A diabetes networking tool to enhance self-management through social networks

 描述（由申请人提供）：我们建议开发糖尿病网络工具（DNT），这是一种移动的健康（mHealth）应用程序，通过支持家庭、住户和社区社会支持机制，增强II型糖尿病患者自我管理和避免疾病并发症的能力。II型糖尿病（T2 D）是一种严重且日益严重的公共卫生问题，不成比例地影响非洲裔美国人。研究表明，社交网络可以支持T2 D患者，特别是在低收入的非洲裔美国人（AA）社区。家庭和社区关系通过提供积极的强化和分享维持健康饮食习惯的本地化技能，影响个人成功改变糖尿病相关行为的能力，从而影响自我管理的成功。DNT利用这些资源来创建智能手机应用程序，该应用程序支持特定微网络（包括家庭和家庭成员以及亲密朋友）和社区内的糖尿病管理通信。微型网络通过私人分享信息，如健康饮食和食品购物提示以及积极的社会强化，为特定家庭/家庭的糖尿病管理行为提供支持。社区网络使用地理围栏技术，可以张贴和分享特定地点的信息（例如关于当地食品商店和健康博览会的信息）。这个探索性的研究项目集中在三个问题：1）DNT，一个移动健康技术应用程序，如何被设计为加强和促进社会关系为基础的支持过程T2 D自我管理相关的食物选择和饮食之间的AA？2)与可行性和文化适当性相关的哪些因素会影响AA与T2 D之间DNT的采用和使用？3)DNT对自我管理有什么影响，通过临床自我管理结果来衡量：血糖测试的频率，减少碳水化合物/糖的摄入量，吃两份或更多份水果/蔬菜？我们的团队汇集了以用户为中心的设计、社交计算、移动健康、T2 D和行为科学研究领域的领导者和专家。该项目的目标，对应于研究问题，是：1）开发一个初始的DNT原型，使用参与式设计过程; 2）介绍DNT的用户在代表性的低收入非洲裔美国人社区，并评估介绍和使用过程;和3）进行初步评估DNT的使用在临床定义的T2 D自我管理结果的变化。拟议项目在开发本地和文化定制的移动健康应用程序方面具有创新性，可增强自然支持系统，以促进高风险AA人群的T2 D管理。为这一应用创造的技术是通用的，很容易应用于其他当地社区。该项目将有助于改善糖尿病相关的行为干预，增加我们对增强的社会支持系统如何影响糖尿病管理和潜在减少疾病并发症的理解。

 DESCRIPTION (provided by applicant): We propose to develop a Diabetes Networking Tool (DNT), a mobile health (mHealth) application that enhances Type II diabetes patients' ability to self-manage and avoid disease complications by bolstering family, household, and community-based social support mechanisms. Type II Diabetes Mellitus (T2D) is a serious and growing public health problem that disproportionately affects African Americans. Research indicates that social networks can support individuals with T2D, especially in low-income African American (AA) communities. Family and community relationships influence an individual's ability to make successful diabetes-related behavior change, and thus the success of self-management, by providing positive reinforcement and sharing localized skills for maintaining healthy eating habits. DNT leverages these resources to create a smart-phone app that supports diabetes management communications within a specific micro- network (including household and family members and close friends), and community. The micro-network provides support for diabetes management behaviors in the context of that specific family/household, via private sharing of information such as healthy eating and food shopping tips as well as positive social reinforcement. The community network, using geo-fencing technology, allows location-specific information (e.g. about local food stores and health fairs) to be posted and shared. This exploratory research project focuses on three questions: 1) How can DNT, an mHealth technology application, be designed to enhance and facilitate social relationship-based support processes for T2D self-management related to food choice and diet among AAs? 2) What factors related to feasibility and cultural appropriateness affect DNT adoption and usage among AA with T2D? 3) What effect does DNT have on self-management as measured by clinical self-management outcomes: frequency of blood-glucose testing, reducing carb/sugar intake, and eating two or more servings of fruit/vegetables? Our team brings a unique combination of leaders and experts in user-centered design, social computing, mHealth, T2D, and behavioral science research. The project aims, corresponding to research questions, are to : 1) develop an initial DNT prototype, using a participatory design process; 2) introduce DNT to users in representative low-income African American communities and assess introduction and usage processes; and 3) conduct initial assessment of DNT usage in terms of changes in clinically defined T2D self- management outcomes. The proposed project is innovative in developing a locally and culturally-tailored mHealth application that enhances natural support systems to promote T2D management in a high risk AA population. The technology created for this application is general and easily applied other local communities. This project will help to improve diabetes-related behavioral interventions by increasing our understanding of how an augmented social support system affects diabetes management and potentially reduces disease complications.