Facebook Intervention to Improve Glycemic Control of Type 2 Diabetes Patients of Bangladesh

The present study will be a randomized controlled trial, comparing (1) standard care (n = 60) with (2) standard care plus a Facebook based educational intervention (n = 60) for 6 months among patients with type 2 diabetes residing in Dhaka city. All the intervention will be provided through a closed and hidden Facebook group moderated by a facilitator who is a qualified physician with 18 years of experience in diabetes management. Participants can join a hidden group by invitation only and the group and contents are not visible to anyone on Facebook except participants. No one searching on Facebook will find the group or be able to request to join as well as group membership or contents will not be visible on the participants’ personal Facebook timelines. This will minimize potential concerns about internet privacy and group policy/guideline will emphasize confidentiality of all content. Further it will hide the intervention materials from control groups and other Facebook users to robust the study design. Intervention tools will be consisted of educational video and blog post developed based on the principles of behavioral learning theory and transtheoretical model of behavioral change using different national and international guidelines for diabetes. Total eight 15-minute narrative educational videos and two patient interview videos will be developed by a culturally sensitive approach to the context with regard to the character, language and cultural practices. Educational videos will be narrated by an expert diabetologist and cover a range of diabetic education including (1) general perspectives and pathophysiology of diabetes, (2) diagnostic procedures and their interpretations, (3) guideline for diet, (4) guideline of exercise, (5) guidelines for diabetes self-care techniques like blood glucose self-monitoring, foot care, regular follow up visits etc., (6) importance of adherence to drugs, (7) knowledge and self-efficacy of insulin use and (8) complications of diabetes and their preventions. Two patient interview videos conducted by expert diabetologist will demonstrate their life experience with diabetes and measures they followed to achieve good glycemic control. Videos will be uploaded in the Facebook group once weekly. Along with educational videos ten jargon free culturally sensitive blog posts, written and evaluated by expert diabetologists each containing around 500 to 1000 words covering diabetic self-care, diet, exercise, and medication guidelines will be posted weekly with each video. Educational videos and blog posts will be followed by an interactive session with diabetologist in comment section where questions raised by the participants will be answered accordingly. Participation is not mandetory rather participation is entirely discretionary. Participants will be tagged by name in the video and posts so that it reaches in their timeline and notification bar. Adherence to the intervention will be monitored by Facebook analytics and if the adherence is not satisfactory, participant miss a video or blog within 48 hours of publication, he/she will be notified by Facebook messenger.