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Patients’ perspectives on social and goal-based comparisons regarding their diabetes health status
  1. William Martinez1,
  2. Kenneth A Wallston2,
  3. David G Schlundt3,
  4. Gerald B Hickson4,
  5. Kemberlee R Bonnet3,
  6. Ricardo J Trochez1,
  7. Tom A Elasy1
  1. 1 Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2 Vanderbilt University School of Nursing, Nashville, Tennessee, USA
  3. 3 Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
  4. 4 Quality, Safety and Risk Prevention, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Dr William Martinez; william.martinez{at}


Objective Social comparisons (ie, self-evaluation in comparison with others) influence patients’ perspectives of their disease and may impact motivation and health behavior; however, little is known about patients’ perspectives toward receiving such information in a clinical context (eg, from their doctor’s office or health system). This study aims to understand patients’ perspectives and anticipated responses to receiving social comparison information regarding measures of their diabetes-related health status (eg, A1C) and how receiving such information would compare with goal-based comparisons (ie, self-evaluation in comparison with goal).

Research design and methods We conducted semistructured interviews with 25 patients with type 2 diabetes mellitus (T2DM) regarding social and goal-based comparisons involving their diabetes health status and qualitatively analyzed interviews for themes.

Results We identified seven major themes: self-relevance, motivation, self-concept, emotions, information seeking, medical care, and self-care. Participants commonly anticipated increased motivation and improved health behaviors in response to both social and goal-based comparisons. Subthemes unique to social comparisons included belief that this information would be motivating by engaging some patients’ competitiveness, perception that this information was more ‘personalized’ than comparisons with a standard goal (eg, A1C<7), and desire to learn from individuals similar to oneself who were doing better.

Conclusions Our findings provide significant insights into the anticipated response of patients with T2DM to receiving social and goal-based comparison information regarding their diabetes health status. Providing patients with diabetes with social and goal-based comparison information may affect motivation, mood, and self-concept in ways that may improve or sustain diabetes self-care behaviors for some patients.

  • diabetes
  • health behavior
  • social comparison
  • qualitative research

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  • Contributors WM, KAW, and TAE conceived of the study. WM, KAW, DGS, GBH, and TAE designed the study. WM and RJT recruited patients. WM and RJT collected the data. WM, DGS, KRB, and RJT analyzed the data. All authors interpreted the data. WM drafted the manuscript. All authors contributed substantially to its revision. WM takes responsibility for the paper as a whole.

  • Funding This work was supported by NIDDK/NIH K23DK106511 and 2P30DK092986-07 and NCATS/NIH UL1 TR000445.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The Vanderbilt University Institutional Review Board approved this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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