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Marshall P, Booth M, Coole M, Fothergill L, Glossop Z, Haines J, Harding A, Johnston R, Jones S, Lodge C, Machin K, Meacock R, Nielson K, Puddephatt JA, Rakic T, Rayson P, Robinson H, Rycroft-Malone J, Shryane N, Swithenbank Z, Wise S, Lobban F. Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis. JMIR Ment Health 2024; 11:e55750. [PMID: 38722680 PMCID: PMC11117133 DOI: 10.2196/55750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 05/15/2024] Open
Abstract
BACKGROUND Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation. OBJECTIVE This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users. METHODS We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff. RESULTS Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety. CONCLUSIONS This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability. TRIAL REGISTRATION PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.
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Affiliation(s)
- Paul Marshall
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Millissa Booth
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Matthew Coole
- School of Computing and Communications, Lancaster University, Lancaster, United Kingdom
| | - Lauren Fothergill
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Zoe Glossop
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Jade Haines
- IT Corporate Services, Berkshire Healthcare NHS Foundation Trust, Berkshire, United Kingdom
| | - Andrew Harding
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Rose Johnston
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Steven Jones
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Christopher Lodge
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Karen Machin
- Survivor Research Network, London, United Kingdom
| | - Rachel Meacock
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, United Kingdom
| | - Kristi Nielson
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Jo-Anne Puddephatt
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Tamara Rakic
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Paul Rayson
- School of Computing and Communications, Lancaster University, Lancaster, United Kingdom
| | - Heather Robinson
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Jo Rycroft-Malone
- Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Nick Shryane
- Social Statistics, University of Manchester, Manchester, United Kingdom
| | - Zoe Swithenbank
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Sara Wise
- IT Corporate Services, Berkshire Healthcare NHS Foundation Trust, Berkshire, United Kingdom
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
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Jing Y, Jiang G. "No man is an island": How Chinese netizens use deliberate metaphors to provide "depression sufferers" with social support. Digit Health 2024; 10:20552076241228521. [PMID: 38303971 PMCID: PMC10832413 DOI: 10.1177/20552076241228521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Objective Online social support provides a way to positively influence depression sufferers. In the present study, we aim to analyze how social support in Chinese online depression communities is communicated through the lens of deliberate metaphor theory (DMT) to deepen the understanding of the under-researched complicated, emotionally laden, and culture-related concepts of this experience. Methods We collected data (n = 3546 comments) from the Warm Supporting section of the Depression Super Topic, a major Chinese online depression community on Weibo. The data were analyzed using a metaphorical analysis with the Metaphor Identification Procedure Vrije Universiteit and a thematic analysis. Results Our findings identify two themes: deliberate metaphors (DMs) of depression and DMs of social environment for depression sufferers. The former conceptualizes future expectations without depression (as rosy images; victorious battles; the beaten black dog); disorder (as subtle objects; subjective initiative events); depression sufferers (as valuable objects; important roles); and present life with depression (as optional events; spiritual practices; fragile objects). The latter conceptualizes social connection (as solid objects; nonessentials); individuals in the social environment (as energetic objects; vicious roles); and prejudice (as colored objects). Conclusions The findings suggest that DMs as important online social support resources, helping to express empathy and normalize depression with more common-sense, and non-judgmental concepts. Additionally, in DMs, Chinese netizens navigate the intricate intersection of medical and moral perspectives on depression and its recovery, leveraging both aspects to offer comprehensive social support. "Confucian-based" elements are embedded in culture-related social support expressions in DMs. In practice, our findings contribute to tailored and appropriate health interventions for depression.
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Affiliation(s)
- Youping Jing
- College of Foreign Languages and Cultures, Xiamen University, Xiamen, Fujian, China
| | - Guiying Jiang
- College of Foreign Languages and Cultures, Xiamen University, Xiamen, Fujian, China
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Storman D, Jemioło P, Swierz MJ, Sawiec Z, Antonowicz E, Prokop-Dorner A, Gotfryd-Burzyńska M, Bala MM. Meeting the Unmet Needs of Individuals With Mental Disorders: Scoping Review on Peer-to-Peer Web-Based Interactions. JMIR Ment Health 2022; 9:e36056. [PMID: 36469366 PMCID: PMC9788841 DOI: 10.2196/36056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/24/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND An increasing number of online support groups are providing advice and information on topics related to mental health. OBJECTIVE This study aimed to investigate the needs that internet users meet through peer-to-peer interactions. METHODS A search of 4 databases was performed until August 15, 2022. Qualitative or mixed methods (ie, qualitative and quantitative) studies investigating interactions among internet users with mental disorders were included. The φ coefficient was used and machine learning techniques were applied to investigate the associations between the type of mental disorders and web-based interactions linked to seeking help or support. RESULTS Of the 13,098 identified records, 44 studies (analyzed in 54 study-disorder pairs) that assessed 82,091 users and 293,103 posts were included. The most frequent interactions were noted for people with eating disorders (14/54, 26%), depression (12/54, 22%), and psychoactive substance use disorders (9/54, 17%). We grouped interactions between users into 42 codes, with the empathy or compassion code being the most common (41/54, 76%). The most frequently coexisting codes were request for information and network (35 times; φ=0.5; P<.001). The algorithms that provided the best accuracy in classifying disorders by interactions were decision trees (44/54, 81%) and logistic regression (40/54, 74%). The included studies were of moderate quality. CONCLUSIONS People with mental disorders mostly use the internet to seek support, find answers to their questions, and chat. The results of this analysis should be interpreted as a proof of concept. More data on web-based interactions among these people might help apply machine learning methods to develop a tool that might facilitate screening or even support mental health assessment.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Paweł Jemioło
- AGH University of Science and Technology, Krakow, Poland
| | - Mateusz Jan Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Zuzanna Sawiec
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Antonowicz
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Prokop-Dorner
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | | | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
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Dean M, Baker JT, Reblin M, Hintz EA, Vadaparampil ST, Haskins C, Quinn GP. Feasibility, acceptability, and outcomes of a pilot intervention facilitating communication about family building between patients with inherited cancer risk and their partners. PEC INNOVATION 2022; 1:100055. [PMID: 37213754 PMCID: PMC10194220 DOI: 10.1016/j.pecinn.2022.100055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 05/23/2023]
Abstract
Objective This study reports the feasibility, acceptability, and outcomes of a longitudinal, communication pilot intervention for patients with inherited cancer risk and their partners. Methods Couples were recruited through social media and snowball sampling. At Time 1 and 2, 15 couples completed a structured discussion task about family building concerns and decisions, followed by an online post-discussion questionnaire and dyadic interview to provide feedback about the experience. Interview data were analyzed to assess outcomes using applied thematic analysis. Results Participants reported the intervention created an opportunity for honest disclosure of family building goals and concerns. Participants also stated the structured nature of the discussion task was useful and did not cause additional stress. The intervention ultimately aided at-risk patients and their partners to realize their concordant concerns, discover/confront discordant concerns, and mutually agree upon next steps. Conclusions This pilot intervention is feasible and acceptable. Furthermore, it offers a framework to facilitate effective communication about family building between patients with inherited cancer risk and their partners. Innovation This intervention is the first conversational tool designed for at-risk patients and their partners.
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Affiliation(s)
- Marleah Dean
- Department of Communication, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Corresponding author at: Department of Communication, University of South Florida, 4202 E. Fowler Ave CIS 3068, Tampa, FL 33620, USA.
| | - Jonathan T. Baker
- Department of Communication, University of South Florida, Tampa, FL, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, VT, USA
| | | | | | - Carolyn Haskins
- Department of Genetic Counseling, Moffitt Cancer Center, Tampa, FL, USA
| | - Gwendolyn P. Quinn
- Department of OB-GYN, Grossman School of Medicine, New York University, NY, USA
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Lawless MT, Hunter SC, Pinero de Plaza MA, Archibald MM, Kitson AL. "You Are By No Means Alone": A Netnographic Study of Self-Care Support in an Online Community for Older Adults. QUALITATIVE HEALTH RESEARCH 2022; 32:1935-1951. [PMID: 36062369 DOI: 10.1177/10497323221124979] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Online peer-to-peer communities provide environments in which people with similar health concerns can interact and exchange information that can support self-care of long-term conditions. However, current theories have not adequately accounted for how self-care support is enacted in online communities. We conducted an observational netnography to identify and analyze posts in a publicly accessible online community (discussion forum boards) designed for older people. A Straussian grounded theory approach was used to examine 659 posts in health-related message boards. Self-care support involved the construction of three interrelated identities: (1) the support seeking self, in which members described problems and requested information; (2) the empathizing self, in which they described similar experiences and offered support; and (3) the influencing self, in which they provided information or advice. Online communities appear to be an important source of peer support and information and may be a cost-effective approach to supplement standard care.
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Affiliation(s)
- Michael T Lawless
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Bedford Park, SA, Australia
- National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, SA, Australia
| | - Sarah C Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Bedford Park, SA, Australia
| | - Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Bedford Park, SA, Australia
- National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, SA, Australia
| | - Mandy M Archibald
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Bedford Park, SA, Australia
- National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, SA, Australia
- College of Nursing, Helen Glass Centre for Nursing, Winnipeg, MB, Canada
| | - Alison L Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, 1065Flinders University, Bedford Park, SA, Australia
- National Health and Medical Research Council Transdisciplinary Centre of Research Excellence in Frailty Research to Achieve Healthy Ageing, Adelaide, SA, Australia
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Seiter CR, Brophy NS. Social Support and Aggressive Communication on Social Network Sites during the COVID-19 Pandemic. HEALTH COMMUNICATION 2022; 37:1295-1304. [PMID: 33601993 DOI: 10.1080/10410236.2021.1886399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
During the COVID-19 pandemic, use of social networking sites (SNSs) surged in many countries, including the United States. This content analysis of a convenience sample of English language conversations examined how users sought and provided social support on three Western-dominated SNSs, Reddit (N = 100), YouTube (N = 100), and Facebook (N = 100), during the week following the declaration of COVID-19 as a pandemic. In addition to analyzing social support, this study examined aggressive communication, which often leads to undesirable mental health outcomes, on Reddit, YouTube, and Facebook during this period. According to the Social Identity Model of Individuation Effects (SIDE), anonymous environments which codify civil communication norms are more likely to yield prosocial behavior. Results indicate that Reddit, YouTube, and Facebook varied significantly in supportive and aggressive communication prevalence. Reddit users more frequently provided social support than did YouTube and Facebook users. Additionally, Reddit users engaged in aggressive communication significantly less than both YouTube and Facebook users. These findings support predictions from the SIDE model, as Reddit both offers users greater anonymity than YouTube and Facebook and codifies supportive, civil communication norms in a rules system called, "Reddiquette."
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Affiliation(s)
| | - Nate S Brophy
- Department of Communication, George Mason University
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Liu Y, Zhu Y, Xia Y. Support-Seeking Strategies and Social Support Provided in Chinese Online Health Communities Related to COVID-19. Front Psychol 2021; 12:783135. [PMID: 34867695 PMCID: PMC8635687 DOI: 10.3389/fpsyg.2021.783135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Online health communities have become one of the most important means for people to seek social support during the coronavirus 2019 disease (COVID-19) pandemic. This study details content analysis of support-seeking strategies and social support offered on the online forum "Baidu COVID-19bar" across different stages of initial stage as well as during the entire initial stage of the COVID-19 pandemic. The results show that asking for support and disclosing directly were the main strategies used across the different stages and during the entire initial stage. Informational support and emotional support were the most common types sought in the first two stages and the entire initial stage, and informational support was the main type during the decline stage. Furthermore, asking for support was more likely to elicit informational support while disclosing directly was more likely to elicit emotional support. Theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Yi Liu
- School of Journalism and Communication, Chongqing University, Chongqing, China
| | - Yiwei Zhu
- School of Journalism and Communication, Chongqing University, Chongqing, China
| | - Yixuan Xia
- School of Journalism and Communication, Chongqing University, Chongqing, China
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8
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Entwistle C, Horn AB, Meier T, Boyd RL. Dirty laundry: The nature and substance of seeking relationship help from strangers online. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2021; 38:3472-3496. [PMID: 34924670 PMCID: PMC8669208 DOI: 10.1177/02654075211046635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Interpersonal relationships are vital to our well-being. In recent years, it has become increasingly common to seek relationship help through anonymous online platforms. Accordingly, we conducted a large-scale analysis of real-world relationship help-seeking to create a descriptive overview of the nature and substance of online relationship help-seeking. By analyzing the demographic characteristics and language of relationship help-seekers on Reddit (N = 184,631), we establish the first-ever big data analysis of relationship help-seeking and relationship problems in situ among the general population. Our analyses highlight real-world relationship struggles found in the general population, extending beyond past work that is typically limited to counseling/intervention settings. We find that relationship problem estimates from our sample are closer to those found in the general population, providing a more generalized insight into the distribution and prevalence of relationship problems as compared with past work. Further, we find several meaningful associations between relationship help-seeking behavior, gender, and attachment. Notably, numerous gender differences in help-seeking and romantic attachment emerged. Our findings suggest that, contrary to more traditional contexts, men are more likely to seek help with their relationships online, are more expressive of their emotions (e.g., discussing the topic of "heartache"), and show language patterns generally consistent with more secure attachment. Our analyses highlight pathways for further exploration, providing even deeper insights into the timing, lifecycle, and moderating factors that influence who, what, why, and how people seek help for their interpersonal relationships.
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Affiliation(s)
| | - Andrea B Horn
- Department of Psychology, University of Zurich, Switzerland
- University Research Priority Program: "Dynamics of Healthy Aging", University of Zurich, Switzerland
| | - Tabea Meier
- Department of Psychology, University of Zurich, Switzerland
- University Research Priority Program: "Dynamics of Healthy Aging", University of Zurich, Switzerland
| | - Ryan L Boyd
- Department of Psychology, Lancaster University, UK
- Security Lancaster, Lancaster University, UK
- Data Science Institute, Lancaster University, UK
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