Forging friendship, soliciting support: A mixed-method examination of message boards for pregnant teens and teen mothers

Who receives support during pregnancy? Variation by intendedness

Social support makes a vital contribution to health and life outcomes, particularly during the transition to motherhood in young adulthood, an often-challenging experience. Women should have the right not only to bear children but also to raise them in a secure environment, which is often aided by support. This study gives attention to how pregnancy intendedness contributes to pregnant women's receipt of support. Using novel data from a weekly survey of 18- to 22-year-old women over two and a half years, I investigate how intendedness is associated with the receipt of support and how support types vary throughout pregnancy. This study reveals new insight into the beginning trajectories of young mothers and highlights variation in the provision of support within social networks. Women with intended pregnancies are less likely to receive social support during pregnancy compared to those with unintended pregnancies. A lack of support may impact the health of both mother and child.

Barriers and Facilitators of Using eHealth to Support Gestational Diabetes Mellitus Self-Management (GDM): A Systematic Literature Review of Perceptions of Healthcare Professionals and Women with GDM (Preprint)

Background

Gestational diabetes mellitus (GDM) is one of the most common medical complications during pregnancy. eHealth technologies are proving to be successful in supporting the self-management of medical conditions. Digital technologies have the potential to improve GDM self-management.

Objective

The primary objective of this systematic literature review was to identify the views of health professionals (HPs) and women with GDM regarding the use of eHealth for GDM self-management. The secondary objective was to investigate the usability and user satisfaction levels when using these technologies.

Methods

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the search included primary papers in English on the evaluation of technology to support self-management of GDM from January 2008 to September 2021 using MEDLINE, CINAHL, Embase, ACM, and IEEE databases. The lists of references from previous systematic literature reviews, which were related to technology and GDM, were also examined for primary studies. Papers with qualitative, quantitative, and mixed methodologies were included and evaluated. The selected papers were assessed for quality using the Cochrane Collaboration tool, National Institute for Health and Care Excellence clinical guidelines, Critical Appraisal Skills Programme Qualitative Checklist, and McGill University Mixed Methods Appraisal Tool. NVivo (QSR International) was used to extract qualitative data, which were subjected to thematic analysis. Narrative synthesis was used to analyze the quantitative data.

Results

A total of 26 papers were included in the review. Of these, 19% (5/26) of studies used quantitative research methodologies, 19% (5/26) used qualitative methods, and 62% (16/26) used mixed methods. In all, 4 themes were identified from the qualitative data: the benefits of using technology, engagement with people via technology, the usability of technology, and discouragement factors for the use of technology. The thematic analysis revealed a vast scope of challenges and facilitators in the use of GDM self-management systems. The challenges included usability aspects of the system, technical problems, data privacy, lack of emotional support, the accuracy of reported data, and adoption of the system by HPs. Convenience, improved GDM self-management, peer support, increased motivation, increased independence, and consistent monitoring were facilitators to use these technologies. Quantitative data showed that there is potential for improving the usability of the GDM self-management systems. It also showed that convenience, usefulness, increasing motivation for GDM self-management, helping with GDM self-management, and being monitored by HPs were facilitators to use the GDM self-management systems.

Conclusions

This novel systematic literature review shows that HPs and women with GDM encountered some challenges in using GDM self-management systems. The usability of GDM systems was the primary challenge derived from qualitative and quantitative results, with convenience, consistent monitoring, and optimization of GDM self-management emerging as important facilitators.

The Influence of Web-Based Tools on Maternal and Neonatal Outcomes in Pregnant Adolescents or Adolescent Mothers: Mixed Methods Systematic Review

BACKGROUND

Pregnant adolescent women increasingly seek support during pregnancy and the puerperium through digital platforms instead of the traditional support system of family, friends, and the community. However, it is uncertain whether digital, web-based tools are reliable and effective in providing information to the user on a variety of topics such as fetal development, pregnancy outcomes, delivery, and breastfeeding to improve maternal and infant outcomes.

OBJECTIVE

We aimed to identify web-based tools designed to promote knowledge, attitudes, and skills of pregnant adolescents or adolescent mothers and determine the efficacy of such web-based tools compared with conventional resources in promoting good pregnancy and infant outcomes.

METHODS

A systematic search was conducted using Medline, Scopus, CINAHL, and PsycINFO for articles published from January 2004 to November 2020 to identify randomized trials and observational studies that evaluated digital, web-based platforms to deliver resources to pregnant adolescents. All articles written in the author's languages were included. Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. Risk of bias in each study was assessed using appropriate tools recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and the Joanna Briggs Institute. We adopted a qualitative synthesis and presented the results in a narrative format due to the heterogenous nature of the studies.

RESULTS

Seven articles met the inclusion criteria and were analyzed. The majority of the studies were graded to be of low to moderate risk for bias. The research methodologies represented were varied, ranging from randomized (n=1) and nonrandomized controlled trials (n=1) and prospective cohort studies (n=1) to mixed methods studies (n=1) and longitudinal surveys (n=3). Four studies included active web-based interventions, and 3 described exposure to web-based tools, including the use of social media and/or other internet content. Web-based tools positively influenced treatment-seeking intentions (intervention 17.1%, control 11.5%, P=.003) and actual treatment-seeking behavior for depression among postpartum adolescents (intervention 14.1%, control 6.5%, P<.001). In contrast, readily available information on the internet may leave adolescents with increased anxiety. The critical difference lies in information curated by health care professionals specifically to address targeted concerns versus self-acquired data sourced from various websites.

CONCLUSIONS

Despite almost universal web use, few studies have used this platform for health promotion and disease prevention. Social media interventions or web-based tools have the potential to positively influence both maternal and infant outcomes in adolescent pregnancy, but there is a need for more well-conducted studies to demonstrate the effectiveness of these support programs. The vastness of the information available on the web limits the ability of health care professionals to monitor or control sources of information sought by patients. Thus, it is important to create professionally curated platforms to prevent or limit exposure to potentially misleading or harmful information on the internet while imparting useful knowledge to the user.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42020195854; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195854.

Digital mediation of candidacy in maternity care: Managing boundaries between physiology and pathology

This paper brings together scholarship across sociology, media and communication, and human computer interaction to explore the intersection of digital health and the maternity care system. We draw on data (including interviews, focus groups, observations, and analyses of digital media content) from 19 studies involving over 400 women to explore women's experiences of using different forms of digital support such as the Internet, mobile technologies (apps and text messaging), social media, and remote monitoring devices in their reproductive journeys. We use a best fit approach to analysis, mapping our findings to the candidacy framework and notions of trajectory work to understand how women engage in digital health practices to negotiate boundaries between physiology and pathology and to enter dialogue with maternity services during conception, pregnancy and the postnatal period. We propose an integrated revised conceptual framework which explicates intersections between digital and care practices, and micro-level negotiations between women and professionals in the maternal health context. Our revised framework retains the dimensions of candidacy, but it introduces a precursor to the identification of candidacy in the form of 'understanding normality'. It identifies distinct forms of digital work (e.g. information work, navigation work, machine work) which operate across the candidacy dimensions that women (and partners at times) engage in to negotiate legitimacy when entering into encounters with the maternity care system. Operating conditions (norms around expert motherhood; neoliberal discourses around health optimisation, risk and responsibilisation) provide a broader macro-level context, influencing the micro-level dialogic processes between women and healthcare professionals. Our synthesis highlights digital mediation as a useful filter to understand care systems, distribution of lay/professional responsibilities, relational practices and the (dis)enablement of candidacy.

A Qualitative Analysis of Adolescent Responses to YouTube Videos Portraying Sexual and Gender Minority Experiences: Belonging, Community, and Information Seeking

Sexual and gender minority youth are at risk for negative mental health outcomes, such as depression and suicide, due to stigma. Fortunately, sense of community, connection, and social support can ameliorate these deleterious effects. Youth express that most of their social support comes from peers and in-school organizations, but these sources require in-person interaction. Past research has identified social media sites as virtual and anonymous sources of support for these youth, but the role of YouTube specifically in this process has not been thoroughly explored. This study explores YouTube as a possible virtual source of support for sexual and gender minority youth by examining the ecological comments left on YouTube videos. A qualitative thematic analysis of YouTube comments resulted in six common themes in self-identified adolescents' YouTube comments: sharing, relating, information-seeking, gratitude, realization, and validation. Most commonly, adolescents shared feelings and experiences related to their identity, especially when they could relate to the experiences discussed in the videos. These young people also used their comments to ask for identity-related advice or information, treating the platform as a source of education. Results suggest that sexual minority youth's use of YouTube can be advantageous for social support and community, identity-related information, identity development, and overall well-being.

The Role of Sense of Presence and Irritation in the Context of Mobile Social Network Sites

While mobile social network sites (SNSs) function as a platform for social and self-communication that leads to sense of others and oneself, users may feel irritation derived from social interaction and technical frustration in using mobile SNSs. Because of the ubiquitous nature of mobile devices, sense of presence and irritation are more influential to users' satisfaction of mobile SNSs. This study investigates the influence of a sense of presence and irritation on users' satisfaction with mobile SNSs. Additionally, the study examines a moderating effect of mobile SNS use intensity between sense of presence (social and self-presence) and irritation (social and technological irritation) and their outcomes. The study contributes to knowledge on social media users, particularly in the mobile context, by proposing and demonstrating a presence-irritation model

Using narrative inquiry to listen to the voices of adolescent mothers in relation to their use of social networking sites (SNS)

AIM

This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers.

BACKGROUND

Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support.

DESIGN

Discussion paper.

DATA SOURCES

This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, "social networking sites", online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995-June 2017.

IMPLICATIONS FOR PRACTICE/RESEARCH

Narrative research inherently values the individual "story" of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents.

CONCLUSION

Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process.

How a moderated online discussion forum facilitates support for young people with eating disorders

INTRODUCTION

Young people with eating disorders are at risk of harm to their social, emotional and physical development and life chances. Although they can be reluctant to seek help, they may access social media for information, advice or support. The relationship between social media and youth well-being is an emotive subject, but not clearly understood. This qualitative study aimed to explore how young people used a youth-orientated, moderated, online, eating disorders discussion forum, run by an eating disorders charity.

METHODS

We applied a netnographic approach involving downloading and thematically analysing over 400 messages posted August-November 2012.

RESULTS

Data analysis generated five themes: Taking on the role of mentor; the online discussion forum as a safe space; Friendship within the online forum; Flexible help; and Peer support for recovery and relapse prevention. Forum moderation may have influenced the forum culture.

DISCUSSION

Our findings are consistent with literature about youth preferences for mental health self-care support. A young person's decision to use this discussion forum can be construed as pro-active self-care. A moderated online discussion forum can make a positive contribution to support for youth with eating disorders, countering negative media perceptions of online groups.

CONCLUSION

This study adds to knowledge about how young people access support via social media. Online discussion forums can be safe and acceptable spaces for youth to access help. Further research could provide insights into the impact of forum moderation.

Social networking sites (SNS); exploring their uses and associated value for adolescent mothers in Western Australia in terms of social support provision and building social capital

OBJECTIVE

to explore the use of social networking sites (SNS) by adolescent mothers in Western Australia (WA) in relation to social support and the building of social capital.

DESIGN

a constructionist narrative inquiry approach was employed to guide the research design and processes. Approval was gained from the university human ethics department. Sampling was purposeful and data were collected using in-depth interviews with seven adolescent mothers in WA.

SETTING

interviews were undertaken within the homes of adolescent mothers across WA.

FINDINGS

from within three fundamental domains of social support; tangible, emotional and informational support, provided by SNS use, five key themes were identified from the narratives. 'Social connectedness' was identified as a form of tangible support, sometimes termed 'practical' or 'instrumental' support. This theme incorporates connectedness with family, friends, and peers and across new and existing social groups. Three themes were identified that relate to emotional support; 'increased parenting confidence'; 'reduced parental stress' and 'enhanced self-disclosure' afforded by use of SNS. 'Access to information' was identified in terms of informational support, with participants often highlighting SNS use as their primary portal for information and advice.

CONCLUSIONS

the findings of this study suggest that SNS use affords adolescent mothers in WA access to tangible, informational and emotional support and thus is a valuable source of social capital for these mothers. This study provides a platform for further exploration into this phenomenon, and possible implications include the potential for midwives and health care professionals to promote the benefits of SNS use with, and for, this group of mothers, or to incorporate SNS use into modern health care practices to further develop the potential for improved social capital related outcomes for them.