Support Groups and Interventions

Modest evidence of worse helplessness or confusion among people with cancer participating in an online group

• Less reduction in helplessness or confusion (worse outcomes) among people with cancer participating in an intervention of a lecture on the use of the internet for support and information followed by participation in an internet support group compared to controls in a large RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²Høybye MT, Dalton SO et al. Effect of Internet peer-support groups on psychosocial adjustment to cancer: a randomised study. British Journal of Cancer. 2010 Apr 27;102(9):1348-54.

Preliminary (conflicting) evidence of more anxiety among people participating online or phone-based support interventions

• Less reduction in anxious preoccupation (worse outcome) among people with cancer participating in an intervention of a lecture on the use of the Internet for support and information followed by participation in an internet support group compared to controls in a large RCT³Høybye MT, Dalton SO et al. Effect of Internet peer-support groups on psychosocial adjustment to cancer: a randomised study. British Journal of Cancer. 2010 Apr 27;102(9):1348-54.
• Higher level of anxiety within 36 months of diagnosis among women with nonmetastatic breast cancer and who reported elevated anxiety or depression participating in structured opportunities to help and encourage others added to the comparison intervention of 5 professionally facilitated live chat sessions (90-minute weekly sessions) and access to an asynchronous discussion board in a mid-sized RCT⁴Lepore SJ, Buzaglo JS, Lieberman MA, Golant M, Greener JR, Davey A. Comparing standard versus prosocial internet support groups for patients with breast cancer: a randomized controlled trial of the helper therapy principle. Journal of Clinical Oncology. 2014 Dec 20;32(36):4081-6.
• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety scores among women with primary breast carcinoma participating in a 12-week, online, social support group (Bosom Buddies) compared to controls in a small RCT⁵Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB. Evaluation of an internet support group for women with primary breast cancer. Cancer. 2003 Mar 1;97(5):1164-73.
• Less anxiety among women with nonmetastatic breast cancer participating in psychoeducational interventions through a mobile phone app and nurse-assisted online mobile-based online group discussions (support sessions) for 4 weeks compared to no intervention in a small RCT⁶Ghanbari E, Yektatalab S, Mehrabi M. Effects of psychoeducational interventions using mobile apps and mobile-based online group discussions on anxiety and self-esteem in women with breast cancer: randomized controlled trial. JMIR Mhealth and Uhealth. 2021 May 18;9(5):e19262.

Preliminary (conflicting) evidence of more depression among people with cancer participating in online or phone-based support groups

• Less reduction in depression (worse outcome) among people with cancer participating in an intervention of a lecture on the use of the internet for support and information followed by participation in an Internet support group compared to controls in a large RCT⁷Høybye MT, Dalton SO et al. Effect of Internet peer-support groups on psychosocial adjustment to cancer: a randomised study. British Journal of Cancer. 2010 Apr 27;102(9):1348-54.
• Higher level of depression during the 36 months after diagnosis among women diagnosed with nonmetastatic breast cancer and who reported elevated anxiety or depression participating in structured opportunities to help and encourage others added to the comparison intervention of 5 professionally facilitated live chat sessions (90-minute weekly sessions) and access to an asynchronous discussion board in a mid-sized RCT⁸Lepore SJ, Buzaglo JS, Lieberman MA, Golant M, Greener JR, Davey A. Comparing standard versus prosocial internet support groups for patients with breast cancer: a randomized controlled trial of the helper therapy principle. Journal of Clinical Oncology. 2014 Dec 20;32(36):4081-6.
• Comparable depressive symptoms among women with breast cancer participating in either moderated or peer-led online support groups in a small randomized trial⁹Klemm P. Effects of online support group format (moderated vs peer-led) on depressive symptoms and extent of participation in women with breast cancer. Computers, Informatics, Nursing: CIN. 2012 Jan;30(1):9-18.
• Lower scores of depression among women with primary breast carcinoma participating in a 12-week online social support group (Bosom Buddies) compared to controls in a small RCT¹⁰Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB. Evaluation of an internet support group for women with primary breast cancer. Cancer. 2003 Mar 1;97(5):1164-73.

• Longer sick leave and more health care utilization in the 12 months since starting an intervention among people with newly diagnosed breast cancer participating in a support intervention of 1 week of a residential session followed by 4 days of follow-up 2 months later and comprising educational information, relaxation training, mental visualization, and nonverbal communication, compared to routine care in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹¹Björneklett HG, Rosenblad A et al. A randomized controlled trial of support group intervention after breast cancer treatment: results on sick leave, health care utilization and health economy. Acta Oncologica. 2013 Jan;52(1):38-47.