JMIR Publications

ABSTRACT

Diabetes mellitus Type II (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 (visible support, invisible support, 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 utilizes objective sensor data in combination with self-reports in couple’s everyday life. This study protocol describes 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 two phases of data collection. The first phase is a naturalistic observation phase of couple’s conversations in combination with an experience sampling phase in daily life of N = 180 T2DM patients and their romantic partners using sensor data from smartwatches, mobile phones and accelerometers for seven consecutive days. The second phase is an observational study in the lab where couples discuss topics related to their diabetes management. The second phase complements the naturalistic observation and experience sampling phase by focusing on the assessment of a full discussion about diabetes-related concerns. Participants are romantic heterosexual couples with one partner having the diagnosis of T2DM. For further research and practice, it is crucial to identify the impact of social support and CDC on couple’s dyadic illness management of T2DM and on their well-being in daily life. Using AAMC will make a key contribution with regard to objective operationalisations 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 of this multimodal sensor approach and feasibility aspects are discussed.