Understanding the impacts and underlying mechanisms of peer online forums for people with mental health difficulties

Full-time PhD studentships are available, funded by the NIHR Applied Research Collaboration (ARC) North West Coast. The purpose of the NIHR ARC funding is to support applied Health Care, Social Care and/or Public Health research relevant to the needs of the diverse communities served by the NIHR ARC and its local health and care system and be implementable across the local region. The research should be generalisable and have wide applicability across health and care nationally, as well as within the local health and care system where it is conducted.

Peer online forums (POFs) are virtual spaces in which groups of people who share a strong common interest, form relationships, and interact online. People are increasingly joining POFs to share information and support for chronic health conditions. There are now hundreds of health related communities, accessed by thousands of people in the UK every day. POFs provide an opportunity for users to feel understood, access important information, make friends, and use their own experiences to help others. They can offer clinicians and carers valuable insights into the lived experience of health conditions and provide opportunities for genuine collaboration to improve services (e.g. Care Opinion).

However, use of online communities can also cause harms, and these must be understood in order to support POFs to become more widely accessible and sustainable. Information shared within online communities can be misleading, inaccurate, or harmful. Normative and reductionist ideas about health may predominant, leaving some users feeling misunderstood or even bullied. Users may not understand the business model of the community or forum hosts, which often rely on advertising or data exploitation to offset hosting costs or make a profit. Staff asked to moderate POFs may not have the training or support they feel they need to manage online conflict, risk, and confidentiality. Others may be reluctant to direct people to use specific communities as they feel unable to judge whether it will be helpful, and may feel threaten by the shift in power and knowledge away from professionals and towards patients. Host organisations may have concerns about their staff being publically criticised on forums. Commissioners may question the increasing reliance on digital tools that may exacerbate unequal access to healthcare, especially for those less able to access the technology, less able to find forums they perceive to be relevant to them, or without the necessary levels of health literacy required to engage in POFs.

Most research to date has focussed on inductive analysis of posts within individual forums to understand more about how people are experiencing a particular health condition or service. What is missing is an in-depth understanding of how the different impacts (positive and negative) of engaging with POFs are realised, and how these impacts differ depending on the characteristics of the people, the design of the community and the context in which it is situated. Our aim is to develop a theory about how POFs for work, and to use this to design a framework for POFs to support development, accessibility, sustainability, safety, and ongoing evaluation of online communities across a range of mental health contexts.

Aim

To understand the impacts of Peer Online Forums for people with mental health problems

Research Question
What are the impacts of Peer Online Forums for mental health – for who, why and in what context?

Objectives

1. Develop an initial programme theory based on realist synthesis of existing literature and interviews with key stakeholders

2. Test and refine the theory in a case example of a mental health forum.

For further information, please refer to our webpages. If you would like to be considered for this opportunity please contact the project supervisor including a covering letter, you CV and a fully completed research proposal (not more than 1000 words excluding references) related to the title you are applying for should be returned by email to [Email Address Removed] quoting the studentship reference number LUARC2021.