Van Mierlo, T. et al.:Moderated online social networking for smokers: Content of first posts from 2,562 members

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Moderated Online Social Networking for smokers: Content of first posts from 2,562 smokers

1Trevor van Mierlo, BA; 2 3 Peter Selby MBBS, CCFP; 2 3 John Cunningham Ph.D.; 1Danielle Parent, BScN

4 September, 2008

1V-CC Systems Inc.2Centre for Addiction and Mental Health (CAMH)3University of Toronto

Disclosures – van Mierlo

• Chief Executive Officer: V-CC Systems Inc. (Canada) & V-CC Systems USA Inc.• Co-Author of Peer-Reviewed Journal Articles• Present at both Scientific and Business Conferences

What Does V-CC Do?• B2B Company (No B2C)• Clients: Pharma, Government, EAP, Insurance, Universities, Non-Profit, Private Companies• License healthcare technologies and development methodologies• Online CBT Programs, Brief Interventions, “Widgets”• Consulting• Host / Service / Moderate / Grow Social Networks (Support Groups) • Specialize in Smoking Cessation, Depression, Panic Disorder, Alcohol Reduction, Healthy Weight, Problem Gambling• Products are tested through Beta Programs

StopSmokingCenter.net (SSC) Beta

SSC Support Group

Study Questions…

• Qualitative evaluation of “posters” versus non posters in the Social Network• How many smokers registered?• Who used the Support Group moderated by trained Health

Educators?• Who didn’t use the Support Group?• How long did it take for a new member to post?• How long did it take before a new member received a

reply?• What did they “discuss”

Methods

• StopSmokingCenter.net (SSC) version 5.0• Lifecycle of version 5.0: Nov 6 2004 – May 15, 2007• Data collected from the v5 database:

• Demographic data for all registrants• Demographic data for “posters” and “non-posters” • “First post” content• Duration to “first response”

• “First response” content- Coded and entered by Danielle Parent• Analysis by John Cunningham

Demographics

• 16,764 registrations (Nov 6 2004 – May 15, 2007)• 69.9% American, 12.6% Canadian, 7.1% from UK, 10.4%

from another Country• Mean age: 38.9 years• 65.4% (n = 10,965) female • Avg. cigarettes per day: 20.6• 6,849 Fagerstrom completions. Mean score: 5.6• 15.3% (n = 2,562) of registrants made at least one post in

the Support Group

Posters vs. non-Posters

n =16,764 Posters (15.3%)n = 2,562

Non-Posters or “lurkers” (84.7%)

n = 14,202

Mean Age 40.4 38.7

% Female 70.1% 64.6%

Country

USA 73.5% 69.3%

Canada 12.3% 12.6%

UK 6.2% 7.3%

Other 8.0% 10.8%

Statistically significant but not clinically significant

Smoking characteristics

Posters(15.3%)n = 2,562

Non-Posters or “lurkers” (84.7%)n = 14,202

Years Smoked

21.6 19.5

Cigs per day 22.2 20.4

Completed Fagerstrom: (mean score)

67% (5.8) 36% (5.5)

How Long Does it Take the Average Registrant to Post?

Time to First Post

0

25

50

75

100

0 20 40 60 80 100

Hours to first post

Per

cen

tile

Posters

• 25% first post 19.2 minutes after registration• 50% first post 2 hours and 58 minutes after registration• 75% first post 81 hours and 32 minutes after registration

How Long Does it Take to Get a Reply?

Time to First Reply

0

25

50

75

100

0 0.5 1 1.5 2

Hours to first reply

Per

cen

tile

Reply

• 25% of first posts have a reply within 12 minutes• 50% of first posts have a reply within 29 minutes• 75% of first posts have a reply within 1 hour 27 min• 81.8% of replies by members, rest by moderator• only 68/2562 did not get a reply at all.

Who is posting?

What percentage of first posts are:

Recent quitter (quit < one month): 54.7%

Getting ready for their quit date: 14.2%

Want to quit but have not yet set a date: 10.4%

Quit >/=one month: 8.9%

Status of quitter undetectable: 4.5%

Quit time unknown: 3.8%

Past member returning to quit again: 1.6%

Friend or family member of a quitter: 1.2%

What are their reasons for posting?Quitter who is struggling and is seeking support or advice:

28%

Responding to another quitter’s questions or comments about cravings or triggers:

17.6%

Question or comment about withdrawal symptoms:

16.1%

Question or comment about cravings or triggers:

15.3%

Discussing their need to quit for their health or the health of others:

13.6%

Sharing a tip or strategy about quitting: 6.8%

Quitter has had a slip or relapsed: 6.2%

Question or comment about NRT or other quit aid:

4.5%

Told to quit by healthcare professional 0.2%

Who replies?

quit within the last month: 23.7%

quit less than one year ago: 35.0%

Total: 58.7%

Responders tend to be from those who have quit more than a month ago, but less than a year.

Member: 81.8% (n = 2,095)

Health Educator: 15.6% (n = 399)

*2.6% (n = 68) of posts did not get a response

Theme of Replies

Existing member offering a tip, strategy, advice or answered a question about quitting:

50%

A reply by a member offering encouragement or congratulations:

26.9%

Other member sharing a personal experience: 13.9%

• Half of respondents offering advice, encouragement or a tip• Encouragement and compliments are common

Limitations

• True Denominator unknown• Self selected• Benefit/harm to lurkers unknown• Quit rates unknown for posters versus non posters• Natural history of online communities is evolutionary• Did not describe super posters / elders.• Impact of new tools in SSC 6.1? (Personal Profile / YouTube

Videos / Blogs / “Mod’s Corner”)

Conclusions

• More women than men • Mainly from the US• Heavy smokers• Post very quickly after registering• Mainly recent quitters who are struggling• Mostly mutual aid by those who have quit for a month or

more• “Online church basement”

Cunningham, J. A., van Mierlo, T., & Fournier, R. (2008). An online support group for problem drinkers: AlcoholHelpCenter.net. Patient Education and Counseling, 70(2), 193-198.

In press: Methodological issues in the evaluation of internet-based interventions for problem drinking

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