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

分析患者博客的使用和提供者的看法，以确定 1 型糖尿病自我管理的障碍和促进因素：一项探索性混合方法研究

• 批准号: 8810313
• 负责人: Sean M Oser
• 金额: $ 48.05万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-22 至 2016-10-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8810313
• 关键词: Address; Adult; Anxiety; Area; Body Weight decreased; Caring; Characteristics; Clinic; Clinical; Code; Cognitive; Communities; Cross-Sectional Studies; Data; Data Analyses; Data Set; Data Sources; Development; Diabetes Mellitus; Distress; Education; Empathy; Ensure; Face; Family; Feedback; Focus Groups; Friends; Frustration; Future; Goals; Group Interviews; Health; Health Professional; Individual; Insulin-Dependent Diabetes Mellitus; Internet; Intervention; Interview; Journals; Judgment; Learning; Life; Malignant Neoplasms; Medicine; Mental Depression; Methodology; Methods; Non-Insulin-Dependent Diabetes Mellitus; Nurse Practitioners; Nutritionist; Outcome; Outcome Measure; Patient Care; Patients; Perception; Physicians; Provider; Psychosocial Assessment and Care; Public Domains; Published Comment; Publishing; Qualitative Methods; Reading; Research; Research Personnel; Resources; Sampling; Self Care; Self Efficacy; Self Management; Site; Social support; Source; Staging; Surveys; Technology; Testing; Time; Translating; Universities; Work; base; burnout; clinical practice; college; diabetes educator; experience; improved; innovation; instrument; meetings; novel; peer; point of care; psychosocial; public health relevance; social; tool; treatment as usual

 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.

 描述（由申请人提供）：很少有健康状况需要像1型糖尿病（T1 D）那样多的患者自我管理。社交媒体使T1 D患者能够找到并保持与T1 D同行的联系，以获得自我管理在线支持。社交媒体增加了患者感受到的联系感，博客（关于内容领域的在线期刊）是由同行制作和主持的一个来源。在对T1 D博客的100条评论进行调查的试点数据中，81%与糖尿病障碍有关。博客是研究人员研究T1 D自我管理的障碍和促进因素的丰富数据源，并了解如何将其作为T1 D的资源。目标：总体目标是了解博客使用如何促进自我管理支持，并确定T1 D的障碍，这些障碍可以在经过验证的调查中进行测试，以告知临床实践中的未来干预措施。提案：宾夕法尼亚州立大学医学院的研究人员旨在1）确定T1 D自我的障碍和促进因素 通过对11个最常访问的T1 D博客网站进行二次数据分析来管理T1 D; 2）开发并验证T1 D障碍调查; 3）使用新开发的调查进行横断面研究，以确定普遍性并确定特征博客与非博客群体的异同;以及4）将研究调查工具转化为实用的、临床上有用的护理点工具，以识别T1 D患者在自我管理中的支持需求和资源。意义：发现和创新通常来自科学界，并传播到诊所和患者。这一建议是一个范式的逆转，根据患者社区（博客）的数据制定干预措施，将其带给医疗保健专业人员，并传播给科学界。这是一个 新的方法进行二次定性分析的博客文章和评论。这些数据将提供一个基本的时间效率的优势，协调，进行和转录个人和/或焦点小组访谈。此外，博客的使用允许实时和患者发起的努力，以寻求自然，渐进和非提示的支持。共同PI和一些顾问有T1 D，为内容开发和分析提供了一种基础和概念上有利的方法。我们计划使用现有的调查工具来获取我们的一些数据，特别是与结局相关的数据;但是，我们还将开发和验证一种新的工具，该工具将实用于日常临床使用和护理点决策支持，而现有工具无法提供这些功能。结论：根据我们的研究结果，我们将提出切实可行的干预措施，以克服临床环境中自我管理的障碍，包括以工作流程为导向的临床有用策略，以提供增强的支持，并帮助管理T1 D自我护理的挑战。

项目成果

Using Social Media to Broaden Understanding of the Barriers and Facilitators to Exercise in Adults With Type 1 Diabetes.

利用社交媒体加深对 1 型糖尿病成人锻炼的障碍和促进因素的了解。

• DOI: 10.1177/1932296819835787
• 发表时间: 2019
• 期刊: Journal of diabetes science and technology
• 影响因子: 5
• 作者: Oser,TamaraK;Minnehan,KaitlinA;Wong,Glenna;Parascando,Jessica;McGinley,Erin;Radico,Julie;Oser,SeanM
• 通讯作者: Oser,SeanM

Glycated Hemoglobin Differences Among Blog-Reading Adults With Type 1 Diabetes Compared With Those Who Do Not Read Blogs: Cross-Sectional Study.

• DOI: 10.2196/13634
• 发表时间: 2019-04-02
• 期刊: JMIR diabetes
• 作者: Oser, Sean M;Stuckey, Heather L;Oser, Tamara K
• 通讯作者: Oser, Tamara K