Abstract
INTRODUCTION: Relatively little is known about how Facebook groups are used to facilitate diabetes self-management support. This study provides a critical analysis of public diabetes Facebook groups and their content. METHODS: Two trained researchers independently identified 34 public Facebook diabetes groups. A coding and classification scheme was applied to the 20 most recent "wall posts" within 15 of the 34 (44.1%) largest groups (n = 300 posts). Nonparametric Mann-Whiney U tests examined differences in group characteristics between groups with more (active) and less (inactive) than 50 posts in the past month. Multivariable logistic regressions evaluated associations between group purpose, post types, membership (engagement leader vs regular user), and modality. RESULTS: We identified 193 458 members of the 34 largest diabetes Facebook groups (Mdn size = 3124 members, IQR = 1298-8523 members). Many groups (20/34, 58.8%) were created to provide instrumental support, while fewer (12/34, 35.8%) aimed to provide emotional support. Nutrition was the only diabetes self-management topic addressed in more than 30% of posts (n = 107). Posts made by engagement leaders were almost five times more likely to appear within inactive compared to active groups. DISCUSSION: Diabetes Facebook groups are used to share both information and emotional support, with greater emphasis placed on sharing information about nutrition. While engagement leaders should theoretically increase the credibility of online forums, frequent posts by group engagement leaders may actually lead to group decay. Health and diabetes educators should consider how to more effectively leverage social media engagement leaders to disseminate valid health information on diabetes self-management.