Abstract

BackgroundDiabetes remains a major health problem in the United States, affecting an estimated 10.5% of the population. Diabetes self-management interventions improve diabetes knowledge, self-management behaviors, and clinical outcomes. Widespread internet connectivity facilitates the use of eHealth interventions, which positively impacts knowledge, social support, and clinical and behavioral outcomes. In particular, diabetes interventions based on virtual environments have the potential to improve diabetes self-efficacy and support, while being highly feasible and usable. However, little is known about the patterns of social interactions and support taking place within type 2 diabetes–specific virtual communities.ObjectiveThe objective of this study was to examine social support exchanges from a type 2 diabetes self-management education and support intervention that was delivered via a virtual environment.MethodsData comprised virtual environment–mediated synchronous interactions among participants and between participants and providers from an intervention for type 2 diabetes self-management education and support. Network data derived from such social interactions were used to create networks to analyze patterns of social support exchange with the lens of social network analysis. Additionally, network correlations were used to explore associations between social support networks.ResultsThe findings revealed structural differences between support networks, as well as key network characteristics of supportive interactions facilitated by the intervention. Emotional and appraisal support networks are the larger, most centralized, and most active networks, suggesting that virtual communities can be good sources for these types of support. In addition, appraisal and instrumental support networks are more connected, suggesting that members of virtual communities are more likely to engage in larger group interactions where these types of support can be exchanged. Lastly, network correlations suggest that participants who exchange emotional support are likely to exchange appraisal or instrumental support, and participants who exchange appraisal support are likely to exchange instrumental support.ConclusionsSocial interaction patterns from disease-specific virtual environments can be studied using a social network analysis approach to better understand the exchange of social support. Network data can provide valuable insights into the design of novel and effective eHealth interventions given the unique opportunity virtual environments have facilitating realistic environments that are effective and sustainable, where social interactions can be leveraged to achieve diverse health goals.

Highlights

  • IntroductionOverviewDiabetes remains a major health problem in the United States, affecting an estimated 34.2 million people of all ages (about 10.5% of the country’s population) [1]

  • OverviewDiabetes remains a major health problem in the United States, affecting an estimated 34.2 million people of all ages [1]

  • Social interaction patterns from disease-specific virtual environments can be studied using a social network analysis approach to better understand the exchange of social support

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Summary

Introduction

OverviewDiabetes remains a major health problem in the United States, affecting an estimated 34.2 million people of all ages (about 10.5% of the country’s population) [1]. Diabetes self-management interventions improve diabetes knowledge and self-management behaviors, in addition to clinical outcomes [12]. Despite these benefits, less than 60% of people with diabetes attend DSME and only about 7% of newly diagnosed patients with diabetes attend DSME within 12 months following their diagnosis [13,14,15,16], indicating a pressing need for the delivery of accessible DSME and ongoing self-management support interventions. Diabetes self-management interventions improve diabetes knowledge, self-management behaviors, and clinical outcomes. Diabetes interventions based on virtual environments have the potential to improve diabetes self-efficacy and support, while being highly feasible and usable. Little is known about the patterns of social interactions and support taking place within type 2 diabetes–specific virtual communities

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