Diss. Linköping : Univ., 2002.

Education has changed as a result of technological advances. Distance learning, particularly online learning, has rapidly increased its presence in higher education. Millennials, a new generation of students who have grown up with the Internet, are college-age. They expect access to the Internet to manage their daily lives. However, as they enter college, many discover that support services that are requisite to a successful college experience, are available on-campus but not online. The goal was to determine what contemporary college-aged students expect as online student support services so that institutions will know what to provide. Data gathered through interviews with administrative support staff were used to modify a published survey and to guide construction of new questions. The modified instrument was validated by three experts and revised accordingly. All current students at Farmingdale State College were invited to respond to the web-based instrument that examined the current status of online support services. Following full-scale implementation, the data were analyzed. Results were used to create recommendations and considerations for the implementation of online support services at the college reviewed by the Vice President of Student Affairs and Enrollment Management. The final report is a comprehensive resource for college administrators who serve millennial undergraduates. It contains valuable information and guidance for the development and implementation of student support services in the 21st century. A serendipitous finding was that many non-traditional, older students expressed comparable needs for online support services.

Childhood trauma and stress can lead to widespread changes in brain function that can lead to lifelong learning and living difficulties and disability that impact parental stress levels. Increasingly, parents are turning to social media to find systems of support. This Interpretive Phenomenological Analysis explores the online talk of 17 participants to better understand how they make meaning out of their participation in an online, faith-based parenting community designed for parents raising children with complex trauma exposure. Findings based on the data analysis included five overarching main themes: a) A community of experts; b) The community dethrones the experts; c) The community empowers women to navigate status from victim to warrior; d) The community provides support for members to grieve what seems "irreparably broken;" and e) Participants express faith that God will "mend what is broken." The findings were overlayed on Bronfenbrenner's bioecological theory (Bronfenbrenner & Evans, 2000) to provide a construct for the professionals interacting with parents of children with trauma. Professionals, therapists and religious leaders interacting with parents of children with trauma may want to incorporate a pluralistic, multileveled perspective, recognizing parents' interpersonal conflicts or personal experiences exist in a broader more nuanced system, thus fostering a nuanced and individualized approach to providing support for parents of children with trauma.

Background: Improvements in cystic fibrosis (CF) treatment over the last two decades have brought large increases in life expectancy. As a result, researchers have become more interested in the long-term quality of life and psychological wellbeing of adults with CF. Introduction of segregation policies to prevent cross-infection have added a new dimension to life with CF; patients are discouraged from meeting face-to-face and this impacts on access to peer support. Systematic review: A systematic search of the published literature since 1990 identified 10 journal articles describing research with adolescents and adults with CF, their mental health needs and social support or functioning. Quantitative papers indicated an inverse relationship between mental health and social support or social functioning. Objectives: The internet has become increasingly used for social networking and accessing social support resources. This thesis aimed to explore the psychological wellbeing of adults with CF who make use of online social support and the themes emerging within online discussion forums. Method: Study 1 is a quantitative survey carried out online which assesses the quality of life, mental health and self-esteem of 74 adults with CF. Study 2 uses framework analysis to provide a qualitative exploration of posts made by participants on an online discussion forum. Results: Moderate levels of quality of life and comparably high levels of self-esteem were found. Thirty per cent of the sample population scored above threshold for clinical levels of mental health difficulty. Significant correlations indicated that poorer self-esteem was associated with poorer quality of life and greater mental health difficulty. Six themes emerged from the discussion forum posts including CF treatment, daily living and occupation, health exacerbations, psychosocial processes and issues and the future. Conclusions: Self-esteem and mental health scores were similar to previous research. However, quality of life was noted to be considerably lower when compared to other research samples. This was thought to be influenced by the overrepresentation of females in the current sample but may also be reflective of the group of people with CF who make use of online resources. Results are discussed in relation to clinical implications, limitations and directions for future research, including the efficacy of internet groups in improving wellbeing and consideration of possible developments in technology to promote socialisation in the CF population.

Educational institutions strive to stay on the edge of technological advances in response to stakeholders' desire to receive value for their investment. Rapid changes in computer technology present a dilemma to colleges and universities in the support and training arena. An important segment of the institutional population, office support staff are vital to the everyday running of departments with extremely diverse responsibilities critical to the institutional mission. Office support staff seem to be left out when support and training programs for new technology are being planned. With technology changing so quickly it is vital that organizations have support and training programs in place that will continually provide office support staff with updated skills. The developmental study used an implementation analysis method to develop an online support community (OSC) to provide a central location to find and contribute support for computer technology issues that affected productivity. A needs assessment comprised of literature reports, focus group feedback, and historical records as well as the results of a pre-survey and inventory ensured data triangulation and was used to define content areas for technology support and training. A Learning Management System was used to plan and design the OSC in the initial treatment and workplace software, SharePoint, for the second treatment. Discussion forums and content areas were created using the defined technology content areas. Office support staff participated in the study and data were collected using surveys, content postings, interviews and electronic reporting. The OSC was evaluated after the first and second treatments using an evaluation model of reaction, learning, behavior, and results. The results indicated that an OSC can be effectively used to provide technology support for office support staff. Elements necessary for design include: long-term documentation, content matter experts, medium that allows for open-ended login, evidence of knowledgeable participants sharing useful data, participant leaders, and IM for immediate answers. The need for support and training for office support staff is ongoing and necessary for the productive and efficient completion of their job and work responsibilities. The results will be useful in designing online support communities and for planning support and training events.

As advances in information and communication technologies give way to more innovative opportunities for teaching and learning at a distance, the need to provide supporting structures for online students similar to those offered to on-campus students is becoming more significant. Although a range of support services has been proposed in the past, there is a need for a comprehensive system which education specialists can use to provide online academic support for medical students working in peer groups. The goal of the investigation was to provide such a system, which has the potential to foster knowledge construction, through high levels of sociocognitive processing, ultimately resulting in enhanced academic achievement. The multi-dimensional approach to investigating this problem necessitated utilizing a combination of qualitative and quantitative methods. The design and development of the system were guided by results of a review of the relevant literature which revealed the necessary considerations for supporting students online. Implementation followed instructional design principles geared at success for online environments. To assess the impact of the use of the system, the following analyses were carried out: to assess the level of sociocognitive processing that took place, discourse analysis and group interaction analysis were carried out; to assess impact on academic achievement, a quasi-experimental approach was carried out, controlling for select variables between the two groups which were used; and to garner the lessons which were learned, observation and survey methodology were employed. The results revealed that students did not interact at high levels of sociocognitive processing and that there was no significant difference in the academic achievement between the treatment and control groups. Survey results provided reasons for lack of participation/interaction and recommendations were proposed for alternative implementations to encourage participation in this particular group which is medical students. The recent developments in social and mobile technologies have provided education specialists with a rich evolving field in which to harvest innovative methods of supporting students in online learning environments. It would be interesting to investigate how these new technologies can encourage active participation in support groups and the impact this support structure would have on academic achievement.

Exploring online support groups has gained more and more popularity in the last decade. Investigating the type of support messages users send each other has broadened the already extensive social support framework built in the last forty years. Mothers utilize online support for various topics, and a very common topic is breastfeeding. The perception of breastfeeding has changed throughout history with shifting beliefs and societal norms coupled with solid facts about its importance in the sustaining of infants. Online breastfeeding support has been previously explored through the categorization of types of support and themes within the interactions. This study extended this by investigating deeper into the advice solicitation patterns and directness of advice patterns. Results indicated that informational support most commonly was responded to support seekers. Support seekers utilized the requesting an opinion or information solicitation type most often when posting to the discussion board. Mothers most commonly offered storytelling as responses to posts and embedded advice within the stories.

The availability of online support communities creates new opportunities for caregivers of children affected by health conditions to manage their illness-related uncertainty. This dissertation includes two studies that examined the presence of uncertainty management behaviors in online interactions among parents (caregivers) of children with clubfeet, and empirically tested the applicability of the uncertainty management theory to online behaviors. The Uncertainty Management Theory provided the theoretical foundation for both studies. For the first study, a content analysis of messages exchanged in an online support community dedicated to parents of children with clubfeet was conducted. Most messages were authored by women. The majority of the emotions expressed in the messages were positive. The most frequent information-seeking behaviors were direct questioning and self-disclosure. Information exchanges as a strategy to manage uncertainty included names of health care professionals and medical information. Five major types of social support (informational, tangible, network, esteem, and emotional) were identified. Informational support was the most frequent type of support provided, followed by emotional and esteem support. A third of the messages included combinations of two or more types of social support. For the second study an online survey was distributed using a snow-balling technique. Based on the survey data structural equation modeling was used to empirically test the uncertainty management framework. Positive relationships were identified between knowledge and information seeking, information seeking and social support, social support and sense of virtual community, uncertainty and stress. The results suggested that the uncertainty management theory may need to be adapted for use in online contexts. Uncertainty seems to be an important part of the experience of parents caring for children with clubfoot. Online communities dedicated to these parents represent a promising setting for studying illness-related uncertainty and its potential causes. Such studies can be a critical source of information to inform priorities for research and practice. This dissertation is the first step in better understanding the audience and provides an initial exploration of uncertainty management and communication processes present in an online support community. As we learn more about the parent audience, the importance of communicating with them becomes increasingly clear.

The purpose of this study was to improve our understanding of uncertainty in Adolescent Idiopathic Scoliosis (AIS), which is a chronic illness involving curvature of the spine and is typically diagnosed in late childhood or early adolescence. The timing of most AIS diagnosis and its subsequent treatment occurs at a critical point developmentally and may place strain on adolescents with AIS and their parents. This dissertation includes two studies. The first study used Cash's (2011) cognitive-behavioral perspective on body image as the framework to assess whether brace treatment had a negative impact on body image appraisals in female adolescents participating in a clinical trial. Contrary to previous studies, this study found that brace treatment did not have a negative impact on female adolescents' body image and that poor body image did not result in brace treatment non-adherence. However, this study found significant correlations in adolescents with AIS between poorer body image and poorer quality-of-life. The second study used Uncertainty Management Theory as the framework for exploring adolescents' and parents' AIS-related uncertainties that were participating in online support groups. Results from this study suggest that adolescents with AIS and parents of a child with AIS are managing their uncertainties regarding the illness and its treatment however, the way they manage the uncertainty is different, in particular regarding appraisals of the uncertainties, whether they are seeking or avoiding information, and the types of social support that is being sought and provided. Parents of a child with AIS tended to seek information regarding the uncertainty surrounding the AIS condition, including information regarding doctors/hospitals and research, while adolescents tended to be participating in the online support groups for the purposes of seeking and providing support to other adolescents that have been or currently are in similar situations, such as wearing a brace. These findings are critical, because differences in uncertainty management behaviors between adolescents and parents, such as the ones that were found in the AIS-related online support group, could result in differences in understandings, concerns, preferences, and expectations regarding the illness and its treatments, which may result in family conflict, poor clinical health outcomes in adolescents and poor psychosocial outcomes in adolescents and in their parents. This study is significant in that it explored AIS-related uncertainty in two entirely different settings where theoretical applications are rare, in a clinical trial and in online support groups. The results from this dissertation suggest that Uncertainty Management Theory and Cash's (2011) cognitive-behavioral perspective on body image may be adapted for these contexts. The synthesis of the findings from across this dissertation suggests that the clinical and psychosocial health outcomes of adolescents with AIS and the psychosocial outcomes of their parents, may be improved through communication tools, such as adolescents, their parents, and providers working together through a treatment decision flow chart to elicit AIS-related current understandings, concerns, preferences, and expectation, which will result in shared decisions. Finally, as new technologies expands and are integrated into decisions regarding illness, findings from this dissertation can be used to improve health communication, support interventions, and policy development.

Online support groups have shown a strong potential to foster resourceful environments for people living with depression without restrictions of time, space, and stigma. Research has found that users of those groups exchange various types of support. However, due to the scarcity of research, many other aspects of depression online support groups remain inconclusive. In particular, how the support exchange contributes to the everyday lives of users living with depression remains unclear. To contribute to filing some of the knowledge gaps, the present study explored what kinds of support were requested and provided in a depression online support group. By doing so, this study aimed to examine the roles of the depression online support group in the management of depression. Mixed methods were employed with a concurrent triangulation strategy. A sample of 980 posts were selected systematically from the support group. Demographic and clinical information of the users who made those posts were recorded. Quantitative and qualitative content analyses were conducted to examine the types of support being exchanged through those posts. Inter-coder reliability was calculated to ensure the consistency of the coding process. The results indicate that users sought informational support, various types of emotional support and coaching support, and social companionship. Users not only sought listening ears, but also practical advice to cope with the situations they were going through. The group appeared to serve its users as a place to meet others with similar experience; to manage loneliness; to discuss what they could not discuss elsewhere; to "just vent"; to gain advice from multiple perspectives on an issue that had been magnifying the impact of depression; to share the experience with formal care provision systems; to express immediate support needs; to share useful discoveries, accomplishments, and creative ways to manage depression; and to experience the value of helping others. This study supports the idea that depression online support groups have the strong potential to contribute to the everyday lives of people living with depression in a way that is not available elsewhere and in a way that complement to the overall framework of existing care provision systems.