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This study investigates how social support and family relationship perceptions influence breast cancer patients' online communication networks in a computer-mediated social support (CMSS) group. To examine social interactions in the CMSS group, we identified two types of online social networks: open and targeted communication networks. The open communication network reflects group communication behaviors (i.e., one-to-many or "broadcast" communication) in which the intended audience is not specified; in contrast, the targeted communication network reflects interpersonal discourses (i.e., one-toone or directed communication) in which the audience for the message is specified. The communication networks were constructed by tracking CMSS group usage data of 237 breast cancer patients who participated in one of two National Cancer Institute-funded randomized clinical trials. Eligible subjects were within 2 months of a diagnosis of primary breast cancer or recurrence at the time of recruitment. Findings reveal that breast cancer patients who perceived less availability of offline social support had a larger social network size in the open communication network. In contrast, those who perceived less family cohesion had a larger targeted communication network in the CMSS group, meaning they were inclined to use the CMSS group for developing interpersonal relationships. [ABSTRACT FROM AUTHOR]

Scholars have adopted Street's (2003) ecological model of communication in medical encounters to investigate the factors promoting patient participation in health care. However, factors demonstrated in the ecological model were bounded in the context of medical care primarily focusing on health care providers and patients. Social factors, such as patients' relationships and supportive communication with others outside the context of health care remain relatively unexplored. To expand the purview of our understanding of factors that influence patient participation, this research integrated social support literature into the research on physician-patient communication and proposed a model which described a process through which social support can enhance patient participation in health care. The data analyzed in this study were a part of two larger clinical trials in which 661 women with breast cancer were recruited from three cancer institutions in the United States. The results from structural equation modeling analysis from cross-sectional and longitudinal data provided strong evidence for the hypotheses predicting that perceived social support was positively associated with health information competence, which in turn fully mediated the association between social support and patient participation in health care. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

With a focus on the nature and dynamic process of social interactions among breast cancer patients, this study argues that the notion of opinion leaders can be another crucial factor in explaining positive psychosocial health outcomes within computer-mediated social support (CMSS) groups. This study investigates the relationship between opinion leaders and their psychosocial health benefits by considering two overarching questions: (a) Who are the opinion leaders? (b) What role do these opinion leaders play in explaining health outcomes? The data analyzed in this study resulted from merging human-coded content analysis of discussion group messages, action log data analysis of interactive health system usage, and longitudinal survey data. Surveys were administered to 221 women with breast cancer; participants were provided free access to and training for the CMSS groups developed by the Comprehensive Health Support System (CHESS) project. The findings suggest that opinion leaders obtained psychosocial health benefits, such as higher levels of cancer information competence, breast cancer knowledge, and better problem-focused coping strategies. Those who had a higher baseline level of breast cancer knowledge and optimism in coping with challenges in their life were more likely to act as opinion leaders. Implications for research and improving psychosocial interventions for people with health concerns are discussed. [ABSTRACT FROM PUBLISHER]