Augmenting Traditional Support Groups for Adolescents With Type 1 Diabetes Using Instagram: Mixed Methods Feasibility Study

Abstract

Background In-person support groups have been shown to benefit adolescents with type 1 diabetes (T1D) by helping to decrease perceived diabetes burden and improving knowledge related to chronic disease management. However, barriers exist to participation in traditional support groups, including the timing and location of meetings and resources needed to attend. Adolescents are increasingly utilizing online support groups, which may provide solutions to some of the challenges faced when implementing in-person support groups. Objective The purpose of this study was to assess the feasibility and acceptability of a hybrid support group model where traditional in-person support groups were augmented with Instagram participation between monthly support group sessions for adolescents with T1D. Methods Participants (13-18 years old with T1D for ≥6 months) were asked to post photos each week for 3 months based on predetermined topics related to diabetes management. At the end of each month, participants attended an in-person support group to discuss their photos using the Photovoice method. Feasibility was assessed through enrollment and retention, number of Instagram posts, poststudy questionnaire, and a template analysis of the focus groups. Results Of 24 eligible participants, 16 (67%) enrolled in the study, with 3 dropping out prior to support group participation. The number of photos posted over 3 months ranged from 14 to 41. Among the 11 participants who completed a follow-up questionnaire, the majority of participants (6/11, 55%) reported that they very much enjoyed participating in the hybrid support group, and more than three-quarters (9/11, 82%) of participants reported that they “related to the photos posted.” Over half of participants (8/11, 73%) reported “learning something new from the photos posted,” which arose from sharing knowledge and experiences related to navigating the common challenges of diabetes management. Additionally, the use of Instagram posts helped facilitate peer discussions during the in-person support groups. Conclusions The novel combination of using Instagram to augment traditional in-person support groups was feasible and acceptable to adolescents with T1D. The overall satisfaction with the hybrid support group model, combined with the observed engagement with peers between support group sessions over social media, suggests that a hybrid support group model may have the potential to provide more pronounced benefits to adolescents than in-person meetings alone. Future research should investigate the use of social media as part of the support group model and examine the potential improvement of self-esteem, benefit-finding, and social support using validated tools in adolescents with diabetes.

Experiences and Views of Young People and Health Care Professionals of Using Social Media to Self-Manage Type 1 Diabetes Mellitus: Thematic Synthesis of Qualitative Studies

“…The characteristics, aim, and main results of the included studies were summarized in Multimedia Appendix 2 . Of the 11 included studies, the majority were qualitative studies [ 22 , 23 , 38 - 40 , 43 - 46 ] and conducted in the United States [ 22 , 39 , 41 , 45 , 46 ]. All used content analysis.…”

“…Most studies focused on young people with T1DM, with only 1 focusing on HCPs [ 43 ]. A total of 4 studies used moderated platforms [ 41 - 43 , 46 ]. All studies met most quality criteria, except 1 that failed to meet 3 out of 10 criteria [ 38 ]; Multimedia Appendix 3 contains our detailed quality assessment for each study.…”

Contrasting Social Media Use Between Young Adults With Inflammatory Bowel Disease and Type 1 Diabetes: Cross-sectional Study

“…These online social connections might be particularly important for patients with IBD as some researchers have postulated that the embarrassment of frequent bathroom trips or diarrhea might lead to perceived stigma and social withdrawal [ 12 ]. One program used Instagram to augment the social supports for adolescents with T1D to avoid the barriers of travel and time required to attend in person [ 20 ]. Online diabetes communities have been shown to be important for peer support as well as problem solving [ 21 ].…”

Social media to promote treatment adherence among adolescents and young adults with chronic health conditions: A topical review and TikTok application.

“…Recently, one study augmented an in-person psychosocial support group for adolescents with Type I diabetes with photo journaling via Instagram about prespecified self-management prompts (e.g., post a picture in response to “what I eat” or “how I cope”; Malik et al, 2021). This approach was feasible and acceptable to adolescents, with adolescents consistently posting and finding other members’ posts interesting and relatable.…”