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

电子健康：第二人生影响糖尿病教育

基本信息

批准号：
7872557
负责人：
Constance Margaret Johnson
金额：
$ 23.4万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-05-31 至 2012-05-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7872557
关键词：
Adult Affect Area Attitude Behavior Behavior Therapy 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 Solutions Support Groups Technology Testing Text Time Transportation Visit Voice base behavior change behavior in diabetes management computerized data processing cost cost effective design diabetes control diabetes education diabetes educator 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

项目摘要

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）：需要创新和媒介来帮助和增强患者的慢性病自我管理能力，以：消除医疗保健的障碍；适应有限的健康素养；提供可持续、具有成本效益的患者教育和支持；超越无效、非互动的健康行为干预措施。 Web 2.0 等通信技术的进步是满足这些需求的一种手段。初步研究表明，虚拟环境通过重复、练习、反馈和应用促进社交互动，从而带来卓越的学习和技能转移。因此，我们建议利用虚拟环境“第二人生”开发和测试一种有理论依据、以技术为基础的生物行为干预措施，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)。众所周知，代谢控制可以降低糖尿病发病率和死亡率，但它仍然是美国第六大死因……T2DM 患者 99% 需要自己护理，从而实现糖尿病自我管理 (DSM)（例如饮食、锻炼）控制的积分。利用患者与提供者互动的定制 DSM 干预措施产生了令人鼓舞的短期效果。然而，这种频繁的互动是无法实现的，而且成本高昂。互联网干预有可能捕捉患者与提供者互动的动态，但迄今为止仍然是“平坦”和单向的异步通信。 “第二人生”等虚拟环境是一种潜在的解决方案，可以通过沉浸式环境中的交互性、同步通信、知识应用和社交网络来捕获患者与提供者之间的动态。我们建议建立一个虚拟糖尿病社区 (SLIDES)，在成人 T2DM 患者、医疗保健专业人员和同龄人之间进行实时互动，这是可行的，并且有可能影响代谢控制和社会心理调节因素。该试点研究采用一组前后测量研究设计来评估参与 SLIDES 的可行性、可用性和效果，其中包括交互式 DSM 教育、支持和资源。 SLIDES 社区将由社区中心、健身房、杂货店和其他地点组成，每个地点都允许交互式知识应用。基于此设计，我们的具体目标是：（1）利用“第二人生”开发沉浸式糖尿病社区（SLIDES），并通过分析过程数据评估可行性； (2) 确定参与 SLIDES 干预对代谢控制和潜在心理社会中介变量的初步影响，作为未来干预研究中效应大小和方差的基础。如果我们的方法有希望，我们将在未来的研究中进行实验功效测试。由于人们对虚拟环境中健康干预措施的可接受性和有效性知之甚少，因此这项研究构成了了解它们如何促进自我管理的重要步骤。 SLIDES 等创新计划有潜力以一种易于传播的替代护理模式改善医疗保健的可及性，从而促进具有成本效益的资源利用。