Social Interaction and Support in a Type-2 Diabetes Computer Mediated Environment

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Abstract 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.