title: The Online Big Blue Test for Promoting Exercise: Health, Self-Efficacy, and Social Support.
abstract: BACKGROUND
  Recent articles have documented the influence of self-efficacy and social support on exercising. Simultaneously, insulin use is also related to the perception of self-efficacy and social support in patients with diabetes. We combine these two ideas through the Big Blue Test experience in a social networking site and propose to analyze whether a change in blood sugar levels after completion of the Big Blue Test and insulin use are related to the perception of self-efficacy and social support in patients with diabetes.
  
  
  METHODS
  To undergo the Big Blue Test, 3,926 participants voluntarily joined the Diabetes Hands Foundation. Responses were analyzed using descriptive analysis.
  
  
  RESULTS
  The participants who reduced their blood glucose after exercise the least were those with lower self-efficacy and also with lower perceived social support. There seems to have been no relationship between changes in blood sugar level and the explicit intention of doing exercise in the future. Insulin-dependent participants demonstrated a lower perception of self-efficacy and social support than non-insulin-dependent participants.
  
  
  CONCLUSIONS
  Change in blood glucose level or being insulin-dependent or not do not explain completely a health behavior such as exercise. Hence, self-efficacy and social support have an impact on behavioral change such as exercise to become a habit in people with diabetes, and this experience through a social networking site is an important tool for this behavioral change. For exercise to become a habit in people with diabetes, it is necessary to consider not only the crucial physiological variables, but also those psychological variables that clearly have an impact on behavioral change.
authors.affiliation: 1 Department of Psychology, Open University of Catalunya , IN3, Barcelona, Spain .
authors.forename: Beni
authors.initials: B
authors.lastname: Gómez-Zúñiga
authors.affiliation: 1 Department of Psychology, Open University of Catalunya , IN3, Barcelona, Spain .
authors.forename: Modesta
authors.initials: M
authors.lastname: Pousada
authors.affiliation: 2 Diabetes Hands Foundation , Berkeley, California.
authors.forename: Manny M
authors.initials: MM
authors.lastname: Hernandez
authors.affiliation: 3 Human Movement Sciences Department, Old Dominion University , Norfolk, Virginia.
authors.forename: Sheri
authors.initials: S
authors.lastname: Colberg
authors.affiliation: 4 Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway , Tromsø, Norway .
authors.forename: Elia
authors.initials: E
authors.lastname: Gabarrón
authors.affiliation: 1 Department of Psychology, Open University of Catalunya , IN3, Barcelona, Spain .
authors.forename: Manuel
authors.initials: M
authors.lastname: Armayones
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose
keywords: behavioral health; e-health; home health monitoring; technology