Communication Currents

Illness presents a variety of challenges. In addition to receiving traditional forms of care, millions of adult Americans turn to the Internet as part of their coping efforts. Online communities such as those found on WebMD, social networking websites such as Facebook, and even blogs are used to connect with others who are facing similar challenges and acquire social support. Yet, what support messages from peers do people coping with illness tend to receive? Are there certain contexts in which some types of support messages are more or less likely? To answer these questions, we conducted a quantitative review of more 40 existing studies.

Social support, which generally involves providing assistance to others, is a critical resource for people facing illness. People may look to others who have experienced or are experiencing the same condition to provide advice, comfort, a sense of belonging, or other specific types of support. During 2012 alone, more than 7 million adult Americans are estimated to have visited an online community for health-related support from their peers. The number of people going online and the variety of resources available has been recognized by scholars. We found more than 40 different studies in which researchers examined one or more online contexts to identify the prevalence of different types of support messages. We aggregated the results of these existing studies to summarize what is known about the types of support messages shared online. Here is what we found.

Most of the studies examining online support tend to focus on online communities exemplified by websites such as Daily Strength. A wide range of mental and physical health conditions have been examined, and several trends were evident across this body of studies. Informational support involving advice and feedback and emotional support involving efforts to comfort and show concern were the most common types of support. These two types of support appeared much more frequently than all other support types. Network support involving efforts to communicate belonging and esteem supportincluding attempts to bolster an individual’s self-worth were less common but still noticeably present. Tangible supportinvolving offers of physical assistance such as a ride to the doctor or help with housework was, by far, the least common. As a whole, our analyses suggest that the Internet is predominately used among people coping with illness to acquire advice and comfort.

Beyond examining the prevalence of different support types, we also attempted to identify some instances in which specific types of support were more or less common. We used the nature of the health condition examined to group studies into different categories. The prevalence of specific support types varied based on the duration of health conditions, impact on one’s personal relationship, potential for death, and level of stigma. Informational and tangible support were more common among chronic health conditions such as diabetes and muscular dystrophy than acute conditions. Emotional and network support were more prevalent among conditions that affected personal relationships, such as infertility and depression. Among conditions where loss in the form of death was more likely, such as HIV/AIDS and heart disease, emotional, esteem, and network support were more common than among conditions less likely to be terminal. Finally, esteem support was more prevalent among conditions that are typically stigmatized, such as clubfoot or disordered eating, relative to less stigmatized conditions.    

Taken together, the results paint a nuanced picture of the way in which the Internet is being used as a coping resource. Individuals appear to be using the Internet to acquire support that is particularly needed or perhaps even lacking in their offline relationships. Online sources of support, such as online community members, are unique in that they are typically coping with the same health conditions as support seekers. These shared experiences may make online sources particularly critical support resources.

Unlike traditional face-to-face support groups, many online support contexts such as blogs and support communities also offer greater opportunities for participating, making social comparisons, and acquiring useful information and other types of support. This may be especially helpful for individuals in rural areas, people who have limited mobility to join a face-to-face support group, and people coping with stigmatized health conditions who may feel more comfortable communicating anonymously with others. These characteristics may help to inform a healthcare professional’s decision to refer patients to one or more online support contexts in an effort to augment or replace traditional sources of support.

For people who are considering using the Internet to acquire social support, we conclude with several tips to keep in mind. These are things we recommend to have the most rewarding experience possible.

• Be mindful of the norms and values of the context in which you are seeking support. In online support communities, for example, it is a good idea to spend some time reading what others have posted prior to actively participating. This will allow you to communicate most effectively with the group.
• Take what you read with a grain of salt. Any advice you receive should be evaluated with a measure of caution and, when in doubt, always follow up with your doctor or a licensed medical professional. When possible, look for interaction opportunities that are moderated by health experts, such as (some of) WebMD’s discussion communities.  
• Be respectful of others’ feelings and perspectives. One of the truly remarkable things we have witnessed in our research is the amount of kindness available in various health-focused online support contexts. Much of this stems from respecting and treating with dignity individuals who are sharing their illness experiences.