Final published version
Licence: CC BY: Creative Commons Attribution 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Understanding the Impacts of Online Mental Health Peer Support Forums
T2 - Realist Synthesis
AU - Marshall, Paul
AU - Booth, Millissa
AU - Coole, Matthew
AU - Fothergill, Lauren
AU - Glossop, Zoe
AU - Haines, Jade
AU - Harding, Andrew
AU - Johnston, Rose
AU - Jones, Steven
AU - Lodge, Christopher
AU - Machin, Karen
AU - Meacock, Rachel
AU - Nielson, Kristi
AU - Puddephatt, Jo-Anne
AU - Rakic, Tamara
AU - Rayson, Paul
AU - Robinson, Heather
AU - Rycroft-Malone, Jo
AU - Shryane, Nick
AU - Swithenbank, Zoe
AU - Wise, Sara
AU - Lobban, Fiona
N1 - ©Paul Marshall, Millissa Booth, Matthew Coole, Lauren Fothergill, Zoe Glossop, Jade Haines, Andrew Harding, Rose Johnston, Steven Jones, Christopher Lodge, Karen Machin, Rachel Meacock, Kristi Nielson, Jo-Anne Puddephatt, Tamara Rakic, Paul Rayson, Heather Robinson, Jo Rycroft-Malone, Nick Shryane, Zoe Swithenbank, Sara Wise, Fiona Lobban. Originally published in JMIR Mental Health (https://mental.jmir.org), 09.05.2024.
PY - 2024/5/9
Y1 - 2024/5/9
N2 - BACKGROUND: Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation.OBJECTIVE: This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.METHODS: We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.RESULTS: Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.CONCLUSIONS: This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.TRIAL REGISTRATION: PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.
AB - BACKGROUND: Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation.OBJECTIVE: This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.METHODS: We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.RESULTS: Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.CONCLUSIONS: This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.TRIAL REGISTRATION: PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.
KW - Humans
KW - Peer Group
KW - Social Support
KW - Mental Health Services
KW - Online Social Networking
KW - Mental Disorders/psychology
U2 - 10.2196/55750
DO - 10.2196/55750
M3 - Journal article
C2 - 38722680
VL - 11
JO - JMIR Mental Health
JF - JMIR Mental Health
SN - 2368-7959
M1 - e55750
ER -