The Role of Digital Media in Chronic Disease Self-Management: Protocol for a Multimethod Study of the DISELMA Research Consortium

Rossmann, C.; Karnowski, V.; Metag, J.; Raupp, J.; Reifegerste, D.; Riesmeyer, C.; Sawalha, N.; Lux, A.; Esser, A.-L.; Kammerer, R.; Singh, F.; Rödel, N.; Brill, J.; Gerling, E.; Wiedicke, A.

Abstract

Background: Chronic diseases, such as type 1 and type 2 diabetes, asthma, and chronic obstructive pulmonary disease , demand long-term treatment and permanent adaptation. One important pillar in coping with these diseases is individuals’ self-management, including support from digital media. Research on their effects confirms their potential. However, it is flawed by theoretical underdevelopment and methodological weaknesses, such as a focus on short-term effects, single digital features, and microlevel studies. Objective: The research unit (RU) DISELMA (“Digital Media in Chronic Disease Self-Management”) aims to examine the continued use patterns and effects of the digital self-management of chronic diseases, as well as the role of the interpersonal, organizational, and societal levels to gain a comprehensive picture of the individual processes, their contextual embeddedness, and cross-level interactions. Methods: To fully capture the manifold multilevel influences, the RU comprises 6 individual projects (IPs), each of which conducts several studies. Two projects at the individual level analyze determinants of use, usage patterns, and effects of digital media, combining systematic reviews, experience sampling method studies, focus groups, panel surveys, and content analysis of apps used. Two projects examine the interpersonal context by analyzing the role of health care providers and the diffusion of digital media in informal networks, conducting a scoping review, online surveys with physicians, semistructured interviews, and participant observations of physician-patient dyads, patient focus groups, and interviews with peers. One project aims to analyze the role of organizations within the mobile health market by conducting a content analysis of organizational messages and a survey. Finally, one project analyzes journalistic and social media to gain insight into the discourses about digital chronic disease self-management on the societal level. Results: The RU received funding approval from the Deutsche Forschungsgemeinschaft (German Research Foundation; grant 456132969) in July 2023, and the 4-year funding period ranges from December 2023 to November 2027. IP1 is currently conducting its systematic reviews and experience sampling method studies, both to be finalized in 2026. IP2 is conducting its systematic review and meta-analysis alongside panel surveys until June 2026. IP3 has completed its online survey with physicians and is currently conducting observations until August 2026. IP4 is conducting its scoping review and peer interviews through 2026, while IP5 is working on its content analysis and survey, and IP6 on its manual content analysis. First publications of the results are expected in 2026. Conclusions: The results will contribute to the existing research through a theoretically and methodologically comprehensive approach that improves our understanding of the processes within and between all levels. These insights will inform providers of digital health solutions and health care practitioners about users’ needs, advance evidence-based disease self-management programs, and contribute to better coping with chronic diseases, improved well-being of affected individuals, and reduced health care costs