Access Type

Open Access Dissertation

Date of Award

January 2021

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Psychology

First Advisor

Mark A. Lumley

Abstract

Social networking-based groups such as Facebook groups have become increasingly popular among people with chronic conditions, and the affordances of such groups make them a promising platform for chronic disease intervention. Yet, there have been few controlled tests of the effects of social networking-based groups. Our team developed a Facebook-based intervention that focuses on enhancing social support by connecting adults with peers who also have chronic pain. Using a randomized controlled clinical trial, we aimed to understand the efficacy of this intervention and to explore whether a professional-led support group leads to greater effects than a support group alone. The study sample included 119 adults with chronic nonmalignant pain. Participants were randomly assigned to one of two conditions: (1) a control condition (peer-led Facebook group; n = 60) in which participants were instructed to offer mutual support for the duration of the group and (2) an experimental condition (professional-led Facebook group; n = 59) in which the investigators disseminated several training components that were selected based on research on social and emotional influences on pain. Participants engaged in their assigned Facebook group for four weeks and completed a battery of measures at baseline, weekly, post-intervention, and 1-month follow-up. Across conditions, participants showed significant reductions in pain severity, pain interference, and depressive symptoms after participating in their Facebook groups for four weeks (medium to large effects). Participants retained their outcomes one month after the Facebook groups ended, and those in the professional-led Facebook groups continued to improve significantly in pain interference. The overall sample did not show significant reductions in anxiety symptoms at post-intervention or 1-month follow-up, but greater Facebook group use was associated with lower anxiety at post-intervention. Between-group analyses showed no significant differences between conditions at post-intervention or 1-month follow-up. Findings from this study indicate that Facebook-based support groups may be beneficial and enjoyable for adults with chronic pain, particularly those who feel unsupported or invalidated by friends and family, are ambivalent about expressing emotions, and have chronic primary pain. There was little evidence of adverse events. Thus, this study supports the use of Facebook-based support groups as an additional tool to address chronic pain and its impact on mood and functioning. Quality improvement studies are needed to enhance and test this novel experimental intervention, which could potentially reduce barriers to treatment for this critical public health problem.

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