Objective: The study aimed to identify the common gaps in skills and self-efficacy for diabetes self-management and explore other factors which serve as enablers of, and barriers to, achieving optimal diabetes self-management. The information gathered could provide health professionals with valuable insights to achieving better health outcomes with self-management education and support for diabetes patients.
 
Methods: International online survey and telephone interviews were conducted on adults who have type 1 or type 2 diabetes. The survey inquired about their skills and self-efficacy in diabetes self-management, while the interviews assessed other enablers of, and barriers to, diabetes self-management. Surveys were analysed using descriptive and inferential statistics. Interviews were analysed using inductive thematic analysis.
 
Results: Survey participants (N=217) had type 1 diabetes (38.2%) or type 2 diabetes (61.8%), with a mean age of 44.56 SD 11.51 and were from 4 continents (Europe, Australia, Asia, America). Identified gaps in diabetes self-management skills included the ability to: recognize and manage the impact of stress on diabetes, exercise planning to avoid hypoglycemia and interpreting blood glucose pattern levels. Self-efficacy for healthy coping with stress and adjusting medications or food intake to reach ideal blood glucose levels were minimal. Sixteen participants were interviewed. Common enablers of diabetes self-management included: (i) the will to prevent the development of diabetes complications and (ii) the use of technological devices. Issues regarding: (i) frustration due to dynamic and chronic nature of diabetes (ii) financial constraints (iii) unrealistic expectations and (iv) work and environment-related factors limited patients’ effective self-management of diabetes. 

Conclusions: Educational reinforcement using technological devices such as mobile application has been highlighted as an enabler of diabetes self-management and it could be employed as an intervention to alleviate identified gaps in diabetes self-management. Furthermore, improved approaches that address financial burden, work and environment-related factors as well as diabetes distress are essential for enhancing diabetes self-management.

Enablers and barriers to effective diabetes self-management: A multi-national investigation.

This article provides an overview of the recent literature on the use of internet-based testing to address important questions in perception research. Our goal is to provide a starting point for the perception researcher who is keen on assessing this tool for their own research goals. Internet-based testing has several advantages over in-lab research, including the ability to reach a relatively broad set of participants and to quickly and inexpensively collect large amounts of empirical data, via services such as Amazon’s Mechanical Turk or Prolific Academic. In many cases, the quality of online data appears to match that collected in lab research. Generally-speaking, online participants tend to be more representative of the population at large than those recruited for lab based research. There are, though, some important caveats, when it comes to collecting data online. It is obviously much more difficult to control the exact parameters of stimulus presentation (such as display characteristics) with online research. There are also some thorny ethical elements that need to be considered by experimenters. Strengths and weaknesses of the online approach, relative to others, are highlighted, and recommendations made for those researchers who might be thinking about conducting their own studies using this increasingly-popular approach to research in the psychological sciences.

Conducting perception research over the internet: a tutorial review.

Absolutist thinking is considered a cognitive distortion by most cognitive therapies for anxiety and depression. Yet, there is little empirical evidence of its prevalence or specificity. Across three studies, we conducted a text analysis of 63 Internet forums (over 6,400 members) using the Linguistic Inquiry and Word Count software to examine absolutism at the linguistic level. We predicted and found that anxiety, depression, and suicidal ideation forums contained more absolutist words than control forums (ds > 3.14). Suicidal ideation forums also contained more absolutist words than anxiety and depression forums (ds > 1.71). We show that these differences are more reflective of absolutist thinking than psychological distress. It is interesting that absolutist words tracked the severity of affective disorder forums more faithfully than negative emotion words. Finally, we found elevated levels of absolutist words in depression recovery forums. This suggests that absolutist thinking may be a vulnerability factor.

https://journals.sagepub.com/doi/pdf/10.1177/2167702617747074

In an Absolute State: Elevated Use of Absolutist Words Is a Marker Specific to Anxiety, Depression, and Suicidal Ideation

This paper introduces the work of the MOOD (Microanalysis Of Online Data) network, an interdisciplinary association of academic researchers exploring ways of conducting close qualitative analyses of online interaction. Despite the fact that much online interaction meets the criteria for ‘conversation’, conversation analysis (CA) has only recently begun to grow and flourish as a methodology for analysing the overwhelming quantity of material that in many cases sits in archive form, visible to millions, on the Internet. We discuss the development of methods that are inherently suited for subjecting online interaction to the kind of rigorous analysis that conversation analysts have applied to talk of all kinds for several decades. We go on to explore the fundamental challenges that online data pose for CA, the value of many CA techniques for online analysis, and the possibilities of developing bespoke modes of analysis that are crafted for use with specific forms of online data (e.g. ‘tweets’ on Twitter ).

Microanalysis Of Online Data: The methodological development of “digital CA”

As the popularity and diversity of social media platforms increases so does their utility for health research. Using social media for recruitment into clinical studies and/or delivering health behavior interventions may increase reach to a broader audience. However, evidence supporting the efficacy of these approaches is limited, and key questions remain with respect to optimal benchmarks, intervention development and methodology, participant engagement, informed consent, privacy, and data management. Little methodological guidance is available to researchers interested in using social media for health research. In this Tutorial, we summarize the content of the 2017 Society for Behavioral Medicine Pre-Conference Course entitled 'Using Social Media for Research,' at which the authors presented their experiences with methodological and ethical issues relating to social media-enabled research recruitment and intervention delivery. We identify common pitfalls and provide recommendations for recruitment and intervention via social media. We also discuss the ethical and responsible conduct of research using social media for each of these purposes.

https://journals.sagepub.com/doi/pdf/10.1177/2055207618771757

Using social media for health research: Methodological and ethical considerations for recruitment and intervention delivery.

Internet-mediated research (IMR) can raise particular, sometimes non-obvious, challenges in adhering to existing ethics principles. In this document we outline some of the key ethics issues which researchers and research ethics committees (RECs) are advised to keep in mind when considering implementing or evaluating an IMR study. Considering each of the four main ethics principles as outlined in the Society's Code of Human Research Ethics, we highlight issues which may need special consideration in an IMR context, using illustrative examples to explain why. These issues include: the public-private domain distinction online; confidentiality and security of online data; procedures for obtaining valid consent; procedures for ensuring withdrawal rights and debriefing; levels of researcher control; and implications for scientific value and potential harm. Emphasis throughout is on offering advice on how to think about and apply existing ethics principles in an IMR context, while recognising that issues need to be assessed and decisions made within the context of a particular piece of research.

Ethics Guidelines for Internet-mediated Research

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Ethics Guidelines for Internet-mediated Research