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Social and psychological determinants of participation in internet-based cancer support groups

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In this study, we identified the social and psychological characteristics of Danish cancer patients that determine use of the internet for support.

Materials and methods

We invited 230 cancer patients taking part in a public rehabilitation program to participate in an internet module comprising training in the retrieval of cancer-related information from the internet and self-support groups. Persons who were motivated to join the internet groups (N = 100; 47%) were compared with persons who chose not to participate (N = 111) on the basis of self-reported baseline questionnaire data. Nineteen persons either did not return the questionnaire or had missing values in confounding variables.


Cancer patients who were motivated to participate in internet support groups belong to higher socioeconomic groups (based on household income and employment) compared to non-participants. We observed no difference between the two groups in quality of life or psychological well-being, while coping to some extent seemed related to participation in internet support groups.


This study adds to the discussion on social inequality in internet use by cancer patients, showing that patients who are not inclined to use internet-based interventions are characterized by social position and employ more passive coping strategies.

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  1. Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB (2003) Evaluation of an internet support group for women with primary breast cancer. Cancer 97:1164–1173

    Article  PubMed  Google Scholar 

  2. Gustafson DH, Hawkins R, Pingree S, McTavish F, Arora NK, Mendenhall J, Cella DF, Serlin RC, Apantaku FM, Stewart J, Salner A (2001) Effect of computer support on younger women with breast cancer. J Gen Intern Med 16:435–445

    Article  CAS  PubMed  Google Scholar 

  3. Owen JE, Klapow JC, Roth DL, Shuster JL Jr, Bellis J, Meredith R, Tucker DC (2005) Randomized pilot of a self-guided internet coping group for women with early-stage breast cancer. Ann Behav Med 30:54–64

    Article  PubMed  Google Scholar 

  4. Wangberg SC, Andreassen HK, Prokosch HU, Santana SM, Sorensen T, Chronaki CE (2008) Relations between internet use, socio-economic status (SES), social support and subjective health. Health Promot Int 23:70–77

    Article  PubMed  Google Scholar 

  5. Andreassen HK, Bujnowska-Fedak MM, Chronaki CE, Dumitru RC, Pudule I, Santana S, Voss H, Wynn R (2007) European citizens’ use of E-health services: a study of seven countries. BMC Public Health 7:53

    Article  PubMed  Google Scholar 

  6. Helft PR, Eckles RE, Johnson-Calley CS, Daugherty CK (2005) Use of the internet to obtain cancer information among cancer patients at an urban county hospital. J Clin Oncol 23:4954–4962

    Article  PubMed  Google Scholar 

  7. Buntrock S, Hopfgarten T, Adolfsson J, Onelov E, Steineck G (2007) The internet and prostate cancer patients: searching for and finding information. Scand J Urol Nephrol 41:367–374

    Article  PubMed  Google Scholar 

  8. Dalton SO, During M, Ross L, Carlsen K, Mortensen PB, Lynch J, Johansen C (2006) The relation between socioeconomic and demographic factors and tumour stage in women diagnosed with breast cancer in Denmark, 1983–1999. Br J Cancer 95:653–659

    Article  CAS  PubMed  Google Scholar 

  9. Dalton SO, Ross L, During M, Carlsen K, Mortensen PB, Lynch J, Johansen C (2007) Influence of socioeconomic factors on survival after breast cancer—a nationwide cohort study of women diagnosed with breast cancer in Denmark 1983–1999. Int J Cancer 121:2524–2531

    Article  CAS  PubMed  Google Scholar 

  10. Dalton SO, Schuz J, Engholm G, Johansen C, Kjaer SK, Steding-Jessen M, Storm HH, Olsen JH (2008) Social inequality in incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: summary of findings. Eur J Cancer 44:2074–2085

    Article  PubMed  Google Scholar 

  11. Høybye MT, Dalton SO, Christensen J, Larsen LR, Kuhn KG, Jensen JN, Carlsen K, Johansen C (2007) Research in Danish cancer rehabilitation: social characteristics and late effects of cancer among participants in the FOCARE research project. Acta Oncol 10:1–9

    Google Scholar 

  12. UNESCO (1997) International Standard Classification of Education (ISCED) 1997.Available from: Accessed 25 November 2005

  13. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  14. McNair DM, Lorr M, Droppleman LF (1971) Profile of mood states. Educational and Industrial Testing Service, San Diego, CA

    Google Scholar 

  15. McNair DM, Lorr M, Droppleman LF (1992) EdiTS manual for the profile of mood states. Manual for the profile of mood states. Educational and Industrial Testing Service, San Diego, CA

    Google Scholar 

  16. Watson M, Law M, dos Santos M, Greer S, Baruch J, Bliss J (1994) The Mini-MAC: further development of the mental adjustment to cancer scale. J Psychosoc Oncol 12:33–46

    Article  Google Scholar 

  17. Watson M, Haviland JS, Greer S, Davidson J, Bliss JM (1999) Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet 354:1331–1336

    Article  CAS  PubMed  Google Scholar 

  18. SAS Institute Inc. (2005) SAS OnlineDoc® 9.1. SAS Institute Inc., Cary, NC

  19. Cameron LD, Booth RJ, Schlatter M, Ziginskas D, Harman JE, Benson SR (2005) Cognitive and affective determinants of decisions to attend a group psychosocial support program for women with breast cancer. Psychosom Med 67:584–589

    Article  PubMed  Google Scholar 

  20. Boesen E, Boesen S, Christensen S, Johansen C (2007) Comparison of participants and non-participants in a randomized psychosocial intervention study among patients with malignant melanoma. Psychosomatics 48:510–516

    Article  PubMed  Google Scholar 

  21. Høybye MT, Johansen C, Tjørnhøj-Thomsen T (2005) Online interaction. Effects of storytelling in an internet breast cancer support group. Psychooncology 14:211–220

    Article  PubMed  Google Scholar 

  22. Shaw BR, Hawkins R, Arora N, McTavish F, Pingree S, Gustafson DH (2006) An exploratory study of predictors of participation in a computer support group for women with breast cancer. Comput Inform Nurs 24:18–27

    Article  PubMed  Google Scholar 

  23. Klemm P, Hurst M, Dearholt SL, Trone SR (1999) Gender differences on internet cancer support groups. Comput Nurs 17:65–72

    CAS  PubMed  Google Scholar 

  24. Owen JE, Klapow JC, Roth DL, Tucker DC (2004) Use of the internet for information and support: disclosure among persons with breast and prostate cancer. J Behav Med 27:491–505

    Article  PubMed  Google Scholar 

  25. Statistics Denmark (2003) Available from: Accessed 1 April 2008

  26. Ottens M, European Commission, Eurostat (2006) Use of the internet among individuals and enterprises. Statistics in focus 12. Available from: Accessed 15 April 2008

  27. European Opinion Research Group (EORG), Spadaro R (2003) Eurobarometer 58.0: European Union citizens and sources of information about health

  28. Talosig-Garcia M, Davis SW (2005) Information-seeking behavior of minority breast cancer patients: an exploratory study. J Health Commun 10(Suppl 1):53–64

    Article  PubMed  Google Scholar 

  29. Demunter C, European Commission, Eurostat (2006) How skilled are Europeans in using computers and the internet? Statistics in focus 17. Available from: Accessed 15 April 2008

  30. Helgeson VS, Cohen S, Schulz R, Yasko J (2000) Group support interventions for women with breast cancer: who benefits from what? Health Psychol 19:107–114

    Article  CAS  PubMed  Google Scholar 

  31. Friedman DB, Hoffman-Goetz L, Arocha JF (2006) Health literacy and the World Wide Web: comparing the readability of leading incident cancers on the internet. Med Inform Internet Med 31:67–87

    Article  CAS  PubMed  Google Scholar 

  32. Lieberman MA, Golant M, Giese-Davis J, Winzlenberg A, Benjamin H, Humphreys K, Kronenwetter C, Russo S, Spiegel D (2003) Electronic support groups for breast carcinoma: a clinical trial of effectiveness. Cancer 97:920–925

    Article  PubMed  Google Scholar 

  33. Groenvold M, Petersen MA, Idler E, Bjorner JB, Fayers PM, Mouridsen HT (2007) Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat 105(2):209–219

    Article  PubMed  Google Scholar 

  34. Klee M, Groenvold M, Machin D (1997) Quality of life of Danish women: population-based norms of the EORTC QLQ-C30. Qual Life Res 6(1):27–34

    Article  CAS  PubMed  Google Scholar 

  35. Debess J, Riis JO, Pedersen L, Ewertz M (2009) Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark. Acta Oncol 4:532–540

    Article  Google Scholar 

  36. Boesen EH, Ross L, Frederiksen K, Thomsen BL, Dahlstrom K, Schmidt G, Naested J, Krag C, Johansen C (2005) Psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study. J Clin Oncol 23(6):1270–1277

    Article  PubMed  Google Scholar 

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The study was funded by the IMK Foundation, the Tryg Foundation, and the Danish Cancer Society. The authors wish to acknowledge the important collaboration of the staff at Rehabilitation Center Dallund, Denmark, in providing time in the rehabilitation schedule at the center for the internet teaching lectures.



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Correspondence to Mette Terp Høybye.

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Høybye, M.T., Dalton, S.O., Christensen, J. et al. Social and psychological determinants of participation in internet-based cancer support groups. Support Care Cancer 18, 553–560 (2010).

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