| 1. Participants keep participating during the intervention | Participants think the intervention suits them, that it is important to participate and expect to benefit from participating in the intervention (outcome expectations, perceived norms, moral norms)
Participants feel supported by their group members and their significant others to participate (self-efficacy, skills, social support)
Participants are motivated to attend by other participants and their significant others (social influence) | Increasing relevance
Collection of questions: to guarantee that the meeting fits the needs of the participants, the group leaders start with a short description of the meeting and write down the participants’ questions on this topic. At the end of the meeting, the group leader checks whether all questions have been addressed. Direct influence of participants on intervention strategies such as role-playing exercises and letter of the week (a fictional letter received from someone with diabetes who has a problem that needs to be solved. The participants are invited to brainstorm together about the problem and help solve the problem), so strategies can be adjusted by the group leader to their needs. Personalising the intervention: intervention focuses on the participant. For example, participants were invited to ask their questions, to bring their own medications, to cook something for the group and got. personalised feedback. Summarising results and complimenting participants: to help participants feel they have spent their time well, helped each other and have learnt a lot, and at the end of each meeting, the group leader summarises what the participants have learnt. Group leaders also tell the participants how appreciative they are of all their achievements.
Reducing practical barriers to participate during the interventionFlexibility in time and day of meetings and adjusting meetings to holidays, Ramadan and so on. Location of intervention in walking distance from participants’ homes 3. Low-key intervention locations such as well-known community centres. Well-known migrant health workers with long working histories as group leaders. Calling participants before each meeting to make them remember the meeting and to stimulate participation. Dealing with resistance/barriers to participate from significant others is a returning subject of the meetings. During the meetings for significant others stimulating a significant other to participate is one of the subjects.
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| 2. Participants experience the atmosphere in their group as pleasant and positive | Participants feel a connection with group members, expect to feel good after attending and have the feeling that their group members think it is pleasant to see each other again (outcome expectations, perceived norms, moral norms)
Participants are able to maintain a positive atmosphere in their group and are able to discuss inappropriate or unpleasant behaviour by group members together by giving each other positive feedback (self-efficacy, skills, social support)
Participants stimulate each other to maintain a positive atmosphere in their group | Strategies to stimulate social support and group bondingAlways tea and coffee present during the meetings and time to drink tea and coffee before the start of the intervention. Energisers (intermezzos) during the intervention that last 5–10 min to stimulate bonding between group members. Examples: passing ball along and giving the person who receives the ball a compliment, playing ‘web of life’ (a game illustrating that we need each other), keeping a balloon up in the air together and so on. Participants share their positive news of the week with each other to get to know each other and to be more open to new information (self-affirmation). This news could be anything, as long as it was experienced as being positive by the participant. Rules for giving and receiving feedback: participants learn how to give appropriate feedback. Exercising together: meant to get participants acquainted with physical activity but also to stimulate group bonding by making sure everyone mixed (opportunity to chat with person other than person next to you, interact with group leader).
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| 3. Participants think the meetings are fun and useful | Participants think the intervention suits them, that it is important to participate and expect to benefit from participating in the intervention (outcome expectations, perceived norms, moral norms)
Participants feel like they and their group members have learnt new things after each meeting and feel like participating is part of their personal development (perceived cultural norms and moral norms) | Increasing relevanceCollection of questions: to guarantee that the meeting fits the needs of the participants, the group leaders start with a short description of the meeting and write down the participants’ questions on this topic. At the end of the meeting, the group leader checks whether all questions have been addressed. Summarising results and complimenting participants: To help participants feel they have spent their time well, helped each other and have learnt a lot, at the end of each meeting the group leader summarises what the participants have learnt. Group leaders also tell the participants how appreciative they are of all their achievements. Direct influence participants on intervention strategies such as role-playing exercises, letter of the week (a fictional letter received from someone with diabetes who has a problem that needs to be solved. The participants were invited to brainstorm together about the problem and help solve the problem).
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| 4. Participants trust each other and feel safe with each other | Participants expect that they can trust their group members and that they are trusted by their group members despite hindrance from their significant others (outcome expectations, perceived norms, moral norms)
Participants feel confident that they can trust their group members, feel supported to exchange confident information and agree on appointments about the exchange of confident information in their group (self-efficacy, social support, social influence) | Team building and human relations
Establishing shared goals and engendering commitment: exercises in which participants had to team up together and also shared goals to achieve as a group: a cookbook, getting both diplomas (phase 1 and phase 2), walking longer and further together each meeting.
Strategies to stimulate social support and group bondingCreating non-judgemental small groups: making a confidentiality pact in the group (what is discussed in this group, stays in this group), rules for giving and receiving feedback (participants learn how to give appropriated feedback) and also rules about communication in the group (letting each other finish their sentences and listening to each other). Forming coalitions/participatory problem solving: most intervention strategies included games in which the participants had to form coalitions, have group discussions or team up together to stimulate group bonding. Stimulate communication and mobilising social support: participants share their positive news of the week with each other to get to know each other and to be more open to new information (self-affirmation), and group leader regularly compliments the participants on the pleasant atmosphere.
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