Anika Batenburg*, VU University Amsterdam, Amsterdam, Netherlands Enny Das*, Radboud University, Nijmegen, Netherlands Track: Research Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: Oral presentation Submission Type: Single Presentation Building: Sheraton Maui Resort Room: B - Kapalua Date: 2014-11-13 02:50 PM – 03:35 PM Last modified: 2014-09-04

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Background: Descriptive studies on peer-led online support communities (often designed as discussion boards) suggest the presence of empowering processes, such as emotional- and informational support, recognition, understanding, and insight. However, studies on the effects of online peer support on wellbeing showed mixed findings. This might be caused by a lack of longitudinal studies testing the effects of solely peer support (i.e., peer-led communities with no professionals or other therapeutic elements involved), while such peer-led communities are common online and accessible to everyone. Besides, previous research rarely considered the influence of individual differences, even though patients have different levels of participation in an online support community and cope with illness-related emotions in different ways. Therefore, there is a need for longitudinal studies explaining when and why peer-led communities are beneficial.
Objective: The current longitudinal study tested the interaction effects of online activity and emotional coping strategies on psychological wellbeing among Dutch breast cancer patients. Studies showed that cancer patients generally benefit from actively approaching emotions rather then avoiding emotions. Because online communities confront patients with (often emotional) experiences of peers, we expected that patients who actively cope with emotions would benefit more from online participation than patients who approach their emotions less actively.
Method: Breast cancer patients visiting a Dutch online peer–led support community filled out a T0 and T1 survey with 6 months in between (n=109), assessing online activity within the online support community, emotional approach coping and psychological wellbeing. We also included potential covariates, such as social support from family and friends, illness stage, and received professional psychological help. We conducted within subjects ANOVAs to test change in wellbeing over time.
Results: Results showed three way interactions of time (T0-T1), online activity, and emotional approach coping on depression (F(1, 88)=8.160, p=.005, η2ρ =.085) and on emotional wellbeing (F(1, 89)=4.506, p=.037, η2ρ =.048). Online active patients (+1SD) who approached their emotions actively (+1SD) did not experience a change in wellbeing over time, but reported highest wellbeing overall. However, patients that scored low on emotional approach coping (-1SD) benefited the most from active participation (+1SD); they reported the lowest score on wellbeing at T0, but emotional wellbeing increased (p=.029) and depression decreased (p=.073) over time. For patients who scored low on online participation (-1SD), active coping with emotions (+1SD) resulted in an increase in emotional wellbeing (p=.005) and a decrease in depression (p=.044), while approaching emotions less (-1SD) caused an increase in depression (p=.080) and no change in emotional wellbeing (p>.10) over time.
Conclusions: The current study is one of the rare studies that examined causal effects of peer-led online support group participation, and showed the importance of individual differences in coping style. Actively participating in an online peer support community is particularly helpful for patients who approach emotions less actively; their wellbeing increases significantly over time. One explanation might be that online interactions intensify emotional disclosure behavior. Another clarification is that other online processes compensate for negative effects of avoiding emotions.