Diabetes Self-Management in the Age of Social Media: Large-Scale Analysis of Peer Interactions Using Semiautomated Methods

Myneni, Sahiti; Lewis, Brittney; Singh, Tavleen; Paiva, Kristi; Kim, Seon Min; Cebula, Adrian V; Villanueva, Gloria R.; Wang, Jing

doi:10.2196/18441

Cited by 17 publications

(21 citation statements)

References 52 publications

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“…Multiple studies point to the utility of web-based interventions in the negotiation of self-management work [ 27 , 29 , 33 - 35 ]. A meta-analysis found 4 mechanisms of self-management support in online groups: collective knowledge and identity building through lived experience, social support through readily accessible gifting relationships, sociability beyond illness, and online disinhibition [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts

et al. 2021

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Background The current opioid crisis in the United States impacts broad population groups, including pregnant women. Opioid use during pregnancy can affect the health and wellness of both mothers and their infants. Understanding women’s efforts to self-manage opioid use or misuse in pregnancy is needed to identify intervention points for improving maternal outcomes. Objective This study aims to identify the characteristics of women in an online health community (OHC) with opioid use or misuse during pregnancy and the self-management support needs of these mothers. Methods A total of 200 web posts by pregnant women with opioid use participating in an OHC were double coded. Concepts and their thematic connections were identified through an inductive process until theoretical saturation was reached. Statistical tests were performed to identify patterns. Results The majority of pregnant women (150/200, 75.0%) in the OHC exhibited signs of misuse, and 62.5% (125/200) of the participants were either contemplating or pursuing dosage reduction. Self-managed withdrawal was more common (P<.001) than professional treatment among the population. A total of 5 themes of self-management support needs were identified as women sought information about the potential adverse effects of gestational opioid use, protocols for self-managed withdrawal, pain management safety during pregnancy, hospital policies and legal procedures related to child protection, and strategies for navigating offline support systems. In addition, 58.5% (117/200) of the pregnant women expressed negative emotions, of whom only 10.2% (12/117) sought to address their emotional needs with the help of the OHC. Conclusions OHCs provide vital self-management support for pregnant women with opioid use or misuse. Women pursuing self-managed dosage reduction are prone to misinformation and repeated relapses, which can result in extreme measures to avoid testing positive for drug use at labor. The study findings provide evidence for public policy considerations, including universal screening of substance use for pregnant women, emphasis on treatment rather than legal punishment, and further expansion of the Drug Addiction Treatment Act waiver training program. The improvement of web-based platforms that can organize geo-relevant information, dispense clinically validated withdrawal schedules, and offer structured peer support is envisioned for harm reduction among pregnant women who opt for self-management of opioid misuse.

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Section: Introductionmentioning

confidence: 99%

Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts

et al. 2021

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“…The massive amounts of social interactions taking place within online communities today are providing researchers with valuable network data. Research has focused on the analysis of online social interactions from both general purpose social media platforms (eg, Twitter and YouTube) and health care-specific platforms (eg, American Diabetes Association online community) [41][42][43][44]. Often, qualitative analysis and computational text analysis are used to analyze social media interactions [41][42][43].…”

Section: Social Network Analysis and Online Health Communitiesmentioning

confidence: 99%

“…Research has focused on the analysis of online social interactions from both general purpose social media platforms (eg, Twitter and YouTube) and health care–specific platforms (eg, American Diabetes Association online community) [ 41 - 44 ]. Often, qualitative analysis and computational text analysis are used to analyze social media interactions [ 41 - 43 ]. Studies have shown that SNA provides insights into social influence, information dissemination, and behavioral diffusion [ 39 , 40 , 45 , 46 ].…”

Section: Introductionmentioning

confidence: 99%

Exchanges in a Virtual Environment for Diabetes Self-Management Education and Support: Social Network Analysis

et al. 2021

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Background Diabetes 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. Objective The 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. Methods Data 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. Results The 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. Conclusions 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. 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.

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“…Multiple studies point to the utility of web-based interventions in the negotiation of self-management work [27,29,[33][34][35]. A meta-analysis found 4 mechanisms of self-management support in online groups: collective knowledge and identity building through lived experience, social support through readily accessible gifting relationships, sociability beyond illness, and online disinhibition [35].…”

Section: Ohcsmentioning

confidence: 99%

Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts (Preprint)

Liang¹,

Chen²,

Bennett³

et al. 2020

Preprint

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BACKGROUND The current opioid crisis in the United States impacts broad population groups, including pregnant women. Opioid use during pregnancy can affect both the health and wellness of women and their infants. OBJECTIVE Our research is driven by the overarching vision of improving the quality of pregnancy for women with substance use disorder. The aims of this study were to (1) contextualize the social environment and healthcare experiences of the pregnant women who use opioids in order to inform program planning for specialized obstetric care and resources; and (2) identify knowledge gaps of the study population that may be addressed by patient education via online health communities. METHODS We conducted a qualitative study of public online discussion posts made by pregnant women with opioid use to understand their experiences and challenges. Three researchers performed three rounds of iterative open coding of randomly selected posts from MedHelp.org. Concepts and their thematic connections were identified through an inductive process. Theoretical saturation was reached within approximately 350 posts. RESULTS The study population had four levels of experience with opioid use: opioid naïve, opioid dependent, opioid misuse, and in treatment. Women engage in online discussions with peers due to several offline challenges. Regardless of their experience level, the women fear that opioids may harm their fetuses and express a desire to know more about the drugs’ effects. The opioid dependent and opioid misuse groups experience additional barriers to recovery: their social environment presents several risk factors including isolation and lack of social support, influences of negative relationships, and pressure to meet societal expectations. They display signs of experiencing guilt and are prone to internalized stigma. They have difficulty obtaining and sustaining specialized obstetric care offering medication-assisted treatment. In the absence of adequate professional care, they resolve to attempt self-guided opioid withdrawal, often misinformed, in an effort to protect their fetuses and to avoid legal complications. They seek peer experiences from the online health community to supplement their difficulty finding medical and legal information from other sources. CONCLUSIONS Women with opioid use problems in an online health community often lack social support and the knowledge necessary to sustain a healthy pregnancy while combating physical and social concerns related to their opioid use. Increased resources in high-risk pregnancy care and greater transparency in hospital reporting protocols is called for to re-align patients and providers. In addition to better engaging women who use opioids in both prenatal care and substance use disorder treatment, the improvement of online platforms that dispense valid information on drug safety, withdrawal schedules, and local neglect-reporting regulations is much needed for those who do not seek professional care.

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Diabetes Self-Management in the Age of Social Media: Large-Scale Analysis of Peer Interactions Using Semiautomated Methods

Cited by 17 publications

References 52 publications

Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts

Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts

Exchanges in a Virtual Environment for Diabetes Self-Management Education and Support: Social Network Analysis

Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts (Preprint)

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