Significance: Type-2 diabetes (T2D) is the 7th leading cause of death in the U.S., as patients with T2D are at increased risk for comorbidities such as heart disease, lower limb amputations, stroke, and renal failure. Type- 2 diabetes and its complications depend largely on a patient's own self-management behaviors, as regular preventative care is essential to preventing comorbidities and maintaining a baseline level of health. Improving self-management of T2D is imperative with 9.3% of U.S. adults diagnosed and an estimated 8.1 million people who remain undiagnosed. As the incidence and prevalence of T2D increase each year, healthcare providers examine how to increase a patient's self-management skills. Social and peer support provides personal, informal advice and knowledge that helps individuals initiate and sustain T2D self-management behaviors, thus increasing adherence to these behaviors. Specifically, current T2D social/peer support research focuses on face-to-face interactions, computer mediated environments (CMEs) with person-to-person interaction via the Internet, mobile health, and the telephone. In CMEs, social interaction is a verbal or written exchange between two or more individuals on a mutually shared, central topic. Interventions provided through CMEs are a promising solution to increase self-management practices' however, little is known about the social interactions among individuals in CMEs, specifically the frequency and content of the social/peer support that is exchanged and how social interaction supports self-management. Purpose: The overall purpose of this study is to gain a comprehensive understanding of social interaction in CMEs, and the social/peer support characteristics that increase and sustain self-management behaviors. Methods: This secondary analysis, using a mixed methods approach, will use data previously collected in a CME study, Second Life Impacts Diabetes Education & Self-Management (SLIDES, 1R21-LM010727-01, PI: Johnson). A convergent parallel mixed method design will be used to explore and compare the qualitative and quantitative findings. The SLIDES site was a virtual replication of a real life community in which 6-months of naturalistic synchronous voice conversations were recorded among participants and providers (500 pages of transcribed text). Summary: This study will increase understanding of social interaction in CMEs, specifically how social/peer support is spontaneously exchanged among individuals living with T2D. Knowledge gained from this proposal will help to guide clinical and public health practice and policy regarding the provision of support for chronic illness via the Internet, by focusing on social interaction using recordings of naturalistic conversations and outcome measures of self-management and health status.

Public Health Relevance

Health programs on the Internet may be a useful way to bring diabetes education and support to more people. This study evaluates how support from friends and nurses can help adults living with type 2 diabetes improve their self-care.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31NR016622-02
Application #
9297097
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Banks, David
Project Start
2016-07-01
Project End
2017-07-13
Budget Start
2017-07-01
Budget End
2017-07-13
Support Year
2
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Duke University
Department
Type
Schools of Nursing
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Lewinski, Allison A; Anderson, Ruth A; Vorderstrasse, Allison A et al. (2018) Type 2 Diabetes Education and Support in a Virtual Environment: A Secondary Analysis of Synchronously Exchanged Social Interaction and Support. J Med Internet Res 20:e61
Lewinski, Allison A; Anderson, Ruth A; Vorderstrasse, Allison A et al. (2017) Analyzing Unstructured Communication in a Computer-Mediated Environment for Adults With Type 2 Diabetes: A Research Protocol. JMIR Res Protoc 6:e65
Lewinski, Allison A; Mann, Tara; Flores, Dalmacio et al. (2017) Partnership for development: A peer mentorship model for PhD students. J Prof Nurs 33:363-369