Trial Information

Psychosocial Outcomes in Online Cancer Support Groups

Purpose/Specific Aims: The purpose of this randomized two-group longitudinal study is to
evaluate whether psychosocial outcomes in women with breast cancer differ based on the
format of online group support. Rationale/Significance of study: No research has explored
differences in psychosocial outcomes between online support groups that use a professional
moderator and those that use a peer-led (self-help) format. This study will address one of
the goals put forth in the 2003-2005 ONS Research Agenda, by studying the effects of
technology based interventions (online support) on psychosocial outcomes (depression,
perceived social support, quality of life) in women with breast cancer. This work will add
to the nursing research base with regard to online support for women with breast cancer and
provide a springboard for additional studies to enhance the research base. Conceptual
Framework: The concept of openness, based on the mutual interaction between human beings and
their environment, and emphasized in Rogers' Science of Unitary Human Beings provides a
basis for this project. The research will utilize two different support environments and
measure how interactions in each affect psychosocial outcomes over time. Main Research
Variables: The independent variables are two treatment conditions (moderated online support,
peer-led online support). The dependent variables are depressive symptoms, perceived social
support, and quality of life. Design: A randomized longitudinal design, comparing two types
of online support groups, on the basis of three principal measures, will be used. Each
measure will be obtained at baseline and at three later timepoints. Setting: Support groups
will be accessed from secure and password protected university web pages devoted exclusively
to this study. Sample: Sixty women with breast cancer, at least 21 years of age, who have
Internet access will be recruited. Methods: Women will be randomly assigned to one of the
two treatment conditions (moderated online support, peer-led online support) given a
password, and instructed to complete a Demographic Form and the study questionnaires online.
All subjects will be asked to complete the study questionnaires again at 6, 12, and 16
weeks. Moderated groups will run in a semi-structured format over 12 weeks, with a different
discussion topic moderated each week by the moderator. Peer-led groups will be run in a peer
support format over 12 weeks. Implications for practice: Women with breast cancer are
turning to online resources for support. Nurses should be aware of the benefits/limitations
of this support alternative. A cost benefit may be suggested if it is shown that peer-led
online support has psychosocial benefits similar to professionally facilitated groups.
Additional research is needed to explore the impact of online support on psychosocial
outcomes in people with other cancers, minorities, and men. This study will add important
information to the research base regarding online support groups and help determine the best
strategy for online cancer support.

NOTE: It was obvious that we could not prevent anyone from joining a support group, if that
was her choice. We also could not control if participants joined a second online support
group or face-to-face group during the study. Therefore, we dropped the "usual care" (no
support) group. The study was completed with just two groups: moderated and peer-support.