Using Mobile Devices to Study Daily Diabetes Management in Marital Context

Ohio University Athens, Athens OH

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Abstract

DESCRIPTION (provided by applicant): With rapidly rising prevalence, diabetes mellitus presents an enormous challenge to healthcare, affecting 25.6 million adults, with 2 million new cases diagnosed annually. It costs a staggering $245 billion of US economy in 2012, which has risen from $174 billion in 2007. Of all cases, approximately 90% are in the form of type 2 diabetes mellitus (T2DM). The impact of T2DM and its treatment occur in an interpersonal and daily context. The medical regimen is demanding and stressful, affecting not only the patients but also their families, especially spouses. Successful T2DM management is a daily endeavor, requiring accommodations and adjustments from intimate partners. However, little is known how the daily stress experience and health behavior of both the patients and their spouses may influence patients' daily glycemic management. Furthermore, considering the recent research on health concordance and emotional transmission within couples, it is an intriguing hypothesis that the spouse's stress and health behavior may transmit to the patient and result in health consequences. In addition, there are several methodological issues in existing studies that weaken their inferences, including reliance on retrospective self-reports susceptible to systematic recall biases and memory failure, no data collected from spouses directly, use of between-person design to test within-person hypotheses, and lack of attention to the daily process of glycemic management. To address these problems and take advantage of the recent technological and methodological advancements, we propose to (1) evaluate the feasibility of using several electronic mobile devices and implementing daily diary and experience sampling method to collect real-time or daily data over 14 days from both patients and their spouses and store the data on a secure cloud computing platform, and (2) use the collected data to explore several within-couple dyadic hypotheses and establish appropriate data analytic strategy for future research. Specifically, we will investigate (1) whether the spouse's daily stress and health behavior (diet and physical activity), in addition to the patent's, influence the patient's daily glycemic management, and (2) whether there is emotional and behavioral transmissions from the spouse to patient such that the spouse's stress and health behavior on one day contribute to a similar pattern in the patient's stress and health behavior which then affect the patient's glycemic management on the same day or the following day. The findings will contribute to the establishment of innovative dyadic data collection and storage strategy to facilitate future research in real-time computing for timely patient feedback and intervention, and they will enhance the performance a prototype of diabetes monitoring system developed by our team to detect clinical problems. The results will also contribute to our long-term goal of developing innovative monitoring and intervention strategies that address critical interpersonal barriers to achieve successful T2DM management in daily marital context.