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.     

Internet use and personal empowerment of hearing-impaired adolescents

The Internet has become an ordinary and widely accepted alternative social environment—known as cyberspace—in which many people take part in numerous activities. For the hearing-impaired, cyberspace provides extra benefits for two basic reasons: means of communication, which is primarily based on visual (text and images) and not auditory channels, and the convenient possibility of concealing their handicap from other users, thus gaining more security and a sense of equality. The purpose of the current study was to examine characteristics, intensity, and types of use of the Internet by hearing-impaired adolescents compared to an equivalent group of normal-hearing participants, with gender and adolescence stage (age 12–15, or 16–19) as additional independent variables. In addition, the intensity of using the Internet as a possible moderator of deaf participants’ well-being was examined by comparing measures of loneliness and self-esteem between low- and high-intensive hearing-impaired users on the one hand, and hearing participants, on the other. Questionnaires were administered to 114 hearing-impaired and 100 hearing participants, matched for intelligence and socio-economic status. Main results showed that for both genders and for the two adolescence stages, hearing-impaired participants were motivated to use, and actually did use, the Internet more intensively than their hearing counterparts. Furthermore, the hearing-impaired used the Internet more than did hearing participants for both personal and group communication. Hearing and intensively Internet-using deaf participants were similar in level of well-being, both higher than the well-being of less-intensively Internet-using deaf participants. The Internet may thus be viewed as an empowering agent for the hearing-impaired.     

An analysis of social support exchanges in online HIV/AIDS self-help groups

Hundreds of thousands of people sharing concerns about HIV/AIDS have taken advantage of online self-help groups to exchange resources and support. Little research so far has focused on the nature and content of actual messages exchanged by group members. To provide an in-depth understanding of social support exchanges in online HIV/AIDS self-help groups, this study identifies and analyzes the dimensions and corresponding frequencies of exchanged social support as well as the group interactions facilitating those exchanges. A total of 5000 postings created within a 1 year period were randomly selected from a selected online HIV/AIDS forum. Content analysis was then conducted to assess the types and proportions of exchanged social support. A thematic analysis of the postings that could not be categorized with the adopted coding system was performed to find further patterns of positive group interactions. The results show that information support (41.6%) and emotional support (16.0%) were exchanged most frequently, followed by network support (6.8%) and esteem support exchanges (6.4%), whereas tangible assistance was quite rare (0.8%). The authors also suggest that three types of group interactions including sharing personal experience, expression of gratitude, and offering congratulations can facilitate social support exchanges among group members.     

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.     

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.     

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.     

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.     

An epidemiological assessment of online groups and a test of a typology: What are the (dis)similarities of the online group types?

A vast multitude of online groups exist, and authors have been rapidly investigating their dynamics. Extant studies have provided great information on the effects of online group membership, but limitations are often noted in these studies. Amongst the most concerning limitations are issues of generalizability. Authors are often unsure whether their results are able to generalize to other online groups, including those that are seemingly similar. For this reason, some researchers have created typologies of online groups, in hopes that online groups that fall within the same category will be generalizable; however, no study has analyzed the merit of an online group typology, and conclusions are based upon speculation. For this reason, the current study analyzed the dynamics of three different online groups, which fall within separate categories of an online group typology: a cancer support forum, a LGBT forum, and a Harry Potter fan forum. The results demonstrate that these groups vary in their properties, including group members’ group identity, well-being, and social support. These results provide support for an online group typology, and precisely demonstrate in what manner these groups differ. Additionally, the results offer valuable information about the individual groups, as some variables were previously unstudied in some group types. The discovery of these previously unknown dynamics leads to the potential of new studies, which is discussed. Therefore, the current study provides important implications for future studies, as well as the interpretation of future research results.     

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.     

First do no harm: Cross-sectional and longitudinal evidence for the impact of individual suicidality on the use of online health forums and support groups

Suicide is a leading cause of death worldwide, especially among the young. This study aims to disentangle the presumed causality between the use of online health forums or support groups and suicidality using a representative telephone survey and a two-wave online panel survey containing the same question wording. Cross-sectional data show positive correlations between suicidality and online health forum use, but not limited to the younger. Using longitudinal panel data and autoregressive models, a positive cross-lagged effect of suicidality on internet-based health forum use one month later was revealed. Despite the wide-spread notion that online health forums can increase suicidality the present study provides evidence for the preventive potential of accessible and helpful information online.     

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.     

E-empowerment: Empowerment by the Internet

This article focuses on the concept of empowerment and the ways in which the Internet is being utilized as an empowering tool. This analysis ranges from the personal to the global levels and the consequences of that empowerment are also discussed. We propose a four-level model that serves to explain what we term E-empowerment and the effects that can be observed at each of the four levels, ranging from (1) the personal; (2) the interpersonal; (3) group; and (4) citizenship. The potential for future development of E-empowerment is also discussed.     

Intragroup status and social presence in online fan groups

Low and high status member posts from online fan message board posts were examined. Low status members, as compared to high status members, were found to use more intimacy and immediacy social presence cues, including: praise for the group, self-disclosure, friendly and positive affective language, first person singular pronouns, and present tense verbs. Low status members were less likely than high status members to use articles, larger words, and discrepancy words. Lastly, low status members were rated as more likeable than high status members. The results suggest that low status members may strategically use social presence cues as a means of ingratiating themselves to the group.     

Individual empowerment of agile and non-agile software developers in small teams

ContextEmpowerment of employees at work has been known to have a positive impact on job motivation and satisfaction. Software development is a field of knowledge work wherein one should also expect to see these effects, and the idea of empowerment has become particularly visible in agile methodologies, in which proponents emphasise team empowerment and individual control of the work activities as a central concern.ObjectiveThis research aims to get a better understanding of how empowerment is enabled in software development teams, both agile and non-agile, to identify differences in empowering practices and levels of individual empowerment.MethodTwenty-five interviews with agile and non-agile developers from Norway and Canada on decision making and empowerment are analysed. The analysis is conducted using a conceptual model with categories for involvement, structural empowerment and psychological empowerment.ResultsBoth kinds of development organisations are highly empowered and they are similar in most aspects relating to empowerment. However, there is a distinction in the sense that agile developers have more possibilities to select work tasks and influence the priorities in a development project due to team empowerment. Agile developers seem to put a higher emphasis on the value of information in decision making, and have more prescribed activities to enable low-cost information flow. More power is obtained through the achievement of managing roles for the non-agile developers who show interest and are rich in initiatives.ConclusionAgile developers have a higher sense of being able to impact the organisation than non-agile developers and have information channels that is significantly differently from non-agile developers. For non-agile teams, higher empowerment can be obtained by systematically applying low-cost participative decision making practices in the manager–developer relation and among peer developers. For agile teams, it is essential to more rigorously follow the empowering practices already established.     

An exploration of empowerment in manufacturing enterprises

This paper investigates empowerment within manufacturing production. Empowerment is multidimensional. Understanding the implications of operationalising empowerment requires an appreciation of all its dimensions. These dimensions are captured in Empowerment Profiles, which are incorporated within a conceptual framework. A sample of the Empowerment Profiles is validated using case studies. The Empowerment Profiles appear to have potential as a tool to assist in preparing to implement empowered work strategies, focusing attention on issues to be considered.     

The who and the what of usage of two cancer online communities

The explosion of use of Internet-based communication for health requires attention to the ways survivors of specific diseases and those close to them participate in using resources. This research focuses on two cancer groups – breast and prostate – and how they use WebMD asynchronous bulletin boards. Four hundred and eighty two messages were coded for communicator (survivors, spouses, others) and content of messages. Most common communicators were survivors, but the two groups differed in percentages of communicator. Of four main categories of content – medical/treatment, intimacy/sexuality, emotional expression, and support – most common were support and medical/treatment. The groups differed significantly on those four categories, with breast cancer more support-dominated and prostate more medical/treatment-dominated and more intimacy/sexuality messages. There were no group differences in emotional-toned vs. social support seeking vs. providing support, or positive vs. negative emotions expressed. Generally, there was considerable commonality, and the differences found primarily supported gender-specific notions of communication and need.     

Differences in intrapersonal and interactional empowerment between lurkers and posters in health-related online support communities

Participation in health-related online support communities plays an important role in the psychological empowerment of people who are faced with health problems. Research has suggested that important differences exist in terms of psychological empowerment depending on the form and intensity of participation in such domains by showing that users who contribute to health-related online support communities by posting messages (posters) generally experience greater benefits in terms of intrapersonal empowerment, compared to participants who only read messages (lurkers). However, as yet, very little is known about how the often-neglected interactional aspect of psychological empowerment is associated with participation in these online domains. Thus, the aim of this study was to explore how different forms and intensity of participation in health-related online support communities are associated with both dimensions of psychological empowerment. Drawing on a nonprobability sample of 616 participants in two health-related online support communities, the analysis of the data, obtained with an online questionnaire, revealed that posters scored significantly higher in degree of interactional empowerment than lurkers, whereas no difference was observed in terms of intrapersonal empowerment. In addition, high posting frequency was significantly associated with a high level of interactional empowerment but not intrapersonal empowerment. The study suggests that to better understand the empowering potential of participation for users of health-related online support communities, it is important to distinguish not only between various forms of participation but also between different aspects of psychological empowerment.     

Kernel-based online machine learning and support vector reduction

We apply kernel-based machine learning methods to online learning situations, and look at the related requirement of reducing the complexity of the learnt classifier. Online methods are particularly useful in situations which involve streaming data, such as medical or financial applications. We show that the concept of span of support vectors can be used to build a classifier that performs reasonably well while satisfying given space and time constraints, thus making it potentially suitable for such online situations. The span-based heuristic is observed to be effective under stringent memory limits (that is when the number of support vectors a machine can hold is very small).     

An online robot trajectory planning and programming support system for industrial use

The manufacturing industry today is still looking for enhancement of their production. Programming of articulated production robots is a major area for improvement. Today, offline simulation modified by manual programming is widely used to reduce production downtimes but requires financial investments in terms of additional personnel and equipment costs. The requirements have been evaluated considering modern manufacturing aspects and a new online robot trajectory planning and programming support system is presented for industrial use. The proposed methodology is executed solely online, rendering offline simulation obsolete and thereby reduces costs. To enable this system, a new cell-based Voronoi generation algorithm, together with a trajectory planner, is introduced. The robot trajectories so achieved are comparable to manually programmed robot programs. The results for a Mitsubishi RV-2AJ five axis industrial robot are presented.     

The Positive Net

The Internet has been ascribed a negative reputation among scholars, for its potentially damaging influence on its users. These include addiction, depression, and loneliness. Although there are individuals who have been harmed through their use of the Internet, this is certainly not the whole story. The Internet provides a rich environment which includes significantly positive aspects as well as negative ones, and, when used appropriately, the Internet may greatly improve the quality of life for its users. This article will focus on the affirmative aspects of the net and on ways in which it may be used to enhance and increase surfers’ well-being, both collectively and individually.