Jeong Yeob Han

The Roles of Social Support and Coping Strategies in Predicting Breast Cancer Patients’ Emotional Well-being Testing Mediation and Moderation Models

The goal of the current study was to examine how social support and coping strategies are related in predicting emotional well-being of women with breast cancer. In achieving this goal, we examined two hypothesized models: (1) a moderation model where social support and coping strategies interact with each other in affecting psychological well-being; and (2) a mediation model where the level of social support influences choices of coping strategies between self-blame and positive reframing. In general, the data from the current study were more consistent with the mediation model than the moderation model.

Expressing Positive Emotions within Online Support Groups by Women with Breast Cancer

Based upon Fredricksons Broaden-and-Build Theory of Positive Emotions, this study examined the role of expressing positive emotions in online support groups for women with breast cancer. Underserved women with breast cancer in rural Wisconsin and Detroit, Michigan were recruited from 2001 to 2003, and they were given access to online support groups. Both pretest and four-month posttest surveys were conducted with a sample of 231 women. Messages from 96 active participants were analyzed using a computerized text analysis program. Psychological benefits that occurred following the expression of positive emotions were greater among those who expressed more negative emotions.

Empathic Exchanges in Online Cancer Support Groups: Distinguishing Message Expression and Reception Effects

Past studies on the efficacy of participation in online cancer support groups have primarily focused on the role of expression in the accrual of health benefits for participants. Unfortunately, few steps have been taken to determine whether this observed effect arises solely from the internal mental processes underlying the act of expressing or, perhaps, owes something to a nuanced, multidimensional understanding of expression that includes reception of responses to what is expressed. To test for the multilayered effect, we attend to one of the key concepts in the online support community scholarship: empathy. Our findings suggest that it is a combination of empathy expression and reception that is crucial to attaining optimal benefits for cancer patients. Further, our finding supports the buffering hypothesis that empathic expression provides a salutary effect for patients who experienced a higher degree of concern associated with their cancer diagnosis and follow-up treatments.

Cancer Talk on Twitter: Community Structure and Information Sources in Breast and Prostate Cancer Social Networks

This study suggests taking a social networks theoretical approach to predict and explain patterns of information exchange among Twitter prostate and breast cancer communities. The authors collected profiles and following relationship data about users who posted messages about either cancer over 1 composite week. Using social network analysis, the authors identified the main clusters of interconnected users and their most followed hubs (i.e., information sources sought). Findings suggest that users who populated the persistent-across-time core cancer communities created dense clusters, an indication of taking advantage of the technology to form relationships with one another in ways that traditional one-to-many communication technologies cannot support. The major information sources sought were very specific to the community health interest and were grassroots oriented (e.g., a blog about prostate cancer treatments). Accounts associated with health organizations and news media, despite their focus on health, did not play a role in these core health communities. Methodological and practical implications for researchers and health campaigners are discussed.

Expression and reception of treatment information in breast cancer support groups: How health self-efficacy moderates effects on emotional well-being

OBJECTIVES To examine the effects of exchanging treatment information within computer-mediated breast cancer support groups on emotional well-being, and to explore whether this relationship is moderated by health self-efficacy. METHODS SAMPLE 177 breast cancer patients using an electronic Health (eHealth) program with discussion group. MEASURE expression and reception of treatment information; emotional well-being scale (0, 4 months). ANALYSES hierarchical regression. RESULTS Effects of expression and reception of treatment information on emotional well-being were significantly greater for those who have higher health self-efficacy. CONCLUSIONS Results conditionally support prior research finding positive effects of treatment information exchanges among breast cancer patients. Such exchanges had a positive impact on emotional well-being for those with higher health self-efficacy, but they had a negative influence for those with lower health self-efficacy. PRACTICE IMPLICATIONS Given that the association between emotional well-being and exchanging treatment information was moderated by health self-efficacy, clinicians should explain the role of health self-efficacy before encouraging patients to use eHealth systems for treatment exchanges.

Unraveling Uses and Effects of an Interactive Health Communication System

By developing a number of measures distinguishing amount, type of content, and when and how that content is used, the current study revealed effective patterns of use that are associated with quality of life benefits during an eHealth intervention. Results generally suggest that the benefits depend on how a patient uses the system, far more than on sheer amount of exposure or even what type of content is chosen. The next generation of eHealth system should focus on providing new and varying content over time, but even more on encouraging intensity of use and long-term commitment to the system.

Lurking as an active participation process: a longitudinal investigation of engagement with an online cancer support group.

To better understand participation in computer-mediated social support (CMSS) groups for breast cancer patients, this study examines two overarching questions of (1) who are posters, lurkers, or nonusers and (2) what role do these different types of engagement play in explaining psychosocial health outcomes? This study incorporates the comprehensive model of information seeking and two competing models of social enhancement and social compensation, as well as the literature on lurking and posting behaviors in online groups to answer research questions. Our findings suggest that patterns of engagement in a CMSS group differed according to patients’ sociodemographic characteristics and psychosocial factors. In addition, we found that lurkers had a higher level of perceived functional well-being than posters at 3 months post baseline. Theoretical and practical implications for effective online cancer support group campaigns are discussed.

Interactivity and presence of three eHealth interventions

A number of researchers have identified interactivity and presence as potentially important attributes of e-Health applications, because they are believed to influence users to interact with systems in ways that increase commitment, learning, and other desirable responses. This paper reports on the development of brief scales to assess the two concepts, and on use of them with participants in six conditions of a large-scale trial of interventions for breast cancer patients. Overall, the Internet scored very low on both measures. Versions of an integrated system of services (CHESS) scored higher, particularly as conditions added features to different versions of the system. Interventions involving a human Cancer Information Mentor scored highest, though even the Mentor was perceived as more interactive and having more presence when combined with the integrated eHealth system.

Predictors of supportive message expression and reception in an interactive cancer communication system.

Social support in computer-mediated settings is an important variable in health communication research, yet little is known about the factors that influence the amount of social support one gives and receives in online support groups. To shed some light on this issue, the authors examined demographics, disease-related factors, psychosocial factors, and strategies for coping with breast cancer as potential determinants of which patients provide support to others and which ones consume it. Data collected from 177 participants in the Comprehensive Health Enhancement Support System “Living With Breast Cancer” program revealed that individuals who are younger, have higher levels of positive reframing, and lower levels of self-blame are more likely to provide emotional support in online settings. In contrast, individuals who are more educated, have less perceived availability of social support, and have lower levels of religious coping are more likely to receive emotional support from others. The authors discuss the theoretical and practical implications for providing effective psychosocial support for women with breast cancer.

Transaction logfile analysis in health communication research: challenges and opportunities.

OBJECTIVE To investigate the individualized nature of eHealth communication, it is necessary for us to go beyond the conventional approach to explain the effect of eHealth initiatives. The current article proposes transaction logfile analysis as a unique method to probe the process by which individuals locate needed information and obtains benefits out of it. METHODS This article discusses the background of logfile analysis along with practical and methodological issues related to the analysis of log data. RESULTS This article recommends potential solutions to resolve issues discussed in the Section 2. CONCLUSIONS This article discusses how transaction logfile analysis could benefit eHealth researchers, along with its relevance and application in health communication research. Logfile analysis could provide rich knowledge on how eHealth applications and tools work if performed on a regular basis, incorporated with appropriate measurement techniques and research design, and interpreted carefully. PRACTICE IMPLICATIONS Logfile analysis can point toward important design implications for more effective eHealth applications. Further, interventions employing logfile analysis require not only well-designed research models but also interdisciplinary research team to handle the multifaceted work involved in the process.