Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention

Abstract

Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (u = 0.56-0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08-1.84, ps < 0.001) and total time of intervention (Ds = 1.13-1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement.

Randomized Trial of a Social Networking Intervention for Cancer-Related Distress

“…Participants and facilitators were invited to post messages to the group at any time to solicit feedback, update other members about their current situation, or follow up on activities that were assigned during the weekly chat session. A webmail feature was also included in health-space.net, where participants had the option to email the entire group or only specific participants or facilitators (28). In order to promote group cohesion, participants were also encouraged to create a profile in which they could describe themselves and their experience with cancer and/or share photos.…”

“…Interventions that marry evidence-based approaches from face-to-face interventions with social components that allow interactions between participants may be particularly effective at delivering online content. We have previously demonstrated that engaging with a social-networking community in an online intervention for cancer survivors is associated with a 5-fold increase in interaction with structured intervention elements, such as coping skills-training exercises and psychoeducational content (28). …”

“…In order to supplement the intervention, we conducted three major revisions to the Survive intervention (which was renamed “health-space”) : 1) dramatically improving opportunities for social networking, by providing a weekly, 90-minute professionally-facilitated group chat, blogs, discussion board, and private mail and 2) supplementing existing coping skills-training exercises with additional content requested by previous participants, and 3) reducing reliance on text by condensing content and emphasizing its graphic design. These revisions have resulted in high levels of overall engagement (438 minutes per participant, total) in both social-networking components of the intervention and coping skills-training exercises (28). …”

Social Media and Mobile Technology for Cancer Prevention and Treatment

“…40 Another recurring finding is that users may prefer different social media platforms, making formative research and/or use of multiple channels an important consideration. 7,41 …”

A systematic and comprehensive review of internet use in cancer patients: Psychological factors

“…Interventions combining more levels of interaction, participation, and integral communication are expected to meet higher needs in a greater number and diversity of patients due to their greater flexibility and adaptability. Encouraging patients to participate is also easier when a professional facilitator is involved in the intervention …”