JMIR Publications

ABSTRACT

Background:

Globally, one in three adults suffers from multiple chronic conditions. Thus, effective interventions are needed to prevent and manage these chronic conditions and contain the associated health care costs. Teaching effective self-management practices to people with chronic diseases is one strategy to address the burden of chronic conditions. With the increasing availability and access to the internet, the implementation of web-based peer support programs in particular has become increasingly common and relevant.

Objective:

The purpose of this scoping review is to synthesize the existing literature and characteristics of online peer support programs for persons with chronic conditions.

Methods:

The current scoping review follows the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidance. Studies were identified by searching MEDLINE (OVID interface), CINAHL (EBSCO interface), EMBASE (Ovid interface), PsycINFO (OVID interface), and PEDro (physiotherapy evidence database). The search was conducted on June 6, 2018 and was limited to the years 2012-2018. Chronic diseases identified by the Public Health Agency of Canada (PHAC) were included. Our review was limited to peer support interventions delivered through online formats. The information abstracted included year of publication, country of study, purpose of the study, participant population, key characteristics of the intervention, outcome measures, and results.

Results:

After duplicates were removed, 9940 articles were screened. Data abstraction was completed for 41 articles. There was a lack of participant diversity in the included studies, specifically with respect to the conditions studied (i.e., the majority of the studies included were related to cancer, cardiovascular disease, and HIV/AIDS). We also noted a lack of studies with elderly participants. There was inconsistency in how the interventions were described in terms of the duration and frequency of the interventions. We found the implementation of all three types of support in the studied interventions – informational, emotional, and appraisal support. We determined that few studies used a randomized controlled trial design. Four of the six randomized controlled trials reported positive and significant results including lowered emotional distress, and increased health service navigation, self-efficacy, social participation, and constructive attitudes and approaches. Among the qualitative studies included in this review, there were several positive experiences relating to participating in an online peer support intervention, including increased compassion and improved attitudes towards the individual’s chronic condition, access to information, and empowerment.

Conclusions:

There is limited, recent high-level evidence on online peer support interventions. Where the evidence does exist, significant improvements in social participation, self-efficacy, and health-directed activity were demonstrated. The use of online peer support for older adults (i.e., >70 years) with chronic conditions is an unexplored area of research. We determined that some of the included studies incorporated a theoretical framework and all forms of support – emotional, informational, appraisal – were identified in the included studies in this review. The results of the current review have identified key gaps in the area of online peer support and will serve to inform the development and implementation of future programs.