiatives included nutrition workshops, a community cookbook, and a solidarity-based medication bank. Participants also highlighted strengthened relationships within and between community members and the need for sustainable coordination mechanisms. This study demonstrates the potential of participatory co-creation to generate locally grounded strategies that strengthen social support for chronic disease management. Community governance structures and collective support mechanisms are fundamental in health promotion efforts addressing chronic diseases. Health promotion strategies should integrate community knowledge and participation to enhance their relevance and sustainability.<\/jats:p>","DOI":"10.1093\/heapro\/daag123","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:58:22Z","timestamp":1785412702000},"source":"Crossref","is-referenced-by-count":0,"title":["Co-creating community support strategies for chronic disease management: insights from our experience with two community groups in southern Quito, Ecuador"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3259-9524","authenticated-orcid":false,"given":"Marta","family":"Puig-Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hern\u00e1ndez de Elche , Crta. Nacional, N-332, s\/n, 03550 Sant Joan d'Alacant (Alicante) ,","place":["Spain"]},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Avenida Montforte de Lemos, 3-5 (Pabell\u00f3n 11, Planta 0), 28029 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2046-4342","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Sanch\u00eds-Ram\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hern\u00e1ndez de Elche , Crta. Nacional, N-332, s\/n, 03550 Sant Joan d'Alacant (Alicante) ,","place":["Spain"]},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Avenida Montforte de Lemos, 3-5 (Pabell\u00f3n 11, Planta 0), 28029 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9091-7255","authenticated-orcid":false,"given":"Elisa","family":"Chilet-Rosell","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hern\u00e1ndez de Elche , Crta. Nacional, N-332, s\/n, 03550 Sant Joan d'Alacant (Alicante) ,","place":["Spain"]},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Avenida Montforte de Lemos, 3-5 (Pabell\u00f3n 11, Planta 0), 28029 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8666-1090","authenticated-orcid":false,"given":"Sergio","family":"Morales-Garz\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hern\u00e1ndez de Elche , Crta. Nacional, N-332, s\/n, 03550 Sant Joan d'Alacant (Alicante) ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2362-4057","authenticated-orcid":false,"given":"Lucy Anne","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hern\u00e1ndez de Elche , Crta. Nacional, N-332, s\/n, 03550 Sant Joan d'Alacant (Alicante) ,","place":["Spain"]},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Avenida Montforte de Lemos, 3-5 (Pabell\u00f3n 11, Planta 0), 28029 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026081809125670500_daag123-B1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s12874-025-02514-4","article-title":"Co-creation methods for public health research\u2014characteristics, benefits, and challenges: a Health CASCADE scoping review","volume":"25","author":"Agnello","year":"2025","journal-title":"BMC Med Res Methodol"},{"key":"2026081809125670500_daag123-B2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/1478-7547-12-23","article-title":"Health research priority setting in selected high income countries: a narrative review of methods used and recommendations for future practice","volume":"12","author":"Bryant","year":"2014","journal-title":"Cost Eff Resour Alloc"},{"key":"2026081809125670500_daag123-B3","doi-asserted-by":"publisher","first-page":"e069329","DOI":"10.1136\/bmjopen-2022-069329","article-title":"Using participatory action research to reimagine community mental health services in Colombia: a mixed-method study protocol","volume":"12","author":"Burgess","year":"2022","journal-title":"BMJ Open"},{"key":"2026081809125670500_daag123-B4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1080\/25729861.2021.1946315","article-title":"Rethinking sustainable development by following Indigenous approaches to community wellbeing","volume":"4","author":"Campos Navarrete","year":"2021","journal-title":"Tapuya"},{"key":"2026081809125670500_daag123-B5","first-page":"1","article-title":"Diabetes Mellitus II: la importancia de las redes de apoyo como soporte al padecimiento","volume":"9","author":"Cartas-Fuentevilla","year":"2011","journal-title":"Poblac Salud Mesoam"},{"key":"2026081809125670500_daag123-B6","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1016\/0277-9536(95)00127-S","article-title":"What is participatory research?","volume":"41","author":"Cornwall","year":"1995","journal-title":"Soc Sci Med"},{"key":"2026081809125670500_daag123-B7","doi-asserted-by":"publisher","first-page":"180757","DOI":"10.1155\/2013\/180757","article-title":"Promoting patient and caregiver engagement in self-management of chronic illness","volume":"2013","author":"DeVito Dabbs","year":"2013","journal-title":"Nurs Res Pract"},{"key":"2026081809125670500_daag123-B8","doi-asserted-by":"publisher","first-page":"375","DOI":"10.18294\/sc.2017.1156","article-title":"Los cuidados de la salud en personas que viven con diabetes: enfoque etnogr\u00e1fico antropol\u00f3gico y perspectiva de g\u00e9nero","volume":"13","author":"Dom\u00ednguez Mon","year":"2017","journal-title":"Salud Colect"},{"key":"2026081809125670500_daag123-B9","doi-asserted-by":"publisher","first-page":"e051430","DOI":"10.1136\/bmjopen-2021-051430","article-title":"A co-design study to develop supportive interventions to improve psychological and social adaptation among adults with new-onset type 1 diabetes in Denmark and the UK","volume":"11","author":"Due-Christensen","year":"2021","journal-title":"BMJ Open"},{"key":"2026081809125670500_daag123-B10","doi-asserted-by":"publisher","first-page":"8700","DOI":"10.3390\/su16198700","article-title":"Empowering communities to act for a change: a review of the community empowerment programs towards sustainability and resilience","volume":"16","author":"Dushkova","year":"2024","journal-title":"Sustainability"},{"key":"2026081809125670500_daag123-B11","first-page":"168","article-title":"De la \u00e9tica m\u00e9dica tradicional a la bio\u00e9tica m\u00e9dica. From traditional medical ethics to medical bioethics","volume":"61","author":"El\u00edo-Calvo","year":"2020","journal-title":"Cuad - Hosp Cl\u00edn"},{"key":"2026081809125670500_daag123-B12","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1007\/BF02506987","article-title":"Using empowerment theory in collaborative partnerships for community health and development","volume":"23","author":"Fawcett","year":"1995","journal-title":"Am J Community Psychol"},{"key":"2026081809125670500_daag123-B13","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1377\/hlthaff.2015.0365","article-title":"Key features of peer support in chronic disease prevention and management","volume":"34","author":"Fisher","year":"2015","journal-title":"Health Aff (Millwood)"},{"key":"2026081809125670500_daag123-B14","author":"Franc\u00e9s"},{"key":"2026081809125670500_daag123-B15","doi-asserted-by":"publisher","first-page":"i17","DOI":"10.1093\/fampra\/cmp027","article-title":"Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research","volume":"27","author":"Funnell","year":"2010","journal-title":"Fam Pract"},{"key":"2026081809125670500_daag123-B16","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.puhe.2024.05.007","article-title":"Building trust and increasing inclusion in public health research: co-produced strategies for engaging UK ethnic minority communities in research","volume":"233","author":"Gafari","year":"2024","journal-title":"Public Health"},{"key":"2026081809125670500_daag123-B17","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1177\/1090198102251030","article-title":"The influence of social support on chronic illness self-management: a review and directions for research","volume":"30","author":"Gallant","year":"2003","journal-title":"Health Educ Behav"},{"key":"2026081809125670500_daag123-B18","doi-asserted-by":"publisher","first-page":"3527","DOI":"10.24251\/hicss.2017.427","volume-title":"Proceedings of the Annual Hawaii International Conference on System Sciences","author":"Higa","year":"2017"},{"key":"2026081809125670500_daag123-B19","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.socscimed.2018.07.019","article-title":"Community participation in general health initiatives in high and upper-middle income countries: a systematic review exploring the nature of participation, use of theories, contextual drivers and power relations in community participation.","volume":"213","author":"Hoon Chuah","year":"2018","journal-title":"Soc Sci Med"},{"key":"2026081809125670500_daag123-B20","doi-asserted-by":"publisher","first-page":"157","DOI":"10.2337\/ds18-0040","article-title":"Pilot of community-based diabetes self-management support for patients at an urban primary care clinic","volume":"32","author":"Johnson","year":"2019","journal-title":"Diabetes Spectr"},{"key":"2026081809125670500_daag123-B21","doi-asserted-by":"publisher","first-page":"696","DOI":"10.4103\/ijem.IJEM_579_17","article-title":"Emotional and psychological needs of people with diabetes","volume":"22","author":"Kalra","year":"2018","journal-title":"Indian J Endocrinol Metab"},{"key":"2026081809125670500_daag123-B22","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1386\/jaah_00012_1","article-title":"Arts and social sustainability: promoting intergenerational relations through community theatre","volume":"11","author":"Killick","year":"2020","journal-title":"J Appl Arts Health"},{"key":"2026081809125670500_daag123-B23","doi-asserted-by":"publisher","first-page":"1766","DOI":"10.1186\/s12889-026-27301-8","article-title":"Promoting community engagement in type 2 diabetes management: a systematic review and meta-analysis of community-based participatory research interventions","volume":"26","author":"Ko","year":"2026","journal-title":"BMC Public Health"},{"key":"2026081809125670500_daag123-B24","first-page":"13","article-title":"La investigaci\u00f3n acci\u00f3n participaci\u00f3n, un aporte al conocimiento y a la transformaci\u00f3n de latinoam\u00e9rica, en permanente movimiento","volume":"33","author":"Leal","year":"2009","journal-title":"Rev Investig"},{"key":"2026081809125670500_daag123-B25","first-page":"76","article-title":"Impacto psicosocial de la diabetes mellitus, experiencias, significados y respuestas a la enfermedad","volume":"23","author":"Led\u00f3n Llanes","year":"2012","journal-title":"Rev Cubana Endocrinol"},{"key":"2026081809125670500_daag123-B26","doi-asserted-by":"publisher","first-page":"597","DOI":"10.25222\/larr.164","article-title":"Imagining Latin American social science from the Global South: Orlando Fals Borda and participatory action research","volume":"53","author":"Lomeli","year":"2018","journal-title":"Lat Am Res Rev"},{"key":"2026081809125670500_daag123-B27","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12992-024-01014-2","article-title":"Conducting co-creation for public health in low and middle-income countries: a systematic review and key informant perspectives on implementation barriers and facilitators","volume":"20","author":"Longworth","year":"2024","journal-title":"Global Health"},{"key":"2026081809125670500_daag123-B28","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.gaceta.2018.06.008","article-title":"Herramientas y m\u00e9todos participativos para la acci\u00f3n comunitaria. Informe SESPAS 2018","volume":"32","author":"L\u00f3pez-S\u00e1nchez","year":"2018","journal-title":"Gac Sanit"},{"key":"2026081809125670500_daag123-B29","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/978-3-319-92177-8_10","volume-title":"Participatory Health Research","author":"Mercado-Mart\u00ednez","year":"2018"},{"key":"2026081809125670500_daag123-B30","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.26633\/RPSP.2022.197","article-title":"HEARTS en las Am\u00e9ricas: innovaciones para mejorar el manejo de la hipertensi\u00f3n y del riesgo cardiovascular en la atenci\u00f3n primaria","volume":"46","author":"Ordunez","year":"2022","journal-title":"Rev Panam Salud P\u00fablica"},{"key":"2026081809125670500_daag123-B31","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1016\/j.pop.2012.03.011","article-title":"Community-based partnerships for improving chronic disease management","volume":"39","author":"Plumb","year":"2012","journal-title":"Prim Care"},{"key":"2026081809125670500_daag123-B32","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1093\/heapro\/daaa133","article-title":"Power, control, communities and health inequalities I: theories, concepts and analytical frameworks","volume":"36","author":"Popay","year":"2021","journal-title":"Health Promot Int"},{"key":"2026081809125670500_daag123-B33","doi-asserted-by":"publisher","first-page":"129","DOI":"10.22201\/fm.20075057e.2024.49.23578","article-title":"Investigaci\u00f3n-acci\u00f3n participativa y educaci\u00f3n basada en evidencias en el campo de la salud: investigar desde las pr\u00e1cticas","volume":"13","author":"Rend\u00f3n Cazales","year":"2024","journal-title":"Investigaci\u00f3n Educ M\u00e9dica"},{"key":"2026081809125670500_daag123-B34","first-page":"379","volume-title":"La Socio-Praxis: un Acoplamiento de Metodolog\u00edas Implicativas","author":"Rodriguez-Villasante","year":"2006"},{"key":"2026081809125670500_daag123-B35","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1177\/1742395309354608","article-title":"Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help?","volume":"6","author":"Rosland","year":"2010","journal-title":"Chronic Illn"},{"key":"2026081809125670500_daag123-B36","doi-asserted-by":"publisher","first-page":"443","DOI":"10.4081\/jphr.2015.443","article-title":"Community priority index: utility, applicability and validation for priority setting in community-based participatory research","volume":"4","author":"Salihu","year":"2015","journal-title":"J Public Health Res"},{"key":"2026081809125670500_daag123-B37","doi-asserted-by":"publisher","first-page":"e031187","DOI":"10.1136\/bmjopen-2019-031187","article-title":"Patients, clinicians and researchers working together to improve cardiovascular health: a qualitative study of barriers and priorities for patient-oriented research","volume":"10","author":"Santana","year":"2020","journal-title":"BMJ Open"},{"key":"2026081809125670500_daag123-B38","doi-asserted-by":"publisher","first-page":"e20650","DOI":"10.2196\/20650","article-title":"A clinician-led, experience-based co-design approach for developing mHealth services to support the patient self-management of chronic conditions: development study and design case","volume":"9","author":"Song","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026081809125670500_daag123-B39","doi-asserted-by":"publisher","first-page":"S41","DOI":"10.2105\/AJPH.2023.307469","article-title":"A participatory trust-building model for conducting health equity research with rural and urban native American, black, and Latinx communities: WEAVE NM (Wide Engagement for Assessing Vaccine Equity in New Mexico)","volume":"114","author":"Stone","year":"2024","journal-title":"Am J Public Health"},{"key":"2026081809125670500_daag123-B40","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s40900-023-00456-z","article-title":"Lessons learned from a virtual Community-Based Participatory Research project: prioritizing needs of people who have diabetes and experiences of homelessness to co-design a participatory action project","volume":"9","author":"Tariq","year":"2023","journal-title":"Res Involv Engagem"},{"key":"2026081809125670500_daag123-B41","first-page":"160","article-title":"Action research and participatory research: an overview","volume":"7","author":"Thiollent","year":"2011","journal-title":"Int J Action Res"},{"key":"2026081809125670500_daag123-B42","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1186\/s12874-019-0889-3","article-title":"Reporting guideline for priority setting of health research (REPRISE)","volume":"19","author":"Tong","year":"2019","journal-title":"BMC Med Res Methodol"},{"key":"2026081809125670500_daag123-B43","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s11606-021-07308-0","article-title":"Co-creating the patient partner guide by a multiple chronic conditions team of patients, clinicians, and researchers: observational report","volume":"37","author":"van Eeghen","year":"2022","journal-title":"J Gen Intern Med"},{"key":"2026081809125670500_daag123-B44","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1093\/cdj\/bsad030","article-title":"Community development via performing art: considering a community theatre intervention","volume":"59","author":"Viola","year":"2024","journal-title":"Community Dev J"},{"key":"2026081809125670500_daag123-B45","doi-asserted-by":"publisher","first-page":"19S","DOI":"10.1177\/1090198119852998","article-title":"Power dynamics in community-based participatory research: a multiple\u2013case study analysis of partnering contexts, histories, and practices","volume":"46","author":"Wallerstein","year":"2019","journal-title":"Health Educ Behav"},{"key":"2026081809125670500_daag123-B46","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1177\/1932296818807689","article-title":"Building bridges through collaboration and consensus: expanding awareness and use of peer support and peer support communities among people with diabetes, caregivers, and health care providers","volume":"13","author":"Warshaw","year":"2019","journal-title":"J Diabetes Sci Technol"},{"key":"2026081809125670500_daag123-B47","doi-asserted-by":"publisher","first-page":"7","DOI":"10.12966\/ojssr.04.02.2013","article-title":"Maximizing chronic disease prevention and management through community based participatory research and inter-collaborative practices","volume":"1","author":"Willison","year":"2013","journal-title":"Open J Soc Sci Res"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/41\/4\/daag123\/70684250\/daag123.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/41\/4\/daag123\/70684250\/daag123.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:13:04Z","timestamp":1787058784000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daag123\/8763730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daag123","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,1]]},"article-number":"daag123"}}