Empowering processes in online support groups among people living with HIV/AIDS: A comparative analysis of ‘lurkers’ and ‘posters’

The proliferation of online support groups provides an opportunity for individuals living with HIV/AIDS to obtain support online. The present study aimed to explore how different levels of participation in online support groups are associated with empowering processes and outcomes for individuals living with HIV/AIDS. A total of 340 individuals living with HIV/AIDS were recruited. They completed an online questionnaire consisting of measures on satisfaction with online support groups, empowering processes, self-care self efficacy, loneliness, optimism, coping, depression, and health-related quality of life. Results revealed that compared to posters, members who only read the messages (lurkers) scored lower in receiving social support and receiving useful information in empowering processes, and lower in satisfaction with their relationship with group members. They also scored higher in distraction and lower in planning in the brief COPE. In addition, they scored lower in social function and higher in energy. There were no significant differences in self-care self efficacy, loneliness, depression, or optimism between posters and lurkers. Our results suggest that lurking in the online support groups may be as empowering as reading and posting messages to the groups. More research is needed to identify the long term effects of online support group use.     

Social interaction in online support groups: Preference for online social interaction over offline social interaction

The purpose of the current study was to identify potential factors leading to preference for social interaction in online support groups (OSGs) over offline interaction. By identifying such factors, the current study advances understanding of the way patients use the Internet as a supportive resource and integrate support from offline and online relationships. An online survey was conducted with current users of health-related OSGs (N = 158). Findings show that those who were dissatisfied with the support they received from their current offline contacts were more likely to prefer social interaction in OSGs. Such a preference was prominent among those who built deeper social relationships in OSGs. Results suggest that some people develop a preference for social interaction in OSGs over offline interaction and use computer-mediated relationships as a possible alternative to offline support networks. Healthcare professionals and users as well as designers of OSGs must acknowledge the limits of online support and caution against the possibility of developing excessive reliance on online support resources.     

Fostering empowerment in online support groups

Online support groups have been used extensively, in numerous areas of distress, for 15 years. Researchers have presented conflicting findings and ideas about their effectiveness in helping people cope with respective problems. Our review of quantitative studies and our qualitative exploration of the nature of the experiences that occur in such groups show that several factors operate to potentially affect participants. Personal and interpersonal dynamics, which are central in producing effects in these groups, are induced and accelerated by the powerful online disinhibition effect. These factors, including the very impact of writing, expressions of emotions, collecting information and thereby improving understanding and knowledge, developing social relationships, and enhancing decision-making skills and consequent behavioral actions all serve as possible generators of a sense of personal empowerment for people in distress. This view may explain why empirical research has frequently found little or no specific outcomes from participating in online support groups; however, it has found much support for nonspecific personal impacts of this means of intervention. Thus, we contend that online support groups are designed to foster, and many of them actually do, well-being, a sense of control, self-confidence, feelings of more independence, social interactions, and improved feelings—all nonspecific but highly important psychological factors. As such, participating in an online support group could foster personal empowerment, which is much needed in handling specific conditions of distress. Nonetheless, this participation has potential costs, too, especially developing dependence, distancing from in-person contacts, and exposure to unpleasant experiences typical of social engagement in cyberspace.     

Differences among breast and prostate cancer online support groups

Online support resources have become viable alternatives to face-to-face support groups for cancer patients. It is important to understand how individuals make use of such online support resources and what, if any, differences exist between groups. A content analysis was conducted on 3203 posted messages to prostate and breast cancer support sites on Google Groups and WebMD. Overall, post-treatment survivors were the most common posters followed by spouses; however, the proportion of posters varied by site. For both groups, messages of support were most frequent. However the type of support varied by cancer type. Support messages on the breast cancer sites were mostly offers of emotional support. Conversely, messages of support on the prostate cancer sites focused on informational support. Messages of emotional well-being and medical-related comments were next most common on the breast cancer sites, whereas medical issues and sexual intimacy were on the prostate cancer sites. Overall, these findings identify several key differences in the use and benefits of online support sites for breast and prostate cancer.     

Nurturing health-related online support groups: Exploring the experiences of patient moderators

The aim of this study was to examine the views of moderators across a diverse and geographically broad range of online support groups about their moderator experiences and to explore both the personal benefits as well as challenges involved. Thirty-three patient moderators completed an online questionnaire which included a series of open-ended questions. Thematic analysis identified three themes: emergence, empowerment, nurturing. Several moderators declared their own diagnosis and for some, being able to share personal insights motivated them to establish the group and in turn offered validation. They felt empowered by helping others and learned more about the condition through accessing the “communal brain”. Some felt the group aided patients’ access to health services and their ability to communicate with health professionals while others worried about them becoming over-dependent. Moderators described needing to nurture their group to ensure it offered a safe space for members. Clear rules of engagement, trust, organisation skills, compassion and kindness were considered essential. Patient moderated online support groups can be successfully developed and facilitated and can be empowering for both the group member and moderator alike.     

Changes in adolescent online social networking behaviors from 2006 to 2009

As online social networking has become an immersive and pervasive phenomenon, traditional considerations and expectations of personal privacy have been drastically altered. This paradigmatic change has led to adolescents possibly making themselves vulnerable to embarrassment, censure, damage to one’s name or reputation, or even victimization by others because of unwise postings or revelations online. The current study sought to determine the extent to which adolescent information disclosure on MySpace.com has changed between 2006 and 2009. We found significant changes in the nature of personal content made publicly available across the two time points and a trend in which teens are being increasingly more selective and discrete when it comes to what they share and with whom they share it.     

Time, technology and groups: An integration

This paper summarizes main findings of the five empirical papers in this issue, and discusses certain themes that connect them.     

Alt.support: modeling social support online

While there is mounting evidence that people use the Internet to expand their social networks and receive social support, little is known about how they do so and with what effect the Internet has on overall levels of social support. Based on a survey of 213 online support seekers, this study explored social cognitive mechanism such as self-efficacy and outcome expectations as predictors of support activity, online support reliance and support network size. From these relationships, we offer preliminary evidence suggesting that those who actively seek social support online are indeed finding it through a complex support system beginning with self-regulation.     

A comparative content analysis of face-to-face vs. asynchronous group decision making

A field experiment was conducted to analyze the process and contents of group discussions. Groups solved a case study either orally or through an asynchronous computer-mediated communication system. Findings show that asynchronous groups had broader discussions and submitted more complete reports than their face-to-face counterparts. However, there was no difference in the ability to transfer information from the discussion to the report; under both conditions, about 15% of the issues mentioned in the discussion were omitted from the final report. In terms of coordination, face-to-face teams covered the case study questions sequentially, while asynchronous groups were more focused on solving their general disagreements.     

Giving and receiving emotional support online: Communication competence as a moderator of psychosocial benefits for women with breast cancer

This study examines the moderating role of emotional communication competence in the relationship between Computer-Mediated Social Support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last two months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and 6-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed.     

Introduction: The JEMCO-2 Study of time, technology, and groups

An experimental study of 60 work groups that met weekly either face to face or via a computer conferencing system for seven weeks is described. The experimental design, computer technology, experimental tasks, and composition of the groups are described in detail. A brief overview is given of the five empirical pieces in this special issue that report findings from this experimental study.     

Comparing the social knowledge construction behavioral patterns of problem-based online asynchronous discussion in e/m-learning environments

In recent years, researchers have conducted various studies on applying wireless networking technology and mobile devices in education settings. However, research on behavioral patterns in learners' online asynchronous discussions with mobile devices is limited. The purposes of this study are to develop a mobile learning system, mobile interactive teaching feedback system (MITFS), linked to both mobile devices and the internet, to support learners with online asynchronous discussion, and combine content analysis and sequential analysis to compare and contrast the social knowledge construction behavioral patterns of problem-based asynchronous discussion in e-learning and m-learning environments. This study investigated four weeks of online discussions in an “Introduction to Computer Science” course involving forty first year university students. The control group (online asynchronous discussion without mobile devices) and the experimental group (online asynchronous discussion with mobile devices) in the group discussions were explored. By using content analysis and sequential analysis for the problem-based online asynchronous discussion of the behavioral patterns and differences between students in control and experimental group, the results showed that using mobile devices in online asynchronous discussion influenced students' learning performance. Some interesting results were found. Firstly, when the students used mobile devices in discussion situations, they could more engage in reflecting thinking, sharing more information, and further facilitating social knowledge construction among group members. Secondly, the experimental group performed better than the control group in terms of participation and diversity in knowledge construction behavioral patterns. Finally, based upon the findings, some implications are proposed for further research.     

Overcoming social awareness in computer-supported groups

We examined status effects in face-to-face and computer-mediated three-person groups. Our expectation that low status members in computer-mediated group discussions would participate more equally, and have more influence over decisions, than their counterparts in face-to-face groups was not confirmed. The results suggest that knowledge of status differences and labels were used to form cognitive impressions of other group members. It seems that when group members are aware of the status characteristics of the group, social cues were magnified rather than redüced. Implications of these findings for mixed status cooperative work groups and for the design of computer communication systems are discussed.     

Estimation of HIV/AIDS parameters

This paper shows how well-established control system techniques can be introduced to formulate guidelines for clinical testing and monitoring of HIV/AIDS disease and the estimation of HIV/AIDS parameters. It is assumed that the viral load and healthy CD4+T cell in plasma are measured. The objective is to estimate all parameters in the basic three-dimensional HIV/AIDS model. For this purpose, through an analysis of basic system properties, the minimal number of measurement samples for the CD4+T cell and the viral load counts is first obtained. The paper determines then the HIV progression stages when an estimation of all parameters is impossible. Outside these stages, the paper proposes two on-line estimation algorithms for all HIV parameters based on the well-known techniques of adaptive identifiers and adaptive observers. Conditions for parameter convergence are discussed. Simulation results are demonstrated for the parameter estimation using adaptive observers.     

The relationship between religious expression and outcomes in online support groups: A partial replication

Shaw and his colleagues [Shaw, B., Han, J., Kim, E., Gustafson, D., Hawkins, R., Cleary, C., et al. (2007). Effects of prayer and religious expression within computer support groups on women with breast cancer. Psycho-oncology, 16(7), 676–687] examined religious expression in breast cancer (BC) online support groups (OSG). Using Pennebaker’s LIWC text analysis to assess religious expression, they found that the more frequent the expression of words related to religion the lower the levels of negative emotions and the higher the levels of health self-efficacy and functional well-being. Our study goal was to replicate their findings. Specifically, we tested their central hypothesis that the percentage of religious words written by members of BC OSG’s are associated with improvement in psychological outcomes. Five BC OSG’s from our previous work [Lieberman, M. A., & Goldstein, B. (2005a). Not all negative emotions are equal: The role of emotional expression in online support groups for women with breast cancer. Psycho-oncology. 15, 160–168; Lieberman, M. A., & Goldstein, B. (2005b). Self-help online: An outcome evaluation of breast cancer bulletin boards. Journal of Health Psychology, 10(6), 855–862] studied 91 participants at baseline and 6 months post. Significant changes in depression and quality of life was found over time. In the current study linear regressions examined the relationship between religious statements and outcomes. The results did not support the hypotheses of a positive relationship between religious expression and positive outcome in both OSG samples. Reviews of studies examining the role of religion in health outcomes report equivocal results on the benefits of religious expression.     

The importance of elementary school students’ social chat online: Reconceptualising the curriculum

The Internet is increasingly being used as a tool for communicating and learning in primary schools across many developed and developing countries. The place of social chat as part of online interactions has as yet not been fully recognised as an important component of learning.     

Effects of disease and leader type on moderators in online support groups

This study examines the effects of illness (cancer and Parkinson’s [PD]) on three moderators, the expression of positive and negative emotions and cognitive mechanisms. Each illness makes its own unique demands on patients and may influence change mechanisms. Similarly, we are asking, what effects do the type of leadership have on mediators that have previously been linked to positive outcomes. Four types of groups were studied, professional, the wellness community (TWC) chat mixed cancer (N groups = 4) and TWC chat PD patient groups (N groups = 6). The two peer groups were bulletin boards for colorectal cancer (N groups = 1) and PD BBs (N groups = 6). The design was a 2×2, disease and leader type. Computer-based text analysis, the linguistic inquiry and word count assessed the dependent variables. The results of the Manova found that; disease is P = NS, leader type, P = .00, interaction, P = .00. The interaction between disease and leader type is statistically significant, indicating that disease in combination with whether the leader is a peer or professional effects the expression of emotions and cognitive mechanisms.     

Roles as a structuring tool in online discussion groups: The differential impact of different roles on social knowledge construction

This study focuses on stimulating social knowledge construction in e-discussions and examines the introduction of five roles: starter, summariser, moderator, theoretician, and source searcher. Asynchronous discussion groups of 10 1st-year students Instructional Sciences were organised to foster students’ processing of the learning content. Four successive authentic tasks of three weeks each were presented. Taking into account the moment of introduction of the role assignment (at the start of the discussions versus at the end), the differential impact of the roles on knowledge construction is studied through quantitative content analysis based on the interaction analysis model of Gunawardena, Lowe, and Anderson (1997). The results show a positive effect of role assignment on students’ social knowledge construction at the start of the discussions. This implies that roles should be introduced at the start of the discussions and can be faded out towards the end. With respect to the differential impact of the roles, the results show that messages from moderators, theoreticians, and summarisers reflect higher levels of knowledge construction at the start of the discussions. Even students without a role in role-supported groups benefit from the role introduction.     

The use of group support systems in focus groups: Information technology meets qualitative research

This paper explores focus groups supported by group support systems (GSS) with anonymous interaction capability in two configurations: same time/same place and same time/different place. After reviewing the literature, we compare and contrast these anonymity-featured GSS-supported focus groups with traditional focus groups and discuss their benefits and limitations. We suggest directions for future research concerning GSS-supported focus groups with respect to technological implications (typing skills and connection speeds), national culture (high and low context; power distance), and lying behavior (adaptation of model of Hancock, J. T., Thom-Santelli, J., & Ritchie, T. (2004). Deception and design: The impact of communication technology on lying behavior. Proceedings of the 2004 conference on human factors in computing systems (pp. 129–134), whereby lying is a function of three design factors: synchronicity, recordability, and distributedness).