Type 2 Diabetes Education and Support in a Virtual Environment: A Secondary Analysis of Synchronously Exchanged Social Interaction and Support

Abstract

BackgroundVirtual environments (VEs) facilitate interaction and support among individuals with chronic illness, yet the characteristics of these VE interactions remain unknown.ObjectiveThe objective of this study was to describe social interaction and support among individuals with type 2 diabetes (T2D) who interacted in a VE.MethodsData included VE-mediated synchronous conversations and text-chat and asynchronous emails and discussion board posts from a study that facilitated interaction among individuals with T2D and diabetes educators (N=24) in 2 types of sessions: education and support.ResultsVE interactions consisted of communication techniques (how individuals interact in the VE), expressions of self-management (T2D-related topics), depth (personalization of topics), and breadth (number of topics discussed). Individuals exchanged support more often in the education (723/1170, 61.79%) than in the support (406/1170, 34.70%) sessions or outside session time (41/1170, 3.50%). Of all support exchanges, 535/1170 (45.73%) were informational, 377/1170 (32.22%) were emotional, 217/1170 (18.55%) were appraisal, and 41/1170 (3.50%) were instrumental. When comparing session types, education sessions predominately provided informational support (357/723, 49.4%), and the support sessions predominately provided emotional (159/406, 39.2%) and informational (159/406, 39.2%) support.ConclusionsVE-mediated interactions resemble those in face-to-face environments, as individuals in VEs engage in bidirectional exchanges with others to obtain self-management education and support. Similar to face-to-face environments, individuals in the VE revealed personal information, sought information, and exchanged support during the moderated education sessions and unstructured support sessions. With this versatility, VEs are able to contribute substantially to support for those with diabetes and, very likely, other chronic diseases.

A Framework for Using eHealth Interventions to Overcome Medical Mistrust Among Sexual Minority Men of Color Living with Chronic Conditions

“…80 Virtual environments can enable the feeling of being virtually present (presence) or virtually co-present (co-presence) with others through capabilities like synchronous voice communication and avatar representation of self. 89 Co-presence in virtual environments is associated with higher levels of engagement and enjoyment in learning, as opposed to solely playing against a computer. 90 Anonymity and co-presence foster self-disclosure.…”

“…81 Preliminary work conducted in a one group feasibility pilot study (SLIDES -Second Life Impacts Diabetes Education and Support) informed the development of LIVE and demonstrated that among a small pilot group of patients with diabetes, perceived support increased, and some participants formed longer term supportive relationships with each other and the health professionals. 80,89 The analysis of the qualitative data collected in SLIDES 89 highlights the potential value of virtual environments in addressing trust among those living with chronic conditions, including diabetes, heart disease, and HIV. Lewinski found that the ties between many participants evolved and became stronger (i.e., closer) and that the personal nature of the narratives shared regarding living with diabetes also increased over time.…”

“…Lewinski found that the ties between many participants evolved and became stronger (i.e., closer) and that the personal nature of the narratives shared regarding living with diabetes also increased over time. 89 These indicate a high level of trust of peers and providers in the virtual environment by participants. In exemplar one, a virtual environment for chronic illness self-management supports our innovative ascending framework towards trust as follows:…”

“…• Self-disclosure -Some participants appeared to bond with each other based on their consistent attendance at weekly classes and support sessions. Conversations increased over time in terms of the depth and personal information 89 Statements by participants to study team members directly indicated that they did not want the intervention study to end. 80 • Social support -Support for diabetes self-management increased significantly over the 6 months of participation in SLIDES (mean score 4.61 to 6.35 over 6 months on a scale of 1-7; p=0.002).…”

Virtual Coaching to Enhance Diabetes Care

“…In addition, they provide the added benefit of allowing participating members of the diabetes community to interact with each other, which has beneficial effects on both metabolic and psychosocial outcomes. [21][22][23] However, there may be some attrition in using these services over time. 21,22 Diabetes App Use…”