This graphic is the theoretical framework for our NIH-funded Women in Control project. I’ve blogged about this project previously here and here, but to briefly recap, this is a health behaviors program intended for African-American women with uncontrolled type 2 diabetes mellitus (T2DM). We are currently recruiting 120 T2DM patients in the Boston area as study participants. Half the subjects will participate in the health education program in traditional, face-to-face sessions conducted at Boston Medical Center while the other half will participate in the same curriculum from the comfort of their own homes, in the virtual world of Second Life. All study participants will be given a laptop computer and those in the virtual world experimental group will receive hands-on training to familiarize them with Second Life.
Our research question is:
Will subjects in the virtual world program demonstrate greater impact at study-end on health behaviors than subjects in the real world, as measured by patient activity levels: calories consumed; adherence to prescribed medication regime; and decrease trends in overall disease indicators (hemoglobin a1c values, body mass, LDL, and blood pressure)?
For the last six months, the project team has been building the curriculum, planning (and building) the Second Life activities, refining the materials, plotting the recruitment procedures, and clarifying the desired outcomes for the intervention.
The “intervention” consists of 3 individual sessions and 8 groups sessions for the subjects led by diabetes educators. The intent is to produce changes in internal factors that lead to changes in behaviors and psychological states for the subjects. The eventual, hoped-for results will be physiological improvements that ultimately lead to improved overall health and quality of life.
The diagram shown at the top of this post provides the theoretical overview of what we hope to accomplish. The tourqouise-colored box shows the factors that could modify the intervention’s impact (e.g. low literacy levels). The purple box displays the variables that the intervention will attempt to modify. While we can’t make people eat more healthily or take their medications regularly, we can use tools and techniques that have been shown to help people change their behavior. The techniques we will use in this study are motivational interviewing, active learning, and the dynamics of group work. It is our hope that these methods will help the subjects take small steps toward greater self-management of their disease.