Social Media and Diabetes

Aligning Diabetes Care with the DSRIP Program Using Social Media A title for the campaign that concisely communicates the objective: "Aligning Diabetes Care with the Delivery System Reform Incentive Payment (DSRIP) Program Using Social Media" A policy brief: Approximately half of all New York residents suffer from at least one chronic health disease, including conditions such as obesity, cardiovascular disorders, and diabetes, and these healthcare consumers need ongoing assistance in helping them prevent and better managing these diseases, particularly as treatment regimens and healthcare technologies become increasingly complex (Long, 2016).

This is especially true when it comes to adult diabetes which represents a serious public health threat to the citizens of New York State (NYS) (Ruberto & Brissett, 2012). Indeed, the NYS Department of Health emphasizes that, "Diabetes has become an epidemic that affects one out of every 10 adult New Yorkers. It has become an epidemic that affects one out of every 12 adult New Yorkers" (Diabetes, 2016, para. 1).

Since 1994, the number of people in the state who have diabetes has more than doubled, and it is likely that number will double again by the year 2050 (Diabetes, 2016). The most current statistics indicate that the prevalence of self-reported diabetes among adults in NYS has steadily increased since 2002, and the 3-year moving average has almost doubled during the period from 2007 to 2009 (from 4.6% in 1996-1998 to 8.5% in 2007-2009) (Ruberto & Brissett, 2012).

Based on self-reports, adults aged between the years of 65 and 74 years in NYS currently experience the highest prevalence rate of diabetes and the prevalence rate is higher among lower-income minorities who comprise fully 44% of the total NYS population suffering from this disease today (Ruberto & Brissett, 2012). Because self-reports likely fail to identify all diabetes sufferers, applying national estimates for the period 2005 through 2006 indicate that there are more than an additional three-quarters of a million people aged 20 years and older in NYS state who suffer from undiagnosed diabetes (Ruberto & Brissett, 2012).

A brief description of the different types of diabetes is provided in Table 1 below. Table 1 Overview of diabetes types Type Description Type 1 Diabetes • Cells in the pancreas are damaged leading to a decreased release of insulin. • Cell damage usually leads to a total lack of insulin production. Type 2 Diabetes • Insulin is not used properly by the body, so glucose is not absorbed. • There may be a problem with insulin being secreted by the pancreas. Gestational Diabetes • Diabetes develops during pregnancy.

• Diabetes often resolves after delivery, although these women are at increased risk for development of type 2 diabetes in the future. Prediabetes • The blood glucose level is high, but not high enough to meet the criteria for diabetes. • Prediabetes is a risk factor for future diabetes. Source: Ruberto & Brissett, 2012, p. 5 The costs that are associated with diagnosing and treating adult diabetes are enormous, and current estimates indicate that at least 20% of the national health care budget is spent on treating this disease (approximately $245 billion in 2012 alone) (Diabetes, 2016).

In fact, the NYS Department of Health (DOH) emphasizes that, "The average yearly health care cost for a person with diabetes is $13,700, a cost that is 2.3 times higher than a person without diabetes. Much of the human and financial costs can be avoided with proven diabetes prevention and management steps" (Diabetes, 2016, para. 3). A description of the audience of influence: Because the risk of diabetes increases with age (Ruberto & Brissett, 2012), the audience of influence for this initiative will be comprised of adults aged 55 years and over.

Properly implemented and administered, posts on social media can help raise awareness of the risk of undiagnosed diabetes among this population across the state. In fact, the NYS DOH already maintains a prominent presence on Twitter (https://twitter.com/Healthnygov) and Facebook at https://www.face book.com/NYSDOH/ and has featured numerous posts concerning better eating habits as well as the need for screening tests and management of adult diabetes including risk factors and community-based resources such as workshops.

This communications strategy is highly cost-effective, particularly given the broad-based audience that uses social media platforms today (Curran & Lennon, 2011). Moreover, some of the existing NYS DOH Facebook page features resources that are specifically targeted at older adults, including the post depicted in Figure 1 below. NYSDOH - New York State Health Department March 24, 2015 • If you answer yes, to any of these questions, take the type 2 diabetes test. www.diabetes.org/are-you-at-risk/diabetes-risk-test/ Figure 1.

Representative example of adult diabetes information featured on NYS DOH Facebook page Source: https://www.facebook.com/NYSDOH/ A desired outcome: The desired outcome of this initiative would be a statistically significant reduction in the adverse health care consequences that can result from undiagnosed diabetes as shown in Figure 2 below consistent with the NYS DOH's Prevention Agenda Toward the Healthiest State initiative, primarily using the NYS DOH's Facebook platform since more older adults use this social media than Twitter (King, 2015). Figure 2.

Objectives of NYS DOH's Prevention Agenda Toward the Healthiest State initiative for reducing undiagnosed diabetes Source: Ruberto & Brisette, 2012, p. 7 At present, diabetes is the main cause of kidney disease, amputations and new cases of blindness and the disease can exacerbate other conditions such as cardiovascular disease, heart disease and stroke which are the leading causes of death in the United States today (Diabetes,.