Decision Support for Diabetes Self-Management: Quantitative and Qualitative Approaches

摘要

Diabetes is a chronic, pervasive illness (CDC, 2014) that requires challenging self-management practices (Skinner et al., 2006). Both type 2 diabetes and prediabetes are common in older adults (Cowie et al., 2009), who may be at greater risk of struggling with self-management due to age-related cognitive change. Decision support systems may be developed to assist with self-management, but many questions remain about the specific type and level of support they should provide, particularly for older users and in the context of diabetes self-management. We conducted two studies to contribute to this knowledge area: a quantitative investigation of the effect of decision support levels and age on performance on a complex nutrition task (Study 1), and a qualitative coding study investigating the topics and types of support on an internet forum dedicated to the discussion of type 2 diabetes (Study 2). Study 1 revealed a significant effect of age on task performance such that younger adults outperformed older adults, but there were no significant differences in level of decision support or interactions between age and support in performance. Study 2 found that internet forum users exchanged both informational and emotional support. We describe the specific forms this support took as well as the topics most often discussed. Implications for the design of decision support systems are discussed, as well as the future studies that will be necessary to better inform the design of age-appropriate decision support for diabetes self-management.