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Diabetes island: preliminary impact of a virtual world self-care educational intervention for african americans with type 2 diabetes.

Ruggiero L, Moadsiri A, Quinn LT, Riley BB, Danielson KK, Monahan C, Bangs VA, Gerber BS - JMIR Serious Games (2014)

Bottom Line: A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes.The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive.This intervention model and method show promise and could be tailored for other populations.

View Article: PubMed Central - PubMed

Affiliation: Institute for Health Research and Policy and Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.

ABSTRACT

Background: Diabetes is a serious worldwide public health challenge. The burden of diabetes, including prevalence and risk of complications, is greater for minorities, particularly African Americans. Internet-based immersive virtual worlds offer a unique opportunity to reach large and diverse populations with diabetes for self-management education and support.

Objective: The objective of the study was to examine the acceptability, usage, and preliminary outcome of a virtual world intervention, Diabetes Island, in low-income African Americans with type 2 diabetes. The main hypotheses were that the intervention would: (1) be perceived as acceptable and useful; and (2) improve diabetes self-care (eg, behaviors and barriers) and self-care related outcomes, including glycemic control (A1C), body mass index (BMI), and psychosocial factors (ie, empowerment and distress) over six months.

Methods: The evaluation of the intervention impact used a single-group repeated measures design, including three assessment time points: (1) baseline, (2) 3 month (mid intervention), and (3) 6 month (immediate post intervention). Participants were recruited from a university primary care clinic. A total of 41 participants enrolled in the 6 month intervention study. The intervention components included: (1) a study website for communication, feedback, and tracking; and (2) access to an immersive virtual world (Diabetes Island) through Second Life, where a variety of diabetes self-care education activities and resources were available. Outcome measures included A1C, BMI, self-care behaviors, barriers to adherence, eating habits, empowerment, and distress. In addition, acceptability and usage were examined. A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes.

Results: The intervention study sample (N=41) characteristics were: (1) mean age of 55 years, (2) 71% (29/41) female, (3) 100% (41/41) African American, and (4) 76% (31/41) reported annual incomes below US $20,000. Significant changes over time in the expected direction were observed for BMI (P<.02); diabetes-related distress (P<.02); global (P<.01) and dietary (P<.01) environmental barriers to self-care; one physical activity subscale (P<.04); and one dietary intake (P<.01) subscale. The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive. The usage patterns showed that the majority of participants logged in regularly during the first two months, and around half logged in each week on average across the six month period.

Conclusions: This study demonstrated promising initial results of an immersive virtual world approach to reaching underserved individuals with diabetes to deliver diabetes self-management education. This intervention model and method show promise and could be tailored for other populations. A large scale controlled trial is needed to further examine efficacy.

No MeSH data available.


Related in: MedlinePlus

Dietitian-led discussion of reading food labels in the grocery store.
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Figure 1: Dietitian-led discussion of reading food labels in the grocery store.

Mentions: Health professionals (as avatars) provided real time formal and informal educational sessions. A series of 10 formal presentation sessions (30–60 minutes in length) were offered, including: (1) six healthy eating topics led by a registered dietitian; (2) one on medication adherence led by a pharmacist; (3) one on physical activity led by an exercise researcher; and (4) two led by a nurse Certified Diabetes Educator on the “ABC’s” of diabetes and proper foot care. Several dietitian-facilitated real time discussions on healthier eating were offered in the grocery store, fast food restaurant, and home. An example of a dietitian-facilitated discussion opportunity involved meeting at the grocery store to discuss making healthier choices while shopping and reading food labels (Figure 1 shows this image). The participants received points for engaging in various Diabetes Island educational activities, and these points could be traded for clothing for their avatars.


Diabetes island: preliminary impact of a virtual world self-care educational intervention for african americans with type 2 diabetes.

Ruggiero L, Moadsiri A, Quinn LT, Riley BB, Danielson KK, Monahan C, Bangs VA, Gerber BS - JMIR Serious Games (2014)

Dietitian-led discussion of reading food labels in the grocery store.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4288760&req=5

Figure 1: Dietitian-led discussion of reading food labels in the grocery store.
Mentions: Health professionals (as avatars) provided real time formal and informal educational sessions. A series of 10 formal presentation sessions (30–60 minutes in length) were offered, including: (1) six healthy eating topics led by a registered dietitian; (2) one on medication adherence led by a pharmacist; (3) one on physical activity led by an exercise researcher; and (4) two led by a nurse Certified Diabetes Educator on the “ABC’s” of diabetes and proper foot care. Several dietitian-facilitated real time discussions on healthier eating were offered in the grocery store, fast food restaurant, and home. An example of a dietitian-facilitated discussion opportunity involved meeting at the grocery store to discuss making healthier choices while shopping and reading food labels (Figure 1 shows this image). The participants received points for engaging in various Diabetes Island educational activities, and these points could be traded for clothing for their avatars.

Bottom Line: A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes.The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive.This intervention model and method show promise and could be tailored for other populations.

View Article: PubMed Central - PubMed

Affiliation: Institute for Health Research and Policy and Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.

ABSTRACT

Background: Diabetes is a serious worldwide public health challenge. The burden of diabetes, including prevalence and risk of complications, is greater for minorities, particularly African Americans. Internet-based immersive virtual worlds offer a unique opportunity to reach large and diverse populations with diabetes for self-management education and support.

Objective: The objective of the study was to examine the acceptability, usage, and preliminary outcome of a virtual world intervention, Diabetes Island, in low-income African Americans with type 2 diabetes. The main hypotheses were that the intervention would: (1) be perceived as acceptable and useful; and (2) improve diabetes self-care (eg, behaviors and barriers) and self-care related outcomes, including glycemic control (A1C), body mass index (BMI), and psychosocial factors (ie, empowerment and distress) over six months.

Methods: The evaluation of the intervention impact used a single-group repeated measures design, including three assessment time points: (1) baseline, (2) 3 month (mid intervention), and (3) 6 month (immediate post intervention). Participants were recruited from a university primary care clinic. A total of 41 participants enrolled in the 6 month intervention study. The intervention components included: (1) a study website for communication, feedback, and tracking; and (2) access to an immersive virtual world (Diabetes Island) through Second Life, where a variety of diabetes self-care education activities and resources were available. Outcome measures included A1C, BMI, self-care behaviors, barriers to adherence, eating habits, empowerment, and distress. In addition, acceptability and usage were examined. A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes.

Results: The intervention study sample (N=41) characteristics were: (1) mean age of 55 years, (2) 71% (29/41) female, (3) 100% (41/41) African American, and (4) 76% (31/41) reported annual incomes below US $20,000. Significant changes over time in the expected direction were observed for BMI (P<.02); diabetes-related distress (P<.02); global (P<.01) and dietary (P<.01) environmental barriers to self-care; one physical activity subscale (P<.04); and one dietary intake (P<.01) subscale. The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive. The usage patterns showed that the majority of participants logged in regularly during the first two months, and around half logged in each week on average across the six month period.

Conclusions: This study demonstrated promising initial results of an immersive virtual world approach to reaching underserved individuals with diabetes to deliver diabetes self-management education. This intervention model and method show promise and could be tailored for other populations. A large scale controlled trial is needed to further examine efficacy.

No MeSH data available.


Related in: MedlinePlus