Online Information Exchanges for Parents of Children With a Rare Health Condition: Key Findings From an Online Support Community

Background The Internet provides new opportunities for parents of children with difficult illnesses and disabilities to find information and support. The Internet is particularly important for caregivers of children with special needs due to numerous health-related decisions they face. For at-risk populations, online support communities can become key settings and channels for health promotion and communication. Objective This study is an initial exploration of the information-seeking and information-provision processes present in an online support community, which is an area of opportunity and interest for Internet-based medical research and practice. The aim of this study was to explore and describe information-related processes of uncertainty management in relationship to clubfoot. Specifically, the study explored interpersonal communication (information seeking and provision) in an online support community serving the needs of parents of children with clubfoot. Methods The study population consisted of messages posted to an online community by caregivers (parents) of children with clubfoot. The theoretical framework informing the study was the Uncertainty Management Theory (UMT). The study used content analysis to explore and categorize the content of 775 messages. Results Women authored 664 of 775 messages (86%) and men authored 47 messages (6%). Caregivers managed uncertainty through information seeking and provision behaviors that were dynamic and multilayered. The ratio of information-seeking messages to information-provision responses was 1 to 4. All five types of information-seeking behaviors proposed by Brashers’ schema were identified, most of them being correlated. Information seeking using direct questions was found to be positively correlated to self-disclosure (r=.538), offering of a candidate answer (r=.318), and passive information seeking (r=.253). Self-disclosure was found to be positively correlated to provision of a candidate answer (r=.324), second-guessing (r=.149), and passive information seeking (r=.366). Provision of a candidate answer was found to be positively correlated with second-guessing (r=.193) and passive information seeking (r=.223). Second-guessing was found to be positively correlated to passive information seeking (r=.311). All correlations reported above were statistically significant (P<0.01). Of the 775 messages analyzed, 255 (33%) identified a medical professional or institution by name. Detailed medical information was provided in 101 (13%) messages, with the main source of information identified being personal experience rather than medical sources. Conclusion Online communities can be an effective channel for caregivers, especially women, to seek and offer information required for managing clubfoot-related uncertainty. To enhance communication with parents, health care institutions may need to invest additional resources in user-friendly online information sources and online interactions with caregivers of children with special illnesses such as clubfoot. Furthermore, explorations of information-seeking and information-provision behaviors in online communities can provide valuable data for interdisciplinary health research and practice.

[1]  D. Stewart,et al.  First step in obtaining child health care: selecting a physician. , 1988, Pediatrics.

[2]  J. R. R. Adams The determination of Historical Popular Reading habits: a Case Study , 1989, J. Documentation.

[3]  M. Mishel Reconceptualization of the uncertainty in illness theory. , 1990, Image--the journal of nursing scholarship.

[4]  J. Suhr,et al.  Controllability of Stressful Events and Satisfaction With Spouse Support Behaviors , 1992 .

[5]  Daniel J. Canary,et al.  The effect of uncertainty reducing strategies on young couples' relational repair and intimacy , 1996 .

[6]  A. Babrow,et al.  The many meanings of uncertainty in illness: toward a systematic accounting. , 1998, Health communication.

[7]  A Coulter,et al.  Evidence based patient information , 1998, BMJ.

[8]  S. Haas,et al.  Uncertainty in illness across the HIV/AIDS trajectory. , 1998, The Journal of the Association of Nurses in AIDS Care : JANAC.

[9]  Vincent R. Waldron,et al.  Communication of social support in computer-mediated groups for people with disabilities. , 1999, Health communication.

[10]  Austin S.Babrow,et al.  Managing Uncertainty in Illness Explanation: An Application of Problematic Integration Theory , 1999 .

[11]  M A Graber,et al.  Readability levels of patient education material on the World Wide Web. , 1999, The Journal of family practice.

[12]  유창조 Naturalistic Inquiry , 2022, The SAGE Encyclopedia of Research Design.

[13]  S. Haas,et al.  Communication in the management of uncertainty: The case of persons living with HIV or AIDS , 2000 .

[14]  P Impicciatore,et al.  Parents on the Web: Risks for Quality Management of Cough in Children , 2000, Pediatrics.

[15]  D. Brashers Communication and Uncertainty Management. , 2001 .

[16]  L. Siu,et al.  Impact of the media and the internet on oncology: survey of cancer patients and oncologists in Canada. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  F. Kristensen,et al.  [Evidence-based patient information]. , 2001, Ugeskrift for laeger.

[18]  Kimberly A. Neuendorf,et al.  The Content Analysis Guidebook , 2001 .

[19]  Joshua Fogel,et al.  Use of the Internet by Women with Breast Cancer , 2002, Journal of medical Internet research.

[20]  J. Powell,et al.  Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. , 2002, JAMA.

[21]  C. B. Taylor,et al.  Evaluation of an internet support group for women with primary breast cancer , 2003, Cancer.

[22]  Lori A Dolan,et al.  Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. , 2004, Pediatrics.

[23]  S. Wyatt,et al.  The Role of the Internet in Patient-Practitioner Relationships: Findings from a Qualitative Research Study , 2004, Journal of medical Internet research.

[24]  Jay M Bernhardt,et al.  Online Pediatric Information Seeking Among Mothers of Young Children: Results From a Qualitative Study Using Focus Groups , 2004, Journal of medical Internet research.

[25]  Allen Foster,et al.  A nonlinear model of information-seeking behavior , 2004, J. Assoc. Inf. Sci. Technol..

[26]  S. Cotten,et al.  Characteristics of online and offline health information seekers and factors that discriminate between them. , 2004, Social science & medicine.

[27]  A. Sarkadi,et al.  Socially unbiased parenting support on the Internet: a cross-sectional study of users of a large Swedish parenting website. , 2005, Child: care, health and development.

[28]  Henrietta O'Connor,et al.  Parenting gone wired: empowerment of new mothers on the internet? , 2006 .

[29]  M. McMullan Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. , 2006, Patient education and counseling.

[30]  Janet R. Jamieson,et al.  Providing Web‐based Support for Families of Infants and Young Children With Established Disabilities , 2007 .

[31]  N. Coulson,et al.  Social support in cyberspace: a content analysis of communication within a Huntington's disease online support group. , 2007, Patient education and counseling.

[32]  A. Bambina Online Social Support: The Interplay of Social Networks and Computer-Mediated Communication , 2007 .

[33]  L. Gold,et al.  The early postnatal period: Exploring women's views, expectations and experiences of care using focus groups in Victoria, Australia , 2008, BMC pregnancy and childbirth.

[34]  S. Thompson,et al.  Advice-Giving and the Management of Uncertainty for Cancer Survivors , 2008, Health communication.

[35]  Rebecca Schaffer,et al.  Producing genetic knowledge and citizenship through the Internet: mothers, pediatric genetics, and cybermedicine. , 2008, Sociology of health & illness.

[36]  H. Bragadóttir Computer-mediated support group intervention for parents. , 2008, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[37]  T. Ginossar Online Participation: A Content Analysis of Differences in Utilization of Two Online Cancer Communities by Men and Women, Patients and Family Members , 2008, Health communication.

[38]  Suzanne Pingree,et al.  Internet-Based Interactive Support for Cancer Patients: Are Integrated Systems Better? , 2008, The Journal of communication.

[39]  Sumaira Malik,et al.  Gender differences in computer-mediated communication: a systematic literature review of online health-related support groups. , 2009, Patient education and counseling.

[40]  Kristian Daneback,et al.  Parenthood, information and support on the internet. A literature review of research on parents and professionals online , 2009, BMC family practice.

[41]  David E. Goodrich,et al.  An Online Community Improves Adherence in an Internet-Mediated Walking Program. Part 1: Results of a Randomized Controlled Trial , 2010, Journal of medical Internet research.

[42]  Lisa Gualtieri,et al.  The Internet as a Health Information Source: Findings from the 2007 Health Information National Trends Survey and Implications for Health Communication , 2010, Journal of health communication.

[43]  R. Sudore,et al.  Information-Seeking at a Caregiving Website: A Qualitative Analysis , 2010, Journal of medical Internet research.

[44]  F. Oprescu,et al.  Bracing in the treatment of children with clubfoot: past, present, and future. , 2010, The Iowa orthopaedic journal.

[45]  C. Walker,et al.  Ponseti method compared with surgical treatment of clubfoot: a prospective comparison. , 2010, The Journal of bone and joint surgery. American volume.

[46]  D. Milne,et al.  The role of the Internet in supporting and informing carers of people with cancer: a literature review , 2010, Supportive Care in Cancer.

[47]  Heiko Spallek,et al.  Using Natural Language Processing to Enable In-depth Analysis of Clinical Messages Posted to an Internet Mailing List: A Feasibility Study , 2011, Journal of medical Internet research.

[48]  B. Nemeth The diagnosis and management of common childhood orthopedic disorders. , 2011, Current problems in pediatric and adolescent health care.

[49]  Giuseppe Riva,et al.  Why Is Facebook So Successful? Psychophysiological Measures Describe a Core Flow State While Using Facebook , 2011, Cyberpsychology Behav. Soc. Netw..

[50]  C. Knapp,et al.  Internet Use and eHealth Literacy of Low-Income Parents Whose Children Have Special Health Care Needs , 2011, Journal of medical Internet research.

[51]  Yoko Setoyama,et al.  Benefits of Peer Support in Online Japanese Breast Cancer Communities: Differences Between Lurkers and Posters , 2011, Journal of medical Internet research.

[52]  J. Masuda,et al.  Online Solutions to Support Needs and Preferences of Parents of Children With Asthma and Allergies , 2011, Journal of family nursing.

[53]  Tonje Gundersen,et al.  'One wants to know what a chromosome is': the internet as a coping resource when adjusting to life parenting a child with a rare genetic disorder. , 2011, Sociology of health & illness.

[54]  Edwin van Teijlingen,et al.  Parenting a child with clubfoot: A qualitative study , 2011 .

[55]  Paul Wicks,et al.  Use of an Online Community to Develop Patient-Reported Outcome Instruments: The Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) , 2011, Journal of medical Internet research.

[56]  J. Morcuende,et al.  Management of congenital talipes equinovarus using the Ponseti method: a systematic review. , 2011, The Journal of bone and joint surgery. British volume.

[57]  Lori A Dolan,et al.  Understanding the Educational Needs for Parents of Children With Clubfoot , 2011, Orthopedic nursing.

[58]  J. Morcuende,et al.  Relapse After Tibialis Anterior Tendon Transfer in Idiopathic Clubfoot Treated by the Ponseti Method , 2012, Journal of pediatric orthopedics.

[59]  Lori A Dolan,et al.  Treatment Results of Late-relapsing Idiopathic Clubfoot Previously Treated With the Ponseti Method , 2012, Journal of pediatric orthopedics.

[60]  E. Ebramzadeh,et al.  The Current Management of Idiopathic Clubfoot Revisited: Results of a Survey of the POSNA Membership , 2012, Journal of pediatric orthopedics.

[61]  Darren Mays,et al.  Results of an Online Community Needs Assessment for Psychoeducational Interventions Among Partners of Hereditary Breast Cancer Previvors and Survivors , 2012, Journal of medical Internet research.

[62]  Steve Howard,et al.  Developing Health Promotion Interventions on Social Networking Sites: Recommendations from The FaceSpace Project , 2012, Journal of medical Internet research.

[63]  Bret R. Shaw,et al.  Creating a Bond Between Caregivers Online: Effect on Caregivers’ Coping Strategies , 2012, Journal of health communication.

[64]  M. Swan Crowdsourced Health Research Studies: An Important Emerging Complement to Clinical Trials in the Public Health Research Ecosystem , 2012, Journal of medical Internet research.

[65]  Brendan R. Watson,et al.  Analyzing Media Messages , 2023 .