Computer-mediated support for adolescents with cerebral palsy or spina bifida.

Social support plays a key role in improving health outcomes for children with chronic conditions. Internet connections are an important component of adolescents' social networks and may overcome geographic and environmental barriers for those with disabilities. This article focuses on the processes associated with a 6-month online support intervention for adolescents with cerebral palsy or spina bifida. Specifically, the purpose was to determine the extent to which adolescents used an online peer support intervention, the processes used, and the perceived benefits and satisfaction with the intervention. Five peer mentors with the same disabilities provided information, affirmation, and emotional support. The online environment created a safe space to foster reciprocal interpersonal connections and appropriate social comparison. Two-thirds of the participants viewed the computer-mediated support intervention as fun. Factors influencing the perceived utility of the intervention included typing speed, cognitive skills, and perceived need for additional support. Girls were significantly more likely to contribute messages than were boys. Peer mentors wished that this type of support program had been available when they were teens, appreciated the supportive elements, and reported learning from the teen participants. Health professionals wanting to implement online support need to consider the age and ability levels of participants and the optimal length and format of the support program.

Brief report: an online support intervention: perceptions of adolescents with physical disabilities.

Adolescents with cerebral palsy and spina bifida report restricted interactions with peers and gaps in social support. A pilot online support intervention offered interactions with peers. Five mentors with cerebral palsy or spina bifida and 22 adolescents with the same disabilities met weekly online for 25 group sessions over six months. Participants completed quantitative measures of loneliness, sense of community, self-perceptions, coping, and social support prior to intervention, post-intervention, and delayed post-intervention. Semi-structured qualitative interviews elicited perceptions of the intervention's impacts. Participants reported more contact with teens with disabilities, decreased loneliness, and increased social acceptance and confidence. A significant increase in sense of community was reported from post-intervention to delayed post-intervention. Encouraging qualitative findings were supported by trends in the quantitative measures. This pilot study can guide a future community-based intervention trial.

Researching reducing health disparities: mixed-methods approaches.

There is a pressing need for assessment and intervention research focused on reducing health disparities. In our research program, the use of mixed methods has enhanced assessment of the mediating impacts of social support on the health of vulnerable populations and enabled the design and testing of support interventions. This paper highlights the benefits and challenges of mixed methods for investigating inequities; and, illustrates the application of mixed methods in two exemplar studies focused on vulnerable populations in Canada. Qualitative methods fostered in-depth understanding of vulnerable populations' support needs, support resources, intervention preferences, and satisfaction with intervention strategies and impacts. Quantitative methods documented the effectiveness and outcomes of intervention strategies, and enhanced the reliability and validity of assessments and interventions. The researchers demonstrate that participatory strategies are needed to make studies more relevant to reducing health disparities, contextually appropriate, and empowering.

Accessible support for family caregivers of seniors with chronic conditions: from isolation to inclusion.

Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.

Adolescent mothers: support needs, resources, and support-education interventions.

Adolescent mothers are prone to live in poor conditions, lack adequate financial resources, suffer high stress, encounter family instability, and have limited educational opportunities. These factors contribute to inadequate parent-child interactions and diminished infant development. Social support can promote successful adaptation for adolescent mothers and their children. This review article describes the support needs and challenges faced by adolescent parents and their children, the support resources available to and accessed by adolescent parents, and existing support-education intervention studies, to provide directions for future research. Relevant research published between January 1982 and February 2003 was obtained from online database indices and retrieved article bibliographies. Frequently encountered problems included small sample sizes and attrition, lack of suitable comparison groups, and measurement inconsistencies. When planning support-education interventions, content, duration, intensity, mode, level, intervention agents, and targets should be considered. Future research can address these challenges.

Deciding on surgery: supporting parents of infants with craniosynostosis.

Families face a difficult decision when choosing whether or not to have surgery for their infant with isolated craniosynostosis. While the skull deformity may not affect the child's physical health, growth, or development, it may have psychosocial impacts on a child's social-emotional development, self-esteem, and interpersonal interactions. Parents are challenged to balance surgical risks with potentially positive effects on their child's psychosocial health. The purpose of this research study was to explore parental decision-making related to surgery for isolated craniosynostosis, and to identify strategies that facilitate their decision-making. A thematic content analysis of focus group interview data revealed four themes that encapsulated the process of parental decision-making. The decision for some parents was agonizing. However, others found the decision relatively straightforward. In all cases, parents spent time thinking and gathering information. Certain critical events helped parents make their decision. Parents identified a number of strategies that would be helpful to the decision-making process.