Few health conditions require as much patient self-management as type 1 diabetes (T1D). Social media has enabled T1D patients to find and maintain connections with T1D peers for self-management online support. Social media increases the sense of connectedness patients feel, and blogs (online journals about a content area), are one source that is produced and moderated by peers. In pilot data examining 100 comments of T1D blogs, 81% were related to diabetes barriers. Blogs are a rich data source for researchers to examine barriers and facilitators to T1D self-management, and to understand how to use them as a resource for T1D. Goal: The overall objective is to understand how blog use facilitates self-management support and identify barriers to T1D that can be tested in a validated survey to inform future interventions in clinical practice. Proposal: Penn State University College of Medicine researchers aim to 1) Identify barriers and facilitators to T1D self management by conducting a secondary data analysis on 11 most-frequented T1D blog sites;2) Develop and validate a survey of barriers for T1D;3) Conduct cross-sectional study with the newly developed survey to determine generalizability and determine characteristics (similarities and differences) between blog and non-blog groups;and 4) Translate the study survey instrument into a practical, clinically useful point of care tool to identify T1D patient support needs and resources in self-management. Significance: Discovery and innovation commonly develop from the scientific community, and disseminated to clinics and patients. This proposal is a paradigm reversal of developing interventions based on data from the patient community (blogs) to bring to healthcare professionals, and disseminated to the scientific community. It is a novel methodology to conduct a secondary qualitative analysis of blog posts and comments. The data will provide a foundational time-efficient advantage over coordinating, conducting, and transcribing individual and/or focus group interviews. Additionally, blog use allows real-time and patient-initiated efforts to seek support that is natural, gradual and non-prompted. The co-PIs and some consultants have T1D, providing a grounded and conceptually advantageous approach to content development and analysis. We plan to use existing survey instruments to obtain some of our data, especially related to outcomes;however, we will also develop and validate a new instrument which will be practical for day-to-day clinical use and point-of-care decision support, which are not offered by the existing instruments. Conclusion: With our findings, we will propose practical interventions to overcome barriers to self-management in clinical settings, including workflow-oriented, clinically useful strategies to provide enhanced support and help manage the challenges of T1D self-care.

Public Health Relevance

The purpose of this application is to leverage the tremendous amount of data available on blogs to improve our understanding of barriers and facilitators to management of type 1 diabetes among adults. Through our interactions with patients, we will further explore barriers and facilitators among those who use blogs and those who do not in order to ensure generalizability of our findings. Finally, we will translate the survey instrument into a point of care tool that can be easily implemented in clinical settings. This work will enabl providers to identify type 1 diabetes patient support needs and resources for self-management.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type 1 Diabetes Targeted Research Award (DP3)
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Special Emphasis Panel (ZDK1-GRB-6 (O2))
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Hunter, Christine
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Pennsylvania State University
Family Medicine
Schools of Medicine
United States
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Hilliard, Marisa E; Sparling, Kerri M; Hitchcock, Jeff et al. (2015) The emerging diabetes online community. Curr Diabetes Rev 11:261-72
Hilliard, Marisa E; Oser, Sean M; Close, Kelly L et al. (2015) From Individuals to International Policy: Achievements and Ongoing Needs in Diabetes Advocacy. Curr Diab Rep 15:59