Support Forums Research Articles

Development of a first intervention for tobacco cessation for sexual and gender minority individuals in Romania

Abstract Background Data on tobacco use among SGM in Romania indicate high use rates, yet tailored smoking cessation efforts do not exist. We collected data from SGM individuals in Romania on tobacco use and cessation attitudes, facilitators and barriers to quitting, and intervention components acceptability to inform the first smoking cessation intervention for SGM in Romania, adapted from a U.S.-based intervention with mobile app support. Methods SGM individuals (≥ 18 years old, current smokers) recruited through community outreach in March 2024 completed a brief assessment and participated in a focus group regarding tobacco use, attitudes, norms, risks knowledge, facilitators and barriers to quitting, and intervention acceptability. Results Focus groups were held with 36 participants characterized as 45% cis male, 40% gender-diverse, 15% cis female; 40% gay, 33% bisexual, 10% queer, 8% pansexual; 6% lesbian, 3% heterosexual; M age=27, SD = 7.62. 70% smoked daily; median age of first cigarette was 17. Participants reported smoking up to 2 packs a day, with 50%-98% of people in their circles being smokers. Common reasons for smoking included to alleviate stress and “fit in.” Most did not receive support to quit from their social circles or within healthcare. While smoking was communal, quitting was individual and siloed, suggesting a preference for a group-based intervention, along with robust strategies to replace the function of smoking with adaptive habits. The app was evaluated positively, especially for its daily smoking tracking, reminders for alternative healthy activities, positive achievements, and forum for support. Conclusions Findings provide a solid platform for creating a first smoking cessation intervention for SGM individuals in Romania. Next steps include iterative testing of the mobile app to examine comprehension, usability, and satisfaction with content and functionality, in preparation for a randomized controlled trial testing the intervention’s efficacy.

Examining support marshalling within an asynchronous online peer support forum for individuals affected by dementia.

Online support communities may provide individuals affected by dementia opportunities for reciprocal peer support, however, the support marshalling strategies employed and their success remain unclear. Analysis of 100 randomly selected conversation threads from the Dementia Support Forum indicated that 29% (29/100) of opening posts included a direct support marshalling strategy (i.e. explicit support request) compared with 54% (54/100) labelled as indirect, with the remainder not seeking support. Within the direct marshalling posts, informational support was the most frequently requested (n = 23), followed by network support (n = 7), emotional support (n = 5) and esteem support (n = 1) with analysis of subsequent posts confirming that the types of support requested were present within responses. Regardless of whether a direct or indirect strategy was used, most posts received a response, typically on the same day. Other response facets were comparable, apart from thread duration with conversations elicited through a direct strategy being longer (M = 39.71 vs 14.62 days).

Illness experience and (unmet) needs of women with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH): a qualitative analysis of an online forum

Objective Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a congenital condition characterized by the underdevelopment or complete absence of the uterus and the upper part of the vagina. Diagnosis is commonly made during adolescence, a sensitive period for psychophysical development, following the absence of menstruation. Having MRKH syndrome can have a profound and multifaceted psychosocial impact that characterizes these women’s subjective experiences, although it continues to be qualitatively understudied. This article explores the lived experience of women with MRKH spontaneously recounted on an online support forum. The aim was to gain insight into the features of the syndrome experience to understand deeply the emotional and social impact of the condition and the individual needs expressed online. Methods Using a naturalistic observation stance, data was collected from an online support forum for MRKH women and systematically analyzed using thematic analysis. Results Four main interconnected themes are identified: the impact of being diagnosed with MRKH, the difficult interaction with the medical environment, challenging social relationships, and the unmet needs of MRKH women. Conclusion A multidisciplinary and person-centered approach that provides effective and sensitive management of the condition and its psychosocial implications, is essential. Recommendations for future research and practical clinical implications for healthcare professionals are proposed.

Work-family interface during COVID-19: a sociolinguistic study of working mums’ identity and mental health

BackgroundThe dramatic reconfigurations of work-family roles and social boundaries resulting from the social restrictions imposed during the Covid-19 pandemic led working mums to look for online sites as spaces of emotional support and regulation where they could vent their emotions, share their concerns and griefs, and seek advice. They also became interactional spaces where mums’ relevant identities were reassessed and enacted as they aimed to balance work-family roles and improve their wellbeing. The paper explores how working mums discursively negotiated their multiple identities in an online support forum during times of global struggle, how these identity constructions reflect the domains of Work-Family Conflict (WFC) and how working mums perceived these identities are related to their mental health.Methods127 posts of Chilean working mums published in a public online support forum for working mums collected during the first half of 2020 were analysed in three phases. The first one involved a thematic analysis to identify themes and subthemes related to working mums’ identity construction in the data. The second phase involved conducting a narrative analysis of working mums’ microstorias in order to identify a master narrative crafted by these working mums, and contesting and conforming ideologies of motherhood, among others. Finally, the third phase involved a fine-grained discourse analysis of the most representative extracts illustrating working mums’ identity negotiation.ResultsThe sociolinguistic analysis showed that working mums’ discourses displayed three themes of self-reflection, namely, diminishing self-care, reassessing their self, and enhancing self through self-care. Identity-related sub-themes for each main theme are discussed and discursively analysed. Two main points are emphasised: (1) the identity that was most salient in working mums’ discourse was their personal identity (rather than work-family roles and identities), and (2) microstorias allowed working mums to challenge the hegemonic power of dominant discourses around their identities and their work-family roles.ConclusionsThe study shows that a sociolinguistic approach to the exploration of working mums’ identity negotiation is useful to highlight the ways in which mums contest binary assumptions of work-family roles and the need to reconsider working mums’ life domains so that they reflect working mums’ actual identity needs and lived experiences. Future lines of research are outlined.

Service Users' Experiences of a Nationwide Digital Type 2 Diabetes Self-Management Intervention (Healthy Living): Qualitative Interview Study.

Diabetes Self-Management Education and Support programs for people living with type 2 diabetes mellitus (T2DM) can increase glycemic control and reduce the risk of developing T2DM-related complications. However, the recorded uptake of these programs is low. Digital self-management interventions have the potential to overcome barriers associated with attendance at face-to-face sessions. Healthy Living is an evidence-based digital self-management intervention for people living with T2DM, based on the Healthy Living for People with Type 2 Diabetes (HeLP-Diabetes) intervention, which demonstrated effectiveness in a randomized controlled trial. NHS England has commissioned Healthy Living for national rollout into routine care. Healthy Living consists of web-based structured education and Tools components to help service users self-manage their condition, including setting goals. However, key changes were implemented during the national rollout that contrasted with the trial, including a lack of facilitated access from a health care professional and the omission of a moderated online support forum. This qualitative study aims to explore service users' experiences of using Healthy Living early in the national rollout. A total of 19 participants were interviewed via telephone or a videoconferencing platform. Topics included users' experiences and views of website components, their understanding of the intervention content, and the overall acceptability of Healthy Living. Transcripts were analyzed thematically using a framework approach. Participants valued having trustworthy information that was easily accessible. The emotional management content resonated with the participants, prompting some to book an appointment with their general practitioners to discuss low mood. After completing the structured education, participants might have been encouraged to continue using the website if there was more interactivity (1) between the website and other resources and devices they were using for self-management, (2) with health professionals and services, and (3) with other people living with T2DM. There was consensus that the website was particularly useful for people who had been newly diagnosed with T2DM. Digital Diabetes Self-Management Education and Support programs offering emotional aspects of self-management are addressing an unmet need. Primary care practices could consider offering Healthy Living to people as soon as they are diagnosed with T2DM. Participants suggested ways in which Healthy Living could increase interaction with the website to promote continued long-term use.

The role of social media as a source of academic information for students

Background of the study: Social media has a huge impact on students' lives. Social media as a means to view and obtain information. This makes social networking sites very interesting sites and allows for a place to share and also a source of information Purpose: Analyze the role of social media as a means of disseminating academic information for students at the IAIN Kerinci. Method: This research is a type of qualitative research with a case study approach. Data management and data analysis include analyzing and investigating data, grouping data, selecting and classifying what will be processed, searching for and finding patterns. Findings: The impact of social media on users includes building social relationships, increasing interest in economic activities, providing a relaxing effect through entertainment functions, as a means of self-actualization. The role of social media is also very significant for IAIN Kerinci students, apart from being a source of academic information as well as a forum for academic support, learning and as a means of academic communication. Conclusion: The use of social media has become a large source of academic information for IAIN Kerinci students, but it has not yet been utilized significantly for the development of academic quality.

Designing a Mentorship Program for APRNs in Specialty Palliative Care Practice.

As advanced practice registered nurses (APRNs) enter practice, support is crucial for success. Formal mentorship has been shown to improve employee turnover, job satisfaction, and clinical competence. In the wake of the COVID-19 pandemic, an APRN team specializing in palliative care experienced an unprecedented rate of staff turnover. As a result, the team decided to create a formal mentorship program to support newly hired colleagues and assist their transition to practice. A subcommittee of APRNs within the palliative care practice met to establish a mentorship practice framework, expectations for the program, and a methodology for matching mentors and mentees. The mentorship program was implemented with two cohorts comprising a total of five mentors and six mentees. It was evaluated by participants using surveys asking open-ended, qualitative questions. Both mentors and mentees reported finding the program valuable. Mentees felt the program helped their transition to practice, created a forum for peer support, and improved their clinical competence. Mentors said the program furthered their own professional development, advanced their clinical growth, and fostered a connection to colleagues. Employee engagement and alignment improved, and staff turnover decreased. Further work is needed to improve on the program framework and analyze the outcomes of mentorship.

A qualitative exploration of online forums to support resilience of rural young people in Australia.

Prevention and early intervention are crucial strategies for improving young people's mental health and well-being. Building resilience is a key component of these strategies, especially among young individuals in rural areas who face well-documented mental health disparities. This study aimed to investigate how online mental health forums can contribute to enhancing individual resilience in young rural users. A sample of forum posts (n = 1,000) made by Australian rural users (18-25 years) on an online peer support mental health forum were qualitatively analyzed. The analysis was guided by themes derived from the literature on indicators of rural resilience. Analysis of forum posts showed evidence of rural resilience in forum users. Online peer support forums offered a virtual space for individuals to establish social connections, experience a sense of belonging, share information, acquire knowledge, and offer mutual support. There were indications of increased self-efficacy among forum users, as they demonstrated their ability to implement strategies for better managing their mental health. These findings significantly contribute to our understanding of how online forums can enhance resilience factors that are beneficial for young people living in rural communities. In the context of prevention and early intervention, this study illustrates the intricate connections between forum design and user activity with resilience outcomes, providing valuable insights into the underlying causal mechanisms. Consequently, it emphasizes the importance of incorporating such digital interventions as integral components of mental health service ecosystems.

Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis.

Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation. This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users. We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff. Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety. This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability. PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.

Preferences for mHealth Intervention to Address Mental Health Challenges Among Men Who Have Sex With Men in Nepal: Qualitative Study.

Men who have sex with men (MSM) are disproportionately burdened by poor mental health. Despite the increasing burden, evidence-based interventions for MSM are largely nonexistent in Nepal. This study explored mental health concerns, contributing factors, barriers to mental health care and support, and preferred interventions to improve access to and use of mental health support services among MSM in Nepal. We conducted focus groups with MSM in Kathmandu, Nepal, in January 2023. In total, 28 participants took part in 5 focus group sessions. Participants discussed several topics related to the mental health issues they experienced, factors contributing to these issues, and their suggestions for potential interventions to address existing barriers. The discussions were recorded, transcribed, and analyzed using Dedoose (version 9.0.54; SocioCultural Research Consultants, LLC) software for thematic analysis. Participants reported substantial mental health problems, including anxiety, depression, suicidal ideation, and behaviors. Contributing factors included family rejection, isolation, bullying, stigma, discrimination, and fear of HIV and other sexually transmitted infections. Barriers to accessing services included cost, lack of lesbian, gay, bisexual, transgender, intersex, queer, and asexual (LGBTIQA+)-friendly providers, and the stigma associated with mental health and sexuality. Participants suggested a smartphone app with features such as a mental health screening tool, digital consultation, helpline number, directory of LGBTIQA+-friendly providers, mental health resources, and a discussion forum for peer support as potential solutions. Participants emphasized the importance of privacy and confidentiality to ensure mobile apps are safe and accessible. The findings of this study have potential transferability to other low-resource settings facing similar challenges. Intervention developers can use these findings to design tailored mobile apps to facilitate mental health care delivery and support for MSM and other marginalized groups.

A Qualitative Forum Analysis of Fathers’ Stressors and Support Seeking Behaviour During the COVID-19 Pandemic

Fathers experienced high rates of mental health concerns during the COVID-19 pandemic. Social support is crucial to mitigate these problems; however, access to and quality of support were impacted by public health guidelines to increase physical distancing. Online forums offer an avenue for peer connection and support. Yet, minimal research has examined forum use during COVID-19. The objective of the current study was to examine the experiences and support needs of fathers during the pandemic through an exploratory qualitative content analysis of an online social support forum. Posts ( N = 299) and comments ( N = 2597) on Reddit’s sub-forum r/daddit (July and October 2020) were systematically analysed through a Framework Analytic Approach. Findings highlighted five main themes (with subthemes): forum use, family functioning, psychological and health factors, interpersonal functioning, and COVID-19. Findings underscore the critical need for mental health and parenting programs tailored to fathers and informing services to support father and family wellbeing.

Digital communication tools in family therapy: A review of opportunities and challenges for English-Speaking practitioners

Digital communication tools have revolutionized the field of family therapy, offering both opportunities and challenges for English-speaking practitioners. With the proliferation of technology, therapists have access to a wide array of platforms and applications that can enhance therapeutic interventions. However, integrating these tools into practice requires careful consideration of ethical, legal, and clinical implications. Digital communication tools offer numerous advantages for family therapy practitioners. Teletherapy platforms enable therapists to reach clients in remote locations or those with mobility constraints, expanding access to care. Video conferencing allows for face-to-face interactions, facilitating rapport building and nonverbal communication cues essential for effective therapy. Additionally, digital tools such as secure messaging apps or virtual whiteboards enhance communication between sessions, fostering continuity of care and homework completion. Online support groups and forums provide clients with opportunities for peer support and community engagement, supplementing traditional therapy approaches. Despite their benefits, digital communication tools pose significant challenges for English-speaking practitioners. Ensuring confidentiality and data security is paramount, requiring adherence to stringent privacy regulations such as HIPAA (Health Insurance Portability and Accountability Act). Therapists must navigate issues of informed consent, boundary maintenance, and emergency protocols in the digital realm. Moreover, technological barriers, such as internet connectivity issues or lack of digital literacy among clients, can hinder the effectiveness of therapy sessions. Cultural considerations also play a role, as language barriers or cultural differences in technology use may impact therapeutic engagement. Digital communication tools offer English-speaking family therapy practitioners unprecedented opportunities to enhance therapeutic interventions. However, these tools come with inherent challenges that must be addressed to ensure ethical and effective practice. By carefully navigating the opportunities and challenges presented by digital communication tools, therapists can harness the power of technology to improve client outcomes and advance the field of family therapy.

Violence on Reddit Support Forums Unique to r/NoFap

ABSTRACT Masturbation abstinence practices have returned to the USA in the form of semen retention communities. Followers on one of these male, anti-masturbation forums, “NoFap,” on Reddit (denoted “r/NoFap”), have engaged in homicidal behaviors that appear to be linked to these sexual beliefs and practices. This study uses a systematic search on r/NoFap and two control forums (r/pornfree, and r/stopdrinking) to define a corpus of violent content. The study's goals were to describe the nature of threats on r/NoFap and suggest whether the violence might be attributable to sexual deprivation or false beliefs that non-sexual targets caused their violent urges. Of the 421 violent posts identified from September 2011 to September 2022, r/NoFap contained the majority (94.3%). Violent threats on r/NoFap mostly targeted pornographers, women, scientists, specific persons, or any person (i.e. homicidal “rage”). Violent threats against r/NoFap’s own followers were growing most quickly. Violent posts were well-supported with upvotes by other followers in r/NoFap. These data are important because NoFap may represent a growing threat for real-world violence.

Self-disclosure and received social support among women experiencing infertility on reddit: A natural language processing approach

The intricate interplay between self-disclosure strategies and the social support received has garnered limited scholarly attention. Guided by communication privacy management theory, the functional theory of self-disclosure, social support theory, and social penetration theory, this study seeks to delve deeper into this dynamic within the context of female infertility. Fertility challenges among women remain sensitive and veiled by societal silence, thereby compelling them to seek information and support through online channels. By leveraging natural language processing techniques, we examined 11,714 posts and 76,022 comments from the Subreddit IVF over a three-year period. Our investigation shows that online support forums provide a convenient and beneficial channel for women dealing with infertility issues to exchange information and express distress. However, a discrepancy exists between the types and intended functions of self-disclosure and the types of social support received. Posts aiming to clarify personal identities negatively predict the network support received. Moreover, disclosing thoughts in posts often fail to elicit esteem support in comments. The results highlight that online support communities exhibit inherent limitations in offering opportunities for sharing good news and seeking validation. These findings offer guidance to policymakers, practitioners, and the public in enhancing support for women experiencing challenges in childbearing.

Influence of the intelligent knee osteoarthritis lifestyle app (iKOALA) on knee joint pain

BackgroundThe intelligent knee osteoarthritis lifestyle app (iKOALA) has been co-developed with target users to extend the support for physical activity (PA) and musculoskeletal health, beyond short-term structured rehabilitation, using personalised PA guidance, education, and social support. The purpose of this study was to assess the preliminary effectiveness and usability of the iKOALA digital intervention on indices of musculoskeletal (MSK) health, symptoms, and physical activity levels in a broad range of individuals with knee osteoarthritis (KOA) over 12 weeks to inform the design of a larger randomised controlled trial.MethodsThirty-eight (33 female) participants living in the UK with a mean (SD) age of 58 (± 9) years diagnosed radiographically or clinically with KOA completed a 12-week user trial of the iKOALA. Participants completed an in-app physical activity questionnaire which intelligently recommended suitable strengthening and aerobic based activities to individuals. Throughout the trial, participants wore a physical activity monitor and were given access to functions within the app (physical activity (PA) reminders, information and education, symptom and PA tracking as well as social support forums) to support them in maintaining their PA plan. Participants completed a MSK questionnaire for chronic symptoms and quality of life (MSK-HQ) as well as an acute iKOALA symptoms questionnaire (confidence, fatigue, mood, pain during the day/night, sleep and ability to walk) in the week prior to starting and following completion of the trial.ResultsPhysical activity levels were consistent over the 12 weeks with total daily steps of 9102 (± 3514) in week 1, 9576 (± 4214) in week 6 and 9596 (± 3694) in week 12. Group mean changes in all iKOALA MSK symptom scores and the total MSK-HQ (pre 33.1 (7.6) vs. post 40.2 (7.6)) score improved significantly (p < .001, 95% CI [-8.89, -5.16]) over the 12-week period.ConclusionsPhysical activity levels were maintained at a high level throughout the 12 weeks. Significant improvements in mean MSK symptom scores and the total MSK-HQ score were also observed. Efforts to ensure more generalised reach amongst sex and socioeconomic status of the digital intervention in a randomised controlled clinical trial are warranted.

Resisting the (re-)medicalisation of dying and grief in the post-digital age: Natural language processing and qualitative analysis of data from internet support forums

In the mid-twentieth century, the social movement of death revivalism sought to resist the medicalisation of dying and grief through promotion of the dying person retaining autonomy, and societal openness toward death and bereavement. Despite this advocacy, present-day dying in high income countries is largely institutionalised, with value placed on control over the body and emotions. These phenomena are at odds with the ambitions of death revivalism, and demonstrate the re-medicalisation of dying and grief. Furthermore, contemporary society is continually advancing into the post-digital age, reflected in digital technologies being a tacit part of human existence. Within this framework, this study aims to investigate how people living with life-limiting illness and their loved ones experience, negotiate, and resist medicalisation of dying and grief through online internet forums. We collected posts through web-scraping and utilised Natural Language Processing techniques to select 7048 forum posts from 2003 to 2020, and initially categorise data, before utilising Inductive Thematic Analysis, which generated two major themes. The theme of ‘Comfort’ describes online forums facilitating psychosocial support which was often used to compensate for systemic deficiencies, especially during the Covid-19 pandemic. Common sources of comfort included animal companions and spirituality, in stark contrast with the medicalised model. The theme of ‘Capability’ describes online forums acting as solutions for people facing disempowering care systems, including providing information on legal rights and benefits which may not be otherwise easily available, and facilitating collective advocacy. Our findings indicate that community-led online forums can play an effective and sustainable role in democratising care and retaining agency when facing life-limiting illness and grief. Future palliative and bereavement care research must focus on how online forums can be integrated into existing systems, made transparent and accessible, be adequately funded and structured, and beoptimised, including compensating for service disruption encountered during future pandemics.

A boosting policy to optimize user forum performance: Model and validation

Near‐constant Internet access through desktop or mobile devices has turned self‐service support forums into the first port of call for users seeking to troubleshoot product or service issues. The firms providing these products and services also benefit from this trend since it reduces user support costs by diverting service requests away from costlier support channels, such as help desks. For the continued success of such a forum, however, the managing entity must ensure that users receive timely solutions to their inquiries quickly and regularly. We develop a mathematical model of a user forum's operations to obtain a “white box” view of a user forum and reveal the support system's dynamics. Then, using a large and comprehensive dataset of questions and answers from Apple's iPhone user forum, we empirically estimate the forum's performance to validate the predictions of the mathematical model. Our results demonstrate that the predictions closely match the forum's actual performance, with an error of less than 10%. We then propose and analyze an optimal threshold policy that boosts a thread to rekindle user interest and demonstrate the benefit of our intervention policy in managing the iPhone forum.

Testing a Digital Health App for Patients With Alcohol-Associated Liver Disease: Mixed Methods Usability Study.

Alcohol-associated liver disease (ALD) is increasingly common and associated with serious and costly health consequences. Cessation of drinking can improve ALD morbidity and mortality; however, support for cessation is not routinely offered to those diagnosed with ALD, and continued drinking or resumption of drinking after diagnosis is common. Mobile health (mHealth) has the potential to offer convenient and scalable support for alcohol cessation to those diagnosed with ALD, but mHealth interventions for alcohol cessation have not been designed for or evaluated in a population with ALD. This study aims to understand how individuals with ALD would perceive and use an mHealth tool for alcohol cessation and to gather their perspectives on potential refinements to the tool that would allow it to better meet their needs. We interviewed 11 individuals who attended clinic visits related to their ALD to elicit their needs related to support for alcohol cessation and views on how mHealth could be applied. After completing initial interviews (pre), participants were provided with access to an mHealth app designed for alcohol cessation, which they used for 1 month. Afterward, they were interviewed again (post) to give feedback on their experiences, including aspects of the app that met their needs and potential refinements. We applied a mixed methods approach, including a qualitative analysis to identify major themes from the interview transcripts and descriptive analyses of use of the app over 1 month. First, we found that a diagnosis of ALD is perceived as a motivator to quit drinking but that patients had difficulty processing the overwhelming amount of information about ALD they received and finding resources for cessation of alcohol use. Second, we found that the app was perceived as usable and useful for supporting drinking recovery, with patients responding favorably to the self-tracking and motivational components of the app. Finally, patients identified areas in which the app could be adapted to meet the needs of patients with ALD, such as providing information on the medical implications of an ALD diagnosis and how to care for their liver as well as connecting individuals with ALD to one another via a peer-to-peer support forum. Rates of app use were high and sustained across the entire study, with participants using the app a little more than half the days during the study on average and with 100% (11/11) of participants logging in each week. Our results highlight the need for convenient access to resources for alcohol cessation after ALD diagnosis and support the potential of an mHealth approach to integrate recovery support into care for ALD. Our findings also highlight the ways the alcohol cessation app should be modified to address ALD-specific concerns.

How People With a Bipolar Disorder Diagnosis Talk About Personal Recovery in Peer Online Support Forums: Corpus Framework Analysis Using the POETIC Framework.

Personal recovery is of particular value in bipolar disorder, where symptoms often persist despite treatment. We previously defined the POETIC (Purpose and Meaning, Optimism and Hope, Empowerment, Tensions, Identity, Connectedness) framework for personal recovery in bipolar disorder. So far, personal recovery has only been studied in researcher-constructed environments (eg, interviews and focus groups). Support forum posts can serve as a complementary naturalistic data resource to understand the lived experience of personal recovery. This study aimed to answer the question "What can online support forum posts reveal about the experience of personal recovery in bipolar disorder in relation to the POETIC framework?" By integrating natural language processing, corpus linguistics, and health research methods, this study analyzed public, bipolar disorder support forum posts relevant to the lived experience of personal recovery. By comparing 4462 personal recovery-relevant posts by 1982 users to 25,197 posts not relevant to personal recovery, we identified 130 significantly overused key lemmas. Key lemmas were coded according to the POETIC framework. Personal recovery-related discussions primarily focused on 3 domains: "Purpose and meaning" (particularly reproductive decisions and work), "Connectedness" (romantic relationships and social support), and "Empowerment" (self-management and personal responsibility). This study confirmed the validity of the POETIC framework to capture personal recovery experiences shared on the web and highlighted new aspects beyond previous studies using interviews and focus groups. This study is the first to analyze naturalistic data on personal recovery in bipolar disorder. By indicating the key areas that people focus on in personal recovery when posting freely and the language they use, this study provides helpful starting points for formal and informal carers to understand the concerns of people diagnosed with a bipolar disorder and to consider how to best offer support.

Characterizing online social support for alcohol use disorder: A mixed-methods approach.

Online social media communities are increasingly popular venues for discussing alcohol use disorder (AUD) and recovery. Little is known about distinct contexts of social support that are exchanged in this milieu, which are critical to understanding the social dynamics of online recovery support. We randomly selected one post per day over the span of a year from the StopDrinking recovery forum. Direct responses to posts were double coded within an established theoretical framework of social support. Within a mixed-methods research framework, we quantified the linguistic characteristics of 1386 responses (i.e., text length, complexity, and sentiment) and qualitatively explored themes within and among different types of social support. Emotional support was most prevalent (74% of responses) and appeared as the sole form of support in 38% of responses. Emotionally supportive responses were significantly shorter, less complex, and more positively valenced than other support types. Appraisal support was also common in 55% of responses, while informational support was identified in only 17%. There was substantial overlap among support types, with 40% of responses including two or more types. Salient themes included the common use of community-specific acronyms in emotional support. Appraisal support conveyed feedback about attitudes and behaviors that are perceived as (un-) favorable for AUD recovery. Informational support responses were composed primarily of recommendations for self-help literature, clinical treatment approaches, and peer recovery programs. Social support in this sample was primarily emotional in nature, with other types of support included to provide feedback and guidance (i.e., appraisal support) and supplemental recovery resources (i.e., informational support). The provided social support framework can be helpful in characterizing community dynamics among heterogeneous online AUD recovery support forums. This framework could also be helpful in considering changes in support approaches that correspond to progress in recovery.