Internet Support Groups: Isolating and Improving Pathways Towards Mental Health

 描述（由申请人提供）：面临严重健康威胁的人越来越多地使用互联网获取信息和支持。互联网支持小组（ISG），人们聚集在一起交换信息和/或支持的在线社区，是患者应对严重医疗状况的重要资源。参与与健康相关的ISG与参与者报告的抑郁，焦虑和其他心理困扰指标的显着减少有关。这些团体提供了很大的干预潜力，这些干预措施具有高度的可扩展性，但很容易根据个人需要进行调整。不幸的是，许多ISG成员过早离开，无法受益。此外，对ISG在其成员中赋予的益处的活性成分的科学理解有限。拟议的研究使用最先进的机器学习和自动语言分析技术来评估在线健康支持小组中的互动类型，这些互动可以改善心理社会健康和健康相关的生活质量，以及这些互动如何发展。它还使用这些技术和我们的实证研究的见解来建立，部署和评估干预措施，改善与健康相关的互联网支持团体的互动。我们的工作有三个主要目标。在目标1和2中，我们将分析来自两个互补的互联网支持小组的数据，以确定（a）维持参与者参与小组的沟通过程和（B）通过点对点互动改善参与者的心理社会结果的沟通过程。这些数据集来自美国癌症协会（ACS）主办的ISG中4，400名癌症幸存者和护理人员正在进行的自然主义研究，以及即将完成的NIMH资助的随机试验（MH 093501），该试验评估了ISG对由其初级保健医生转诊的抑郁和焦虑患者的有效性。这两个数据集都包括参与者层面的抑郁、焦虑、压力和其他心理社会结果数据，以及详细的服务器日志，其中包含页面浏览量、在网站上的时间和参与者之间的通信内容等信息。在目标3中，我们将制定和试行测试干预措施，以鼓励目标1和目标2中确定为有效的沟通过程。我们将测试在以下干预措施后，情绪、对互动的满意度和参与度是否会增加：（a）增加参与者从他人获得个性化支持的机会;（B）为参与者提供向他人提供支持的机会;（c）促进参与者表达情绪;（d）增加参与者的参与度。 以及（d）帮助参与者与类似的同伴建立关系。在一系列随机实验中，我们将研究这些干预措施如何影响参与者的沟通行为以及他们在线互动的短期参与度和满意度。该项目的结果将促进R 01应用程序的开发，用于随机临床试验，测试个性化ISG干预对参与者继续参与ISG的时间长度以及参与者的抑郁，焦虑和其他心理社会结果以及医疗保健利用的影响。

 DESCRIPTION (provided by applicant): People facing serious health threats increasingly use the Internet to obtain information and support. Internet support groups (ISGs), online communities where people come together to exchange information and/or support, are an important resource for patients grappling with serious medical conditions. Participation in health-related ISGs has been associated with significant reductions in participant-reported depression, anxiety and other indicators of psychological distress. These groups offer great potential for interventions that are highly scalable and yet easily tailored to individual needs. Unfortunately many ISG members leave too soon to benefit. In addition, there is limited scientific understanding of the active ingredients underlying the benefits that ISGs confer among their members. The proposed research uses state-of-the art machine learning and automated language analysis techniques to assess the types of interactions in online health support groups that lead to improved psychosocial well-being and health-related quality of life and how these interactions develop. It also uses these technologies and insight from our empirical research to build, deploy, and evaluate interventions that improve the interactions in health-related Internet support groups. Our work has three major aims. In Aims 1 and 2, we will analyze data from two complementary Internet support groups to identify (a) the communication processes that sustain participant engagement in the group and (b) the communication processes through which peer-to-peer interactions improve participants' psychosocial outcomes. These datasets come from an ongoing naturalistic study of 4,400 cancer survivors and caregivers in ISGs hosted by the American Cancer Society (ACS) and from a soon-to-be-completed NIMH-funded randomized trial (MH093501) assessing the effectiveness of an ISG for depressed and anxious patients referred to the group by their primary care physicians. Both datasets include participant-level data on depression, anxiety, stress and other psychosocial outcomes and detailed server logs containing information on page views, time on site, and the content of communications between participants. In Aim 3, we will develop and pilot test interventions to encourage the communication processes identified as effective in Aims 1 and 2. We will test whether mood, satisfaction with interactions and engagement in the group increase following interventions that (a) increase participants' receipt of individualized support from others; (b) provide participants with opportunities to offer support to others; (c) facilitate participants' expression of emotions; and (d) help participants form relationships with similar peers. In a series of randomized experiments, we will examine how these interventions affect participants' communication behaviors as well as short-term engagement and satisfaction with their online interactions. Results from this project will facilitate the development of an R01 application for a randomized clinical trial testing the impact of personalized ISG interventions on the length of time participants continue to participate in ISGs and participants' depression, anxiety and other psychosocial outcomes as well as healthcare utilization.