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

Digital Tools in the Service of Peer and Social Support for Perinatal Mental Health

PURPOSE OF REVIEW

This study is critically evaluating the current status of digital tools for perinatal mental health, specifically focusing on how these tools can enhance peer and social support.

RECENT FINDINGS

Digital tools could be used to: (1) identify individuals in need and guide them towards appropriate human-supportive care; (2) autonomously train and allocate peers to aid women experiencing perinatal mental health challenges; and (3) amplify support from their natural social network. Despite clear evidence supporting the significance of social support for perinatal mental health, there is a dearth of studies on digital tools aimed at boosting such support, leaving a gap in the evidence. Findings underscore the necessity of developing digital initiatives that explicitly aim to augment social support as an active ingredient of therapeutic change for women's perinatal mental health. To establish clear evidence of digital tools' value in providing digital peer-support, further development and research are indispensable.

Social Networking Services as a Tool for Support of Mothers: A Literature Review

BACKGROUND

Difficulties experienced by mothers in raising their children can be resolved using social networking services (SNSs). Being aware of issues associated with SNSs in such situations may be useful for supporting mothers. We herein review the issues associated with using SNSs to support mothers.

METHODS

This review was conducted using an electronic search engine to search for articles that described issues associated with using SNSs to support mothers, and which were published up to August 2022.

RESULTS

After screening, a total of 19 articles were included. We thematically categorized the contents into three major issues associated with using SNSs for support of mothers: (1) issues on the management side, (2) issues on the user side, and (3) social and environmental issues. The mainly discussed issues were the safety of using SNSs and/or securing and training human resources on the management side, busyness of mothers on the user side, as well as sociocultural and communication environment-related limitations as social and environmental issues.

CONCLUSIONS

The issues we detected would aid in developing the use of SNSs as a tool to support mothers. Further research on these issues is needed.

First-Time Mothers' Invisible Presence Using Social Networking Sites

PURPOSE

To describe first-time mothers' experiences with online social networking sites in the early postpartum period, explore how mothers use them to gain support, and to evaluate how their use can aid or hinder maternal role transition.

STUDY DESIGN

Qualitative descriptive study.

METHODS

This qualitative descriptive study, using convenience and snowball sampling, first-time mothers in the early postpartum period were recruited through social media. Semistructured interviews were conducted virtually where mothers were asked to describe their experiences with online social networking. Thematic analysis methods were used to develop themes from participant interviews.

RESULTS

Twelve first-time mothers ranging from 4 to 12 weeks postpartum participated in the study. Thematic analysis revealed four themes: 1) Habits of first-time mom using social networking sites, 2) New purpose online, 3) Taking it to the moms, and 4) Impact on motherhood.

CLINICAL IMPLICATIONS

Maternal child nurses have opportunities to further customize support for first-time mothers online. Awareness of habits, trends, implications of early mothering during COVID-19, and the role social networking sites can play in supporting mothers in the early postpartum period offers new ways for nurses to support and empower the motherhood collective.

Strengthening Peer Mentoring Relationships for New Mothers: A Qualitative Analysis

(1) Background: The transition to motherhood can be challenging, especially for first-time mothers, and can accompany maternal distress. Social support—such as that offered by peers—can be important in assisting mothers to manage such distress. Although primiparous mothers often seek out and value peer support programs, few researchers have investigated factors that may influence the strength of relationships in non-professional maternal peer support programs. Insight into these factors can be key to enhancing the success of future peer support interventions. (2) Methods: Reflexive thematic analysis was applied to data gathered from 36 semi-structured interviews conducted with 14 primiparous mothers and 17 peer mentors in a peer support program. (3) Results: Four themes related to successful mentorship were identified: expectations of peer relationship, independence of peer mentor, contact, and similarities. (4) Conclusions: For primiparous mothers who are developing their support network, these factors appear important for promoting close and effective peer support relationships. Interventions that harness the dynamics between these factors may contribute to more successful peer support relationships and mental health outcomes for participants.

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.

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.

Online Peer Support and Well-being of Mothers and Children: Systematic Scoping Review

BACKGROUND

Online peer support groups are common and can be an effective tool for mothers with young children. The purpose of this review is to examine the types of support that online-based peer groups establish as well as its health effects to mothers and their children.

METHODS

Systematic scoping review. Systematic review of existing literature was conducted using Pubmed, Cinahl, Medline, Cochrane and Ichushi (Japanese language) database in December 2019.

RESULTS

Based on the inclusion and exclusion criteria, total of 1,475 articles were extracted by initial search. After the review of titles, abstracts and full texts, total of 21 articles met the inclusion criteria. The types of support mothers received were mainly informational and emotional support. Mothers also felt a sense of connection and community. Some health effects of online-based peer support group were seen in the area of mothers' mental well-being. Minimal effects were seen in behavioral modification for child nutrition and breastfeeding.

CONCLUSION

Due to the limited evidence in interventional studies, the effects of online-based peer support groups were inconclusive. Further studies with rigorous research designs would be helpful in future research.

Social networking sites: Can midwives and nurses working with adolescent mothers harness their potential value?

AIM

This paper aims to discuss social networking sites as potentially salutogenic, culturally relevant extensions to maternity care provision for adolescent mothers.

BACKGROUND

Studies report that online networking may enhance social capital, a concept linked to enhanced well-being, particularly for marginalized individuals. Improving outcomes for adolescent mothers is an ongoing global strategy; thus, this paper has relevance for all professionals involved in their care.

DESIGN

This is a discussion paper.

DATA SOURCES

This paper draws on the authors' research and is supported by literature and theory. Key terms and Boolean operators were used to identifiy English-language papers published in January 1995 to January 2019 in nine databases and Google Scholar databases.

IMPLICATIONS FOR NURSING

Despite limited evidence specific to adolescent mothers, contextual studies suggest that social networking sites may enhance well-being. Nurses and midwives need to understand adolescent mothers' use of online networks to aid development of innovative, health-enhancing care strategies using adolescent-familiar modalities.

CONCLUSION

This paper highlights the need for further research regarding the value of professional engagement in online networks to enhance an adolescent's transition to motherhood.

The 'fallacy of normalcy': A content analysis of women's online post-childbirth health-related support

BACKGROUND

Online forums have changed traditional sources of seeking help because they provide an anonymous and non-judgemental environment particularly suited for women with post-childbirth problems.

QUESTION

What support is given to mothers who have posted questions about post-childbirth morbidities?

METHODS

A total of 333 messages posted on a post-childbirth online forum were loaded into NVIVO 12 Pro and were analysed using content and thematic analysis. Content analysis identified the major health problems, and thematic analysis was used for identifying motivations and the support offered.

FINDINGS

Seventeen different health problems were discussed on posts, with a strong emphasis on pelvic problems, followed by mental health concerns. The key motivation for seeking online help identified using 'typology of advice solicitation' was request for opinion or information (48.85%). The two main support themes were: peer to peer support (82%) and normalisation (not always appropriate) of post-childbirth problems (18%). Most of the support offered was emotional (56.9%) followed by practical (22.7%) and informational support (20.4%).

DISCUSSION

Postpartum adjustment of post-childbirth experiences can be supportive but if ill-informed may provide a barrier to safe and reliable health care.

CONCLUSION

We recommend women have access to online forums moderated by healthcare providers who can notify participants when a problem requires support from a relevant health professional opinion.

Promoting the health of mothers of young children in Australia: A review of face-to-face and online support

ISSUE ADDRESSED

Social support is essential during early motherhood. Societal changes have altered the support networks of mothers of young children, placing them at greater risk of social isolation. The aim of this review was to explore the research related to the experience of social support for mothers of young children to understand how to best promote social connections for the current generation of mothers.

METHODS

A systematic search of eight electronic databases through EBSCOhost was undertaken to identify Australian research published from 2013 onwards. No study design limits were applied. Research which focussed into understanding the social support of mothers with children 0-5 years and had outcomes related to mothers experiences were included.

RESULTS

Fifteen studies were included. Both face-to-face and online support provided benefits to mothers of young children in terms of shared experiences and reciprocity; trust and intimacy; community connectedness and; mental well-being. While online communities offered immediacy of access to social support, contemporary mothers continued to value social support accessed in face-to-face settings. Accessing face-to-face support was a challenge for young mothers and those in new housing areas.

CONCLUSIONS

Face-to-face programs continue to promote the health of contemporary mothers; however, online settings provide avenues for alternative or complimentary support. There is a need to further develop support programs for vulnerable and isolated mothers. SO WHAT?: Social support is essential for mothers of young children and opportunities to enhance social connections are important to boosting mental well-being. While face-to-face programs still need to be provided, services should consider including online options to promote the health of contemporary Australian mothers.

Impact of a peer virtual community on pregnant women's well-being: A repeated-measure and quasi-experimental study

AIM

To investigate the effects of a virtual community on pregnant women's well-being.

BACKGROUND

The virtual social network has been growing rapidly but its effects remain unclear.

DESIGN

A repeated-measure and quasi-experimental study.

METHODS

We designed a closed Facebook community for peer-to-peer interaction with no mediator. A total of 121 pregnant women were assigned to either experimental or control group. Data were collected from May 2012-January 2015 using five instruments related to pregnant women's well-being.

RESULTS

Significant differences on pregnant women's well-being were not found between groups. However, higher adherence to the virtual community was significantly related to first-time pregnant women and women whose pregnancy was assisted by a technology treatment.

CONCLUSIONS

Nurses and midwifes are recommended to pay more attentions on first-time pregnant women and women whose pregnancy was assisted by a technology treatment regarding their pregnancy-related concerns.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov NCT03692923.

Exploring the views of young women and their healthcare professionals on dietary habits and supplementation practices in adolescent pregnancy: a qualitative study

Background

Nutrition is a modifiable factor affecting foetal growth and pregnancy outcomes. Inadequate nutrition is of particular concern in adolescent pregnancies with poor quality diet and competing demands for nutrients. The aim of this study was to explore knowledge and understanding of nutrition advice during adolescent pregnancy, and identify barriers and facilitators to dietary change and supplementation use in this vulnerable population.

Methods

Semi-structured interviews were conducted with young women and key antenatal healthcare providers: midwives, family nurses and obstetricians. Doncaster, Manchester and London were chosen as sites offering different models of midwifery care alongside referral to the Family Nurse Partnership programme.

Results

A total of 34 young women (adolescents aged 16–19 years) and 20 health professionals were interviewed. Young women made small changes to their dietary intake despite limited knowledge and social constraints. Supplementation use varied; the tablet format was identified by few participants as a barrier but forgetting to take them was the main reason for poor adherence. Health professionals provided nutrition information but often lack the time and resources to tailor this appropriately. Young women’s prime motivator was a desire to have a healthy baby; they wanted to understand the benefits of supplementation and dietary change in those terms.

Conclusion

Pregnancy is a window of opportunity for improving nutrition but often constrained by social circumstances. Health professionals should be supported in their role to access education, training and resources which build their self-efficacy to facilitate change in this vulnerable population group beyond the routine care they provide.

Electronic supplementary material

The online version of this article (10.1186/s40795-018-0254-7) contains supplementary material, which is available to authorized users.

Digital Peer-Support Platform (7Cups) as an Adjunct Treatment for Women With Postpartum Depression: Feasibility, Acceptability, and Preliminary Efficacy Study

Background

Peer support is considered to be an important framework of support for mothers experiencing postpartum depression (PPD); however, some barriers exist that may limit its use including peer availability and mothers’ lack of time due to child care.

Objective

This non-randomized study was designed to examine the feasibility, acceptance, and preliminary clinical outcomes of using 7 Cups of Tea (7Cups), a digital platform that delivers self-help tools and 24/7 emotional support delivered by trained volunteers, as an adjunct treatment for mothers diagnosed with PPD.

Methods

Mothers with PPD were referred during intake to the study coach who provided guidance about 7Cups. 7Cups features included self-help tools and chats with trained volunteers who had experienced a perinatal mood disorder in their past. Acceptability was measured by examining self-reports and user engagement with the program. The primary outcome was the Edinburgh Postnatal Depression Scale (EPDS) change score between pre- and postintervention at 2 months, as collected in usual care by clinicians blinded to the study questions. Using a propensity score matching to control for potential confounders, we compared women receiving 7Cups to women receiving treatment as usual (TAU).

Results

Participants (n=19) proactively logged into 7Cups for a median of 12 times and 175 minutes. Program use was mostly through the mobile app (median of mobile use 94%) and between 18:00 and 08:00 when clinicians are unavailable (68% of total program use time). Participants chatted with volunteers for a total of 3064 minutes and have indicated in their responses 0 instances in which they felt unsafe. Intent-to-treat analysis revealed that 7Cups recipients experienced significant decreases in EPDS scores (P<.001, Cohen d=1.17). No significant difference in EPDS decrease over time was found between 7Cups and TAU, yet the effect size was medium favoring 7Cups (P=.05, Cohen d=0.58).

Conclusions

This study supports using a computerized method to train lay people, without any in-person guidance or screening, and engage them with patients diagnosed with mental illness as part of usual care. The medium effect size (d=0.58) favoring the 7Cups group relative to TAU suggests that 7Cups might enhance treatment outcomes. A fully powered trial has to be conducted to examine this effect.

Dietary habits and supplementation practices of young women during pregnancy: an online cross-sectional survey of young mothers and health care professionals

BACKGROUND

Nutrition is a modifiable factor affecting birth outcomes, particularly in adolescent pregnancies. This study explores diet and supplementation practices, information and advice before, during and after pregnancy from the perspectives of pregnant or new young mothers and healthcare professionals.

METHODS

Two cross-sectional surveys used online questionnaires for young women who were currently pregnant or who had recently given birth, and health care professionals providing antenatal care. The surveys utilised a combination of question types including free text and multiple choice. Recruitment was conducted via the Tommy's website, online forums for young mothers and professional networks.

RESULTS

A total of 205 young women and 146 health care professionals were included in the study.Most young women reported taking supplements at some stage of pregnancy (93.2%), with 54.6% taking it on a daily basis. Those who reported taking supplements less than 7 days a week stated it was mainly due to forgetting. Health care professionals however reported that some young women had difficulties accessing healthy start supplements. Young women reported positive dietary changes; however a significant proportion of participants indicated that they avoided some foods unnecessarily. Avoiding or reducing foods such as red meat (22.7%), eggs (40.6%), oily fish (60.4%) and soft cheese (36.2%) is of concern. Midwife/family nurse (38.0%) was young women's current favourite information source; smartphone applications (apps) and recipe booklets were suggested by over 50% of participants as a new addition to existing services. Health care professionals reported they included nutritional information and support as part of their role; however they felt there were some gaps in knowledge and confidence. Midwives in particular suggested a lack of sufficient time and resources as a main challenge in providing adequate support.

CONCLUSIONS

Avoiding or reducing major food groups was reported which can indicate a poor dietary pattern. A positive change in dietary intake reported by the majority of young women in this survey indicates willingness to adopt a healthy lifestyle. This, in addition to their trust in health professionals particularly midwives, provides an opportunity for health interventions which support behaviour change to improve birth outcomes. Identified gaps in knowledge and confidence by health professionals in providing dietary advice highlight the need for some additional training for health professionals in delivering dietary and lifestyle behaviour change interventions. Independent and trustworthy online resources for women and their health professionals which can be accessed at any time to provide up to date information in between appointments are also required.

Beyond Baby Steps: Today's Use of Social Networking Sites and the Nursing Profession

Nurses' use of online social networking sites, such as Facebook and Twitter, are increasing and with it the controversy surrounding the compatibility of social networking sites within a profession that values privacy and confidentiality. This article draws on case studies, experiments, surveys, and policies from professional organizations, academic research, and nursing education programs spanning the last 5 years to highlight best practices that address 2 critical areas where the values of the nursing profession and those of social media most directly collide: regulatory issues and the blurring of professional and personal online identities. It also suggests ways of using social media to complement patient outcomes and the professional development of nurses while remaining consistent with professional ethics and values.

Local disease concepts relevant to the design of a community-based surveillance program for influenza in rural Guatemala

Background

Early detection of emergent influenza strains is a global health priority. However, maintaining active surveillance is economically and logistically challenging. While community-based surveillance is an attractive alternative, design and operation of an effective epidemiological surveillance program requires community engagement that can be linked to public health reporting and response. We report the results of a study in rural Guatemalan communities aimed at identifying opportunities for and barriers to community engagement in disease surveillance.

Methods

Using an ethnographic approach followed by a descriptive cross-sectional survey, we documented local terms and ideas about animal illnesses, including the possibility of animal-human transmission.

Results

The community perceived disease causation principally in terms of changes in the physical environment and weather and categorized illnesses using local terminology based on observable clinical signs. Knowledge about prevention and treatment was derived predominantly from local networks of family and friends without evidence of professionally-based knowledge being regularly introduced into the community.

Conclusions

Bridging the divide between professional and community-based descriptive disease terminology, incorporating animal and human health responsiveness to common illnesses, and providing professional knowledge into the community-based networks were identified as addressable challenges to effective implementation of community-based surveillance.

A social network analysis of supportive interactions on prenatal sites

Objective

The purpose of this exploratory study was to validate and extend previous research on social support by identifying which dimensions of social support are most commonly exchanged on health-related social networking sites and how social network structure varies with each support dimension exchanged.

Methods

This research applies a multiple case study approach by examining two social networking sites that focus on pregnancy and prenatal health. For one month, support seeking and providing messages were content analyzed and a social network analysis examined the connections between members.

Results

The sample size consisted of 525 support-seeking messages and 1965 support-providing messages. Findings indicate that participants requested informational and emotional support more than esteem and network support, with no requests for tangible support. Findings also suggest participants substituted emotional support for informational support when they were unable to provide the information sought. The social network analysis showed that network structure varied across support dimensions, with the informational and emotional support networks having the largest number of members and greatest density and reciprocity.

Conclusions

This study suggests that online support networks are fairly effective in meeting participants’ needs. The support dimension sought was generally provided and when it was not another dimension of support may have been substituted; thus, participants may have benefitted in unintended ways. The data also suggest there may be an optimal network size to support member engagement, whereby too large of a network may facilitate diffusion of responsibility and too small a network may not facilitate enough momentum to support a well-connected community.