Carron-Arthur, Bradley John
Description
Internet Support Groups (ISGs) are a valued and popular source of
health information and
support among consumers and carers. Although ISGs are premised
upon mutual help, it has
been observed that only a small minority of users, of the order
of 1%, are responsible for the
majority of activity. Despite their potential importance to the
outcomes and sustainability of
online groups, little is known about the characteristics of these
participants or the...[Show more] nature of
their participation.
This thesis comprises a systematic review of the literature on
styles of participation in ISGs
followed by a series of five empirical studies focusing on the
nature of participation in a
Mental Health Internet Support Group (MHISG). These studies
sought to address fundamental
gaps in our knowledge regarding active participation in an MHISG,
posing the questions: ‘Who
participates?’, ‘With whom do they communicate?’, ‘What
do they communicate about?’ and
‘How do these factors differ as a function of user
engagement?’. These questions were
addressed using log data generated by all active users (n=2932)
of the MHISG ‘BlueBoard’ and
a mixture of qualitative and quantitative methods including novel
analyses, such as social
network modularity and topic modelling algorithms.
It was found that the demographic characteristics of higher- and
lower-engaged users were
broadly similar, although the members of the higher-engaged group
were older and more
likely to identify as consumers. Network analysis demonstrated
users communicated with each
other in a pattern that resembled five generational cohorts
transcending disorder-specific subforums,
in which the highest-engaged users of each cohort were central
and registered earlier
than the majority of other users. Topic modelling and qualitative
content analysis revealed the
content of the communications of the two groups differed. The
communications of higherengaged
users appeared to reflect a consumer model of recovery and those
of lower-engaged
users a medical model of recovery. However, higher-engaged users
modified the content of
their responses when communicating with lower-engaged users.
Qualitative analysis of
users’ initial posts revealed higher- and lower-engaged users
differed in terms of their
‘awareness’ characteristics at the outset of participation,
with higher-engaged users
demonstrating greater interpersonal-, mental health- and
self-awareness.
Based on these findings, this thesis presents ‘The Tripartite
Model of MHISG Participation’
which, contrary to prevailing assumptions, posits that
differences in posting frequency are
associated with different styles of active participation across
the spectrum of
engagement. The higher end comprises a minority group of
users—referred to as ‘mutual
helpers’—who are central, aware and proactive about
participating in peer support for their
ongoing recovery. At the lower end, the majority of users,
referred to as ‘active help seekers’
and ‘active help providers’, participate in transient and
asymmetrical exchanges, often with
‘mutual helpers’. Those who do not post are ‘passive
followers and help seekers’. The model is
iterated for each cohort. In addition to extending our scientific
knowledge base, and informing
the above new model of user participation, these findings are of
potential relevance to the
design of future research studies, managers of Internet support
groups and policy makers.
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