Definition of Terms
The following terms are found within this literature review:
Asynchronous - posting to a discussion forum or via email. There is a delay between initial posting/sending of message and response. There is no interaction in real time (Buchanan & Coulson, 2007; Coursaris & Liu, 2009; LaCoursiere, 2001; Suler, 2004).
Computer-mediated communication - Communication between individuals that is done exclusively on the computer (Buchanan & Coulson, 2007; Scharer, 2005).
Homophily - Shared internet characteristics e.g. age, gender or lifestyle (Brown, Broderick, & Lee, 2007).
Social networking site - Websites that allow individuals to interact with other individuals with whom they have a connection and with an identity they define (Boyd & Ellison, 2008).
Currency of Issues
The Internet and computer-mediated communication's influence on an individual's everyday life is ubiquitous, allowing individuals to participate, work and communicate with others when they deem it most convenient. Individuals across all incomes, ethnicities, ages and geographical locations are accessing the Internet (U.S Department of Commerce [Commerce], 2002; U.S Department of Commerce, 2004). The primary reasons individuals go online is for communication and information (Skinner & Latchford, 2006; Commerce, 2002; Commerce, 2004). Across the globe, the predominant users of the Internet are Asia, Europe and North America, with a population penetration on the Internet of 73.9% by North America, 50.1% in Europe and 18.5% in Asia (IWC, 2009). In 2007, 61.8% of all households in America had computers with a majority of them (87%) using them to access the Internet (U.S. Department of Commerce, 2007; Commerce, 2004). Families with children are more likely to have computers and Internet than those without children (Commerce, 2002; Scharer, 2005).
Significance of Topic in Communications
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Communication via technology mediated avenues are becoming daily activities as children and young adults prefer technology mediated communication to other traditional communication methodologies (Greenhow & Robelia, 2009; Scharer, 2005). Individuals are less inhibited online and disclose more than traditional face-to-face which can expedite a relationship process (Foster & Roffe, 2009). Friendships that develop on line follow the same pattern as face-to-face relationship through shared experiences, care and encouragement (Foster & Roffe, 2009). The ties between individuals however can range based on the intimacy of the postings and the frequency of the exchanges (Brown, Broderick, & Lee, 2007). A sense of community on social networking sites is derived by the need to congregate and share aspects of ones life, however again, the results are proportional to the amount of participation and the quality of the posted content (Barak, & Dolev-Cohen, 2006; Brown, Broderick, & Lee, 2007; Rotman et. al., 2009). Frequently the precipitating factor leading an individual to seek support online is an alteration of perceived or actual health and wellbeing (LaCoursiere, 2001).
Summary of Literature
With the ever increasing role of technology-mediated communication in the day-to-day activities of individuals, the role of social networking sites such as entertainment bulletin boards and discussion forums is also changing. Social networking technology varies depending upon whether its purpose is entertainment or information. Online relationships, interpersonal communication, and belonging to a group are among a myriad of reasons why an individual may join a social networking site. As shared experiences and bonding are key to online social support, how do the various non-health related sites meet individual's emotional needs?
Social Networking Sites
Online social networks, no matter their form or function, are based primarily on a framework of community. The site provides its members a shared connection and identity, linked by perceived common ties. Individuals reach out to other like-minded persons based upon mutual interest, fulfillment of perceived needs and to obtain information. The achievement of an individual's networking goals is influenced by the quality and scope of their interactions with others within the social networking site.
Computer-mediated communication e.g. the Internet, allows like-mined individuals almost instant access to others who have mutual interests without many of the barriers found in traditional face-to-face interactions. The Internet is used primarily for functional communication and entertainment, but it also allows an individual to maintain geographically diverse personal relationships and friendships (Foster & Roffe, 2009; Hlebee, Manfreda, & Vehovar, 2006). It can decrease the barriers to meaningful social interactions; foster a feeling of community, and create a sense of belonging (Barak, Boniel-Nissim, & Suler, 2008; Bar-Lev, 2008; Miller, 2008). Like-minded individuals make up online communities. These individuals share mutual interests and have a common perceived culture (Rotman, Golbeck, & Preece, 2009; Zaphiris & Sarwar, 2006). Online computer-mediated communities exist for social relationship building, in addition to task oriented functions (Rau, Gao, & Ding, 2008). The communication spans time and space barriers and allows contact with a wide range of individuals within seconds (Beder, 2005; Zaphiris & Sarwar, 2006).
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Social networking sites are distinctive as they are created by individuals who have a shared connection and identity, linked by perceived common ties. Social networking sites are a unique cultural forum and are different from other online communities (Bar-Lev 2008; Rau, Gao, & Ding, 2008). Social ties and a sense of commonality among the participants are hallmark characteristics within a social networking forum (Lorence & Chen, 2007; Rau, Gao, & Ding, 2008). The shared connection is more direct and interpersonal, however it can be socially isolating at the same time (Rau, Gao, & Ding, 2008; Tanis & Postmes, 2007). Interaction through mutual experiences allow for the shaping of a common identity and a sense of community (Dino, Reysen & Branscombe, 2009; Rotman, Golbeck & Preece, 2009). Personal ties, relationships, and various types of communication interactions build an online social networking forum (Rotman, Golbeck & Preece, 2009; Williams & Durrance, 2008).
Social networking technology varies depending upon its goal and purpose however a sense of community is the foundational element. When looking for online social networks, one of the reasons a community is formed is mutual interests e.g. fan sites (Dino, Reysen, & Branscombe, 2009). There are a variety of computer-mediated forums that meet the criteria of a social network. These include the most common communication methods on the Internet, email and instant messaging, (Commerce, 2004; Commerce, 2002). When support is the primary impetus for the establishment of a site, discussion and bulletin boards are the most common venue (Coursaris & Liu, 2009). The extent of engagement is linked to the medium used. Discussion and bulletin boards are text driven, where as sites such as YouTube have a video component, and sites such as Facebook provide a blending of text and images (Zaphiris & Sarwar, 2006)
Fulfillment of perceived need and information can lead an individual to participate in social networking sites; however the quality and scope of the interactions influence the achievement of these goals. Individuals use social networking sites and the Internet as a vehicle to interact with others to meet social, emotional, friendship, and informational needs (Best & Krueger, 2006; Ellison, Lampe, & Steinfield, 2009; Rau, Gao, & Ding, 2008). Social networking sites and particularly message/discussion forums have increasingly become a sophisticated resource of information, emotional support, and a source of experiential knowledge from other members within the group (Barak, Boniel-Nissim, & Suler, 2008; Kenen, et. al., 2007). A discussion forum provides an asynchronous style of contact with the convenience of availability 24 hours a day, 7 days a week (Coursaris & Liu, 2009; Kouri, Turunen, Tossavainen, & Saarikoski, 2006; Leiberman & Goldstein, 2005; Suler, 2004). Ties with other members in a discussion forum are implicitly created through the patterns of interaction among the members, and the content of the messages shared (Rotman, Golbeck and Peece, 2009). ). Initial postings can set the tone for the relationship and discourage participation if there is not positive feedback (Vayreda & Antaki, 2009). The interaction between the participants is not pre-planned or monitored, allowing the technology to function as the mediator between people and information (Barak et. al., 2008; Kouri et.al., 2006).
Online support groups
When examining emotional support online, the preponderance of research has been conducted regarding it's efficacy with health-related issues. Online support is influenced by a group's open communication among its members, a perceived shared identity and a common language. Both face-to-face and online support is founded upon shared experiences and empathetic communication among the members and a perceived group identity. Ultimately, the quality of perceived support by any individual is based upon how the support is offered and how that support is received.
An online community support group empowers users through shared experiences, perceived relationships, and empathetic connections. Support is multi-dimensional. It can address the spiritual, social, economic, political, and psychological views of the individual (Barak et.al., 2008; LaCoursiere, 2001). As an individual initiates any participation in a computer-mediated support network, it enhances their group relationships as they work through problems which ultimately lead to self awareness (Barak et.al., 2008; LaCoursiere, 2001). This process includes exchanging information, providing emotional support, and finding recognition and understanding of mutual shared issues which fosters a perceived intimate relationship (van Uden-Kraan, Drossaert, Taal, Seydel, & van de Laar, 2008). The most valuable component is shared experiences as they legitimize feelings, provide a sense of control and personal empowerment, and promote group social cohesiveness (Barak et. al., 2008; Bar-Lev, 2008; Kouri et.al., 2006).
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The preponderance of research regarding online support groups in many different venues, has been conducted on various health related topics concerning both the process and effectiveness with emotional support. The use of online support groups has been used to address health related issues and their psychological repercussions for over 20 years (Barak et.al., 2008; Buchanan & Coulson, 2007; Miller, 2008). Online venues can include mailing lists, news groups, discussion forums and chat rooms. The methodology can be synchronous e.g. chat rooms or asynchronous e.g. discussion forums (Coursaris & Liu, 2009). This access to support is especially important to individuals dealing with health related issues, as it allows for immediate access to help, can be disease specific, and provides a source of information for rare or poorly understood diseases (Barak et.al., 2008; Scharer, 2005; Skinner & Latchford, 2006; Lorence & Chen, 2007).
The quality of perceived support by an individual is impacted by how the support is offered and how that support is perceived. The types of support are based upon the virtual makeup of the network housing it, and relationships between the individuals comprising the group (LaCoursiere, 2001). The most important aspect of a support group is the opportunity to share feelings, thoughts, opinions, experiences and to gain information (Buchanan & Coulson, 2007; Mo & Coulson, 2008). Emotional support is provided in three ways; esteem building through complementary messages, expression of caring and concern, and tangible informational support related to a specific task or request (Mo & Coulson, 2008). Ultimately, online support goes through three filters within the individuals participating. These filters are perceptual, based upon the emotional state of the individuals involved; cognitive, requiring intellectual processing; and transactual, which is an evaluation of all the information received (LaCoursiere, 2001)
Online support is created via a shared identity, common language, a sense of support and open communication. The Internet can provide a lifeline to support and information through increasingly complex virtual environments (Coursaris & Liu, 2009; Kenen et.al. 2007). When seeking support, individuals control the extent of involvement and the ultimate results of the interactions (Barak & Dolev-Cohen, 2006). Support groups provide communication tools to create a rapport through shared experiences including fears, joys and sorrows (Buchanan & Coulson, 2007; Rau et.al., 2008). What online support groups provide is a sense of homophily through shared characteristics and communication with individuals who one would not normally interact (Brown et. al, 2007; Ellison et.al., 2009; Greenhow & Robelia, 2009; Hlebec et. al., 2006). The components found to be the most beneficial in online support groups include the peer-to-peer support, the perceived lack of criticism and judgment, the shared common language, and a spirit of open debate and evaluation of the topics (Barak et.al., 2008; Bar-Lev, 2008; Brown et. al., 2007; Buchanan & Coulson, 2007; Kouri et.al., 2006; Lorence & Chen, 2007). Message boards have been used by health care as a resource for emotional support and information. They allow for individuals discuss common issues, function as a resource for advise and emotional release, and as an avenue to reduce a sense of isolation (Foster & Roffe, 2009; Kenen, Shapiro, Friedman, & Coyne, 2007; LaCoursiere, 2001).
Computer-mediated online groups are influenced by a variety of theories, of which the Social Penetration Theory and the Social Networking Theory are the most applicable. Social networking theory is one that defines a community built with diverse individuals (Williams & Durrance, 2008). When social networking analysis is applied to the theory, it specifically examines the ties that connect one individual to other individual; along with the behaviors, influences, positions and connections within the online community (Knoke & Yang, 2008; Zaphiris & Sarwar, 2006). Factors that influence an online group include the membership, the amount of influence the group has on the membership, the amount of fulfillment and satisfaction derived from the interactions, and if there is a shared emotional connection (Rotman, Golbeck, & Preece, 2009). When looking at the extent of emotional support provided by social networks, the social penetration theory is the most germane theory due to its approach to relationship development. West and Turner (2007) outline how relationships develop online via this theory. The first assumption is that relationships naturally progress from non-intimate to intimate. The progression is systematic and predictable and requires individuals to self-disclose information. The description of this relationship progression mirror what occurs in social networking sites and support discussion forums.
Critique of the Literature
The preponderance of literature regarding emotional support online was health care related. As such, much of the dialogue concerned disease specific issues and support. There does not appear to be any literature related to how entertainment social networking sites, specifically popular discussion forums are used for support. There is limited transfer of benefits recognized between various social networking sites.
Remaining Research Questions
Based on this literature review, the following topics yield the need for further exploration:
- How are recent iterations of social networking sites e.g. Twitter and Face Book utilized as a support medium?
- Are health relation support groups emotional support benefits different than those found at non-medical groups?
- What is the difference in perceived support between active poster and lurkers?
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- Barak, A, & Dolev-Cohen, M.. (2006). Does activity level in online support groups for distressed adolescents determine emotional relief. Counseling and Psychotherapy Research, 6(30), 186-190.
- Bar-Lev, S. (2008). "We are here to give you emotional support": Performing emotions in an online HIV/AIDS support group. Qualitative Health Research, 18(4), 509-521.
- Best, S.J., & Krueger, B.S. (2006). Online interactions and social capital. Social Science Computer Review, 24(4), 395-410.
- Brown, J., Broderick, A.J., & Lee, N. (2007). Word of mouth communication within online communities: Conceptualizing the online social network. Journal of Interactive Marketing, 21(3), 2-20.
- Buchanan, H., & Coulson, N.S. (2007). Accessing dental anxiety online support groups: An exploratory qualitative study of motives and experiences. Patient Education and Counseling, 66, 263-269.
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- Greenhow, C., & Robelia, B. (2009). Old communication, new literacies: Social network sites as social learning resources. Journal of Computer-Mediated Communication, 14, 1130-1161.
- Hlebec, V., Manfreda, K.L., & Vehovar, V. (2006). The social support networks of internet users. New Media & Society, 8(1), 9-32.
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- Kenen, R.H., Shapiro, P.J., Friedman, S., & Coyne, J.C. (2007). Peer-support in coping with medical uncertainty: Discussion of oophorectormy and hormone replacement therapy on a web-based message board. Psycho-Oncology, 16, 763-771.
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- Miller, S.M. (2008). The effect of frequency and type of Internet use on perceived social support and sense of well-being in individuals with spinal cord injury. Rehabilitation Counseling Bulletin, 51(3), 148-158.
- Mo, P.K.H., & Coulson, N.S. (2008). Exploring the Communication of Social Support within Virtual Communities: A content analysis of messages posted to an online HIV/AIDS support group. CyberPsychology & Behavior, 11(3), 371-374.
- Rau, P.P., Gao, Q., & Ding, Y. (2008). Relationship between the level of intimacy and lurking in online social network services. Computers in Human Behavior, 24, 2757-2770.
- Rotman, D., Golbeck, J., & Preece, J. (2009). The community is where the rapport is: On sense and structure in the YouTube community. Proceeding from: C&T 09, June 25-28, 2009, University Park, Pennsylvania.
- Scharer, K. (2005). An Internet discussion board for parents of mentally ill young children. Journal of Child and Adolescent Psychiatric Nursing, 18(1), 17-25.
- Skinner, A.E.G., & Latchford, G. (2006). Attitudes to counseling via the Internet: A comparison between in-person counseling clients and Internet support group users. Counseling and Psychotherapy Research, 6(30), 158-163.
- Suler, J. (2004)/. The online disinhibition effect. CyberPsychology & Research, 7(3), 321-326.
- Tanis, M., & Postmes, T. (2007). Two faces of anonymity: Paradoxical effects of cues to identity in CMC. Computers in Human Behavior, 23, 955-970.
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- van Uden-Kraan, C.F., Drossaert, C.H.C., Taal, E., Seydel, E.R., & van de Laar, M.A.F.J. (2008). Self-reported differences in empowerment between lurkers and posters in online patient support groups. Journal of Medical Internet Research, 10(2), 1438-1471.
- Vayreda, A., & Antaki, C. (2009). Social support and unsolicited advice in a Bipolar disorder online forum. Qualitative Health Research, 19(7), 931-942.
- West, R., & Turner, L. H. (2007). Introducing communication theory: Analysis and application (3rd ed.). New York: McGraw Hill Higher Education.
- Williams, K., & Durrance, J.C. (2008). Social networks and social capital: Rethinking theory in community informatics. Journal of Community Informatics, 4(3), Retrieved from: http://www.ci-journal.net/index.php/ciej/article/viewArticle/465/430.
- Zaphiris, P., & Sarwar, R. (2006). Trends, similarities, and differences in the usage of teen and senior public online newsgroups. ACM Transactions on Computer-Human Interactions, 13(3), 403-422.8.