A Virtual World Versus Face-to-Face Intervention Format to Promote Diabetes Self-Management Among African American Women: A Pilot Randomized Clinical Trial
Authors
Rosal, Milagros C.Heyden, Robin
Mejilla, Roanne
Capelson, Roberta
Chalmers, Karen A.
Rizzo DePaoli, Maria
Veerappa, Chetty
Wiecha, John M.
UMass Chan Affiliations
Prevention Research CenterDepartment of Medicine, Division of Preventive and Behavioral Medicine
Document Type
Journal ArticlePublication Date
2014-10-24Keywords
African Americansclinical trials
feasibility
health behavior
health disparities
minority health
randomized clinical trial
technology
type 2 diabetes
virtual systems
Behavioral Disciplines and Activities
Behavior and Behavior Mechanisms
Community Health and Preventive Medicine
Preventive Medicine
Metadata
Show full item recordAbstract
BACKGROUND: Virtual world environments have the potential to increase access to diabetes self-management interventions and may lower cost. OBJECTIVE: We tested the feasibility and comparative effectiveness of a virtual world versus a face-to-face diabetes self-management group intervention. METHODS: We recruited African American women with type 2 diabetes to participate in an 8-week diabetes self-management program adapted from Power to Prevent, a behavior-change in-person group program for African Americans with diabetes or pre-diabetes. The program is social cognitive theory-guided, evidence-based, and culturally tailored. Participants were randomized to participate in the program via virtual world (Second Life) or face-to-face, both delivered by a single intervention team. Blinded assessors conducted in-person clinical (HbA1c), behavioral, and psychosocial measurements at baseline and 4-month follow-up. Pre-post differences within and between intervention groups were assessed using t tests and chi-square tests (two-sided and intention-to-treat analyses for all comparisons). RESULTS: Participants (N = 89) were an average of 52 years old (SD 10), 60% had < /=high school, 82% had household incomes < US $30,000, and computer experience was variable. Overall session attendance was similar across the groups (6.8/8 sessions, P = .90). Compared to face-to-face, virtual world was slightly superior for total activity, light activity, and inactivity (P = .05, P = .07, and P = .025, respectively). HbA1c reduction was significant within face-to-face (-0.46, P = 02) but not within virtual world (-0.31, P = .19), although there were no significant between group differences in HbA1c (P = .52). In both groups, 14% fewer patients had post-intervention HbA1c > /=9% (virtual world P = .014; face-to-face P = .002), with no significant between group difference (P = .493). Compared to virtual world, face-to-face was marginally superior for reducing depression symptoms (P = .051). The virtual world intervention costs were US $1117 versus US $931 for face-to-face. CONCLUSIONS: It is feasible to deliver diabetes self-management interventions to inner city African American women via virtual worlds, and outcomes may be comparable to those of face-to-face interventions. Further effectiveness research is warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT01340079; http://clinicaltrials.gov/show/NCT01340079 (Archived by WebCite at http://www.webcitation.org/6T2aSvmka).Source
JMIR Res Protoc. 2014 Oct 24;3(4):e54. doi: 10.2196/resprot.3412. Link to article on publisher's siteDOI
10.2196/resprot.3412Permanent Link to this Item
http://hdl.handle.net/20.500.14038/44908PubMed ID
25344620Related Resources
Link to Article in PubMedRights
Copyright ©Milagros C Rosal, Robin Heyden, Roanne Mejilla, Roberta Capelson, Karen A Chalmers, Maria Rizzo DePaoli, Chetty Veerappa, John M Wiecha. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.10.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
ae974a485f413a2113503eed53cd6c53
10.2196/resprot.3412