Social Support as a Moderator of the Big-Fish-in-a-Little-Pond Effect in Online Self-Help Support Groups1

Virtual care during the pandemic: Multi-family group sessions for Hong Kong Chinese families of adolescents with intellectual disabilities

The suspension of social services in Hong Kong during the COVID-19 pandemic increased the caregiver strain for families of adolescent children with intellectual disabilities, possibly aggravating their family relationships. This article reports on an online Multi-Family Group (MFG) conducted during the pandemic for Hong Kong Chinese families of adolescents affected by mild-to-moderate intellectual disabilities. A thematic analysis of the experiences of the participating service users revealed three positive effects of the intervention model: improved family relationships, mutual helpful influences occurring among families, and a new understanding of family members with intellectual disabilities. The therapeutic group process used to promote family development is illustrated by a group vignette. The challenges and the practical considerations for conducting an MFG online are discussed.

A comparison of lurkers and posters within infertility online support groups

Current research shows that online support groups can offer people affected by infertility a unique and valuable source of social support. However, to date most research has focused on the experiences of people who post messages to online infertility support groups; in comparison, little is known about how "lurkers" (i.e., those individuals who read messages but do not post messages) use and benefit from online infertility support groups. The purpose of the present study was to compare the use and experience of online infertility support groups between lurkers and posters. A total of 295 participants who were recruited from several online infertility support groups completed an online questionnaire containing questions about their use and experience of online support groups and measures of loneliness, social support, marital satisfaction, and perceived infertility-related stress. Differences between lurkers and posters were analyzed using Mann-Whitney U and χ or Fisher exact tests. Results revealed that compared with posters, lurkers visited the online support groups less often and scored significantly lower in overall satisfaction with the online support group. However, both lurkers and posters reported gaining a range of unique benefits from access to an online support group. Furthermore, there were no significant differences in loneliness, social support, infertility-related stress, and marital satisfaction between lurkers and posters. These findings suggest that reading messages posted to online support groups may be as beneficial as interacting with the group.

Consumer e-health: an overview of research evidence and implications for future policy

Consumer e-health is rapidly becoming a fundamental component of healthcare. However, to date only provisional steps have been taken to increase our understanding of how consumers engage with e-health. This study, an interpretive review, assessed the evidence about consumer use of e-health and identified five categories that encompass consumer e-health: (i) peer-to-peer online support groups; (ii) self-management/self-monitoring applications; (iii) decision aids; (iv) the personal health record; and (v) Internet use. Our findings reveal that e-health offers consumers many possibilities and potential benefits, although there appears to be apprehension concerning the efficacy of some interventions and barriers relating to the trustworthiness of Internet-acquired information. It is imperative that policy initiatives address these issues to ensure that consumer e-health services can be effectively, efficiently, and safely accessed.

Self-reported differences in empowerment between lurkers and posters in online patient support groups

BACKGROUND

Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have focused on the members of these groups who actively contribute by sending postings (posters). Thus far, little is known about the impact for "lurkers" (ie, those who do not actively participate by sending postings).

OBJECTIVE

In the present study, we explored if lurkers in online patient support groups profit to the same extent as posters do.

METHODS

We searched the Internet with the search engine Google to identify all Dutch online support groups for patients with breast cancer, fibromyalgia, and arthritis. Invitations to complete an online survey were sent out by the owners of 19 groups. In the online questionnaire, we asked questions about demographic and health characteristics, use of and satisfaction with the online support group, empowering processes, and empowering outcomes. The online questionnaire was completed by 528 individuals, of which 109 (21%) identified themselves as lurkers.

RESULTS

Lurkers (mean age 47 years) were slightly older than active participants (mean age 43 years, P = .002), had a shorter disease history (time since diagnosis 3.7 years vs 5.4 years, P = .001), and reported lower mental well-being (SF 12 subscore 37.7 vs 40.5, P = .004). No significant differences were found in other demographic variables. Posters indicated visiting the online support groups significantly more often for social reasons, such as curiosity about how other members were doing, to enjoy themselves, as a part of their daily routine (all P < .001), and because other members expected them to be there (P = .003). Lurkers and posters did not differ in their information-related reasons for visiting the online support group. Lurkers were significantly less satisfied with the online support group compared to posters (P < .001). With regard to empowering processes such as "exchanging information" and "finding recognition," lurkers scored significantly lower than posters. However, lurkers did not differ significantly from posters with regard to most empowering outcomes, such as "being better informed," "feeling more confident in the relationship with their physician," "improved acceptance of the disease," "feeling more confident about the treatment," "enhanced self-esteem," and "increased optimism and control." The exception was "enhanced social well-being," which scored significantly lower for lurkers compared to posters (P < .001).

CONCLUSION

Our study revealed that participation in an online support group had the same profound effect on lurkers' self-reported feelings of being empowered in several areas as it had on posters. Apparently, reading in itself is sufficient to profit from participation in an online patient support group.

Empowering processes and outcomes of participation in online support groups for patients with breast cancer, arthritis, or fibromyalgia

Ever since the rise of online support groups it has been presumed that there is an empowering effect from patients' participating in these groups, despite a lack of evidence to back up this assumption. In this study we explored if, and in which ways, patients feel empowered by participation. Additionally, we studied which empowering and disempowering processes occur as a result of taking part in these groups. To accomplish this aim, we interviewed 32 participants of online support groups. This analysis revealed the following empowering processes: exchanging information, encountering emotional support, finding recognition, sharing experiences, helping others, and amusement. Disempowering processes were mentioned far less often. Empowering outcomes mentioned were being better informed; feeling confident in the relationship with their physician, their treatment, and their social environment; improved acceptance of the disease; increased optimism and control; enhanced self-esteem and social well-being; and collective action. This article demonstrates that participation in online support groups can make a valuable contribution to the emergence of empowered patients.