JMIR Publications

ABSTRACT

Background:

Diabetes impacts nearly 25% of Veterans and is associated with impaired daily functioning and quality of life. Most Veterans do not engage in recommended physical activity and other diabetes self-management behaviors. Self-management typically takes place outside of medical visits; however, factors related to self-management are only assessed at the time of medical visits, likely missing large amounts of variability.

Objective:

The overarching goal of this study is to understand daily, time-varying factors (comorbid affective symptoms, social context) that influence physical activity, diabetes self-management, glycemic management, daily functioning, and quality of life in participants’ natural environments.

Methods:

We are recruiting Veterans with type 2 diabetes (target N = 100) and are using ecological momentary assessment (EMA), a method of real-time data collection. Participants receive 5 momentary EMA surveys and 1 daily EMA survey per day, in which Veterans report on comorbid affective symptoms (mood, stress, pain), social support, social interactions, physical activity, and other self-management behaviors. Momentary surveys are delivered randomly, during daily pre-programmed intervals over a 14-day sampling period. Accelerometry and continuous glucose monitoring are also used to assess physical activity and blood glucose, respectively.

Results:

The project received funding in April of 2023. Enrollment began in March of 2023 and is planned to be completed in April 2025.

Conclusions:

Assessment tools developed from the present study can inform clinical decision-making by considering barriers to self-management that occur in daily life. Clinical applications include tailored, adaptive technology-supported interventions to improve self-management that provide the right type and amount of support, at the right time by adapting to an individual’s changing internal and contextual state. Clinical Trial: N/A non-RCT