Evaluation of nurse‐led social media intervention for diabetes self‐management: A mixed‐method study

Abstract

Aims This study aimed to investigate the effectiveness and understand the process of a nurse‐led social media intervention for health behavior and glucose control for diabetes self‐management among patients with type 2 diabetes mellitus. Design This study had an explanatory sequential mixed methods design, with a randomized controlled trial and qualitative interviews. Methods A total of 89 patients diagnosed with type 2 diabetes mellitus were randomly assigned to an intervention or a control group. Patients in the intervention group were invited to join the closed nurse‐led social media platform that included diabetes information, action planning, unmoderated chat, and questions and answers. The outcomes of diabetes self‐care behavior, hemoglobin A1c (HbA1c) percentage, fasting blood sugar level (FBS), systolic and diastolic blood pressure, and triglyceride (TG) and total cholesterol levels were measured at baseline, 3 months, and 6 months. A linear mixed model was used to analyze the effectiveness of the intervention over time. Qualitative data were collected from interviews with seven patients engaged in the intervention and analyzed using qualitative content analysis. Findings After 6 months, insulin users who were provided with the social media intervention had significantly lower FBS and TG levels than those with usual care (135.80 ± 12.37 vs. 175.82 ± 15.34 mg/dL, p = 0.049; 206.85 ± 38.26 vs. 387.50 ± 56.19 mg/dL, p = 0.013; respectively). Although a similar rate of decrease in the HbA1c level over time was observed among insulin and noninsulin users after the social media intervention, this decrease was significantly greater among noninsulin users at 3 and 6 months compared with the control group (6.38 ± 0.34 vs. 7.25 ± 0.24, p = 0.040; 6.31 ± 0.37 vs. 7.28 ± 0.26, p = 0.036; respectively). Interview with seven patients who engaged in the intervention revealed that their engagement in the intervention was primarily determined by their acceptance of the role of managing their diabetes. Being engaged in the intervention, patients benefited from information sharing and interactive support to motivate their self‐care, nurses' professional advice to modify their behaviors, and action planning to make progress toward behavioral change. Conclusions The positive outcomes of the nurse‐led social media intervention indicate that the social media platform is an effective strategy to implement diabetes self‐management in clinical nursing practice. Clinical Relevance The social media intervention would be successfully implemented by nurses to facilitate patients accepting their role in diabetes management and employing key services for diabetes information, support, professional advice, and action planning.

Use of Online Communities among People with Type 2 Diabetes: A Scoping Review

“…Follow-up: 3 and 6 months. Kim et al (2022); South Korea [ 23 •] To research the effectiveness and understand the process of a nurse-led social media intervention for health behavior and glucose control for diabetes self-management. Mixed methods study (sequential explanatory design) including a randomized control trial.…”

“…Online diabetes communities can be set up on specific platforms or use available social networks. Related to this issue, both studies by Litchman et al [ 25 •, 26 ] and Herrero et al [ 21 •] used a diabetes-specific online community created on a web domain, while the other authors studied communities created on broader social networks such as Facebook [ 21 •, 24 ]; Never Cafe [ 23 •] or Second Life [ 22 ]. All of them still active.…”

“…Never Café ( https://cafe.naver.com/ ) is one of the most popular social networks in South Korea, very similar to the previous one. On this platform, the authors developed the community “Diabetes, my companion” with four main activities: diabetes information, action planning in everyday life, patients´ chat room and questions and answers [ 23 •].…”

“…It was originated in 2014 and focuses on learning and discussing the low-carbohydrate diet. Kim et al (2022) [ 23 •] Diabetes, my companion: Group within the social network “Never Café”, one of the most popular social networks in South Korea. The contents of this page included: information about diabetes, planning of actions in daily life, chat room for patients and questions and answers.…”

“…In addition, the community included three weekly intervention-related postings that focused on describing a personal experiment and goal setting; goal recording and problem-solving; and a final goal review. Facebook groups [ 21 •, 24 ] It is not detailed whether there was moderation or not Observed communities Diabetes, my companion [ 23 •] Diabetes nurse educators Based on social cognitive theory, they provided information on self-management (diet, exercise, glucose monitoring, medications, and other occasional health issues) and provided interactive support. SLIDES [ 22 ] Specialized nurses, diabetes educators or invited health professionals These professionals gave 12 weekly classes in the virtual world of the Second platform Life, one hour long, using the American Diabetes Association/American Association of Diabetes Educators self-management training about: healthy eating, staying active, glucose monitoring, medications, problem solving, healthy coping, and risk reduction.…”