An analysis of social support exchanges in online HIV/AIDS self-help groups

Acquiring Social Support in an Online HPV Support Group: Exploring the Roles of Threat and Efficacy

Social media have become crucial communication channels for human papilloma virus (HPV) patients to seek and receive social support that can benefit their physical and psychological health. To promote supportive communication on online social platforms, we analyzed 96,543 messages, including 7,407 posts and 89,136 comments, concerning social support on Baidu HPV Forum, one of China's largest online HPV support groups. We examined factors (i.e., threat and efficacy) in posts requesting social support associated with the amount of social support received in comments. Results revealed that the majority of social support messages received in comments represented informational support, whereas relatively few comments featured instrumental social support. Beyond that, high-threat, non-efficacy posts requesting social support received a greater amount of informational and emotional support in the comments than other types of posts requesting social support. Theoretical and practical implications of our study are discussed as well.

Social networking: An analysis of health-related social support messages posted in a Facebook group for Kashmiri women

The support groups within social networking sites such as Facebook have become a popular platform for various kinds of conversation and social support including health, especially among women. The aim of this study was to explore and analyze the types of health-related social support messages posted in a month by Kashmiri women in a Facebook group and the most common health topics for which social support was sought. A total of 302 health-related posts were selected for analysis. The results revealed that of various health-related social support posts in the group, informational support messages were posted more frequently and most requested information was related to pregnancy.

Social Support Among Women With Potential Essure-Related Complaints: Analysis of Facebook Group Content

BACKGROUND

Social support groups are an important resource for people to cope with problems. Previous studies have reported the different types of support in these groups, but little is known about the type of reactions that sharing of personal experiences induce among members. It is important to know how and to what extent members of support groups influence each other regarding the consumption of medical care. We researched this in a web-based Facebook group of women sterilized with Essure. Essure was a device intended for permanent contraception. From 2015 onward, women treated with Essure for tubal occlusion raised safety concerns and numerous complaints.

OBJECTIVE

This study aimed to evaluate the use of social support in a Facebook community named "Essure problemen Nederland" (EPN; in English, "Essure problems in the Netherlands").

METHODS

All posts in the closed Facebook group EPN between March 8 and May 8, 2018, were included. In total, 3491 Facebook posts were analyzed using a modified version of the Social Support Behavior Codes framework created by Cutrona and Suhr in 1992. Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a modified version of the Social Support Behavior Codes framework, and applied the codes to the collected data.

RESULTS

We found that 92% of messages contained a form of social support. In 68.8% of posts, social support was provided, and in 31.2% of posts, social support was received. Informational and emotional support was the most frequently used form of provided social support (40.6% and 55.5%, respectively). The same distribution was seen with received social support: informational support in 81.5% and emotional support in 17.4% of cases. Our analysis showed a strong correlation between providing or receiving social support and the main form of social support (P<.001). In a total of only 74 (2.2%) cases, women advised each other to seek medical care.

CONCLUSIONS

The main purpose of women in the EPN Facebook group was to provide and receive informational or emotional support or both.

Speech acts and the communicative functions of emojis in LIHKG online discussion forum amid COVID-19

Since the beginning of 2022, the Hong Kong government has imposed strict social distancing measures and changed its stance on various regional policies with the aim to contain the so-called 'fifth wave' of COVID-19. In these pandemic and 'infodemic' times filled with uncertainty and fear, Hong Kong netizens used local online discussion forums as a resource to establish an innovative form of 'helping network.' This study is based on 230 posts from a popular local online discussion forum 'LIHKG' in February 2022 when the pandemic was regarded as most critical by the Department of Health. Speech Acts theoretic approach was adopted to explore how forum users employed speech acts to perform various communicative practices such as expressing concerns, asking for information, and engaging with others in a CMC environment amid a global health crisis. Representatives were found to be the most dominant text-based speech acts, followed by directives, expressives and commissives. Speech acts provide forum users a context in which emoji usage occurs. Forum users not only make use of words to 'do' things in the online self-help forum, but they also employ emojis to either supplement or complement speech acts. This study also shows that emojis perform multiple functions in the discussion posts and argues that they do not merely function as emotion indicators of their textual company, but also carry significant pragmatic meanings by illustrating how they can also carry illocutionary force and in some cases, even alter the illocutionary force of their preceding texts. The findings of this study enhance our understanding of how forum users communicate via verbal and nonverbal means within the underexplored 'helping domain' of online discussion forums. It also suggests that online discussion forum interactions need to be approached differently than other better understood alternatives.

"Whenever you need support, you first turn to the group": motivations and functions of WhatsApp groups for youth living with HIV

Social support is a critical component of achieving positive health outcomes for youth living with HIV (YLWH). Mobile health (mHealth) has significant potential for providing social support to YLWH. However, little is known about the domains of social support most needed by YLWH which mHealth interventions might address. Drawing on the spontaneous creation of WhatsApp support groups by YLWH in Nairobi, Kenya, we characterized Kenyan YLWH's social support needs and potential roles of social media groups in meeting them. We conducted interviews and focus-groups with 68 YLWH, 24 caregivers and 20 healthcare workers, and observed two YLWH-led WhatsApp groups for 6 weeks. Youth reported that existing support systems, including family and healthcare workers, already provided informational and instrumental support. However, they emphasized unmet companionship and emotional support needs, leading to isolation, hopelessness, and medication adherence challenges. Participants identified connection with other YLWH as a unique source of emotional and companionship support that allowed them to feel more secure and less isolated. Interviews and observed WhatsApp chats demonstrated that WhatsApp groups were a desirable medium for companionship support that overcame barriers to in-person connection.

How People with Physical Disabilities Can Obtain Social Support through Online Videos: A Qualitative Study in China

BACKGROUND

Online video creation is becoming an option for many people with physical disabilities in China. However, few studies have considered how physically disabled individuals access social support through online video creation.

METHODS

For this qualitative study, semi-structured interviews were conducted with 18 online video creators with physical disabilities. The starting point of this study was video creation by people with physical disabilities, with a focus on the social interactions between creators, online video platforms, followers, viewers and sponsors, as well as the perceived social support in the process.

RESULTS

Thematic analysis was used to identify six social support themes: (i) meeting emotional needs; (ii) obtaining informational support; (iii) obtaining creative benefits; (iv) constructing identity; (v) reconstructing social relationships; and (vi) discovering self-worth. Four risk-related themes were identified: (i) online language violence; (ii) invasion of commercial capital; (iii) online video addiction; and (iv) fragile social support.

CONCLUSIONS

The findings indicate that, although people with physical disabilities can obtain effective social support through creating online videos, it is accompanied by many risks. In addition, the social support gained through creating online videos differs from traditional online social support (e.g., changes in online support groups, emphasis on creative gain).

PROSPECT

Future research should perform more detailed analyses of different types of social support and specific risks of creation, while taking into account individual differences and sociodemographic backgrounds.

Black heterosexual men's resilience in times of HIV adversity: findings from the "weSpeak" study

BACKGROUND

In Canada, heterosexual African, Caribbean and Black (ACB) men tend to suffer a disproportionate burden of HIV. Consequently, studies have examined the underlying contributors to this disparity through the nexus of behavioral and structural factors. While findings from these studies have been helpful, their use of deficit and risk models only furthers our knowledge of why ACB men are more vulnerable to HIV infection. Thus far, there is a dearth of knowledge on how heterosexual ACB men mobilize protective assets to promote their resilience against HIV infection.

METHODS

As part of a larger Ontario-based project called weSpeak, this study examined how ACB men acquire protective assets to build their resilience to reduce their HIV vulnerability. We analyzed three focus group discussions (n = 17) and 13 in-depth interviews conducted with ACB men using NVivo and a mixed inductive-deductive thematic analyses approach.

RESULTS

The findings show that ACB men mostly relied on personal coping strategies, including sexual abstinence, to build resilience against HIV. Interpersonal resources such as family, friends, and religious communities also played an important role in constructing ACB men's resilience. ACB men bemoaned their lack of access to essential institutional resources, such as health services, that are important in managing HIV adversity.

CONCLUSION

Based on these findings, there is an urgent need for HIV policy stakeholders, including service providers, to engage the ACB community in the design of intervention programs. Additionally, addressing the socioeconomic disadvantages faced by ACB communities will increase the capacity of ACB men to develop resilience against HIV.

Social Support in a Diabetes Online Community: Mixed Methods Content Analysis

BACKGROUND

Patients with diabetes may experience different needs according to their diabetes stage. These needs may be met via online health communities in which individuals seek health-related information and exchange different types of social support. Understanding the social support categories that may be more important for different diabetes stages may help diabetes online communities (DOCs) provide more tailored support to web-based users.

OBJECTIVE

This study aimed to explore and quantify the categorical patterns of social support observed in a DOC, taking into consideration users' different diabetes stages, including prediabetes, type 2 diabetes (T2D), T2D with insulin treatment, and T2D remission.

METHODS

Data were collected from one of the largest DOCs in Europe: Diabetes.co.uk. Drawing on a mixed methods content analysis, a qualitative content analysis was conducted to explore what social support categories could be identified in users' posts. A total of 1841 posts were coded by 5 human annotators according to a modified version of the Social Support Behavior Code, including 7 different social support categories: achievement, congratulations, network support, seeking emotional support, seeking informational support, providing emotional support, and providing informational support. Subsequently, quantitative content analysis was conducted using chi-square post hoc analysis to compare the most prominent social support categories across different stages of diabetes.

RESULTS

Seeking informational support (605/1841, 32.86%) and providing informational support (597/1841, 32.42%) were the most frequent categories exchanged among users. The overall distribution of social support categories was significantly different across the diabetes stages (χ²₁₈=287.2; P<.001). Users with prediabetes sought more informational support than those in other stages (P<.001), whereas there were no significant differences in categories posted by users with T2D (P>.001). Users with T2D under insulin treatment provided more informational and emotional support (P<.001), and users with T2D in remission exchanged more achievement (P<.001) and network support (P<.001) than those in other stages.

CONCLUSIONS

This is the first study to highlight what, how, and when different types of social support may be beneficial at different stages of diabetes. Multiple stakeholders may benefit from these findings that may provide novel insights into how these categories can be strategically used and leveraged to support diabetes management.

Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM

Antiretroviral therapy (ART) adherence is suboptimal among gay, bisexual, and other men who have sex with men (GBMSM). Online interventions that incorporate social support represent new opportunities to improve adherence. This study focused on how social support was provided and sought within a technology-based ART adherence intervention. We coded and analyzed 1,751 messages. Within the social support messages, half of the time participants sought social support and half of the time they provided social support. Emotional and informational support were the most frequently exchanged forms. The most frequent topic that participants sought support around was interpersonal relationships (29%), followed by HIV care and treatment (28%). Similarly, 31% and 27% of messages in which participants provided support was related to HIV treatment and care and interpersonal relationships, respectively. HIV treatment and care issues most salient were ART adherence, lab results and upcoming tests, ART side effects, changes in ART regimens, and relationships with healthcare providers. Participants used the messaging feature in this intervention to spontaneously discuss and exchange support around HIV treatment and care. This analysis provided an opportunity to understand how participants informally interact with one another, how they seek and provide social support online, and their salient personal issues.

Emotional support received moderates academic stress and mental well-being in a sample of Afghan university students amid COVID-19

BACKGROUND

Academic stress experienced during the COVID-19 pandemic has triggered high levels of anxiety and depression and other severe mental health issues among university students around the globe. In Afghanistan, there is a paucity of research on the academic and mental health issues of Afghan university students and none pertaining to their academic stress and mental well-being amid the pandemic.

AIM

This research examines the potential stress-buffering role of emotional support received between academic stress and mental well-being in a sample of Afghan university students during the COVID-19 outbreak.

METHOD

The study sample comprised 508 Afghan university students. An online survey was developed for data collection. Model 1 of the PROCESS macro was used to conduct the moderation analysis.

RESULTS

These indicate that moderate and high levels of emotional support received may protect against the negative effects of higher levels of academic stress on mental well-being.

CONCLUSION

This research makes an important contribution to the literature on social support. It may be inferred from the results that Afghan university students who experience academic stress, but have strong emotional support are able to attain greater mental well-being during the COVID-19 outbreak as compared to those with weak emotional support. Results may encourage mental health practitioners, university counselors, education administrators, and faculty to jointly formulate strategies for offering emotional support to Afghan university students.

Predicting Social Support Exchanging Among Male Homosexuals Who are HIV-Positive in Social Media Context: The Role of Online Self-Disclosure

This study investigated social support exchanges on social media among male homosexuals who are HIV-positive (MHHP) in China and explored how online self-disclosure relates to such activity. Analyses were based on 9,459 Weibo messages posted by 188 targeted users.Results showed that the informational and emotional support messages were prevalent in the Chinese context, and esteem social support was first found to be the most salient by the current investigation. Results of independent samples t-tests suggested that MHHP who engaged in significant self-disclosure on Weibo tended to have more frequent social support exchanges than those who did not. In particular, MHHP who expressed sex-seeking intentions and companionship seeking intentions were likely to post more supportive messages than those who did not express such intentions. Moreover, MHHP who disclosed their concerns over discrimination tended to post more emotional, informational, and esteem support messages than those who did not express discrimination concerns.

The Role of Online Support Groups in Helping Individuals Affected by HIV and AIDS: Scoping Review of the Literature

Background

Online support groups provide opportunities for individuals affected by HIV and AIDS to seek information, advice, and support from peers. However, whether and how engagement with online support groups helps individuals affected by HIV and AIDS remains unclear, as does the nature of the evidence on this topic.

Objective

This scoping review sought to explore whether engagement with HIV and AIDS–related online support groups benefits members in terms of psychosocial well-being and illness management, whether members experienced any negative aspects of these groups, and what types of social support are exchanged within HIV and AIDS–related online support groups.

Methods

A scoping review of English-language articles (including both qualitative and quantitative studies) was undertaken using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The databases searched included MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL (Cochrane Register of Controlled Trials), and Scopus. Key findings were synthesized using a narrative and thematic approach.

Results

A total of 22 papers met the inclusion criteria from an initial pool of 3332 abstracts. These papers included 23% (5/22) quantitative studies, 9% (2/22) mixed methods studies, and 68% (15/22) qualitative studies published between 2007 and 2019. Cross-sectional evidence suggests that engagement with HIV and AIDS–related online support groups is empowering for members and may lead to a range of psychosocial benefits. Furthermore, qualitative evidence suggests that these groups provide an opportunity to connect with similar people and share experiences. This can help improve self-worth, reduce stigma, facilitate improved illness management, and gain greater confidence when interacting with health professionals. However, online support groups are not without their limitations as qualitative evidence suggests that users may encounter examples of interpersonal conflict between members as well as be exposed to challenging content. Finally, HIV and AIDS–related online support groups are avenues through which individuals can solicit support, most commonly informational or emotional.

Conclusions

HIV and AIDS–related online support groups may have some benefits for members, particularly in terms of providing social support. There is a need for a systematic review of this literature that includes an assessment of the methodological quality of the available evidence.

The role of online social networks in improving health literacy and medication adherence among people living with HIV/AIDS in Iran: Development of a conceptual model

Online social networks have been used to enhance human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) prevention, diagnosis, and treatment programs worldwide. This study aimed to develop a conceptual model of using online social networks in improving health literacy and medication adherence among people living with HIV/AIDS in Iran. This mixed-method sequential exploratory study was conducted in three phases. Firstly, a series of semi-structured interviews with a purposive sample of 29 HIV-positive patients were conducted to investigate the perceptions and experiences of HIV-positive patients about using online social networks to support health literacy and medication adherence. Thematic analysis was used to analyse qualitative interviews, extract potential components, and design a conceptual model. Then, a Delphi study with 27 HIV-positive patients was subsequently conducted to examine the consensus of patients on the proposed model. Finally, the trustworthiness and credibility of the proposed model were reviewed and evaluated by expert panel members from epidemiology and public health. Seven themes and 24 sub-themes emerged from the qualitative interviews. Five themes encompassed components of online social networks that supported communication and information-seeking behaviour of people living with HIV/AIDS. The two other themes encompassed social support and health-related outcomes including medication adherence. The credibility of the proposed conceptual model was confirmed methodologically using the expert panel and Delphi technique. Our findings highlighted that using online social networks has empowered Iranian people living with HIV/AIDS, making them more connected, safe, and able to access HIV/AIDS-related information and services. The role of online social networks in improving health literacy and medication adherence was also demonstrated in a conceptual model to understand the supportive components of online social networks in the HIV care continuum as well as customized interventions to improve the success of antiretroviral therapies.

Identifying and Characterizing Medical Advice-Seekers on a Social Media Forum for Buprenorphine Use

Background: Online communities such as Reddit can provide social support for those recovering from opioid use disorder. However, it is unclear whether and how advice-seekers differ from other users. Our research addresses this gap by identifying key characteristics of r/suboxone users that predict advice-seeking behavior. Objective: The objective of this analysis is to identify and describe advice-seekers on Reddit for buprenorphine-naloxone use using text annotation, social network analysis, and statistical modeling techniques. Methods: We collected 5258 posts and their comments from Reddit between 2014 and 2019. Among 202 posts which met our inclusion criteria, we annotated each post to determine which were advice-seeking (n = 137) or not advice-seeking (n = 65). We also annotated each posting user’s buprenorphine-naloxone use status (current versus formerly taking and, if currently taking, whether inducting or tapering versus other stages) and quantified their connectedness using social network analysis. To analyze the relationship between Reddit users’ advice-seeking and their social connectivity and medication use status, we constructed four models which varied in their inclusion of explanatory variables for social connectedness and buprenorphine use status. Results: The stepwise model containing “total degree” (p = 0.002), “using: inducting/tapering” (p < 0.001), and “using: other” (p = 0.01) outperformed all other models. Reddit users with fewer connections and who are currently using buprenorphine-naloxone are more likely to seek advice than those who are well-connected and no longer using the medication, respectively. Importantly, advice-seeking behavior is most accurately predicted using a combination of network characteristics and medication use status, rather than either factor alone. Conclusions: Our findings provide insights for the clinical care of people recovering from opioid use disorder and the nature of online medical advice-seeking overall. Clinicians should be especially attentive (e.g., through frequent follow-up) to patients who are inducting or tapering buprenorphine-naloxone or signal limited social support.

Influence of social support on individual health knowledge adoption in online diabetes communities: the mediating role between cognition and emotion

Purpose

To address the problem of how to guide and promote health knowledge adoption, based on online diabetes communities, this study explores the impact mechanism of social support on users' individual health knowledge adoption to provide insights for online diabetes community management and personal health management.

Design/methodology/approach

Integrating the theories of cognitive-affective personality system (CAPS) and social support, this study constructs a theoretical model, collects data through a questionnaire and uses a structural equation model to analyse 356 data.

Findings

The results show that: (1) Considering the online diabetes communities, it is reasonable to divide social support into emotional, information, network and respect support. (2) Social support affects individual health knowledge adoption through the intermediaries of knowledge argument quality, knowledge source credibility and positive emotions. (3) The order of the mediating effect of cognitive and emotional factors between social support and health knowledge adoption is knowledge argument quality > knowledge source credibility > positive emotions and rationality > sensibility. (4) Users pay more attention to the source credibility of professional health knowledge than that of experiential health knowledge.

Originality/value

This research expands the application scope of CAPS and opens the “black box” of the impact of social support on individual health knowledge adoption behaviour. Simultaneously, the dimensions of social support and the mediating effect between social support and the two types of health knowledge are discussed.

The miscarriage circle of care: towards leveraging online spaces for social support

Background

Lack of social support during and after miscarriage can greatly affect mental wellbeing. With miscarriages being a common experience, there remains a discrepancy in the social support received after a pregnancy is lost.

Method

42 people who had experienced at least one miscarriage took part in an Asynchronous Remote Community (ARC) study. The study involved 16 activities (discussions, creative tasks, and surveys) in two closed, secret Facebook groups over eight weeks. Descriptive statistics were used to analyse quantitative data, and content analysis was used for qualitative data.

Results

There were two main miscarriage care networks, formal (health care providers) and informal (friends, family, work colleagues). The formal care network was the most trusted informational support source, while the informal care network was the main source of tangible support. However, often, participants’ care networks were unable to provide sufficient informational, emotional, esteem, and network support. Peers who also had experienced miscarriage played a crucial role in addressing these gaps in social support. Technology use varied greatly, with smartphone use as the only common denominator. While there was a range of online support sources, participants tended to focus on only a few, and there was no single common preferred source.

Discussion

We propose a Miscarriage Circle of Care Model (MCCM), with peer advisors playing a central role in improving communication channels and social support provision. We show how the MCCM can be used to identify gaps in service provision and opportunities where technology can be leveraged to fill those gaps.

Comparative Analysis of Social Support in Online Health Communities Using a Word Co-Occurrence Network Analysis Approach

Online health communities (OHCs) have become a major source of social support for people with health problems. Members of OHCs interact online with others facing similar health problems and receive multiple types of social support, including but not limited to informational support, emotional support, and companionship. The aim of this study is to examine the differences in social support communication among people with different types of cancers. A novel approach is developed to better understand the types of social support embedded in OHC posts. Our approach, based on the word co-occurrence network analysis, preserves the semantic structures of the texts. Information extraction from the semantic structures is supported by the interplay of quantitative and qualitative analyses of the network structures. Our analysis shows that significant differences in social support exist across cancer types, and evidence for the differences across diseases in terms of communication preferences and language use is also identified. Overall, this study can establish a new venue for extracting and analyzing information, so as to inform social support for clinical care.

Understanding the use of heart failure online health forums: a qualitative study

AIMS

Heart failure is a major public health challenge and is described as an epidemic. Many people resort to the internet as a source of health information and online health forums have become an increasingly common way to obtain information and support regarding health-related issues. This study aims to explore what information people concerned about heart failure seek from online health forums, and how this shapes decision-making, trust, and interactions with healthcare professionals.

METHODS AND RESULTS

Widely available internet search engines (Google, Yahoo, and Bing) were used to identify online health forums, accessed by people seeking information on heart failure. Comments posted between 2016 and 2019 were screened, downloaded, and analysed thematically. Normalization Process Theory provided the underlying conceptual lens to inform analysis. Ten online health forums were identified, and 204 individual posts analysed. Three themes were identified [(information and support needs; online diagnosis; and relationship with healthcare professionals (HCPs)]. The most common purpose for using online health forums was to plug information/knowledge gaps surrounding diagnosis or treatments (e.g. discussion of results, medication/health insurance queries). They were used as a tool to aid decision-making regarding, (i) whether to seek further medical attention and (ii) lifestyle choices, medications, and other advice surrounding concerns. Negative experiences with HCPs were discussed, and sometimes online health forums appeared to promote distrust with HCPs.

CONCLUSION

Online health forums offer a supportive platform and help fill key informational gaps. However, online forums may amplify distrust with HCPs.

A Content Analysis of Social Support Messages about Environmental Breast Cancer Risk within Blogs for Mothers

Bloggers can help stimulate online conversations among their readers about a variety of health topics, including breast cancer. However, in previous studies, researchers have not specifically examined supportive messages within an online blogger community that stem from an intervention where bloggers were provided with evidence-based information about breast cancer risk that they could tailor and disseminate to their readers. In the current study, we content analyzed 282 supportive messages within online conversations from participants in blogger communities over a 2-month period immediately following an intervention where the authors provided 74 bloggers who write about motherhood issues with an infographic based on evidence-based information from the Breast Cancer and the Environment Research Program (BCERP) about environmental breast cancer risk/prevention. Bloggers who shared information about their personal breast cancer risk generated a significantly higher number of blog reader comments than bloggers who did not share information about their personal breast cancer risk. Bloggers who cited breast cancer statistics in posts were more likely to draw esteem and emotional support from their readers. Bloggers' repetition of information from blog intervention messages was more likely to elicit esteem, informational, and emotional support from readers. Disclosure of a personal breast cancer diagnosis was associated with mixed types of social support messages. The theoretical and practical implications are discussed along with key limitations of the study and future directions for research in this area.

Users' Intention to Continue Using Online Mental Health Communities: Empowerment Theory Perspective

INTRODUCTION

Online mental health communities may provide new opportunities for rehabilitation for people with mental illness, so it is important to understand the factors that influence the continued use of online mental health communities by people with mental illness.

METHODS

From the perspective of empowerment, based on the theory of health self-efficacy and expectation confirmation, this study explored the mediating role of health self-efficacy and expectation confirmation in the empowerment process of patients in online mental health communities and users' intention to continue using online mental health communities. To verify this model, we obtained 272 valid questionnaires. The SmartPLS 3.0 software was selected for model construction and empirical analysis.

RESULTS

Health self-efficacy completely mediates the relationship between the empowerment process (i.e., emotional support, information support, helping others and sharing experiences) and users' intention to continue using an online mental health community. Expectation confirmation partially mediates the relationship between the empowerment process (i.e., information support and finding recognition) and users' intention to continue using an online mental health community.

CONCLUSION

The empowerment process is the main predictor of user health self-efficacy and expectation confirmation. This study has certain theoretical and practical significance for online mental health community research.

Feasibility, Acceptability and Preliminary Efficacy of Tikambisane ('Let's Talk to Each Other'): A Pilot Support Group Intervention for Adolescent Girls Living With HIV in Zambia

Background:

In Zambia, 84,959 adolescent girls and young women (AGYW) aged 15-24 are currently living with HIV. We explored the feasibility and acceptability of a 6-session, curriculum-based support group intervention designed to address key concerns of AGYW living with HIV.

Setting:

Urban Zambia

Methods:

Surveys and in-depth interviews were collected pre- and post-intervention from participants enrolled from 2 health facilities. Eight participant observations of sessions were conducted. Descriptive statistics at baseline were reported only for AGYW who participated in the intervention (N = 21), while analyses comparing baseline and endline outcome measures were restricted to participants who had data at both time points (N = 14).

Results:

Support groups were feasible to conduct and acceptable to participants. Co-facilitation by an adult counselor and peers living with HIV raised confidence about session content. Sessions on antiretroviral therapy (ART), disclosure and stigma, and grief and loss were most in demand. We did not observe significant differences in key outcome measures between baseline and follow-up. However, qualitative data supported the positive impact of the intervention on ART adherence and hope for the future following the intervention among our participants.

Conclusion:

A short-term, structured support group series holds promise for helping AGYW living with HIV safely navigate a complex time in their lives.

Understanding relationship commitment and continuous knowledge sharing in online health communities: a social exchange perspective

Purpose

Online health communities (OHCs) have become increasingly popular sources of health information in recent years. However, little is known about the factors that affect the relationship commitment and continuous knowledge sharing intention among OHC members. Thus, this study aims to integrate social exchange and commitment-trust theories to establish a theoretical model to fill the gap.

Design/methodology/approach

A research model that integrates social exchange theory and commitment-trust theory is developed. Quantitative data from 519 valid questionnaires are collected via an offline survey. Statistical product and service solutions 20.0 and analysis of a moment structures 20.0 software are used to test the hypotheses.

Findings

Relationship commitment directly influences continuous knowledge sharing intention, partially mediates the relationship between social support and continuous knowledge sharing intention, and fully mediates the relationship between perceived health risks and continuous knowledge sharing intention. Informational and emotional supports are identified as benefit factors that positively affect relationship commitment and perceived health risks are regarded as cost factors that negatively influence relationship commitment. Informational and emotional supports of OHC members produce different effects on relationship commitment when members obtain social support from different sources. Moreover, trust moderates the influences of informational support and perceived health risks on relationship commitment.

Originality/value

The findings provide additional insights that can augment the knowledge management literature by indicating how people are driven to share knowledge continuously in the context of OHCs. This study empirically clarifies the relationships of benefits (i.e. social support) and costs (i.e. perceived health risks) to continuous knowledge sharing intention by demonstrating the significant mediating effect of relationship commitment. In addition, the findings of this study highlight the importance of the social support source in OHCs and provide additional insights into commitment–trust theory by integrating the moderating effect of trust on the relationships between relationship commitment and its antecedents.

Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter?

Background

While self-help groups have been formed among people living with HIV, few studies have been conducted to assess the role of self-help groups in mitigating depressive symptoms. This study investigated the association between self-help group membership and depressive symptoms among people living with HIV in Yangon, Myanmar.

Methods

In this cross-sectional study, data were collected from people living with HIV at three antiretroviral therapy clinics in 2017. Multiple logistic regression analyses were carried out to examine the associations between having self-help group membership and depressive symptoms. Three ART clinics were purposively selected based on the recommendation from the National AIDS Program in Myanmar. At these clinics, people living with HIV were recruited by a convenience sampling method.

Results

Among people living with HIV recruited in this study (n = 464), 201 (43.3%) were members of a self-help group. The membership was not associated with having depressive symptoms (adjusted odds ratio [AOR] 1.59, 95% confidence interval [CI] 0.98–2.59). Factors associated with having depressive symptoms were female (AOR 3.70, 95% CI 1.54–8.88) and lack of social support (AOR 0.97, 95% CI 0.96–0.98) among self-help group members, and female (AOR 3.47, 95% CI 1.70–7.09), lack of social support (AOR 0.98, 95% CI 0.97–0.99), and internalized stigma (AOR 1.28, 95% 1.08–1.53) among non-members.

Conclusions

This study did not find evidence on the association between membership in self-help groups and depressive symptoms among people living with HIV. Social support was a protective factor against depressive symptoms both self-help group members and non-members, although the level of social support was lower among members than non-members. The activities of self-help groups and care provided by the ART clinics should be strengthened to address mental health problems among people living with HIV in the study site.

Peer Group Focused eHealth Strategies to Promote HIV Prevention, Testing, and Care Engagement

PURPOSE OF REVIEW

Electronic communication platforms are increasingly used to support all steps of the HIV care cascade (an approach defined as eHealth). Most studies have employed individual-level approaches in which participants are connected with information, reminders, or a healthcare worker. Recent growth in use of social media platforms, which create digital communities, has created an opportunity to leverage virtual peer-to-peer connection to improve HIV prevention and care. In this article, we describe the current landscape of peer group eHealth interventions in the HIV field, based on a review of published literature, an online survey of unpublished ongoing work, and discussions with practitioners in the field in an in-person workshop.

RECENT FINDINGS

We identified 45 published articles and 12 ongoing projects meeting our inclusion criteria. Most reports were formative or observational; only three randomized evaluations of two interventions were reported. Studies indicated that use of peer group eHealth interventions is acceptable and has unique potential to influence health behaviors, but participants reported privacy concerns. Evaluations of health outcomes of peer group eHealth interventions show promising data, but more rigorous evaluations are needed. Development of group eHealth interventions presents unique technological, practical, and ethical challenges. Intervention design must consider privacy and data sovereignty concerns, and respond to rapid changes in platform use. Innovative development of open-source tools with high privacy standards is needed.

The Investigation of Mobile Health Stickiness: The Role of Social Support in a Sustainable Health Approach

In recent years, there has been a phenomenal proliferation of multifunctional fitness apps (MFAs), many of which are deeply ingrained into modern daily life as an aid to trace, manage, and improve users’ health and fitness. With technological advancement, these emerging information technology (IT) artifacts have the potential to facilitate the sustainable development of society and the environment. However, MFAs are facing a critical predicament: how to ensure user stickiness and continuous use. Drawing on the social support theory, this study aims to investigate stickiness as a multi-dimensional construct and to explore the antecedents of continuance usage and continuance purchase intentions in MFAs. The research model is empirically tested with data collected from 328 users of mobile fitness apps. A structural equation modeling analysis reveals both instrumental stickiness and social stickiness exert statistically significant influences on continuance usage intentions and in-app purchase intentions. Appraisal support, information support, and network support are significant antecedents for instrumental stickiness. While emotion support, esteem support, network support, and tangible support are significant antecedents for social stickiness. In addition, two facets of user sustainability—instrumental stickiness and social stickiness—exert different levels of influence on continuance usage and continuance app purchase intensions, respectively. The findings of this study will provide valuable insights for practitioners and policymakers involved in designing sustainable health products and engendering e-health systems.

HIV-Related Knowledge, Attitudes, Behaviors and Experiences of Kenyan Adolescents Living with HIV Revealed in WhatsApp Group Chats

INTRODUCTION

Mobile technologies represent a scalable platform for delivering knowledge and interventions targeting adolescents living with HIV (ALWH) in low and middle income countries. Data from mobile interventions can be used to assess the contextual understanding and experiences of ALWH.

METHODS

We examined HIV-related knowledge, attitudes, beliefs, behaviors, and experiences of Kenyan ALWH revealed in the contextual data from enrollment in a WhatsApp® group chat intervention.

RESULTS

Thirty ALWH (17 female, mean age 15.4) on ART, engaged in HIV care and aware of their status, were enrolled. Qualitative analysis of WhatsApp® chat discussions identified a gap in HIV knowledge, high medication-taking literacy, need for mental health support and significant barriers to adherence. Participants discussed challenges with HIV stigma and medication-taking in the school setting.

CONCLUSION

These discussions demonstrate a need for education on HIV topics, mental health support for ALWH, and interventions for stigma mitigation in the school setting.

Community attachment and emotional well-being: an empirical study of an online community for people with diabetes

Purpose

The purpose of this study is to investigate how community attachment to an OHC reduces the OHC users' emotional distress and therefore improves their emotional well-being.

Design/methodology/approach

A survey study was conducted in one of the largest online health communities (OHC) for people with diabetes.

Findings

OHC participants are likely to experience reduced emotional distress when they have developed an attachment to the community. This attachment is, in turn, positively associated with the normative expectations of reciprocity and the affective feeling of gratitude. However, some commonly used behavioral measures of community participation, such as visit frequency and membership tenure, have little to do with either community attachment or reduced emotional distress.

Research limitations/implications

The research highlights the pivotal role of community attachment in appraising the much-debated benefits of OHCs. However, the cross-sectional survey study has its limitations in terms of establishing causality.

Practical implications

OHC managers need to look beyond some of the commonly used metrics, such as monthly visits and number of new postings, and focus on fostering a sense of attachment among existing users in order to fulfill the OHC's potential of emotional support. Our study implies that design features facilitating reciprocation and gratitude expression among users can lead to a strong emotional bond.

Originality/value

This is one of the first studies on the antecedents of community attachment and the relationship between community attachment and emotional distress in the context of OHC.

What triggers online help-seeking retransmission during the COVID-19 period? Empirical evidence from Chinese social media

The past nine months witnessed COVID-19's fast-spreading at the global level. Limited by medical resources shortage and uneven facilities distribution, online help-seeking becomes an essential approach to cope with public health emergencies for many ordinaries. This study explores the driving forces behind the retransmission of online help-seeking posts. We built an analytical framework that emphasized content characteristics, including information completeness, proximity, support seeking type, disease severity, and emotion of help-seeking messages. A quantitative content analysis was conducted with a probability sample consisting of 727 posts. The results illustrate the importance of individual information completeness, high proximity, instrumental support seeking. This study also demonstrates slight inconformity with the severity principle but stresses the power of anger in help-seeking messages dissemination. As one of the first online help-seeking diffusion analyses in the COVID-19 period, our research provides a reference for constructing compelling and effective help-seeking posts during a particular period. It also reveals further possibilities for harnessing social media's power to promote reciprocal and cooperative actions as a response to this deepening global concern.

Antiretroviral Therapy (ART)-related Knowledge Seeking among People Living with HIV (PLHIV) in China: Role of Information & Communication Technology (ICT)

This paper investigated the use of information communication technology (ICT) to seek antiretroviral therapy (ART)-related knowledge among people living with HIV (PLHIV) taking antiretroviral treatment in Guangxi, China. A total 1902 participants who undertook ART and had used ICT were recruited from 12 sites with the highest cumulative HIV incidence. A questionnaire survey was used to collect data on the participants’ sociodemographic characteristics, clinical outcomes, infections in the family and comorbidity, access to healthcare resources, ICT using behavior in HIV management, and ART-related knowledge. The results showed that 15% of the participants had searched HIV-related information online, fewer participants had contacted healthcare providers via computer (1.6%) or text messaging (11.9%), and only 7.7% of the participants had contacted other PLHIV using ICT. Education had a positive impact on the knowledge level of all three categories of ART-related knowledge. Participants with better medication and mechanisms knowledge were more likely to search HIV-related information online and less likely to contact healthcare providers using text messages. Findings of this study suggested that ICT was used as an effective approach to acquire some type of ART-related knowledge. ICT was underutilized in health communication among the PLHIV in this study due to low education level and insufficient eHealth literacy. Future intervention programs should address the customization of the communication tools and focus on improving the education level and eHealth literacy of the PLHIV to better promote ICT as an efficient platform for ART-related knowledge seeking.

Evaluating the Communication of Online Social Support: A Mixed-Methods Analysis of Structure and Content

Social support in online self-help groups has been found to benefit participants with emotional instability or mental illness. Many studies have employed content analysis to reveal categories of social support, claiming the prevalence of emotional and informational support can aid support seekers. In the studies, optimal matching theory is used to explain the helpfulness of these types of support. This article argues that content analysis is unpersuasive in its claim that support seekers benefit from social support; participants' communicative behaviors should also be considered to evaluate the potential advantages and drawbacks of such groups. Drawing on a mixed-method approach of conversation analysis and content analysis, this study investigates the sequential structure and content of social support in communication in six online self-help groups for anxiety and depression (OSGADs). The main findings show that optimal matching theory may not be suitable for elucidating how support seekers receive help due to the immediate provision of social support and little interaction otherwise. In addition, results identify expressed understanding/empathy and advice as prominent support categories in OSGADs, with most thread openers requesting support indirectly.

Type 1 Diabetes Mellitus Virtual Patient Network as a Peer Support Community: Protocol for Social Network Analysis and Content Analysis

Background

Type 1 Diabetes Mellitus Virtual Patient Network (T1DM-VPN) is a private Facebook group for youths with type 1 diabetes mellitus (T1DM) in Canada intended to facilitate peer-to-peer support. It was built on the finding that stigma is prevalent among youth with T1DM and impedes self-management.

Objective

We aim to determine if T1DM-VPN provides support as intended and to ascertain what type of members provide support. Specifically, we will (1) identify text consistent with any one of 5 social support categories, (2) describe the network by visualizing its structure and reporting basic engagement statistics, and (3) determine whether being a designated peer leader is related to a member’s centrality (ie, importance in the network) and how frequently they offer social support.

Methods

We will manually extract interaction data from the Facebook group (posts, comments, likes/reactions, seen) generated from June 21, 2017 (addition of first member), to March 1, 2020. Two researchers will independently code posts and comments according to an existing framework of 5 social support categories—informational, emotional, esteem, network, and tangible—with an additional framework for nonsocial support categories. We will calculate how frequently each code is used. We will also report basic engagement statistics (eg, number of posts made per person-month) and generate a visualization of the network. We will identify stable time intervals in the history of T1DM-VPN by modeling monthly membership growth as a Poisson process. Within each interval, each member’s centrality will be calculated and standardized to that of the most central member. We will use a centrality formula that considers both breadth and depth of connections (centrality = 0.8 × total No. of connections + 0.2 × total No. of interactions). Finally, we will construct multivariate linear regression models to assess whether peer leader status predicts member centrality and the frequency of offering social support. Other variables considered for inclusion in the models are gender and age at diagnosis.

Results

T1DM-VPN was launched in June 2017. As of March 1, 2020, it has 196 patient-members. This research protocol received ethics approval from the McGill University Health Centre Research Ethics Board on May 20, 2020. Baseline information about each group member was collected upon addition into the group, and collection of interaction data is ongoing as of May 2020.

Conclusions

This content analysis and social network analysis study of a virtual patient network applies epidemiological methods to account for dynamic growth and activity. The results will allow for an understanding of the topics of importance to youth with T1DM and how a virtual patient network evolves over time. This work is intended to serve as a foundation for future action to help youth improve their experience of living with diabetes.

International Registered Report Identifier (IRRID)

PRR1-10.2196/18714

Do smartphones and social network sites become more important when experiencing stress? Results from longitudinal data

Previous research on stress and media use mainly concentrated on between-person effects. We add to this research field by additionally assessing within-person associations, assuming that experiencing more stress than usual goes along with more nomophobia (“no-mobile-phone phobia”) and more passive and active Facebook use than usual, cross-sectionally and over time, and by exploring potential age differences. We conducted a secondary analysis of three waves of a representative multi-wave survey of adult Dutch internet users (N = 861). Specifically, we used two subsamples: (1) smartphones users for the analyses on nomophobia (n = 600) and (2) Facebook users for the analyses on social media (n = 469). Employing random-intercept cross-lagged panel models, we found within-person correlations between nomophobia and stress at one time-point, but not over time. For the younger age group (18–39 years), more passive Facebook use than usual was associated with more stress than usual six months later, and more stress than usual was followed by less passive Facebook use six month later. There were no longitudinal relationships for active Facebook use across the different age groups. Methodological and theoretical implications are discussed.

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We study the relationships of nomophobia, Facebook use and stress over time.

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Nomophobia and stress correlate on the within-person level at one time-point.

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Passive Facebook use is associated with more stress over time for younger adults.

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Stress relates to less passive Facebook use six months later for younger adults.

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There are no longitudinal effects for nomophobia, active Facebook use, and stress.

They support, so we talk: the effects of other users on self-disclosure on social networking sites

Purpose

Social networking sites (SNSs) have significantly influenced people's lives and changed their behavior. Although previous research has explored self-disclosure in virtual communities, little is known about the impact of other users, particularly their online social support, on self-disclosure. The aim of this study is to explore how online social support dimensions (i.e., emotional, informational, esteem, instrumental and network support) influence people's self-disclosure, which in turn affects their commitment to SNSs.

Design/methodology/approach

Based on social exchange theory, this study proposes a research model that explores the role of other users on self-disclosure. This study collects data from a sample of 558 respondents and applies the structural equation modeling technique to test the research model.

Findings

The findings show that users are motivated to disclose information and commit to a specific SNS because of the supportive climate. Results also show that self-disclosure mediates the effect of online social support on users' commitment to SNSs.

Originality/value

This study focuses on the influence of other users' roles on self-disclosure on SNSs, extending the application of social exchange theory.

#HIV: Alignment of HIV-Related Visual Content on Instagram with Public Health Priorities in the US

Instagram, with more than 1 billion monthly users, is the go-to social media platform to chronicle one's life via images, but how are people using the platform to present visual content about HIV? We analyzed public Instagram posts containing the hashtag "#HIV" (because they are self-tagged as related to HIV) between January 2017 and July 2018. We described the prevalence of co-occurring hashtags and explored thematic concepts in the images using automated image recognition and topic modeling. Twenty-eight percent of all #HIV posts included hashtags focused on awareness, followed by LGBTQ (24.5%) and living with HIV (17.9%). However, specific strategies were rarely cited, including testing (10.8%), treatment (10.3%), PrEP (6.2%) and condoms (4.1%). Image analyses revealed 44.5% of posts included infographics followed by people (21.3%) thereby humanizing HIV and stigmatized populations and promoting community mobilization. Novel content such as the handwriting image-theme (3.8%) where posters shared their HIV test results appeared. We discuss how this visual content aligns with public health priorities to reduce HIV in the US and the novel, organic messages that public health could help amplify.

What to Say When Seeking Support Online: A Comparison Among Different Levels of Self-Disclosure

The current study examined the effect of exposure to online support-seeking posts containing different levels of depth self-disclosure (baseline, peripheral, core) affecting the quality (person-centeredness and politeness) of participants’ support-provision messages. Participants of the study were assigned to the role of a support-provider. Compared to participants who read support-seeking posts with baseline and core self-disclosure, participants who read support-seeking posts with peripheral self-disclosure rated the support-seekers as less anonymous. Compared to participants who read support-seeking posts in the baseline condition, participants who read the support-seeking posts with peripheral self-disclosure wrote support-provision messages with higher level of person-centeredness and politeness. Participants’ perceived anonymity of the support-seekers mediated the effect of the depth of self-disclosure on the politeness of the response messages.

Giving and receiving social support in online substance use disorder forums: How self-efficacy moderates effects on relapse

OBJECTIVE

Individuals in recovery for substance use disorders (SUDs) increasingly use online social support forums, necessitating research on how communicating through these forums can affect recovery. This study examines how giving and receiving support within an SUDs recovery forum predict substance use, and considers whether effects vary according to participants' self-efficacy.

METHODS

We applied content analysis to 3440 messages that were posted by 231 participants in an online SUDs forum. Surveys assessed social support reception and substance use at three timepoints. We assessed relationships between giving and receiving support and substance use (risky drinking days, illicit drug use days), and the interactions between self-efficacy and social support in predicting substance use outcomes.

RESULTS

Receiving more emotional support was associated with reduced illicit drug use at 6 and 12 months. For those with low self-efficacy, giving more emotional support predicted less risky drinking at month 12, whereas giving more informational support predicted more risky drinking at month 12.

CONCLUSION

These results suggest conditional benefits of exchanging support in an online SUDs forum, depending upon type of support (informational versus emotional), the participants' role (giver or receiver), and their self-efficacy.

PRACTICE IMPLICATIONS

We discuss implications for designing and using peer-to-peer support platforms.

Improving cancer survivors' e-health literacy via online health communities (OHCs): a social support perspective

PURPOSE

Cancer survivors should have adequate e-health literacy to help them better use online health information. Online health communities (OHCs) can offer cancer survivors different types of social support that can represent another resource to improve health outcomes. However, there is little knowledge of how these OHC are directly related to a cancer survivors' e-health literacy. This study explores how different types of social support in OHCs are associated with cancer survivors' e-health literacy.

METHODS

A questionnaire was developed to collect data from two Chinese OHCs used by cancer survivors. The questionnaire is composed of two parts: six sociodemographic variables (i.e., gender, age, city, education, tenure, and prior Internet experience), two scales for informational support behaviors (i.e., health knowledge seeking and provision of health knowledge), a measure of emotional support within such a setting, and a measure of e-health literacy. Based on 162 complete samples, we determined the measurement properties of the scales used, provided descriptive statistics on major sociodemographic variables and conducted bivariate and multivariable hierarchical regression.

RESULTS

For cancer survivors, females demonstrate higher levels of e-health literacy. Higher education level was related to higher e-health literacy. Health knowledge seeking, contributing to health knowledge, and emotional support were all positively associated with e-health literacy. The interaction effect between health knowledge and emotional support is positively associated with e-health literacy.

CONCLUSIONS

Informational support and emotional support, as two major subtypes of social support within resources available in OHCs, are positively associated with e-health literacy among cancer survivors.

IMPLICATIONS FOR CANCER SURVIVORS

Cancer survivors might benefit from an active strategy for improving personal e-health literacy that includes more active informational involvement and emotional support rather than a passive lurking through e-health information and seeking and reading postings in OHCs.

Understanding the role of Facebook to support women with endometriosis: A Malaysian perspective

AIMS

To examine the pertinent issues discussed by endometriosis patients in Malaysia on MyEndosis Facebook group as an alternative platform for online support.

METHODS

Using thematic analysis based on three frameworks, 120 posted messages and comments were examined from MyEndosis Facebook group-a support group for women with endometriosis from January to July 2014.

RESULTS

Results showed the issues discussed were (a) personal struggles, (b) medication and treatment, (c) alternative medication, (d) side effects, and (e) medication recommended by doctors. While using this social medium, users found (a) emotional support, (b) esteem support, (c) information support, (d) network support, and (e) tangible assistance in their engagement with others.

CONCLUSION

The analysis suggested that users' interactions were structured around information, emotion, and community building, which many doctors and nurses were not aware of. The group was shaped as a social network where peer users share social support, cultivate companionship, and exert social influence.

The role of off-topic discussions in online health support groups: insights from a content analysis of an online rectal cancer group

PURPOSE

Both off-topic discussions and exchanges of social support are important to the success of online health support groups. Analyzing their relationship could enhance our understanding of the nature of helpful interactions in online cancer support groups and ways promoting their success.

METHODS

A total of 15,284 messages were collected and analyzed from an online support group for rectal cancer. Two coders coded and categorized the messages into 211 threads using directed content analysis and a social support classification system. The relationship between off-topic discussions and social support was explored using the quadratic assignment procedure.

RESULTS

There are 91 threads of off-topic discussions, 83 threads of informational support, 22 threads of emotional support, seven threads of tangible support, five threads of network support, and three threads of esteem support. More of the off-topic discussions are associated with more emotional and tangible support. Both off-topic discussions and informational support are mutually influenced by the mediating role of emotional support. In addition, off-topic discussions and network support are mutually influenced by the mediating role of emotional and tangible support, and off-topic discussions and esteem support are mutually influenced by the mediating role of tangible support.

CONCLUSIONS

Off-topic discussions directly or indirectly promote different types of social support in an online rectal cancer support group.

Network Evolution of a Large Online MSM Dating Community: 2005-2018

Due to multiple sexual partners and low rates of condom use, the HIV infection rate among MSM (men who have sex with men) is much higher than that of the general population. In order to analyze the characteristics of online activities of MSM, and to understand the evolution of their social networks, in this study we collect a comprehensive dataset, covering the period from January 2005 to June 2018, from the largest Chinese online community, Baidu Tieba. We build an online dating network for MSM-related individuals in the gay-bar community, and analyze the network from static and dynamic aspects. It is found that there is a strong homophily regarding the cities where users reside when developing interactions with others, and that most network measurements tend to be stable at the later stages of evolution, while the size of the largest community fluctuates. This is an indication that the network is formed of rapidly flexible interactions which changes quickly. In comparison with studies on heterosexual networks, we find that the MSM dating network shows differences in many aspects, such as the positive degree-degree correlation and high clustering coefficient, suggesting different thinking and measures should be taken in the policy making of public health management towards the MSM population.

Exploring How People Affected by Methamphetamine Exchange Social Support Through Online Interactions on Facebook: Content Analysis

BACKGROUND

Methamphetamine is an illicit and addictive psychostimulant that remains to be a significant cause of economic burden in Australia. Social media is increasingly being used by nongovernment organizations and health services to encourage the growth of social support networks among people with health-related issues. Several studies have investigated the utility of social media in providing social support to groups of people with health-related issues. However, limited research exists that explores how people who have been directly or indirectly affected by methamphetamine use social media for social support.

OBJECTIVE

This study aimed to determine the types of social support being sought and provided by people affected by methamphetamine when interacting with others on a Facebook page.

METHODS

A total of 14,777 posts were collected from a Facebook page and transferred into an Excel document for content analysis. The posts were manually coded into categories of social support using an adapted version of Cutrona and Suhr's Social Support Behavior Code. Posts could be coded into more than one category. Saturation was reached at 2000 posts, which were used to draw inferences.

RESULTS

Emotional support was the most offered support type, with 42.05% (841/2000) of posts providing this form of support. This is followed by esteem support, which was provided in 40.40% (808/2000) of posts. Overall, 24.20% (484/2000) of posts offered informational support. Network support and tangible support were the least offered support types, with 2.25% (45/2000) and 1.70% (34/2000) of posts offering these types of support, respectively.

CONCLUSIONS

This study suggests that online social support groups can be effective in challenging stigma by encouraging people affected by methamphetamine to connect with each other and talk about their struggles. This in turn represents an important step toward successful rehabilitation.

The role of social support in moderating the relationship between HIV centrality, internalised stigma and psychological distress for people living with HIV

Research has documented the negative impact of stigma on health outcomes for people living with HIV (PLHIV). How central HIV is to the identity of the individual may increase the negative effects of stigma, including greater psychological distress, while having strong social supports may play a buffering role. This study aimed to establish whether internalised stigma mediates the relationship between the centrality of HIV identity and psychological distress, while also assessing the role of social support as a moderator. PLHIV (n = 181) responded to a survey assessing experiences of living with HIV focussed on centrality of HIV identity, internalised stigma, and wellbeing. After controlling for age and education, findings from the mediation analysis show that the more central HIV is to an individual's identity, the more stigma is internalised and the greater the negative impact on psychological wellbeing. However, this is only the case for people with low levels of social support. Regardless of how central HIV is to identity, social support appears to act as a buffer and promote positive wellbeing. For those working with PLHIV, promoting the importance of good social support systems may be one way to address some of the negative impacts of stigma.

The central roles of embeddedness and engagement in virtual communities

Purpose

The purpose of this paper is to develop a deeper understanding of how to promote members’ beneficial behaviors toward other members and toward the virtual community (VC). The authors extend Ray et al.’s (2014) framework by developing a more precise definition of community embeddedness, and determining how such embeddedness relates to social support and community engagement.

Design/methodology/approach

The authors test the proposed research model using data collected from 333 users of online social support communities/groups dedicated to sharing knowledge about pregnancy and child care. Partial least squares is used to analyze the measurement and structural models.

Findings

The study shows that embeddedness and engagement are significant determinants of willingness to help others and willingness to help the community. Embeddedness has a strong, positive effect on engagement. Social support positively affects community identification and embeddedness. However, community identification does not have a significant effect on engagement.

Research limitations/implications

Some of the findings, such as the relative importance of embeddedness in fostering willingness to help the community and the relative importance of engagement in fostering willingness to help others, might not be generalizable to VCs where members join for fun and sharing interests.

Practical implications

Although knowledge contributors could self-derive some drivers of embeddedness and engagement, managers or hosts of VCs should develop strategies and mechanisms to provide or enhance the value they add to knowledge sharing and other beneficial behaviors, even though such added value might be largely intangible.

Social implications

Social support plays an important role in shaping an individual’s embeddedness within a VC. Managers of VCs should develop strategies to stimulate exchanges of support among members.

Originality/value

The authors believe that community embeddedness plays a more important role than engagement in shaping the VC’s success and effectiveness. However, the extant VC literature has indicated a relatively weak understanding of the notion of community embeddedness. This study intends to fill that void.

Understanding the psychosocial impact of joint hypermobility syndrome and Ehlers-Danlos syndrome hypermobility type: a qualitative interview study

PURPOSE

Little attention has been paid to psychosocial factors in Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome (hypermobility type). This study sought to identify the psychosocial impact by examining participants' lived experiences; and identify characteristics of effective coping.

MATERIALS AND METHODS

Adults with Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome (Hypermobility Type) were invited to discuss their own lived experiences and the impact of the condition. All met recognized criteria for clinically significant joint hypermobility, and had a self-confirmed diagnosis. The transcripts were coded and analyzed using inductive thematic analysis.

RESULTS

Seventeen participants (14 women, 3 men) purposively selected to broadly represent different genders, ages and ethnicities. Analysis identified five key themes: healthcare limitations, a lack of awareness of Joint Hypermobility, and Ehlers-Danlos Syndrome (Hypermobility Type) among healthcare professionals; a restricted life; social stigma; fear of the unknown; and ways of coping.

CONCLUSIONS

The results highlight the significant psychosocial impact on participants' lives. Coping approaches identified included acceptance, building social networks, learning about joint hypermobility, and adapting activities. Physiotherapists supported regular exercise. Further research should consider potential interventions to improve information provision, address psychological support, and increase awareness of hypermobility among healthcare professionals.Implications for rehabilitationParticipants who had help from family members to complete activities described guilt and shame, highlighting the need for a greater rehabilitation focus on maintaining independence.Difficulties with sexual relationships due to prolapse or erectile dysfunction, and associated anxieties have indicated a need for greater awareness of these issues within primary care.The provision of reliable information and materials is vital, both for healthcare professionals and patients, to reduce misinformation and fear.Physiotherapists with knowledge of Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome hypermobility type were cited as sources of support and hope, which helped people to cope with and manage their condition.

Access to digital and social media among Romanian HIV/AIDS clinical providers

The WHO/UNAIDS suggests that digital tools – such as social media and online training opportunities, can connect providers in difficult social and medical contexts to providers elsewhere for guidance, support, and advice. Social media is emerging as an innovative option for connecting clinicians together and for enhancing access to professional resources. In Romania, characterized by an atypical HIV/AIDS epidemic which is further challenged by a range of access complexities, it is unclear how often – and which kinds of – social media clinicians use to support clinical care. This study was conducted to ascertain social media use for clinical providers based in two regions of Romania (Transylvania and Moldavia) who face distance challenges that could potentially be alleviated by social media interaction. We used an online survey to understand what social media are currently popular and perceived to be useful for learning clinical information. Descriptive and bivariate analyses were conducted. Providers indicated Facebook and WhatsApp were the most common social media platforms, with 62% and 45% reporting daily use, respectively. Providers who used one media platform were significantly more likely to use another social media platform (p < .05). These data are helpful for creating an online training platform on HIV/AIDS for Romanian clinical providers.

Inferring Smoking Status from User Generated Content in an Online Cessation Community

Introduction

User generated content (UGC) is a valuable but underutilized source of information about individuals who participate in online cessation interventions. This study represents a first effort to passively detect smoking status among members of an online cessation program using UGC.

Methods

Secondary data analysis was performed on data from 826 participants in a web-based smoking cessation randomized trial that included an online community. Domain experts from the online community reviewed each post and comment written by participants and attempted to infer the author's smoking status at the time it was written. Inferences from UGC were validated by comparison with self-reported 30-day point prevalence abstinence (PPA). Following validation, the impact of this method was evaluated across all individuals and time points in the study period.

Results

Of the 826 participants in the analytic sample, 719 had written at least one post from which content inference was possible. Among participants for whom unambiguous smoking status was inferred during the 30 days preceding their 3-month follow-up survey, concordance with self-report was almost perfect (kappa = 0.94). Posts indicating abstinence tended to be written shortly after enrollment (median = 14 days).

Conclusions

Passive inference of smoking status from UGC in online cessation communities is possible and highly reliable for smokers who actively produce content. These results lay the groundwork for further development of observational research tools and intervention innovations.

Implications

A proof-of-concept methodology for inferring smoking status from user generated content in online cessation communities is presented and validated. Content inference of smoking status makes a key cessation variable available for use in observational designs. This method provides a powerful tool for researchers interested in online cessation interventions and establishes a foundation for larger scale application via machine learning.