{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:59:07Z","timestamp":1791385147224,"version":"4.3.3"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social prescribing (SP) interventions have been increasingly developed to improve wellbeing, promote healthier behaviors, and support the management of chronic diseases such as type 2 diabetes mellitus (T2DM). This study aims to explore the REDE D+ program, a complex SP intervention designed to promote self-care and health literacy among people with T2DM from the perspective of users in the primary health care context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A qualitative study was conducted following the implementation of a non-randomized pilot cohort study (REDE D+ program), carried out in primary health care and the community. Acceptability was assessed through two focus groups involving 18 people living with T2DM who had engaged with the SP intervention. The semi-structured interviews were transcribed and analyzed using a\n                      <jats:italic>reflexive thematic analysis<\/jats:italic>\n                      , following the six-phase approach proposed by Braun and Clarke. Five main themes emerged from the analysis: acceptance of the intervention, benefits, barriers and challenges, facilitators, and overall satisfaction. The perceived barriers were analyzed through the lens of the COM-B model from the\n                      <jats:italic>Behavior Change Wheel<\/jats:italic>\n                      theory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The REDE D+ program demonstrated a high level of acceptance and satisfaction among individuals living with T2DM. The main benefits were highlighted by the adoption of healthier behaviors, such as healthy eating and physical activity, improvements in the level of knowledge and awareness about the disease, and the promotion of health literacy. Participants also reported improvements in their quality of life, including better social interaction and reduced feelings of loneliness. Regarding barriers and challenges, physical capability was related to age and osteoarticular pain, as well as difficulties in understanding; reflective motivation was related to previous preconceived ideas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The REDE D+ program suggested that it can contribute to better self-care behaviors in T2DM and support health-related decision-making by improving health literacy. The intervention has proven to be a valid and impactful approach, with strong potential for future integration into primary health care services to support the monitoring and management of individuals with T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1762723","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:51:22Z","timestamp":1773903082000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Acceptability of a social prescribing program (REDE D+) for self-care and health literacy among people with type 2 diabetes mellitus\u2014a qualitative study"],"prefix":"10.3389","volume":"14","author":[{"given":"Dulce","family":"Oliveira","sequence":"first","affiliation":[{"name":"Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem (ESEUL), Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Escola Superior de Enfermagem de Lisboa (ESEUL), Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Department of Nursing, Escola Superior de Sa\u00fade da Cruz Vermelha Portuguesa de Lisboa","place":["Lisbon, Portugal"]},{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Henriques","sequence":"additional","affiliation":[{"name":"Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem (ESEUL), Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Laborat\u00f3rio Associado TERRA, Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem (ESEUL), Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Laborat\u00f3rio Associado TERRA, Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Biomathematics Laboratory, Faculdade, de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreia","family":"Costa","sequence":"additional","affiliation":[{"name":"Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem (ESEUL), Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]},{"name":"Laborat\u00f3rio Associado TERRA, Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijerph17010246","article-title":"Increased mortality risk in people with type 2 diabetes mellitus in Lithuania","volume":"17","author":"Linkeviciute-Ulinskiene","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B2","unstructured":"Guidance on global monitoring for diabetes prevention and control Framework, indicators and application\n          \n          2024"},{"key":"B3","unstructured":"Global Health Observatory: Life Expectancy and Leading causes of death and disiability.\n          \n          2024"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1136\/bmj.l1285","article-title":"Social prescribing","volume":"364","author":"Drinkwater","year":"2019","journal-title":"BMJ"},{"key":"B5","doi-asserted-by":"publisher","first-page":"E474","DOI":"10.1503\/cmaj.160177","article-title":"Taking action on the social determinants of health in clinical practice: a framework for health professionals","volume":"188","author":"Andermann","year":"2016","journal-title":"CMAJ"},{"key":"B6","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1186\/s12889-024-17736-2","article-title":"A rapid review of opportunities and challenges in the implementation of social prescription interventions for addressing the unmet needs of individuals living with long-term chronic conditions","volume":"24","author":"Yadav","year":"2024","journal-title":"BMC Public Health"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e008524","DOI":"10.1136\/bmjgh-2022-008524","article-title":"Global developments in social prescribing","volume":"7","author":"Morse","year":"2022","journal-title":"BMJ Glob Health"},{"key":"B8","unstructured":"A TOOLKIT ON HOW TO IMPLEMENT SOCIAL PRESCRIBING Region Pacific Western Organization World Health.\n          \n          2022"},{"key":"B9","doi-asserted-by":"publisher","first-page":"104992","DOI":"10.1016\/j.healthpol.2024.104992","article-title":"A comparison of social prescribing approaches across twelve high-income countries","volume":"142","author":"Scarpetti","year":"2024","journal-title":"Health Policy Elsevier Ireland Ltd."},{"key":"B10","unstructured":"Kitson\n              A\n            \n            \n              Conroy\n              T\n            \n            \n              Kuluski\n              K\n            \n            \n              Locock\n              L\n            \n            \n              Lyons\n              R\n            \n          \n          Reclaiming and redefining the fundamentals of care: nursing's response to meeting patients' basic human needs\n          \n          2013"},{"key":"B11","doi-asserted-by":"publisher","first-page":"S68","DOI":"10.2337\/dc23-S005","volume":"46","author":"Elsayed","year":"2023","journal-title":"Diabetes Care"},{"key":"B12","doi-asserted-by":"publisher","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"30","author":"Skivington","year":"2021","journal-title":"BMJ."},{"key":"B13","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1136\/bmj.a1655","article-title":"Developing and evaluating complex interventions: the new Medical Research Council guidance","volume":"337","author":"Craig","year":"2008","journal-title":"BMJ"},{"key":"B14","doi-asserted-by":"publisher","first-page":"52","DOI":"10.7748\/ns.2017.e10765","article-title":"Implementing fundamental care in clinical practice","volume":"31","author":"Feo","year":"2017","journal-title":"Nurs Stand."},{"key":"B15","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1097\/NNR.0000000000000271","article-title":"The fundamentals of care framework as a point-of-care nursing theory","volume":"67","author":"Kitson","year":"2018","journal-title":"Nurs Res."},{"key":"B16","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1111\/j.1440-172X.2010.01861.x","article-title":"Defining the fundamentals of care","volume":"16","author":"Kitson","year":"2010","journal-title":"Int J Nurs Pract."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1111\/jocn.14247","article-title":"Towards a standardised definition for fundamental care: a modified Delphi study","volume":"27","author":"Feo","year":"2018","journal-title":"J Clin Nurs."},{"key":"B18","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1186\/s40359-024-01900-9","article-title":"Validation of the Portuguese version of the diabetes self-management questionnaire-revised (DSMQ-R) in people with type 2 diabetes mellitus","volume":"12","author":"Oliveira","year":"2024","journal-title":"BMC Psychol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1186\/s12875-025-03081-9","article-title":"Evaluation of diabetes knowledge among people with type 2 diabetes mellitus in Portugal primary care \u2013 where is the gap","volume":"26","author":"Oliveira","year":"2025","journal-title":"BMC Primary Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.71861\/pensarenf.v28iSup.375","article-title":"Barriers to self-care for people with type 2 diabetes","volume":"28","author":"Oliveira","year":"2024","journal-title":"Pensar em Enfermagem"},{"key":"B21","doi-asserted-by":"publisher","first-page":"6765353","DOI":"10.1155\/hsc\/6765353","article-title":"Consensus building using modified delphi panel and nominal group techniques for social prescribing intervention in patients with type 2 diabetes mellitus","volume":"2025","author":"Oliveira","year":"2025","journal-title":"Health Soc Care Community."},{"key":"B22","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12913-018-2893-4","article-title":"Facilitators and barriers of implementing and delivering social prescribing services: a systematic review","volume":"18","author":"Pescheny","year":"2018","journal-title":"BMC Health Serv Res."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1186\/s12913-021-07186-6","article-title":"Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging","volume":"21","author":"Costa","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e0306404","DOI":"10.1371\/journal.pone.0306404","article-title":"Implementing a social prescribing program in primary care units in Portugal: a qualitative study exploring enablers, barriers and lessons learned from the perspectives of stakeholders involved in the program implementation","volume":"19","author":"Hoffmeister","year":"2024","journal-title":"PLoS ONE"},{"key":"B25","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/17533015.2017.1334002","article-title":"Non-clinical community interventions: a systematised review of social prescribing schemes","volume":"10","author":"Chatterjee","year":"2018","journal-title":"Arts Health. Routledge"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e013384","DOI":"10.1136\/bmjopen-2016-013384","article-title":"Social prescribing: less rhetoric and more reality. a systematic review of the evidence","volume":"7","author":"Bickerdike","year":"2017","journal-title":"BMC Open"},{"key":"B27","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/hsc.12839","article-title":"What approaches to social prescribing work, for whom, and in what circumstances? A realist review","volume":"28","author":"Husk","year":"2020","journal-title":"Health Soc Care Community"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-024-02315-x","article-title":"Impact of social prescribing intervention on people with type 2 diabetes mellitus in a primary healthcare context: a systematic literature review of effectiveness","author":"Oliveira","year":"2024","journal-title":"J Public Health Nat."},{"key":"B29","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/2041-210X.12860","volume":"9","year":"2018","journal-title":"Methods Ecol Evol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: guided by information power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual Health Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"18","author":"Braun","year":"2020","journal-title":"Qual Res Psychol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1080\/2159676X.2019.1704846","article-title":"To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales","volume":"13","author":"Braun","year":"2019","journal-title":"Qual Res Sport Exerc Health"},{"key":"B33","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1177\/104973202129120052","article-title":"\u201cOuting\u201d the researcher: the provenance, process, and practice of reflexivity","volume":"12","author":"Finlay","year":"2002","journal-title":"Qual Health Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qual Res Sport Exerc Health."},{"key":"B35","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1177\/160940690900800105","article-title":"The space between: on being an insider-outsider in qualitative research","volume":"8","author":"Dwyer","year":"2009","journal-title":"Int J Qual Methods."},{"key":"B36","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1111\/j.1752-7325.2011.00241.x","article-title":"Qualitative methods to ensure acceptability of behavioral and social interventions to the target population","volume":"1","author":"Ayala","year":"2011","journal-title":"J Public Health Dent."},{"key":"B37","unstructured":""},{"key":"B38","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement Sci"},{"key":"B40","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1111\/j.1524-4733.2004.72252.x","article-title":"Satisfaction with medication: an overview of conceptual, methodologic, and regulatory issues","volume":"7","author":"Shikiar","year":"2004","journal-title":"Value Health."},{"key":"B41","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12913-017-2031-8","article-title":"Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework","volume":"17","author":"Sekhon","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"B42","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1186\/s12912-024-02573-w","article-title":"Tailoring nursing interventions to empower patients: personal coping strategies and self-management in type 2 diabetes care","volume":"23","author":"Ibrahim","year":"2024","journal-title":"BMC Nurs"},{"key":"B43","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1186\/s12913-023-09895-6","article-title":"Empowerment interventions designed for persons living with chronic disease - a systematic review and meta-analysis of the components and efficacy of format on patient-reported outcomes","volume":"23","author":"Stepanian","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"B44","unstructured":"Peer support approaches: to what extent are they appropriate, acceptable, beneficial?\n          \n          \n            \n              Peersman\n              G\n            \n            \n              Fletcher\n              G\n            \n            \n              Rahman\n              S\n            \n            \n              Macfarlan\n              A\n            \n            \n              Hassall\n              K\n            \n          \n          \n          2019"},{"key":"B45","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1258\/jhsrp.2008.008014","article-title":"Designing and implementing behaviour change interventions to improve population health","volume":"13","author":"Michie","year":"2008","journal-title":"J Health Serv Res Policy."},{"key":"B46","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1111\/hsc.12669","article-title":"Arts on prescription for community-dwelling older people with a range of health and wellness needs","volume":"27","author":"Poulos","year":"2019","journal-title":"Health Soc Care Community."},{"key":"B47","doi-asserted-by":"publisher","first-page":"e033186","DOI":"10.1136\/bmjopen-2019-033186","article-title":"Effects of participating in community assets on quality of life and costs of care: longitudinal cohort study of older people in England","volume":"10","author":"Munford","year":"2020","journal-title":"BMJ Open."},{"key":"B48","doi-asserted-by":"publisher","first-page":"113149","DOI":"10.1016\/j.socscimed.2020.113149","article-title":"Community asset participation and social medicine increases qualities of life","volume":"259","author":"Munford","year":"2020","journal-title":"Soc Sci Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implement Sci"},{"key":"B50","doi-asserted-by":"publisher","first-page":"85","DOI":"10.2337\/diaspect.24.2.85","article-title":"Review of volunteer-based peer support interventions in diabetes","volume":"24","author":"Tang","year":"2011","journal-title":"Diabetes Spectrum."},{"key":"B51","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1186\/s12913-022-07816-7","article-title":"Peer support for people with chronic conditions: a systematic review of reviews","volume":"22","author":"Thompson","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"B52","doi-asserted-by":"publisher","first-page":"116601","DOI":"10.1016\/j.socscimed.2024.116601","article-title":"What does social prescribing look like in practice? a qualitative case study informed by practice theory","volume":"343","author":"Calder\u00f3n-Larra\u00f1aga","year":"2024","journal-title":"Soc Sci Med"},{"key":"B53","doi-asserted-by":"publisher","first-page":"6613809","DOI":"10.1155\/hsc\/6613809","article-title":"The role of social prescribing interventions in addressing health inequalities in the United Kingdom: a narrative review","volume":"2025","author":"Melam","year":"2025","journal-title":"Health Soc Care Commun"},{"key":"B54","doi-asserted-by":"publisher","first-page":"114037","DOI":"10.1016\/j.socscimed.2021.114037","article-title":"Social prescribing and classed inequality: a journey of upward health mobility?","volume":"280","author":"Gibson","year":"2021","journal-title":"Soc Sci Med"},{"key":"B55","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12875-025-02908-9","article-title":"Stakeholder understanding of social prescribing in England: a qualitative study in primary care","volume":"26","author":"Fattorini","year":"2025","journal-title":"BMC Primary Care"},{"key":"B56","doi-asserted-by":"publisher","first-page":"e10421","DOI":"10.2196\/10421","article-title":"Identifying brief message content for interventions delivered via mobile devices to improve medication adherence in people with type 2 diabetes mellitus: a rapid systematic review","volume":"21","author":"Long","year":"2019","journal-title":"J Med Int Res."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1762723\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:51:23Z","timestamp":1773903083000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1762723\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":56,"alternative-id":["10.3389\/fpubh.2026.1762723"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1762723","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]},"article-number":"1762723"}}