Social Support System:TWO

CHAPTER TWO

LITERATURE REVIEW

2.1 Introduction

Years ago, social networking existed of personal interaction, via regular mail, and traditional telephones. Back then, people would have to make plans in person, by phone, or by mail.  In a short time, communication moved from verbalizing to a much less vocal world. Also, planning a social event or a simple outing sometimes took time but today, it can be accomplished in mere minutes because communication has moved from face-to-face to text. People can text, tweet, email, blog or interact with others on a social site within minutes. Information can be received on a computer or phone within minutes. This in turn has enhanced constant communication among people more than in the past. So, communication is occurring at a much faster scale. This chapter discusses in detail Social networking, social media in health sector, Social Support, Social Support Groups, Online Social Support system, as well as all the other tools and technologies that will be used in this project. In addition to this, various projects that utilise the Social Support system and other projects that this is based on will be discussed.
2.2 Social Networking
Social networking, the art of meeting and building contacts on the Web, is an increasingly popular way to gain personal and professional contacts, make new friends, develop professional relationships, promote personal or business Web sites, and even find a new job (Warner 2008). Over the past few years, social networking sites (SNS) have received growing media attention. At many high schools and colleges, every student has a profile on at least one of the SNS such as MySpace and Facebook.(Farkas 2007).

2.2.1 Facebook (www.FaceBook.com)
Facebook is a social networking service and website launched in February 2004, owned and operated by Facebook Inc. As of May 2012, Facebook has over 900 million active users, more than half of them using Facebook on a mobile device. Users must register before using the site, after which they may create a personal profile, add other users as friends, and exchange messages, including automatic notifications when they update their profile. Additionally, users may join common-interest user groups, organized by workplace, school or college, or other characteristics, and categorize their friends into lists such as "People From Work" or "Close Friends". The site was originally considered a vanity site and a place for students to connect and trade stores, but it is growing fast now that anyone who wants to participate can join the site’s community. Its professional power is growing with its ever-expanding audience. (Warner 2008)

2.2.2 MySpace (www.MySpace.com)
This is one of the all-time most popular social networking sites, MySpace makes it easy to create a profile site, add music, write a blog, and post as many photos as possible to share with the world. Its huge online audience is a popular place for musicians, performers, and many others to promote themselves and their Web sites. (Warner 2008,)

2.2.3 Bebo (www.Bebo.com)
This is a networking site that has been growing consistently. Bebo is beginning to give some of the other social networking sites a real run for their money. Like other sites, users can personalize their profiles, add apps, set privacy settings and join groups. (Social Networking Websites Review 2009)
2.3 Social Media in the Health Sector
The use of different social media websites such as Twitter, Facebook, yahoo and others is growing among hospital and health system sectors, but there will always be caveats with this type of information sharing (Cecilia Backman, 2011).  In hospitals and other health systems, social media is mostly used in the following ways: communicating, marketing, patient engagement/health education, philanthropy, recruitment and online background checks. According to the study conducted by (Backman C. Et al, 2011), a study in the Journal of Health Information management (AHIMA) on hospital social media use in 2010, and of the 260 hospital respondents, 144 were using social media in some fashion. Of those using social media, 80 percent primarily used it for marketing while 63 percent mostly used it for communication purposes. All of these functions can help convey the hospital's mission and values to the public, and social media is serving new functions as well, such as gauging patient satisfaction. "Social media is replacing a lot of standard research, and it is seen as a rich resource to meet people's needs" (Backman 2011).

2.4 Social Support

Social support is generally defined within the context of interpersonal relationships as exchange of emotional, informational, or instrumental support between individuals (Hogan, Linden & Najarian, 2002; Lin & Bhattacherjee, 2009).  Social support is said by some theorists to have a “buffering effect” when it comes to a person dealing with a stressor in their life.  “Buffering” refers to a sort of block against what would otherwise be a stronger stress response. Cohen and McKay (1984) suggest that the effectiveness of a buffering effect is related to the perceived availability of support. When a person has support readily available to them, such as being with supportive friends when a stressful event occurs, they have a diminished stress response and are thus more readily able to deal with the stressor than if they were alone. A study by Kikusui, Winslow, & Mori (2006) showed that being in a social setting at the time of a stressful event resulted in a smaller neurological stress response than in the absence of social connections.  
2.4.1 Social Support Groups
Hogan, Linden & Najarian (2002) reviewed 100 studies that examined social support.  Studies showed that people participating in support groups or other types of group support interventions benefited from both receiving and giving support to individuals dealing with the same or similar issue(s).  In many of the studies they reviewed wherein social support from friends, family, or strangers was manipulated, the presence of social support appeared to yield better and longer-lasting results than in the absence of support.  Individuals participating in bidirectional support (providing and receiving support) appeared to benefit the most from support group settings (Hogan, Linden & Najarian, 2002).
2.5 The Internet and social support
As a result, individuals increasingly seek social support through the Internet, which helps build, foster and maintain online social support network (Bhattacherjee & Lin, 2002). The Internet has proven to be a useful forum and platform for the proliferation of online support groups. The Internet has not only increasingly served as a tool to locate and seek professional help, but also as a virtual space for patients to collectively interact. Prior to the advent of the Internet, online social support communities consisted of dial-up bulletin board services; messages for seeking and giving support were communicated via local operators (LaCoursiere, 2003, p. 61). The mid-1990s marked the emergence of asynchronous communities—listservs and email-based social support.  Synchronous social support mediums, such as chat services and discussion boards, started marking their presence on the World Wide Web around this time as well (LaCoursiere, 2003, p.61). Where contact with social support used to be limited to letters, phone calls and face to face visits, the advent of the internet and smart-phones has revolutionized the ways with which people can connect with one another, creating increasingly sophisticated and expansive support groups for communities ranging from drug addiction to weight loss to dental anxiety.
2.6 Emphatic Online communities
Studies  of  empathic  online  communities  have  so  far  been mainly focused on health-related online communities for people suffering from an illness and/or for  their  caregivers.  Findings show that factual information about the diseases; practical tips about how to handle the situation, and emotional support are the major topics of online empathic communication (Preece J. Et al 2002). People value to talk to others that are in a similar situation and turn to the online community for support when they face problems. Infertile couples often share a similar life situation; it becomes imperative that we develop an online community to support them. Social support appears to enhance people’s self-efficacy; the advent of the Internet has made social support more available and accessible to an increasingly diverse population of individuals through the development of online social support systems.
2.7 Online Social Support System
According to LaCoursiere (2003) online social support system is defined as “the cognitive, perceptual and transactional process of initiating, participating in, and developing electronic interactions or means of electronic interactions to seek beneficial outcomes in health care status, perceived health, or psychosocial processing ability” (p. 66). Studies have shown that the access to information, being a fellow sufferer, and the ability to share one’s own experiences empowers people. They become “active participants who demonstrate strength and power” (Barak, Boniel-Nissim & Suler, 2008). For these reasons, amongst others, the internet has become a new interface for social support, increasing individuals’ capacity to access and share information through online social support system.
2.7.1 Benefit of an online social support system over traditional system
The growing popularity of Online Social Support has inadvertently spurred research surrounding the efficacy of online social support. There are many aspects of Online Social Support system that are potentially advantageous to individuals seeking social support.  Barak, Boniel-Nissim and Suler(2008) delineate several of these factors in their analysis of the empowering aspects of online social support. Two important factors are the concepts of frequency and access, and the disinhibition effect.
1.      Frequency and Access
Unlike face-to-face interactions where time is a limiting factor, Online Social Support system provide greater socio-emotional communication in the absence of time constraints (LaCoursiere, 2003).  The online medium not only provides the unlimited access to information but also flexibility in terms of correspondence.  A study by Winzelberg (2007) showed that in an online support forum for people dealing with eating disorders; approximately 33% of posts were posted between 11pm and 7am .Synchronous (real-time) interactions occur through mediums such as chats or video conferencing.  An advantage of synchronous interactions is the continuous availability of support that participants can access at any time (Winzelberg, 2007).  While traditional support group settings have inherent constraints of time, access, and style of communication.
2. Disinhibition Effect
The dis-inhibition effect refers to the idea that people say and do things online that they would not otherwise do in a “real world” setting.  One potential benefit of this effect in an online support forum is that people may be more open and honest about how they feel—a person might reach out for help where they otherwise would be afraid to do so. According to the SIDE (Social Identity and De-individuation Model) the contextual features of online situations such as anonymity and isolation contribute to individuals’ ability to effect interactions leading to self-empowerment and behavioural change (Spears & Lea, 1994). Three aspects of the dis-inhibition effect are anonymity, invisibility, and neutralization of status (Barak, Boniel-Nissim & Suler, 2008).
With the invisibility feature of an online support forum, people dealing with stressors who are discouraged or unable to take part in a face-to-face support group are able to interact with a supportive network without being seen. As a result, individuals with physical deformities or other body image concerns can share their feelings with less fear of being judged. “Anonymous participation may reduce the embarrassment and shame that some people associate with disorders and may make it easier to discuss their problems and setbacks” (Winzelberg, 1997). In online social support settings, a person has the ability to fully disclose information as an anonymous entity while still benefiting from social support (Barak, Boniel-Nissim & Suler, 2008). A final but very important aspect of Online Social Support system is neutralization of status. In an online environment a person has no inherent status.  It is said that the neutralizing of status “encourages people to self-disclose” and is “especially important in online support groups, which historically have emphasized peer-to-peer assistance” (Barak, Boniel-Nissim & Suler, 2008).  This principle is shown in a study examining an online support medium for cardiovascular patients, where age was not related to outcome (Brennan et al., 2003).
3. There are other benefits of Online Social Support system which include: access to information for research purpose and effective communication.
2.7.2 The Limitation of the system
1.      Non-availability of internet connection in some part of the country can limit people access to information.
2.      If proper care is not taken in such an online support system, dangerous information could be passed out to people in the absence of medical experts.

2.8 Review of Related Projects

Following is a brief description of some related projects:
·         Bipolar Online social support system
·         HIV/AIDS Online Social Support System
·         Medhelp online health community

2.8.1 Bipolar Online Social Support System

Bipolar Online support system is an online community for mentally derailed to discuss and share information. In this system, we have group of professionals who maybe either doctors, psychologist, sociologist and others. This system is monitored by an administrator who checks any post that is being sent on the group. It is a controlled group and not just anybody can register because in the support system people are well monitored.
2.8.2 HIV/AIDS Online Social Support System
We have different HIV/AIDS support system on the web today. These systems are controlled by body of recognized Organizations like NACA. According to research, it was discovered that about 1000 people from different regions and countries registered for these support systems in a less than couple of months. 
2.8.3    Medhelp Online Health Community
This is one such free online health community that connects people with medical experts and others who have similar experiences. Each day, members visit MedHelp to receive the support they need from other patients like them, and to share their knowledge with others in need. The website features news, clinical trials, personalized tools and chat forums. It was founded in 1994 as a resource to help patients cope with their health conditions by connecting users with information.
2.9 Online Social Support System for Infertile People

As Online Social support system has become a platform that is inexpensive, easily accessible to anyone with internet access, so this online support system is meant for infertile couples and other people experiencing infertility. This community of people that once suffered infertility will be able to share their experience thereby rendering support to other people. Articles that contain useful information about how to deal with infertility will be posted on the site on a regular basis.

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