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

摘要 意义：2型糖尿病(T2D)是美国第七大主要死亡原因，T2D患者的死亡率为 增加心脏病、截肢、中风和肾功能衰竭等合并症的风险。类型- 糖尿病及其并发症很大程度上取决于患者自身的自我管理行为，这是正常的 预防性护理对于预防合并症和维持基线健康水平至关重要。改进 T2D的自我管理势在必行，9.3%的美国成年人被诊断为T2D，估计有810万人 他们仍然没有被诊断出来。随着T2D的发病率和患病率每年都在增加，医疗保健提供者 检查如何提高病人的自我管理技能。社会和同伴支持提供个人、 非正式的建议和知识，帮助个人启动和维持T2D自我管理行为，从而 越来越多地遵守这些行为。具体地说，当前的T2D社交/同伴支持研究侧重于 面对面交互、计算机中介环境(CME)，通过 互联网、移动医疗和电话。在CME中，社交是指两人之间的口头或书面交流 两个或两个以上的人在共同分享的中心话题上。通过CME提供的干预措施是 增加自我管理实践的有希望的解决方案然而，人们对社会互动知之甚少 在CME中的个人之间，特别是交换的社会/同伴支持的频率和内容 以及社交如何支持自我管理。 目的：本研究的总体目的是全面了解中国的社会互动。 CME，以及增加和维持自我管理行为的社会/同伴支持特征。 方法：使用混合方法进行二次分析，将使用以前在 继续医学教育研究，第二人生对糖尿病教育和自我管理的影响(幻灯片，1R21-LM010727-01，PI： 约翰逊)。将使用收敛的并行混合方法设计来探索和比较定性和 量化研究结果。幻灯片网站是对现实生活社区的虚拟复制，在这个社区中，6个月的时间 参与者和提供者之间录制了自然主义的同步语音对话(500页 抄本)。 摘要：这项研究将增加对CME中的社会互动的理解，特别是如何社会/同伴 患有T2D的个体之间会自发地交换支持。从这项建议中获得的知识 将有助于指导临床和公共卫生实践和政策，为慢性病提供支持 疾病通过互联网，通过使用自然对话和录音的社交互动来关注 自我管理和健康状况的结果衡量标准。

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.