Analyzing Patient Blog Use and Provider Perceptions to Identify Barriers and Facilitators to Type 1 Diabetes Self-Management: An Exploratory Mixed-Methods Study

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 DESCRIPTION (provided by applicant): 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.