Computer-mediated Support Groups Research Articles

Understanding Computer-Mediated Support Groups: A Revisit Using a Meta-Analytic Approach

ABSTRACTThe increasing popularity of computer-mediated support groups (CMSGs) has drawn scholarly attention in recent decades. Fifteen empirical controlled studies have been published since Rains and Young’s meta-analysis, showing mixed results, with a large variation of effect sizes ranging from −.77 to 1.33 in Cohen’s d. To provide a better understanding of CMSGs, the current study meta-analyzed these 15 newly published studies along with the studies included in Rains and Young’s meta-analysis, and tested study design and demographic moderators that have not been examined before. In addition, the study also revisited group size as a moderator and provided updated results with a larger sample size. Theoretical and practical implications of findings are discussed.

Computer/Online-Mediated Social Support for Cancer-Related Fatigue

Fatigue is a pervasive symptom in individuals with cancer that is often underrecognized and undertreated by health care providers. Contrasted with the sparse data in support of pharmacologic interventions for the management of cancer-related fatigue, the literature for nonpharmacologic interventions is vast. In particular, support groups have proven beneficial. Limited access, transportation issues, and unwillingness to share in a public forum represent just a few of the barriers to more widespread participation in face-to-face support groups. Millions of people with cancer rely on the Internet to gain information regarding their diagnosis and to validate their cancer experience. Tapping into this wealth of online information is an obvious avenue for patients with cancer-related fatigue to seek support. This article explores online- and computer-mediated support groups for fatigue.

Weak-Tie Support Network Preference, Health-Related Stigma, and Health Outcomes in Computer-Mediated Support Groups

Although computer-mediated support groups have been argued to be beneficial for individuals coping with health-related stigma, few studies have explored how communication processes may moderate perceptions of stigma and health outcomes. Increasing our understanding of the relationships among these variables may help to inform social support interventions for individuals facing stigmatized health issues. Drawing from the optimal matching model, the reported study examined the relationships among strong-tie/weak-tie support network preference and health-related stigma for stress and depression among members of health-related computer-mediated support groups. The results indicated that health-related stigma was positively associated with preference for weak-tie support, and preference for weak-tie support was found to moderate the relationship between stigma and both stress and depression. The implications of the findings for the role of on-line weak-tie network supportive relationships in reducing stigma and its application to developing support-focused health interventions and segmenting potential intervention participants are discussed.

Weak Tie Support Preference and Preferred Coping Styles as Predictors of Perceived Credibility Within Health-Related Computer-Mediated Support Groups

Drawing upon an optimal matching model framework, this study examined weak tie support preference and coping style as predictors of credibility perceptions among members of health-related computer-mediated support groups. One hundred and thirty-five participants from various health-related online support groups responded to a survey questionnaire. The results indicated that increases in weak tie support network preference and problem-focused coping scores predicted increases in perceptions of credibility of online support group members. However, emotion-focused coping was not a significant predictor of perceived credibility. The implications of these findings for weak tie support network, coping, and credibility theories are discussed along with limitations of the study and directions for future research.

Computer-mediated and face-to-face communication in metastatic cancer support groups

To compare the experiences of women with metastatic breast cancer (MBC) in computer-mediated and face-to-face support groups. Interviews from 18 women with MBC, who were currently in computer-mediated support groups (CMSGs), were examined using interpretative phenomenological analysis. The CMSGs were in an asynchronous mailing list format; women communicated exclusively via email. All the women were also, or had previously been, in a face-to-face support group (FTFG). CMSGs had both advantages and drawbacks, relative to face-to-face groups (FTFGs), for this population. Themes examined included convenience, level of support, intimacy, ease of expression, range of information, and dealing with debilitation and dying. CMSGs may provide a sense of control and a greater level of support. Intimacy may take longer to develop in a CMSG, but women may have more opportunities to get to know each other. CMSGs may be helpful while adjusting to a diagnosis of MBC, because women can receive support without being overwhelmed by physical evidence of disability in others or exposure to discussions about dying before they are ready. However, the absence of nonverbal cues in CMSGs also led to avoidance of topics related to death and dying when women were ready to face them. Agendas for discussion, the presence of a facilitator or more time in CMSGs may attenuate this problem. The findings were discussed in light of prevailing research and theories about computer-mediated communication. They have implications for designing CMSGs for this population.

Adolescents Living with Cancer

The present study sought to explore the types of social support being provided to adolescents with cancer accessing a computer-mediated support group. Three hundred and ninety-three messages posted to a computer-mediated support group aimed at adolescents with cancer were coded for instances of informational and emotional support and then subjected to thematic analysis. Analysis revealed frequent instances of both informational and emotional support provision and sub-themes included 'treatment concerns', 'losing friends' and 'struggling with school'. Adolescents were also found to be frequently accessing the group to make requests for social support. It is concluded that health professionals need to tailor the services they provide to adolescent patients more appropriately.

Weak-Tie Support Network Preference and Perceived Life Stress Among Participants in Health-Related, Computer-Mediated Support Groups

The study reported here examines characteristics of weak-tie support network preference among members of health-related computer-mediated support groups. Drawing on weak-tie support network theory and socioemotional selectivity theory, participants' age and health condition were assessed as predictors of weak ties support network preference. Relationships between the dimensions of weak-tie support network preference and perceived stress also were evaluated. The results demonstrated that age was negatively associated with a preference for weak-tie support, and that participants not facing a terminal illness were more likely than those preferring a terminal illness to prefer weak-tie support. The objective utility and greater-perceived-risks dimensions of weak-tie support network preference were significant predictors of perceived stress. The implications of these findings for health communication interventions are discussed.

Individuals With Eating Disorders and the Use of Online Support Groups as a Form of Social Support

The increase in Internet use in recent years has fostered the development of online support groups to help individuals cope with a number of conditions. Individuals with eating disorders may particularly benefit from such groups as they provide a means of sharing experiences, knowledge, and support with like-minded individuals without the anxiety and worry of others negatively evaluating their appearance. The aim of this study was to examine the nature and types of social support that took place on an anorexia discussion forum. The deductive thematic analysis of 325 messages indicates that the primary function of the group was the communication of encouragement and esteem and information support notably in terms of diagnosis, treatment, and interaction with healthcare specialists. Considering the high rate of relapse among individuals with eating disorders, it is imperative that some form of support is available when they leave treatment centers. Regulated computer-mediated support groups provide a low-cost, easily accessible self-help service to individuals with eating disorders.

A conceptual framework for electronic socio-emotional support for people with special needs

In recent years an increasing number of people under psychological distress turn to computer-mediated communication for support. A related development is the increasing number of computer-mediated support groups in which people meet, share interests, and exchange socio-emotional support through text-based messages on computer networks. To date, a few policy makers and researchers have addressed the phenomenon of social-emotional support through electronic communication for populations with special needs. This paper presents a conceptual framework developed to characterize an electronic socio-emotional support process for people with special needs. The electronic socio-emotional support framework is based on a review of the literature as well as the results of a pilot study, which examined the use of an electronic mentoring intervention program based on mutual self-disclosure and friendship between mentors and youth with special needs. The implications of the electronic socio-emotional support framework for people with special needs are discussed.

A Meta-Analysis of Research on Formal Computer-Mediated Support Groups: Examining Group Characteristics and Health Outcomes

This article reports a meta-analysis of 28 studies examining the health-related outcomes associated with participation in a formal computer-mediated support group (CMSG) intervention. In particular, health outcomes related to social support were assessed and four group-level characteristics of CMSGs were tested as potential moderators of intervention effectiveness. The results show that participating in a CMSG intervention—comprised of educational and group communication components—led to increased social support, decreased depression, increased quality of life, and increased self-efficacy to manage one's health condition. Changes in health outcomes were moderated by group size, the nature of the communication channels available, and the duration of the CMSG intervention.

Computer‐Mediated Support Group Intervention for Parents

The purpose of this study was to evaluate the feasibility of a computer-mediated support group (CMSG) intervention for parents whose children had been diagnosed with cancer. An evaluative one-group, before-and-after research design. A CMSG, an unstructured listserve group where participants used their E-mail for communication, was conducted over a 4-month period. Participation in the CMSG was offered to parents in Iceland whose children had completed cancer treatment in the past 5 years. Outcome measures were done: before the intervention (Time 1), after 2 months of intervention (Time 2) and after 4 months of intervention (Time 3) when the project ended. Measures included: demographic and background variables; health related vulnerability factors of parents: anxiety, depression, somatization, and stress; perceived mutual support; and use of the CMSG. Data were collected from November 2002 to June 2003. Twenty-one of 58 eligible parents participated in the study, with 71% retention rate for both post-tests. Mothers' depression decreased significantly from Time 2 to Time 3 (p<.03). Fathers' anxiety decreased significantly from Time 1 to Time 3 (p<.01). Fathers' stress decreased significantly from Time 2 to Time 3 (p<.02). To some extent, mothers and fathers perceived mutual support from participating in the CMSG. Both mothers and fathers used the CMSG by reading messages. Messages were primarily written by mothers. Study findings support further development of CMSGs for parents whose children have been diagnosed with cancer. Using computer technology for support is particularly useful for dispersed populations and groups that have restrictions on their time. Computer-mediated support groups have been shown to be a valuable addition to, or substitute for, a traditional face-to-face mutual support group and might suit both genders equally.

Relationships Among Caregivers' Demographic Characteristics, Social Support Ratings, and Expectations of Computer-Mediated Support Groups

Computer-mediated support groups (CMSG) for family caregivers are proliferating; however, actual social support needs of potential CMSG users and their expectations regarding CMSG use have not been studied. The authors used path analysis to investigate how the responses of 118 family caregivers to scales measuring the importance to them of four dimensions of social support (CASS-I), their expectations regarding three dimensions of CMSG technology (CATS-E) and their demographic characteristics were interrelated. Caregiver gender and race were related to two of four CASS-I scores; caregiver education, gender, and race were directly related to two of the three CATS-E scores; and gender and race also were indirectly related to two of three CATS-E scores through their impact on CASS-I scores. Results suggest that CASS-I and CATSE assessments might be helpful in customizing CMSG to meet particular subgroup needs, in understanding and influencing patterns of CMSG use, and in evaluating impacts of CMSG use.

Effects of Insightful DisclosureWithin Computer Mediated Support Groupson Women With Breast Cancer

Written expression about emotionally traumatic events is associated with physical and mental health benefits, and this study examines how insightful disclosure within a computer-mediated support group for women with breast cancer affects breast cancer-related concerns, emotional well-being, and self-reported physical well-being. Using a word counting program that notes the percentage of words related to various linguistic dimensions, this research specifically examined the effects of insightful disclosure written within these groups. Surveys were administered just before group access and then 2 months and 5 months later. Insightful disclosure improved emotional well-being and reduced negative mood but did not influence breast cancer-related concerns or self-reported physical well-being. Despite the common and frequent use of computer-mediated social support (CMSS) groups for people coping with health concerns, very little research to date has quantitatively tested the effects of participating in CMSS groups, and this is among the first published studies to quantitatively link any specific activity within a CMSS group to any specific outcomes. Implications for improving psychosocial interventions for people with health concerns are discussed, and future research objectives are suggested.

How Underserved Breast Cancer Patients Use and Benefit From eHealth Programs

This article consolidates insights from 15 years of research examining howthe medically underserved use and benefit from an eHealth program, the Comprehensive Health Enhancement Support System (CHESS). The authors outline results from early feasibility tests to determine if the underserved would use CHESS. Distinctive behaviors of underserved populations who have used CHESS are reported with a focus on how online health information and computer-mediated support groups are used. The article then reports on how the underserved benefit from using CHESS. Best practice recommendations for recruitment and training the underserved are offered, and implications for closing the digital divide are discussed.

Receiving Social Support Online: An Analysis of a Computer-Mediated Support Group for Individuals Living with Irritable Bowel Syndrome

In recent years, the rapid expansion in Internet access and computer-mediated communication has fostered new opportunities for individuals with health-related concerns to participate in supportive communication within a network of individuals dealing with similar issues. The aim of this study was to examine the nature of socially supportive communication that took place within a computer-mediated support network for individuals affected by irritable bowel syndrome. Using deductive thematic analysis, 572 posted messages were examined with reference to five main categories of social support (i.e., emotional, esteem, information, network, and tangible assistance). The analysis suggests that the primary function of this group was the communication of informational support, notably within the areas of symptom interpretation, illness management, and interaction with health care professionals.

AA online: the enactment of supportive Computer Mediated Communication

This study compared self‐presentation and other‐orientation behaviors and interaction patterns in three types of online AA groups (i.e., asynchronous discussions, formal synchronous AA meetings, and informal chats) to the behaviors and interaction patterns in other computer mediated support groups and computer mediated nonsupport (interest) groups. Results showed AA groups differed somewhat from other support groups and support groups differed from nonsupport interest groups. Asynchronous AA discussions had the highest proportion of semi‐private and private‐personal self‐presentations, agreements, and personal acceptance. Private‐personal disclosures also tended to be followed by personal acceptance. Formal synchronous AA meetings were characterized by reciprocity of private personal disclosure and informal chats between recovering alcoholics were characterized by reciprocity of personal acceptance. AA groups in particular and support groups in general engaged in fewer negative comments, and opinion disclosures were not as likely to evoke negative responses as in nonsupport interest groups. Results supported Walther's (1996) hyperpersonal model and the supportive character of online AA groups. Overall there was reciprocity of self‐presentation and other‐orientation, and self‐presentation codes predicted the nature of other‐orientation responses.

Health-related Support Groups on the Internet: Linking Empirical Findings to Social Support and Computer-mediated Communication Theory

This literature review of research on health-related computer-mediated support groups links features of these groups to existing theory from the areas of social support and computer-mediated communication research. The article exams computer-mediated support groups as weak tie networks, focuses on how these support groups facilitate participant similarity and empathic support and identifies changes in supportive communication due to characteristics of the medium.

Experiences of Women with Breast Cancer: Exchanging Social Support over the CHESS Computer Network

Using an existential¨phenomenological approach, this paper describes how women with breast cancer experience the giving and receiving of social support in a computer-mediated context. Women viewed their experiences with the computer mediated support group as an additional and unique source of support in facing their illness. Anonymity within the support group fostered equalized participation and allowed women to communicate in ways that would have been more difficult in a face-to-face context. The asynchronous communication was a frustration to some participants, but some indicated that the format allowed for more thoughtful inter action. Motivations for seeking social support appeared to be a dynamic process, with a consistent progression from a position of receiving support to that of giving support. The primary benefits women received from participation in the group were communicating with other people who shared similar problems and helping others, which allowed them to change their focus from a preoccupation with their own sickness to thinking of others. Consistent with past research is the finding that women in this study expressed that social support is a multidimensional phenomenon and that their computer-mediated support group provided abundant emotional support, encouragement, and informational support. Excerpts from the phenomenological interviews are used to review and highlight key theoretical concepts from the research literatures on computer-mediated communication, social support, and the psychosocial needs of women with breast cancer.

Computer-Mediated Peer Support of Consultation: Case Description and Evaluation

In this article we describe the design, implementation, and outcomes of a computer-mediated peer support group. Four school psychologists used an enhanced version of electronic mail (e-mail) referred to as groupware. The purpose of the e-mail messages was to provide two of the school psychologists with support in regard to their consultations with teachers. During the 15-week project, the school psychologists exchanged 65 e-mail messages. Their perceptions of the learning and social outcomes of the group were assessed. The school psychologists indicated that the majority of the messages contributed to their becoming more knowledgeable about consultation and knowing what support to offer the other school psychologists. Overall, the computer-mediated group experience seemed to meet or exceed the school psychologists' preproject high expectations in regard to learning about classroom-based interventions and receiving social support. Moreover, they also perceived their computer-mediated group to be highly cohesive.

Online Help: Cancer Patients Participate in a Computer-Mediated Support Group

This study investigated a computer mediated support group of six breast cancer patients. For a three-month period, patients used home computers to connect to a computer bulletin board on which they read messages from and posted messages to each other. The patients had no difficulty learning to use the computer and used it an average of one hour a week. The patients discussed their medical conditions, shared personal concerns, and offered support. This online approach provided many features of traditional face-to-face support groups.