Using Mobile Devices to Study Daily Diabetes Management in Marital Context

使用移动设备研究婚姻中的日常糖尿病管理

• 批准号: 8638373
• 负责人: Biing-Jiun Shen
• 金额: $ 23.53万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-15 至 2013-12-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8638373
• 关键词: Address; Adherence; Adult; Affect; Attention; Behavior; Behavioral; Chronic Disease; Clinical; Cloud Computing; Complex; Couples; Data; Data Collection; Data Storage and Retrieval; Devices; Diabetes Mellitus; Diagnosis; Diet; Diet Records; Distress; Electronics; Emotional; Energy Intake; Event; Exhibits; Failure; Family; Feedback; Food; Glucose; Goals; Health; Health behavior; Healthcare; Individual; Internet; Intervention; Legal patent; Life; Measures; Mediating; Medical; Memory; Mental Health; Methodology; Methods; Modeling; Monitor; Newly Diagnosed; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; Participant; Patient Self-Report; Patients; Pattern; Performance; Persons; Physical activity; Play; Prevalence; Process; Psychological Stress; Regimen; Reliance; Reporting; Research; Role; Sampling; Secure; Self Care; Spouses; Stress; Surveys; System; Tablet Computer; Testing; Text; Time; Voice; Wireless Technology; base; blood glucose regulation; cost; data management; design; diabetes management; diaries; diet and exercise; emotional distress; encryption; experience; glucose monitor; glucose sensor; glycemic control; handheld mobile device; innovation; non-diabetic; physical conditioning; prototype; public health relevance; transmission process; usability

DESCRIPTION (provided by applicant): With rapidly rising prevalence, diabetes mellitus presents an enormous challenge to healthcare, affecting 25.6 million adults, with 2 million new cases diagnosed annually. It costs a staggering $245 billion of US economy in 2012, which has risen from $174 billion in 2007. Of all cases, approximately 90% are in the form of type 2 diabetes mellitus (T2DM). The impact of T2DM and its treatment occur in an interpersonal and daily context. The medical regimen is demanding and stressful, affecting not only the patients but also their families, especially spouses. Successful T2DM management is a daily endeavor, requiring accommodations and adjustments from intimate partners. However, little is known how the daily stress experience and health behavior of both the patients and their spouses may influence patients' daily glycemic management. Furthermore, considering the recent research on health concordance and emotional transmission within couples, it is an intriguing hypothesis that the spouse's stress and health behavior may transmit to the patient and result in health consequences. In addition, there are several methodological issues in existing studies that weaken their inferences, including reliance on retrospective self-reports susceptible to systematic recall biases and memory failure, no data collected from spouses directly, use of "between-person" design to test "within-person" hypotheses, and lack of attention to the daily process of glycemic management. To address these problems and take advantage of the recent technological and methodological advancements, we propose to (1) evaluate the feasibility of using several electronic mobile devices and implementing daily diary and experience sampling method to collect real-time or daily data over 14 days from both patients and their spouses and store the data on a secure cloud computing platform, and (2) use the collected data to explore several within-couple dyadic hypotheses and establish appropriate data analytic strategy for future research. Specifically, we will investigate (1) whether the spouse's daily stress and health behavior (diet and physical activity), in addition to the patent's, influence the patient's daily glycemic management, and (2) whether there is emotional and behavioral "transmissions" from the spouse to patient such that the spouse's stress and health behavior on one day contribute to a similar pattern in the patient's stress and health behavior which then affect the patient's glycemic management on the same day or the following day. The findings will contribute to the establishment of innovative dyadic data collection and storage strategy to facilitate future research in real-time computing for timely patient feedback and intervention, and they will enhance the performance a prototype of diabetes monitoring system developed by our team to detect clinical problems. The results will also contribute to our long-term goal of developing innovative monitoring and intervention strategies that address critical interpersonal barriers to achieve successful T2DM management in daily marital context.

描述（由申请人提供）：随着患病率的迅速上升，糖尿病对医疗保健提出了巨大的挑战，影响了 2560 万成年人，每年诊断出 200 万新病例。 2012 年美国经济损失达 2,450 亿美元，较 2007 年的 1,740 亿美元有所上升。在所有病例中，约 90% 为 2 型糖尿病 (T2DM)。 T2DM 及其治疗的影响发生在人际和日常环境中。医疗护理要求高、压力大，不仅影响患者，也影响患者的家人，尤其是配偶。成功的 T2DM 管理是一项日常工作，需要亲密合作伙伴的适应和调整。然而，很少有人知道患者及其配偶的日常压力经历和健康行为如何影响患者的日常血糖管理。此外，考虑到最近对夫妻间健康一致性和情绪传递的研究，一个有趣的假设是，配偶的压力和健康行为可能会传递给患者并导致健康后果。此外，现有研究中存在一些方法论问题削弱了他们的推论，包括依赖回顾性自我报告，容易受到系统性回忆偏差和记忆力衰退的影响，没有直接从配偶那里收集数据，使用“人与人之间”的设计来检验“人内部”的假设，以及缺乏对血糖管理日常过程的关注。为了解决这些问题并利用最新的技术和方法进步，我们建议（1）评估使用多种电子移动设备并实施每日日记和经验采样方法的可行性，以从患者及其配偶收集14天内的实时或每日数据并将数据存储在安全的云计算平台上，以及（2）使用收集的数据探索几个夫妻内二元假设并为未来的研究建立适当的数据分析策略。具体来说，我们会调查（1）配偶的日常压力和健康状况是否 除了专利之外，行为（饮食和身体活动）也会影响患者的日常血糖管理，以及（2）是否存在从配偶到患者的情绪和行为“传递”，以致配偶一天的压力和健康行为会导致患者的压力和健康行为形成类似的模式，从而影响患者当天或第二天的血糖管理。这些发现将有助于建立创新的二元数据收集和存储策略，以促进未来的实时计算研究，以实现及时的患者反馈和干预，并将提高我们团队开发的糖尿病监测系统原型的性能，以检测临床问题。研究结果还将有助于我们制定创新监测和干预策略的长期目标，以解决关键的人际障碍，从而在日常婚姻中实现 T2DM 的成功管理。