The Web of Care: A Multi-method Study Examining the Role of Online Communities as a Source of Peer-to-peer Supportive Care for Breast Cancer Survivors

This dissertation uses a multi-method approach to examine the role of online communities as a source of peer-to-peer supportive care for breast cancer survivors. A collection of four studies is presented. Study 1) A systematic search of the Internet identified 111 active online communities for breast cancer survivors with extensive archives of personal health experiences (one third had over 100,000 posts each as of 2010-10-26). More than one-third (36.0%) were initiated by breast cancer survivors or loved ones, and more than two-thirds (69.5%) were maintained with little or no professional input. Study 2) An analysis of Facebook (www.Facebook.com) identified 620 public breast cancer groups containing a total of 1,090,397 members as of 2008-11-23. The majority of groups were created for fundraising and awareness purposes (92.6%), rather than supportive care (7.4%).

[1]  A. Bandura Self-Efficacy: The Exercise of Control , 1997, Journal of Cognitive Psychotherapy.

[2]  R. Gray,et al.  ‘Nothing fit me’: nationwide consultations with young women with breast cancer , 2006, Health expectations : an international journal of public participation in health care and health policy.

[3]  Hsiu-Fen Lin,et al.  Understanding Behavioral Intention to Participate in Virtual Communities , 2006, Cyberpsychology Behav. Soc. Netw..

[4]  C. V. van Uden-Kraan,et al.  Health-related Internet use by patients with somatic diseases: Frequency of use and characteristics of users , 2009, Informatics for health & social care.

[5]  D. Boyd Facebook's Privacy Trainwreck , 2008 .

[6]  J.L. Bender,et al.  Supporting cancer patients through the continuum of care: a view from the age of social networks and computer-mediated communication , 2008, Current oncology.

[7]  Qimei Chen,et al.  Internet Community Group Participation: Psychosocial Benefits for Women with Breast Cancer , 2005, J. Comput. Mediat. Commun..

[8]  C. V. van Uden-Kraan,et al.  Participation in online patient support groups endorses patients' empowerment. , 2009, Patient education and counseling.

[9]  V. Strecher Internet methods for delivering behavioral and health-related interventions (eHealth). , 2007, Annual review of clinical psychology.

[10]  Arent Greve,et al.  THE ROLE OF OPINION LEADERS IN THE DIFFUSION OF A CONSTRUCTION TECHNOLOGY IN A JAPANESE FIRM , 2002 .

[11]  Bret R. Shaw,et al.  Experiences of Women with Breast Cancer: Exchanging Social Support over the CHESS Computer Network , 2000, Journal of health communication.

[12]  M. Roland,et al.  What Predicts Patients' Interest in the Internet as a Health Resource in Primary Care in England? , 2003, Journal of health services research & policy.

[13]  Anne-Grete Sandaunet A Space for Suffering? Communicating Breast Cancer in an Online Self-Help Context , 2008, Qualitative health research.

[14]  V. Pitts,et al.  Illness and Internet Empowerment: Writing and Reading Breast Cancer in Cyberspace , 2004, Health.

[15]  Richard J. Holden,et al.  The Technology Acceptance Model: Its past and its future in health care , 2010, J. Biomed. Informatics.

[16]  P. Butow,et al.  Sustaining Leaders of Cancer Support Groups , 2006, Social work in health care.

[17]  M. Pringle,et al.  Evaluating eHealth: How to Make Evaluation More Methodologically Robust , 2009, PLoS medicine.

[18]  W. Rakowski,et al.  Breast cancer in older women: quality of life and psychosocial adjustment in the 15 months after diagnosis. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  S. Wyatt,et al.  'Ignorance is bliss sometimes': constraints on the emergence of the 'informed patient' in the changing landscapes of health information. , 2003, Sociology of health & illness.

[20]  K. Wright Social support within an on-line cancer community: an assessment of emotional support, perceptions of advantages and disadvantages, and motives for using the community from a communication perspective , 2002 .

[21]  Rob Procter,et al.  The Impact of eHealth on the Quality and Safety of Healthcare , 2009, EuropeComm.

[22]  Marko Čupić,et al.  Online communities – Designing Usability, Supporting Sociability , 2003 .

[23]  C. Bender,et al.  The impact of parental cancer on the adolescent: an analysis of the literature , 2007, Psycho-oncology.

[24]  M. Hardey 'E-health': the internet and the transformation of patients into consumers and producers of health knowledge , 2001 .

[25]  A. Farmer,et al.  Social networking sites: a novel portal for communication , 2009, Postgraduate Medical Journal.

[26]  Russell E Glasgow,et al.  eHealth evaluation and dissemination research. , 2007, American journal of preventive medicine.

[27]  Kerk F. Kee,et al.  Being Immersed in Social Networking Environment: Facebook Groups, Uses and Gratifications, and Social Outcomes , 2009, Cyberpsychology Behav. Soc. Netw..

[28]  Larry Norton,et al.  Long‐term adjustment of survivors of early‐stage breast carcinoma, 20 years after adjuvant chemotherapy , 2003, Cancer.

[29]  J. Owen,et al.  Internet Support and Information for Women with Breast Cancer , 2002 .

[30]  R. Gray,et al.  A consultation with Canadian rural women with breast cancer , 2004, Health expectations : an international journal of public participation in health care and health policy.

[31]  Cliff Lampe,et al.  The Benefits of Facebook "Friends: " Social Capital and College Students' Use of Online Social Network Sites , 2007, J. Comput. Mediat. Commun..

[32]  Robert D. Putnam,et al.  Bowling alone: the collapse and revival of American community , 2000, CSCW '00.

[33]  B. Lundman,et al.  Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. , 2004, Nurse education today.

[34]  S. Thompson,et al.  Maintaining perceptions of control: finding perceived control in low-control circumstances. , 1993, Journal of personality and social psychology.

[35]  M. Sandelowski Focus on Research Methods Whatever Happened to Qualitative Description? , 2022 .

[36]  Tom Ferguson,et al.  What I've Learned from E-Patients , 2005, PLoS medicine.

[37]  E. Larson,et al.  Dissemination of health information through social networks: twitter and antibiotics. , 2010, American journal of infection control.

[38]  M. Fitch,et al.  Supportive care framework. , 2008, Canadian oncology nursing journal = Revue canadienne de nursing oncologique.

[39]  Carol E Golin,et al.  How New Subscribers Use Cancer-Related Online Mailing Lists , 2005, Journal of medical Internet research.

[40]  Bret R. Shaw,et al.  Use and Impact of eHealth System by Low-income Women With Breast Cancer , 2005, Journal of health communication.

[41]  P. Butow,et al.  Support and training needs of cancer support group leaders: a review , 2006, Psycho-oncology.

[42]  L. Festinger A Theory of Social Comparison Processes , 1954 .

[43]  J. Avery,et al.  The long tail. , 1995, Journal of the Tennessee Medical Association.

[44]  Ben-Tzion Karsh,et al.  Toward a theoretical approach to medical error reporting system research and design. , 2006, Applied ergonomics.

[45]  J. Pennebaker,et al.  Who talks? The social psychology of illness support groups. , 2000, The American psychologist.

[46]  Mette Terp Høybye,et al.  Social and psychological determinants of participation in internet-based cancer support groups , 2010, Supportive Care in Cancer.

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

[48]  Christian Köhler,et al.  How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews , 2002, BMJ : British Medical Journal.

[49]  Tony Delamothe,et al.  What next for electronic communication and health care? , 2004, BMJ : British Medical Journal.

[50]  M. Dorval,et al.  Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[51]  M. Hardey Doctor in the house: the Internet as a source of lay health knowledge and the challenge to expertise , 1999 .

[52]  Michael R Kidd,et al.  Personal electronic health records: MySpace or HealthSpace? , 2008, BMJ : British Medical Journal.

[53]  P. Butow,et al.  Lay constructions of decision‐making in cancer , 2002, Psycho-oncology.

[54]  D. Cook,et al.  Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. , 2000, JAMA.

[55]  E. Feuer,et al.  The changing face of cancer survivorship. , 2001, Seminars in oncology nursing.

[56]  D. Gustafson,et al.  An Evidence-Based Approach to Interactive Health Communication: A Challenge to Medicine in the Information Age , 1998 .

[57]  C. V. van Uden-Kraan,et al.  Self-Reported Differences in Empowerment Between Lurkers and Posters in Online Patient Support Groups , 2008, Journal of medical Internet research.

[58]  James Stewart,et al.  Doctor-patient relationship as motivation and outcome: Examining uses of an Interactive Cancer Communication System , 2007, Int. J. Medical Informatics.

[59]  David Blumenthal,et al.  Doctors in a wired world: can professionalism survive connectivity? , 2002, The Milbank quarterly.

[60]  L. Hoey,et al.  Systematic review of peer-support programs for people with cancer. , 2008, Patient education and counseling.

[61]  S. Ziebland,et al.  What do patients with prostate or breast cancer want from an Internet site? A qualitative study of information needs. , 2004, Patient education and counseling.

[62]  B. F. Sharf Communicating breast cancer on-line: support and empowerment on the Internet. , 1997, Women & health.

[63]  F. Griffiths,et al.  Why Are Health Care Interventions Delivered Over the Internet? A Systematic Review of the Published Literature , 2006, Journal of medical Internet research.

[64]  Fred D. Davis Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[65]  D. Gustafson,et al.  Effect of computer support on younger women with breast cancer , 2001, Journal of General Internal Medicine.

[66]  G. Zimet,et al.  Psychometric Properties of the Multidimensional Scale of Perceived Social Support in Urban Adolescents , 2000, American journal of community psychology.

[67]  P. Butow,et al.  Breast cancer survivors’ supportive care needs 2–10 years after diagnosis , 2007, Supportive Care in Cancer.

[68]  A. Sheikh,et al.  Evaluating eHealth Interventions: The Need for Continuous Systemic Evaluation , 2009, PLoS medicine.

[69]  K. Wilson,et al.  An analysis of the Human Papilloma Virus vaccine debate on MySpace blogs. , 2010, Vaccine.

[70]  G E Grande,et al.  How do patients who participate in cancer support groups differ from those who do not? , 2006, Psycho-oncology.

[71]  C. Delnicki,et al.  Supportive care for cancer patients. , 2000, Hospital quarterly.

[72]  David W. Bates,et al.  Evaluating eHealth: Undertaking Robust International Cross-Cultural eHealth Research , 2009, PLoS medicine.

[73]  E. Katz,et al.  The Uses of Mass Communications: Current Perspectives on Gratifications Research. Sage Annual Reviews of Communication Research Volume III. , 1975 .

[74]  Peter A. Todd,et al.  Understanding Information Technology Usage: A Test of Competing Models , 1995, Inf. Syst. Res..

[75]  L. Kristjanson,et al.  Information and support needs of adolescent children of women with breast cancer. , 2004, Oncology nursing forum.

[76]  Shelley E. Taylor Adjustment to threatening events: A theory of cognitive adaptation. , 1983 .

[77]  M. T. Høybye,et al.  Online interaction. Effects of storytelling in an internet breast cancer support group , 2005, Psycho-oncology.

[78]  M. Andersen,et al.  Meeting the needs of rural breast cancer survivors: what still needs to be done? , 2000, Journal of women's health & gender-based medicine.

[79]  B. Gottlieb,et al.  Cancer support groups: a critical review of empirical studies , 2007, Psycho-oncology.

[80]  A. Broom Virtually He@lthy: The Impact of Internet Use on Disease Experience and the Doctor-Patient Relationship , 2005, Qualitative health research.

[81]  Bret R. Shaw,et al.  Empowering Processes and Outcomes of Participation in Online Support Groups for Patients With Breast Cancer, Arthritis, or Fibromyalgia , 2008, Qualitative health research.

[82]  J. Rowland,et al.  Recovery issues in cancer survivorship: a new challenge for supportive care. , 2006, Cancer journal.

[83]  Anne-Grete Sandaunet,et al.  The challenge of fitting in: non-participation and withdrawal from an online self-help group for breast cancer patients. , 2008, Sociology of health & illness.

[84]  S. E. Taylor,et al.  Social comparison activity under threat: downward evaluation and upward contacts. , 1989, Psychological review.

[85]  Characteristics of professionally-led and peer-led cancer support groups in the United Kingdom , 2010, Journal of cancer survivorship : research and practice.

[86]  Sue Ziebland,et al.  The importance of being expert: the quest for cancer information on the Internet. , 2004, Social science & medicine.

[87]  P. Ganz,et al.  Fatigue in long‐term breast carcinoma survivors , 2006, Cancer.

[88]  Naomi Vaisrub,et al.  Biostatistics: The Bare Essentials , 2009 .

[89]  Bonnie Kaplan,et al.  Evaluating informatics applications - some alternative approaches: theory, social interactionism, and call for methodological pluralism , 2001, Int. J. Medical Informatics.

[90]  K. Hermelink Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer , 2011, Cancer.

[91]  R. Gray,et al.  The information needs of well, longer-term survivors of breast cancer. , 1998, Patient education and counseling.

[92]  Daniel W. Russell,et al.  Type of social support and specific stress: Toward a theory of optimal matching. , 1990 .

[93]  Kevin B. Wright,et al.  Health-related Support Groups on the Internet: Linking Empirical Findings to Social Support and Computer-mediated Communication Theory , 2003, Journal of health psychology.

[94]  Kazuhiro Nakayama,et al.  Comparing support to breast cancer patients from online communities and face-to-face support groups. , 2011, Patient education and counseling.

[95]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[96]  Jennifer Preece,et al.  Sociability and usability in online communities: Determining and measuring success , 2001, Behav. Inf. Technol..

[97]  Cameron D. Norman,et al.  eHealth Literacy: Essential Skills for Consumer Health in a Networked World , 2006, Journal of medical Internet research.

[98]  Danah Boyd,et al.  Social Network Sites: Definition, History, and Scholarship , 2007, J. Comput. Mediat. Commun..

[99]  Leanne M. Currie,et al.  Evaluation frameworks for nursing informatics , 2005, Int. J. Medical Informatics.

[100]  Debbe Thompson,et al.  A framework for evaluating eHealth research. , 2006, Evaluation and program planning.

[101]  Cameron Marlow,et al.  Social network activity and social well-being , 2010, CHI.

[102]  M. Denniston,et al.  Health status and life satisfaction among breast cancer survivor peer support volunteers , 2002, Psycho-oncology.

[103]  Ichiro Kawachi,et al.  Social networks, social support, and survival after breast cancer diagnosis. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[104]  R. P. Vilhauer,et al.  Perceived Benefits of Online Support Groups for Women with Metastatic Breast Cancer , 2009, Women & health.

[105]  Sun Young Lee,et al.  Why Do Patients Seek an Alternative Channel? The Effects of Unmet Needs on Patients' Health-Related Internet Use , 2010, Journal of health communication.

[106]  F. Peccatori,et al.  Unmet needs of cancer survivors: supportive care’s new challenge , 2006, Supportive Care in Cancer.

[107]  Shani Orgad,et al.  The cultural dimensions of online communication: a study of breast cancer patients’ internet spaces , 2006, New Media Soc..

[108]  I. Ajzen The theory of planned behavior , 1991 .

[109]  G. Tomlinson,et al.  YouTube as a source of information on immunization: a content analysis. , 2007, JAMA.

[110]  B. Rimer,et al.  How Cancer Survivors Provide Support on Cancer-Related Internet Mailing Lists , 2007, Journal of medical Internet research.

[111]  H Sharon Campbell,et al.  Cancer peer support programs-do they work? , 2004, Patient education and counseling.

[112]  Jennifer Preece,et al.  Online Communities: Design, Theory, and Practice , 2005, J. Comput. Mediat. Commun..