Lüscher Janina, Kowatsch Tobias, Boateng George, Santhanam Prabhakaran, Bodenmann Guy, Scholz Urte
Applied Social and Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.
JMIR Res Protoc. 2019 Oct 4;8(10):e13685. doi: 10.2196/13685.
Type II diabetes mellitus (T2DM) is a common chronic disease. To manage blood glucose levels, patients need to follow medical recommendations for healthy eating, physical activity, and medication adherence in their everyday life. Illness management is mainly shared with partners and involves social support and common dyadic coping (CDC). Social support and CDC have been identified as having implications for people's health behavior and well-being. Visible support, however, may also be negatively related to people's well-being. Thus, the concept of invisible support was introduced. It is unknown which of these concepts (ie, visible support, invisible support, and CDC) displays the most beneficial associations with health behavior and well-being when considered together in the context of illness management in couple's everyday life. Therefore, a novel ambulatory assessment application for the open-source behavioral intervention platform MobileCoach (AAMC) was developed. It uses objective sensor data in combination with self-reports in couple's everyday life.
The aim of this paper is to describe the design of the Dyadic Management of Diabetes (DyMand) study, funded by the Swiss National Science Foundation (CR12I1_166348/1). The study was approved by the cantonal ethics committee of the Canton of Zurich, Switzerland (Req-2017_00430).
This study follows an intensive longitudinal design with 2 phases of data collection. The first phase is a naturalistic observation phase of couples' conversations in combination with experience sampling in their daily lives, with plans to follow 180 T2DM patients and their partners using sensor data from smartwatches, mobile phones, and accelerometers for 7 consecutive days. The second phase is an observational study in the laboratory, where couples discuss topics related to their diabetes management. The second phase complements the first phase by focusing on the assessment of a full discussion about diabetes-related concerns. Participants are heterosexual couples with 1 partner having a diagnosis of T2DM.
The AAMC was designed and built until the end of 2018 and internally tested in March 2019. In May 2019, the enrollment of the pilot phase began. The data collection of the DyMand study will begin in September 2019, and analysis and presentation of results will be available in 2021.
For further research and practice, it is crucial to identify the impact of social support and CDC on couples' dyadic management of T2DM and their well-being in daily life. Using AAMC will make a key contribution with regard to objective operationalizations of visible and invisible support, CDC, physical activity, and well-being. Findings will provide a sound basis for theory- and evidence-based development of dyadic interventions to change health behavior in the context of couple's dyadic illness management. Challenges to this multimodal sensor approach and its feasibility aspects are discussed.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/13685.
2型糖尿病（T2DM）是一种常见的慢性病。为了控制血糖水平，患者在日常生活中需要遵循关于健康饮食、体育活动和药物依从性的医学建议。疾病管理主要由伴侣共同承担，涉及社会支持和共同二元应对（CDC）。社会支持和CDC已被确定对人们的健康行为和幸福感有影响。然而，可见支持也可能与人们的幸福感呈负相关。因此，引入了无形支持的概念。在夫妻日常生活中的疾病管理背景下，将这些概念（即可见支持、无形支持和CDC）放在一起考虑时，尚不清楚哪个概念与健康行为和幸福感表现出最有益的关联。因此，为开源行为干预平台MobileCoach开发了一种新型的动态评估应用程序（AAMC）。它在夫妻的日常生活中结合使用客观传感器数据和自我报告。
本文旨在描述由瑞士国家科学基金会（CR12I1_166348/1）资助的糖尿病二元管理（DyMand）研究的设计。该研究已获得瑞士苏黎世州州立伦理委员会的批准（Req-2017_00430）。
本研究采用强化纵向设计，分两个阶段收集数据。第一阶段是对夫妻对话的自然观察阶段，并结合他们日常生活中的经验抽样，计划连续7天跟踪180名T2DM患者及其伴侣，使用智能手表、手机和加速度计的传感器数据。第二阶段是在实验室进行的观察性研究，夫妻在实验室中讨论与他们的糖尿病管理相关的话题。第二阶段通过专注于对糖尿病相关问题的全面讨论的评估来补充第一阶段。参与者为异性恋夫妻，其中一方被诊断患有T2DM。
AAMC在2018年底设计并构建完成，并于2019年3月进行了内部测试。2019年5月，试点阶段开始招募。DyMand研究的数据收集将于2019年9月开始，结果分析和展示将于2021年完成。
对于进一步的研究和实践，确定社会支持和CDC对夫妻二元管理T2DM及其日常生活幸福感的影响至关重要。使用AAMC将在可见和无形支持、CDC、体育活动和幸福感的客观操作化方面做出关键贡献。研究结果将为基于理论和证据的二元干预发展提供坚实基础，以在夫妻二元疾病管理背景下改变健康行为。讨论了这种多模态传感器方法面临的挑战及其可行性方面。
国际注册报告识别号（IRRID）：PRR1-10.2196/13685。
