Cardiovascular Disease, Diabetes
Conditions
Keywords
Diabetes, Social Media
Brief summary
Twitter use is surprisingly well represented across broad demographic population segments and health-related messages. The promise of using Twitter is that its use is growing rapidly, it allows the investigators to view communications that were impossible to intercept before, and it potentially provides information faster and less expensively than collection from other media channels. Prior work also supports that social media interventions can improve health behavior change (e.g. weight loss, physical activity) and outcomes.The overarching goals of this proposal are to understand the uses and limitations of this communication channel to improve patients' ability to manage their CV health condition.
Detailed description
Use Twitter to deliver high impact CV health related content to improve patient activation and disease management for diabetes.
Interventions
BEHAVIORALTwitter Diabetes Intervention
This group will be asked to use twitter for heart health ( e.g. tweeting, following, receiving tweets)
Sponsors
National Heart, Lung, and Blood Institute (NHLBI)
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* diabetes * uses social media
Exclusion criteria
* \<21 years of age * pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Patient Activation Measure (PAM) Score From Baseline | baseline and 6 months | The Patient Activation Measure (PAM) is a validated and reliable tool that assesses a person's ability to manage their health, using a 100-point total score scale and four activation levels. The total score ranges from 0 to 100, with higher scores indicating better outcomes-specifically, higher scores represent better outcomes. The overall score is summed from individual items, reflecting the level of activation and self-management ability. The four levels are: Level 1 (Score: 0-47.0): Lowest activation, indicating disengagement and lack of confidence in managing health. Level 2 (Score: 47.1-55.1): Some awareness of self-management but limited skills and confidence. Level 3 (Score: 55.2-67.0): Actively trying to manage health but inconsistent success. Level 4 (Score: 67.1-100): Highest activation, indicating confidence and proactive health management. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Systolic Blood Pressure From Baseline | baseline and 6 months | Initial systolic blood pressure (SBP) measurements were obtained from the electronic medical record (EMR). For the majority of patients, final blood pressure measurements (i.e., the 6-month measurement) were obtained in a five to eight month period after enrollment from a documented reading in the the EMR. For patients who did not have a documented SBP reading in the health system during this time period, we requested that patients either meet our team in person for a manual reading or provide a photograph from their mobile phone of the screen showing their SBP reading from a home blood pressure cuff, pharmacy machine, or doctor's office from outside of our health system. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Twitter Diabetes Control This group will be identified as having diabetes from Twitter. This group will be contacted and asked to complete brief surveys | 316 |
| Twitter Diabetes Intervention This group will be identified as having diabetes from Twitter. This group will be contacted and asked to complete brief surveys. This group will be asked to use twitter for heart health ( e.g. tweeting, following, receiving tweets)
Twitter Diabetes Intervention: This group will be asked to use twitter for heart health ( e.g. tweeting, following, receiving tweets) | 295 |
| Total | 611 |
Baseline characteristics
| Characteristic | Total | Twitter Diabetes Intervention | Twitter Diabetes Control |
|---|---|---|---|
| Age, Continuous | 52.0 year STANDARD_DEVIATION 11.7 | 52.0 year STANDARD_DEVIATION 11.2 | 52.0 year STANDARD_DEVIATION 12.2 |
| Annual household income > $100,000 | 188 Participants | 77 Participants | 111 Participants |
| Annual household income < $50,000 | 205 Participants | 102 Participants | 103 Participants |
| Annual household income $50,000 - 99,999 | 171 Participants | 95 Participants | 76 Participants |
| Annual household income Missing | 47 Participants | 21 Participants | 26 Participants |
| BMI, mean | 34.3 kg/m^2 STANDARD_DEVIATION 9.3 | 35.0 kg/m^2 STANDARD_DEVIATION 10 | 33.6 kg/m^2 STANDARD_DEVIATION 8.5 |
| Education College graduate | 328 Participants | 156 Participants | 172 Participants |
| Education High school or lower | 71 Participants | 37 Participants | 34 Participants |
| Education Some college | 212 Participants | 102 Participants | 110 Participants |
| Employment status Employed | 387 Participants | 181 Participants | 206 Participants |
| Employment status Homemaker | 32 Participants | 17 Participants | 15 Participants |
| Employment status Out of work | 80 Participants | 44 Participants | 36 Participants |
| Employment status Retired | 109 Participants | 53 Participants | 56 Participants |
| Employment status Student | 3 Participants | 0 Participants | 3 Participants |
| Prior Twitter use No | 199 Participants | 101 Participants | 98 Participants |
| Prior Twitter use Yes | 412 Participants | 194 Participants | 218 Participants |
| Race/Ethnicity, Customized Asian | 7 Participants | 2 Participants | 5 Participants |
| Race/Ethnicity, Customized Black | 229 Participants | 121 Participants | 108 Participants |
| Race/Ethnicity, Customized Latino/Spanish | 9 Participants | 3 Participants | 6 Participants |
| Race/Ethnicity, Customized Other/unknown | 17 Participants | 10 Participants | 7 Participants |
| Race/Ethnicity, Customized White | 349 Participants | 159 Participants | 190 Participants |
| Region of Enrollment United States Missing | 1 Participants | 0 Participants | 1 Participants |
| Region of Enrollment United States NJ | 97 Participants | 44 Participants | 53 Participants |
| Region of Enrollment United States Other | 18 Participants | 3 Participants | 15 Participants |
| Region of Enrollment United States PA | 495 Participants | 248 Participants | 247 Participants |
| Self-rating of health Fair | 223 Participants | 110 Participants | 113 Participants |
| Self-rating of health Good | 293 Participants | 133 Participants | 160 Participants |
| Self-rating of health Poor | 44 Participants | 27 Participants | 17 Participants |
| Self-rating of health Very good | 43 Participants | 18 Participants | 25 Participants |
| Self-rating of health Very poor | 8 Participants | 7 Participants | 1 Participants |
| Sex: Female, Male Female | 345 Participants | 179 Participants | 166 Participants |
| Sex: Female, Male Male | 266 Participants | 116 Participants | 150 Participants |
| US residence No | 1 Participants | 0 Participants | 1 Participants |
| US residence Yes | 610 Participants | 295 Participants | 315 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Change in Patient Activation Measure (PAM) Score From Baseline
The Patient Activation Measure (PAM) is a validated and reliable tool that assesses a person's ability to manage their health, using a 100-point total score scale and four activation levels. The total score ranges from 0 to 100, with higher scores indicating better outcomes-specifically, higher scores represent better outcomes. The overall score is summed from individual items, reflecting the level of activation and self-management ability. The four levels are: Level 1 (Score: 0-47.0): Lowest activation, indicating disengagement and lack of confidence in managing health. Level 2 (Score: 47.1-55.1): Some awareness of self-management but limited skills and confidence. Level 3 (Score: 55.2-67.0): Actively trying to manage health but inconsistent success. Level 4 (Score: 67.1-100): Highest activation, indicating confidence and proactive health management.
Time frame: baseline and 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Twitter Diabetes Control | Change in Patient Activation Measure (PAM) Score From Baseline | 3.4 score on a scale | Standard Deviation 17.4 |
| Twitter Diabetes Intervention | Change in Patient Activation Measure (PAM) Score From Baseline | 0.0 score on a scale | Standard Deviation 20.7 |
Secondary
Change in Systolic Blood Pressure From Baseline
Initial systolic blood pressure (SBP) measurements were obtained from the electronic medical record (EMR). For the majority of patients, final blood pressure measurements (i.e., the 6-month measurement) were obtained in a five to eight month period after enrollment from a documented reading in the the EMR. For patients who did not have a documented SBP reading in the health system during this time period, we requested that patients either meet our team in person for a manual reading or provide a photograph from their mobile phone of the screen showing their SBP reading from a home blood pressure cuff, pharmacy machine, or doctor's office from outside of our health system.
Time frame: baseline and 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Twitter Diabetes Control | Change in Systolic Blood Pressure From Baseline | -19.8 mm Hg | Standard Deviation 19.3 |
| Twitter Diabetes Intervention | Change in Systolic Blood Pressure From Baseline | -18.5 mm Hg | Standard Deviation 20.4 |