Second Life Provides Unique Approach to Diabetes Education and Management

Monday, August 16 2010

Written by Bill Loftus

COEUR D'ALENE, Idaho – SeAnne Safaii-Fabiano, a University of Idaho food and nutrition specialist at Coeur d'Alene, hopes the global blockbuster "Avatar" will help her quest to teach young people better diabetes management in a virtual world.

"Avatar" the movie drew viewers into a virtual world and made them care about issues one step removed from reality.

Safaii-Fabiano, assistant professor of food and nutrition, and her research team are setting out to tackle real-life diabetes issues among young people using avatars, or virtual stand-ins chosen by the user in the online world of Second Life by creating a virtual diabetes center.

Partnering with the Humphrey's Diabetes Center in Boise and Brian Cleveley, University of Idaho College of Art and Architecture senior lecturer and program coordinator of virtual technology and design, Safaii-Fabiano will use the virtual world of Second Life to explore new ways to reach 18- to 28-year olds with diabetes.

She hopes the assumed virtual identities and participation in a virtual social networking forum will help encourage young adults to learn and practice better diabetes management.

"Avatars are really trendy right now so we're feeling lucky to have this hit at the right time even though we started working on this grant more than a year ago," Safaii-Fabiano said.

Five years ago, she earned her doctorate from the University of Idaho based on research on feeding school age children in group settings, a strength of the Margaret Ritchie School of Family and Consumer Sciences in the College of Agricultural and Life Sciences. She joined the college faculty at Coeur d'Alene in 2008 because of its expertise is in child nutrition and dietetics.

Young adults in particular are typically hard to reach for diabetes counselors and educators. As they transition from pediatric care to adult care, young adults tend to drop off the radar in terms of care and meeting with care providers. A consequence is the young men and women with diabetes often rely on each other for information, some of it inaccurate.

The result can be tragic. "We are seeing more young people in Idaho die because of diabetes-related causes that proper care could have prevented," Safaii-Fabiano said.

Funded by a nearly $1 million grant from the National Institutes of Health, the research team will begin working with focus groups this month to develop the virtual diabetes center.

The goal is to help and encourage young adults to use the diabetes self-management counseling and education provided by the Humphrey's Diabetes Center.

Young people navigating the transition to adulthood rely less on their families and traditional health care while changing where they live, eat, go to school, work and recreate.

Adapting diabetes management counseling to the virtual world will take some doing, Cleveley said. "We're going to teach people to live and play in the virtual world. We will assist them in feeling comfortable while inhabiting a virtual world."

The virtual diabetes counseling will include group sessions where avatars will share their experiences with avatar counselors, nurses, dietitians, physicians and other avatar participants. They will participate in online chats; counseling sessions and educational forums. Only those participating in the study will have access to the virtual world.

Trying to keep those group sessions true to real life will pose interesting challenges. Safaii-Fabiano said psychologists and counselors often look at body language during group sessions to help them understand the individual's comments and that absence will be one of the interesting aspects of the work. "Avatars don’t have a lot of expression and their body movements are limited," she noted.

But Cleveley noted that the speech and wording in Second Life will help compensate for physical limitations. "We're learning how to use other senses to more acutely note frustration with educational content," he said.

Another interesting aspect of the virtual world, according to Safaii-Fabiano, is that users can design their own avatars, helping provide a sense of sense of anonymity. "You can be 6 feet 3 inches or 5 feet 1 inch tall, or green, blue, orange, brunette, blonde, etc," she said. "In real life, many people with type 2 diabetes are overweight. In Second Life, they can be whomever they want to be and have more confidence in talking about issues."

In the larger world of social media, and particularly in computerized health care, privacy concerns will be a major focus. "That's going to be one of the hot button issues. One of the first questions will be, 'What about privacy?'" she noted.

Challenges aside, the project's promise is finding ways to get critical health care information to young adults even if it means delivering it virtually. Safaii-Fabiano said, "I'm really excited about this because it has never been done before and I think it will be good for the university and for Idaho."
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About the University of Idaho
Founded in 1889, the University of Idaho is the state’s flagship higher-education institution and its principal graduate education and research university, bringing insight and innovation to the state, the nation and the world. University researchers attract nearly $100 million in research grants and contracts each year; the University of Idaho is the only institution in the state to earn the prestigious Carnegie Foundation ranking for high research activity. The university’s student population includes first-generation college students and ethnically diverse scholars. Offering more than 130 degree options in 10 colleges, the university combines the strengths of a large university with the intimacy of small learning communities. The university is home to the Vandals, the 2009 Roady’s Humanitarian Bowl champions. For information, visit

About the University of Idaho
The University of Idaho helps students to succeed and become leaders. Its land-grant mission furthers innovative scholarly and creative research to grow Idaho's economy and serve a statewide community. From its main campus in Moscow, Idaho, to 70 research and academic locations statewide, U-Idaho emphasizes real-world application as part of its student experience. U-Idaho combines the strength of a large university with the intimacy of small learning communities. It is home to the Vandals. For information, visit