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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

Total weekly log-ins and total avatars that logged in each week.
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Figure 2: Total weekly log-ins and total avatars that logged in each week.

Mentions: Although there was a sharp spike in log-ins for the first seven weeks, and a sharp decrease in the last four weeks, the rates were relatively consistent for much of the intervention period (Figure 2 shows this information). The total number of log-ins for the first half of the program was 771 compared to 637 for the second half. The total log-ins per week ranged from 40 to 78, with an average weekly log-in rate of 55. The average number of avatars that logged in per week was 20, with a range of 13 to 28. Consistent with the log-in rates, the usage patterns per avatar were greater in the first half of the time period, with ranges of 49% (18/37) to 76% (28/37) of avatars logging in each week compared with 35% (13/37) to 57% (21/37) in the second half.


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)

Total weekly log-ins and total avatars that logged in each week.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Total weekly log-ins and total avatars that logged in each week.
Mentions: Although there was a sharp spike in log-ins for the first seven weeks, and a sharp decrease in the last four weeks, the rates were relatively consistent for much of the intervention period (Figure 2 shows this information). The total number of log-ins for the first half of the program was 771 compared to 637 for the second half. The total log-ins per week ranged from 40 to 78, with an average weekly log-in rate of 55. The average number of avatars that logged in per week was 20, with a range of 13 to 28. Consistent with the log-in rates, the usage patterns per avatar were greater in the first half of the time period, with ranges of 49% (18/37) to 76% (28/37) of avatars logging in each week compared with 35% (13/37) to 57% (21/37) in the second half.

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