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

摘要 意义：2型糖尿病（T2D）是美国第七大死亡原因，因为T2D患者在 心脏病、下肢截肢、中风和肾衰竭等合并症的风险增加。类型- 2型糖尿病及其并发症在很大程度上取决于患者自己的自我管理行为， 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。改善 T2D的自我管理是必要的，9.3%的美国成年人被诊断出，估计有810万人 仍未确诊的人随着T2D的发病率和患病率每年增加，医疗保健提供者 研究如何提高病人的自我管理能力。社会和同伴的支持提供了个人， 非正式的建议和知识，帮助个人发起和维持T2D自我管理行为，从而 增加对这些行为的坚持。具体来说，目前的T2D社会/同伴支持研究集中在 面对面的互动，计算机介导的环境（CME）与人对人的互动，通过 互联网，移动的健康，和电话。在CME中，社会互动是一种口头或书面交流， 两个或两个以上的人在一个共同的，中心的话题。通过CME提供的干预措施是 然而，人们对社会互动知之甚少， 在CME中的个体之间，特别是交换的社会/同伴支持的频率和内容 以及社会互动如何支持自我管理。 目的：本研究的总体目的是全面了解社会互动， 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：使用混合方法的二次分析将使用以前在 CME研究，第二生命影响糖尿病教育和自我管理（幻灯片，1R21-LM010727 - 01，PI： 约翰逊）。一个收敛的平行混合方法设计将用于探索和比较定性和 定量的发现。SLIDES网站是一个真实的生活社区的虚拟复制， 在参与者和提供者之间记录了自然的同步语音对话（500页， 转录文本）。 总结：这项研究将增加对CME中社会互动的理解，特别是社会/同伴如何 在患有T2D的个体之间自发地交换支持。从本提案中获得的知识 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。 通过互联网，通过使用自然主义对话的录音， 自我管理和健康状况的结果测量。

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.