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

 描述(由申请人提供)：我们建议开发一个糖尿病网络工具(DNT)，这是一个移动健康(MHealth)应用程序，通过加强家庭、家庭和社区的社会支持机制，增强II型糖尿病患者的自我管理能力和避免疾病并发症。II型糖尿病(T2D)是一个严重且日益严重的公共卫生问题，对非裔美国人的影响不成比例。研究表明，社交网络可以支持患有T2D的个人，特别是在低收入的非裔美国人(AA)社区。家庭和社区关系通过提供积极的强化和分享保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利用这些资源创建了一款智能手机应用程序，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。微型网络通过私下分享健康饮食和食品购物提示等信息以及积极的社会强化，在特定家庭/家庭的背景下为糖尿病管理行为提供支持。社区网络使用地理围栏技术，允许张贴和分享特定地点的信息(例如关于当地食品店和健康博览会的信息)。这项探索性研究项目集中于三个问题：1)DNT是一种mHealth技术应用程序，如何设计来增强和促进基于社会关系的支持过程，以支持与AA之间食物选择和饮食相关的T2D自我管理？2)哪些与可行性和文化适当性相关的因素影响T2D患者对DNT的采用和使用？3)根据临床自我管理结果衡量，DNT对自我管理有什么影响：血糖检测频率，减少碳水化合物/糖摄入量，吃两份或两份以上的水果/蔬菜？我们的团队带来了以用户为中心的设计、社交计算、移动健康、T2D和行为科学研究领域的领导者和专家的独特组合。与研究问题相对应，该项目的目标是：1)利用参与性设计过程开发DNT的初始原型；2)将DNT介绍给具有代表性的低收入非裔美国人社区的用户，并评估引入和使用过程；以及3)根据临床定义的T2D自我管理结果的变化，对DNT的使用进行初步评估。拟议的项目在开发本地和文化定制的mHealth应用程序方面具有创新性，该应用程序增强了自然支持系统，以促进在高风险再生障碍性贫血人群中进行T2D管理。为该应用程序创建的技术是通用的，并且很容易应用到其他当地社区。该项目将通过增加我们对增强的社会支持系统如何影响糖尿病管理并潜在地减少疾病并发症的理解，帮助改进与糖尿病相关的行为干预。

 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.