. 2014 Jul;104(7):e20–e37. doi: 10.2105/AJPH.2014.301980

TABLE 2—

Social Media Cancer Studies With Descriptive Designs and Various Foci

Measurement	Type of Cancer (Study)	Participants	Social Media Platforms/Study Goals	Key Findings
Online survey	General (Seckin⁴⁰)	Adult cancer survivors	Examine whether online self-help group interactions encourage patients’ sense of control over their illness and lead to higher satisfaction with health status.	Online support increased perception of control over cancer, which led to higher levels of satisfaction with health status. Individuals with less education and lower income levels reported more benefits from electronic coping support.
	Breast (Kim et al.²⁸^,^a)	Medically underserved African American and White women with BC	Use online support groups (CHESS) to examine interplay between emotional support giving and receiving and the effects of emotional support giving and receiving on patients’ psychosocial health outcomes.	Those receiving high social support were less likely to have BC concerns and more likely to reframe their problems positively as well as to adopt positive strategies for coping.
	Breast (Tercyak et al.⁴³)	Adult partners (male and female) of women at risk for hereditary BC	Understand the role of a Web-based message board and chat in meeting psychoeducational needs among partners of hereditary BC survivors.	Partners had a moderately high need for psychoeducational interventions across content areas. Partners tended to prefer printed self-help and interactive online resources.
	Skin (Hawkins et al.²³)	Adult patients and parents of children with xeroderma pigmentosum	Use online support group to recruit participants to complete a survey on symptoms and QOL.	All participants reported positive effects on lifestyles and QOL from participation in online support group.
	Colorectal (Hwang et al.²⁴)	Older adult cancer survivors	Assess the acceptability of narratives to promote CRC screening among members of an online weight loss community (sparkpeople.com).	Among members who were up to date with CRC screening, 39% were interested in sharing narratives. This positively correlated with African American race and negatively correlated with age, marital status, and CRC worry.
	Testicular (Bender et al.¹¹^,^b)	Canadian young adult male cancer survivors	Examine met or unmet support care needs of survivors and their use of Internet, social media, and online communities.	Participants had more met than unmet needs; 62.5% had ≥ 1 unmet need. Most respondents (76%) used social media and 26% had used an online support community. Social media users were more likely to speak English as a first language and to have unmet needs.
Survey and content analysis	General (Fernsler and Manchester⁹)	Adult cancer survivors	Use forum to post cancer-related information.	Respondents used the cancer forum to connect with others sharing similar cancer experiences, to seek information, to encourage other survivors, and to seek emotional support
	Breast (Weinberg et al.⁸)	Adult BC patients	Investigate the use of online message boards that emotional and informational support.	Participants logged in to the BC bulletin board 158 times. Online approach was similar to face-to-face support groups. Participants discussed medical condition/treatment, shared personal experiences and concerns, and offered support for other members.
Survey and in-depth interviews	Breast (Bender et al.¹³)	Canadian adult BC survivors	Explore the role of online communities from the perspective of survivors who are face-to-face support group facilitators.	Online communities were used by 31.5% of participants, mostly during cancer treatment, for information, symptom management, and an emotional outlet to address unmet needs during periods of peak stress or uncertainty.
Survey and Web metrics	Breast (Han et al.²²^,^a^,^c)	Medically underserved African American and White women with BC	Explore the social and psychological characteristics that predict different levels of engagement on an online BC support group message board (CHESS).	Many women do not use online support groups. Of participants, 44.6% posted messages, 32% lurked on the sites, and 23.4% did not log in to the system. Women who posted were more often were younger and lived alone. Nonusers and lurkers had significantly more social support than those who posted online.
Social network analysis	General (Durant et al.²⁰)	Patients, caregivers, researchers, and providers	Determine whether gender-preferred social styles can be observed in user interactions in an online cancer community.	Men preferred to socialize in large, less intimate groups. Women were more likely to form a highly intimate bond on a women-specific cancer forum.
Focus groups and content analysis	Breast (Lieberman and Goldstein³⁰)	Adult BC patients	Examine emotions expressed by women participating in online bulletin boards.	Expression of negative emotion did not predict psychosocial improvement. Expression of fear and anxiety was associated with lower QOL and with depression.
In-depth interviews and content analysis	Breast and prostate (Seale³⁹)	Adult cancer survivors	Compare interviews and Internet postings involving people with BC and PC and discussion of sexual health.	Patients who disclosed information on the Web forum provided more detailed health and sexual health information online than during in-depth interviews.
Blogs
Interviews	General (Andersson et al.⁴⁷)	Swedish adult relatives of cancer patients	Highlight relatives’ experiences of blogging when a family member is in the end-of-life phase of cancer.	Themes were delivering information about cancer, vulnerability in writing the blog, sensitivity of information, not knowing who viewed the blog, blogging to ease burden of cancer, and blogging to build strength.
Focus groups	General (Chiu and Hsieh⁴⁸)	Adult cancer patients and caregivers	Explore how cancer patients’ posting on and reading blogs, social networking sites, and online support groups play a role in their illness experience.	Themes were wanting to be remembered after death, writing for relief and gaining strength, writing to support fellow patients, influence of other cancer patients, finding other survivors, and a sense of belonging.
Survey	General (Chung and Kim⁴⁶)	Adult cancer patients and their companions	Examine use of blogs related to gratification outcomes.	Four areas emerged as gratifications of blog use: prevention and care, problem solving, emotion management, and information sharing. Participants found blogging most helpful for emotion management and information sharing.
Microblog
Social network analysis	Breast and prostate (Himelboim and Han⁶⁸)	Unknown	Assess density and interconnectedness of social networks of individuals who post information on Twitter about BC and PC.	Authors categorized groups who frequently posted about BC and PC as core communities and groups who more sporadically discussed these cancers as visiting communities. The different types of communities exhibited distinct patterns of information flow, information sources, and user interactions. Regardless of group classification, communities that discussed BC were significantly larger than PC communities. Visiting communities were not common in BC clusters but played an integral role in PC clusters.
Social networking sites
Survey	Cervical (Zaid et al.⁶⁵^,^b)	Women with history of small- or large-cell cervical cancer	Determine feasibility of posting a survey on Facebook for epidemiological and QOL research.	Use of social media for epidemiological and QOL research with patients with rare gynecologic tumors appeared feasible. Social media permitted research to be conducted efficiently and rapidly.
	Cervical (Gunasekaran et al.⁵⁹)	Young adult women in Australia	Assess and investigate predictors of cervical cancer and HPV knowledge among participants recruited on Facebook	Most respondents (> 50%) knew that HPV is a common virus. Predictors of high HPV knowledge were older age, higher SES, Australian birth, older at sexual debut, awareness of HPV vaccines, self-reported HPV vaccination status.
	Breast (Kapp et al.⁶⁰)	Women aged 35–49 y	Assess feasibility of recruiting cancer patients via Facebook.	Few women (3.2%) clicked on ad and proceeded to survey; none completed survey.
	Colon and skin (Leighton et al.⁶¹^,^b)	Young adults and adult genetic counselors	Recruit participants via Facebook to participate in study of perceptions and understanding of direct-to-consumer genetic testing.	General public and genetic counselors differed significantly in interpretation of genetic test results in 3 of 4 chronic disease mock scenarios.
Multiple channels
Web metrics	General (Justice-Gardiner et al.⁷²^,^a^,^c)	Racially and ethnically diverse populations	Use blogs, microblogs, and social networking sites to increase awareness of and access to existing Spanish-language cancer resources for cancer survivors.	Web site traffic increased in all areas from 2008 print and radio campaign to 2009 campaign with the addition of social media.
	Osteosarcoma (Lam et al.⁷³^,^b)	Unknown	Assess quality, readability, and social reach of blogs, YouTube, Facebook, and social bookmarking sites used to post information on pediatric osteosarcoma.	Only 12.5% of social media included adolescent-specific content. Only 1 Web site achieved readability targets and provided adolescent-specific content.
Survey	Breast (Paxton et al.⁷⁴^,^a^,^c)	Adult African American BC survivors	Use social networking (blog, Facebook, Twitter) recruitment to determine physical activity intervention preferences and whether preferences differ by medical or demographic factors.	Participants were interested in interventions that used the Web, e-mail, or postal mail to promote walking and resistance activities. Intervention preferences did not differ by medical or demographic factors.
Survey	General (Song et al.⁶³)	Racial and ethnic minority young adult cancer survivors	Explore cancer survivor identities and how these are associated with internalized stereotypes about survivorship and psychological health on a social networking site and video blog for cancer survivors (LIFECommunity).	Survivors of childhood cancer did not publicly dwell on cancer stereotypes when discussing their experiences with each other. Survey found evidence for internalizing positive and negative stereotypes. Self-perceived negative stereotypes were positively associated with depression.
Frequencies of study enrollment	General (Rabin et al.⁶²)	Young adult cancer survivors	Assess various strategies to recruit participants for for pilot intervention, including use of Facebook and Twitter.	Most participants were recruited from mailings. Internet and social media recruitment accounted for 15% of study contacts, 7% of those screened, and no enrollees.

Note. BC = breast cancer; CRC = colorectal cancer; HPV = human papilloma virus; PC = prostate cancer; QOL = quality of life; SES = socioeconomic status.

Article references Internet access digital divide.

Article references health literacy.

Article references cancer health disparities.