eHealth: Second Life Impacts Diabetes Education & Self-Management (SLIDES)

电子健康：第二人生影响糖尿病教育

• 批准号: 8077876
• 负责人: Constance Margaret Johnson
• 金额: $ 18.72万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-31 至 2013-05-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8077876
• 关键词: Adult; Affect; Area; Attitude; Behavior; Behavior Therapy; Behavioral; Bio-Base; Blood Pressure; Body mass index; Caring; Cause of Death; Characteristics; Chronic Disease; Clothing; Coin; Communication; Communities; Computers; Diabetes Mellitus; Disease Management; Economics; Education; Environment; Exercise; Family; Feedback; Future; Glucose; Glycosylated hemoglobin A; Goals; Health; Health Professional; Health behavior; Health behavior change; Healthcare; Human; Immersion Investigative Technique; Individual; Internet; Intervention; Intervention Studies; Knowledge; Lead; Learning; Life; Location; Measures; Mediating; Mediator of activation protein; Metabolic; Metabolic Control; Modeling; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Nurse Practitioners; Outcome; Patient Education; Patients; Perception; Pharmacy facility; Pilot Projects; Population; Problem Solving; Provider; Research Design; Resources; Restaurants; Role playing therapy; Self Efficacy; Self Management; Simulate; Site; Social Interaction; Social Network; Social Problems; Solutions; Support Groups; Technology; Testing; Text; Time; Transportation; Visit; Voice; base; behavior change; computerized data processing; cost effective; design; diabetes control; diabetes education; diabetes educator; diabetes management; diet and exercise; driving force; efficacy testing; empowered; experience; health care quality; health care service utilization; health literacy; improved; innovation; interdisciplinary approach; mortality; peer; phrases; programs; psychosocial; real world application; skills; social; usability; virtual

DESCRIPTION (provided by applicant): Innovations and mediums to assist and empower patients in chronic illness self-management are needed to: eliminate barriers to healthcare; accommodate limited health literacy; provide sustainable, cost-effective patient education and support; and move beyond ineffective, non-interactive health behavior interventions. Advances in communication technology such as the Web 2.0 are a means to fill these needs. Initial studies suggest that virtual environments, which promote social interaction via repetition, practice, feedback, and application, lead to superior learning and skill set transfer. Therefore, we propose to develop and test a theoretically grounded, technologically-based, bio-behavioral intervention using the virtual environment, Second Life to facilitate self- management of diabetes. Diabetes affects 23.6 million US adults, most of whom have Type 2 Diabetes (T2DM). Metabolic control is known to reduce diabetes morbidity and mortality, yet it remains the 6th leading cause of death in the U.S... Individuals with T2DM provide 99% of their own care, making diabetes self- management (DSM) (e.g. diet, exercise) integral to control. Tailored DSM interventions utilizing patient- provider interaction have had encouraging short-term effects. However, this frequent interaction is unattainable and costly. Internet interventions have the potential to capture the dynamics of patient-provider interaction, but to date remain "flat" and unidirectional with asynchronous communication. Virtual environments such as Second Life are a potential solution to capturing patient-provider dynamics via interactivity, synchronous communication, knowledge application, and social networking in an immersive environment. We propose that a virtual diabetes community (SLIDES) with real-time interaction among adults with T2DM, healthcare professionals, and peers is feasible and has the potential to influence metabolic control and psychosocial mediators. This pilot study utilizes a one group, pre-mid-post measure study design to evaluate the feasibility, usability, and effect of participation in SLIDES, which includes interactive DSM education, support, and resources. The SLIDES community will consist of a community center, gym, grocery store, and other locations, each allowing for interactive knowledge application. Based on this design our specific aims are: (1) Develop an immersive diabetes community (SLIDES) using Second Life and assess the feasibility by analyzing process data; and (2) Determine the preliminary effects of participation in the SLIDES intervention on metabolic control and potential psychosocial mediating variables as a basis for effect sizes and variance in future intervention studies. If our approach is promising, we will pursue experimental efficacy testing in future studies. As little is known about the acceptability and efficacy of health interventions in a virtual environment, this study constitutes important steps to understand how they promote self-management. Innovative programs such as SLIDES have potential for improving healthcare access in an easily disseminated alternative model of care that promotes cost-effective resource utilization.

描述（由申请人提供）：需要在慢性疾病自我管理中为患者提供帮助和赋予能力的创新和媒介：消除医疗保健的障碍；容纳有限的健康素养；提供可持续的，具有成本效益的患者教育和支持；并超越无效的非交互性健康行为干预措施。通信技术（例如Web 2.0）的进步是满足这些需求的一种手段。初步研究表明，通过重复，实践，反馈和应用促进社交互动的虚拟环境会导致出色的学习和技能转移。因此，我们建议使用虚拟环境开发和测试理论上基于技术的，基于技术的，生物行为干预，以促进糖尿病的自我管理。糖尿病影响2360万美国成年人，其中大多数患有2型糖尿病（T2DM）。已知代谢控制可以降低糖尿病的发病率和死亡率，但它仍然是美国第六大死亡原因……T2DM患者提供了自己99％的护理，使糖尿病自我管理（DSM）（例如，饮食，锻炼）可以控制。使用患者提供者互动的量身定制的DSM干预措施具有令人鼓舞的短期影响。但是，这种频繁的互动是无法实现且昂贵的。互联网干预措施有可能捕获患者提供者互动的动态，但迄今为止，与异步通信保持“平坦”和单向。虚拟环境（例如第二人生）是通过在沉浸式环境中互动，同步通信，知识应用和社交网络来捕获患者提供动态的潜在解决方案。我们建议，具有T2DM，医疗保健专业人员和同伴的成年人之间具有实时互动的虚拟糖尿病社区（幻灯片）是可行的，并且有可能影响代谢控制和社会心理调解人。这项试点研究利用一组，中序的测量研究设计来评估参与幻灯片的可行性，可用性和影响，其中包括交互式DSM教育，支持和资源。幻灯片社区将由社区中心，健身房，杂货店和其他地点组成，每个社区都允许进行交互式知识应用。基于此设计，我们的具体目的是：（1）使用第二人寿开发一个沉浸式糖尿病社区（幻灯片），并通过分析过程数据来评估可行性； （2）确定参与幻灯片干预对代谢控制和潜在的社会心理介导变量的初步影响，作为未来干预研究中效应大小和差异的基础。如果我们的方法很有希望，我们将在未来的研究中进行实验效力测试。对于虚拟环境中健康干预措施的可接受性和功效知之甚少，本研究构成了了解它们如何促进自我管理的重要步骤。诸如幻灯片之类的创新计划有可能在易于传播的替代护理模型中改善医疗保健访问，从而促进具有成本效益的资源利用。