JMIR Publications

ABSTRACT

Background:

Self-management is critical for older adults with type 2 diabetes mellitus, but the practice of the self-management remains suboptimal. Social media has become an accessible and effective stimulus source for the public which has the potential to promote health behaviors, but its effect on self-management of older adults with type 2 diabetes mellitus remains unknown.

Objective:

To investigate the relationships between social media exposure, specifically time exposure and content exposure, and the self-management of older adults with type 2 diabetes mellitus.

Methods:

In this cross-sectional study, we enrolled 257 older adults with type 2 diabetes mellitus and who used short-form video Apps from community healthcare centers. We assessed subjective and objective time and content exposure. We transformed the text-based content exposure into the diabetes-related content exposure encompassing irrelevant, harmful, hypobeneficial and hyperbeneficial categories using Q-methodology. The self-management was assessed through a validated questionnaire. We used restricted cubic splines and linear regression models to model the relationships between time exposure and content exposure and the self-management, respectively.

Results:

Of 257 older adults with type 2 diabetes (median age 69 [65-72] years), 53.3% were women, the mean sum score of self-management was 35.7 (10.4). the median subjective time exposure was 120 (60-120) minutes, and 61.1% of them were exposed to hyperbeneficial content. There was an approximate L-shaped dextrorotatory relationship between time exposure and self-management, with a decline in self-management when time exposure surpassed 139.8 minutes daily. Exposure to hyperbeneficial content was positively associated with the overall self-management (B = 3.46, 95%CI 0.71 to 6.21). For participants exposure more than 139.8 minutes daily, this positive association remained robust (B = 7.27, 95%CI 1.54 to 13.00). In sub-dimensional analyses, hyperbeneficial content exposure was positively associated with general diet (B = 1.51, 95%CI 0.54 to 2.49), and blood-glucose testing (B = 1.31, 95%CI 0.25 to 2.38), respectively.

Conclusions:

Social media exposure had two-sided effects on self-management of older adults with type 2 diabetes mellitus. The self-management declined when the daily time spent on social media exceeded 139.8 minutes. However, exposure to hyperbeneficial content contributed to better self-management of individuals, regardless of excessive time spent on social media. It is important to explore the potential of social media in empowering the self-management of older adults with type 2 diabetes mellitus.