Here’s a good example of online therapy, maybe we could use it for an activity?

I wonder how ethical this is, and how much trouble CNN could get into for giving “wrong” advice, but Dr. Gupta seems to be sticking to safe topics, like how to keep your family healthy while traveling for the holidays.

The CNN blog also features other topics- not all are reader questions. On November 23rd, The Biggest Loser’s Jillian Michaels was featured on the blog, talking about how to stay motivated during the holidays. The CNN blog is a wealth of information, and I’m interested to see what other reader questions will be featured!

However, there was a lot of confusion in the online world when the U.S. Preventative Service’s Task Force’s  new recommendation against teaching women how to do breast self-examinations may seem perplexing. The guidelines also changed regarding when women should start getting mammograms and how frequently they should receive them. Here’s the WSJ story, and the link to the blog entry.

Tanis, M. (2008). Health-related on-line forums: What’s the big attraction?. Journal of Health Communication, 13(7), 698-714.

Overview

In this article, Martin Tanis recognizes that the Internet serves as a significant platform which individuals utilize in order to research and further understand health-related issues. More specifically, he reveals that online forums have become popular due to several aspects which attract users and enable health-related coping. His study explores what motivates people to use health-related online forums, how the forums help with coping and which features are perceived to be helpful in coping.

Although research has been conducted previously about the motives for Internet use in general and on searching for health-related information, Tanis’s investigation uses a users-gratification approach which has never before been used for this kind of study. The results of previous studies were used as theoretical background for this study and enabled Tanis to draw upon six motives for using health-related online forums and ultimately establish a research question. Also, preceding research about what makes CMC and online forums different from face-to-face interactions permitted Tanis to group and to measure features related to how people use the forums and what attracts them to the forums. Tanis conducted his research about the forums with an online questionnaire. The findings about the forums demonstrated that they had an overall positive effect on people coping with their situation; however, the forums did have a negative effect on coping for people who used them for discussion.

Methodology

In order to conduct his study, Tanis posted a message inviting people to participate in his online survey on 25 forums about varying issues including physical and mental conditions in the Netherlands in November 2005. The questionnaire was posted for 3 weeks and out of the 325 people who clicked on the hyperlink, 189 completed the survey. Of the respondents, 74% were female with the average age being 37.52. The youngest was 14 and the oldest was 71 and the education level varied significantly.

Tanis posed four hypotheses and a research question. Hypothesis 1 stated that “Participating in health-related online forums will be positively related to coping.” Next, hypothesis 2 said that “People who face a situation that makes it harder for them to interact with others about their health-related issues will perceive online forums helpful in coping because of their text-based character.” Then, hypothesis 3 said that “People who feel they have a stigmatized condition will perceive health-related online forums helpful in coping because of the anonymity these forms afford.” Lastly, hypothesis 4 stated that “People who feel restricted in their mobility will perceive health-related online forums helpful in coping because of the possibility that these forms offer to extend one’s network.” Additionally, Tanis posed a research question asking, “Do different motives to make use of health-related online forums have different effects on coping?”

Also, Tanis used five measures to analyze the data. First, he measured participation by observing the number of weeks, number of visits per week, and the number of messages per week that were posted by the individuals. Second, he measured the uses and gratification motives by conducting an exploratory factor analysis and a Principal Component Analysis (PCA). The PCA measured 6 components including discussion, inclusion, information-seeking, supporting others, passing time, and convenience. Third, coping was measured with the PCA and looked at socially related coping and condition related coping. Fourth, the characteristics of condition, stigmatized, and restricted mobility, was measured on a 5-Point Likert Scale. Last, he analyzed the importance of forum features with the 5-point scale and looked at anonymity, text-based character, and extension of the social network.

Findings

In general, the hypotheses were supported by the research conducted but each was distinct. For hypothesis 1, mixed support was found. Some of the variables were positively related to coping while others, like the number of weeks someone was active on the forum, proved to be related to coping negatively. Next, hypothesis 2 was accepted as it supported that text-based character led to greater appreciation by those stigmatized and with restricted mobility. Then, hypothesis 3 was partly supported because it revealed that those stigmatized appreciated anonymity but anonymity was not necessarily related to coping. Finally, hypothesis 4 was supported because people with restricted mobility did indeed appreciate the possibilities of extending networks that the online forums offered and in the end, related positively to coping. Moreover, the results of the hypotheses indicated that participating in online health forums did relate positively to coping. The results showed that the convenience motive was the strongest for coping and the second strongest was the inclusion motive. However, a dependable factor attending to emotional support was not found and using online forums to discuss conditions was related negatively to coping.

Critique

Although this study is not entirely original, like most research articles, it did provide a new angle, the users-gratification approach, from which to investigate the effects of and the motives for using online forums. I thought that the article was well written but I thought some sections could have been condensed, namely the results section. The results would have appeared more organized if they were more concise. Also, I thought the methodology was effective but difficult to interpret due to the verbose explanation of the multiple methods used.

Application to Final Paper

The implications of this article contribute to my final project because it supports my interest in health communication and online therapy and provides new insight about the topic. This new approach was called the users-gratification approach and it added new findings about the attraction and motives to use and benefits of using online forums. Also, the article reiterated the notion that health forums are important and potential future phenomena in the world of health. However, more research must be conducted to further develop this thesis.

Cousineau, T., Rancourt, D., & Green, T. (2006). Web chatter before and after the women’s health initiative results: A content analysis of on-line menopause message boards. Journal of Health Communication, 11(2), 133-147.

Overview

In this article, Cousineau, Rancourt, and Green acknowledge the valuable role that the Internet plays in collecting data for research in the health field. Thus, they utilize this venue to observe the health information sought by women experiencing the menopausal transition. Their observations were enabled through a content analysis they conducted on two on-line menopause message boards, one medically oriented and the other community support oriented, before and after the announcement of the Women’s Health Initiative study about hormone therapy risks. In result, awareness about menopause as a health issue was promoted through the use of message boards and of the 785 messages coded, 93% were agreed upon by the two raters. Furthermore, this study has supported research about menopausal women’s needs and concerns as well as the significant role the message boards on the Internet play to create new health awareness. Also, the study serves as a springboard for further research in the field.

Methodology

In order to understand the concerns of menopausal women seeking on-line support today, Cousineau, Rancourt, and Green conducted a content analysis on two on-line menopause message boards, one medically oriented and the other community support oriented. The study endured 18 months, before and after the announcement of the Women’s Health Initiative (WHI) study results on hormone therapy risks. Both boards were moderated; therefore, in order to analyze the women’s initial personal inquiries about menopause, they chose to only look at posted messages. Also, they applied Sudweeks and Simoff’s (1999) Complementary Explorative Data Analysis (CEDA) framework because they claimed that the integration of qualitative and quantitative methods permitted the formulation and reformulation of hypothesis during data analysis.

The data analysis process of the menopause messages included the data mining and qualitative reasoning, quantitative and qualitative analysis, and qualitative refinement steps. First, the data mining and qualitative reasoning step included determining the time frame of message board analysis, 18 months, the number of messages to analyze, 100 randomly selected messages per message board per time period, and the categories for coding. Second, the quantitative analysis entailed random sampling, code messages, Inter-rater reliability, and Chi-Square tests for linear trend. The Inter-rater reliability of the context codes, content codes, and the number of codes assigned to each message were calculated using percent agreement and Cohen’s kappa and were important to the overall analysis of the message boards. Then, the Chi-Square tests were conducted to find differences in proportions of the contrasting community and medical board postings. Then they analyzed four topics, Seeking Symptom Advice, Pharmaceutical Advice, Emotional Support, Community Check-Ins and Offering Opinion or News Item. Third, the qualitative analysis included the identification of the context codes for themes and content codes for specific issues and refining of the coding scheme based on sub-sample message analysis, and last, the qualitative refinement involved amending terms and categories and incorporating quantitative and categorical models.

Findings

In total, 785 messages from both message boards were coded and 1,132 content coding units were received and overall, the two raters had agreement on one or more codings of 93% of the messages. The message boards revealed that seeking symptom advice about physical symptoms represented 49% of the codes while other content codes demonstrated questions about taking prescription hormone therapies, checking in with community members, how to cope with the menopausal transition, and changes in menstrual patterns and menopause onset. Additionally, the Chi-square tests evinced an increase in pharmaceutical advice codings and after the Women’s Health Initiative, a trend of asking “Is this menopause?” on the community board. This indicated that awareness about menopause as a health issue was provoked by the message boards.

The results of the Women’s Health Initiative that the risks of the hormone therapy outweighed the benefits drew more attention to women’s midlife health issues and revealed uncertainty about the management of menopause symptoms and health decision related to menopause. This study has proven that observation of health message boards is advantageous because in this particular case, it allowed the researchers to recognize women’s specific health concerns and provide a platform for refining research questions to further understand and promote health issues.

Critique

Although this article has served as a helpful, cost effective preliminary study for the development of an Internet-based computer-mediated psychoeducational resource for women, limitations do exist and indicate that more extensive research should be conducted. One problem was encountered due to the issue of anonymity. Raters could not identify multiple postings by the same person because the people did not identify themselves each time they posted. Another limitation existed because only the original messages posted were coded while additional posts were not available.

Also, the researchers realized that because the research was only conducted about women with access to the Internet, it left a void which obscured the results. I believe the article was structured in a coherent format but I thought the findings section could have been organized better in accordance with the method.

Application to Final Paper

This article contributes to my research project because it supports my interest in CMC health and online therapy. It indicates that this new field is growing and requires further research in order to understand the scope of the implications. My previous research article was similar to this one as it addressed the online participation of users on message boards about cancer and as it indicated the utilization for the purposes of support and information seeking. I believe this will be helpful in my future research because it supports my initial hypothesis that CMC about health is a growing trend with immense benefits.

PFIZER CLEAR HEALTH COMMUNICATION WEB SITE RECEIVES 2007 “WORLD WIDE WEB HEALTH AWARD”

New York, NY – September 26, 2007 – Pfizer Inc’s Clear Health Communication Website, www.clearhealthcommunication.org, received a “Bronze” 2007 World Wide Web Health Awards. This program recognizes the best Web-based health-related content for consumers and professionals, and is held twice a year with the goal of providing a “seal of quality” for electronic health information. Pfizer’s winning entry was among more than 100 entries judged by a panel of health information experts.

“This award validates our efforts to improve communication between healthcare professionals and patients,” said Barbara DeBuono, Executive Director, Public Health and Government, Pfizer Inc. “Our clear health communication Web site is designed to provide professionals with all the resources and tools they need to improve patient understanding, in one easy-to-navigate site.”

The awards program is coordinated by the Health Information Resource Center, a national clearinghouse for consumer health information programs and materials. The Center, which houses a large collection of public and private sector health resources, promotes the distribution of accurate, timely consumer health information materials to professionals and  managers in the field.

For nearly a decade, Pfizer has taken a leadership role in advocating for clear health communication, partnering with nationally recognized organizations and experts to develop tools and solutions that can help improve communication between patients and providers. The Pfizer Clear Health Communication Initiative strives to positively impact the health care system by enhancing patient-provider communication to increase compliance and improve patient health outcomes. To learn more about Pfizer’s efforts to improve clear health communication and health literacy, please visit www.clearhealthcommunication.org.

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2. Online Therapy- Cancer/Illness

3.  Health Literacy- Franki

4. Online Training Modules for Doctors- Haley

5. Psychosocial Benefits

6. Behavioral Change Theory- Morgan

These are the topics we discussed, but they aren’t set in stone! If there is not enough information, we can combine these with others. Post other ideas- the topics were placed with people who said they were interested, but we can change those too or work on them together!