Abstract
This pilot study investigated the feasibility and preliminary efficacy of an Internet Support Group (ISG) for parents of children with NF1. Eligible parents were recruited by email and completed baseline questionnaires assessing social support, self-efficacy, depression, and anxiety. The ISG involved eight weekly 90-min chat sessions and a discussion forum open 24 h/day for 8 weeks. Follow-up measures were completed immediately post-intervention and 3 months later. Parents from 33 families (29 mothers, 4 fathers) completed baseline measures. Over half of parents (52 %) rated their child’s disease severity as mild, 33 % moderate, and 15 % severe. Among 21 parents who completed post-intervention measures, ratings of perceived emotional (p = .0008) and informational (p = .0003) support increased. There were no significant changes in self-efficacy, depression, or anxiety (ps > .05). The mean satisfaction rating was moderately high (7.6/10; range 4–10). Some parents commented that the chat sessions were at inconvenient times, which may have limited participation. Preliminary evidence in this small sample of parents suggests that ISGs may be a feasible and potentially efficacious method of providing support to parents of children with NF1. Having multiple weekly chat sessions held at various days and times may improve accessibility and participation. Clinicians are encouraged to help parents access online support resources.
Similar content being viewed by others
References
Ablon, J. (1996). Gender response to neurofibromatosis 1. Social Science & Medicine, 42(1), 99–109.
Amichai-Hamburger, Y., Gazit, T., Bar-Ilan, J., Perez, O., Aharony, N., Bronstein, J., & Dyne, T. S. (2016). Psychological factors behind the lack of participation in online discussions. Computers in Human Behavior, 55, 268–277.
Arafa, M. A., Zaher, S. R., El-Dowaty, A. A., & Moneeb, D. E. (2008). Quality of life among parents of children with heart disease. Health and Quality of Life Outcomes, 6, 91. doi:10.1186/1477-7525-6-91.
Barak, A., Klein, B., & Proudfoot, J. G. (2009). Defining internet-supported therapeutic interventions. Annals of Behavioral Medicine, 38(1), 4–17. doi:10.1007/s12160-009-9130-7.
Barke, J., Coad, J., & Harcourt, D. (2016). Parents' experiences of caring for a young person with neurofibromatosis type 1 (NF1): a qualitative study. Journal of Community Genetics, 7, 33–39.
Barrera Jr., M., Glasgow, R. E., McKay, H. G., Boles, S. M., & Feil, E. G. (2002). Do internet-based support interventions change perceptions of social support?: an experimental trial of approaches for supporting diabetes self-management. American Journal of Community Psychology, 30(5), 637–654.
Baum, L. S. (2004). Internet parent support groups for primary caregivers of a child with special health care needs. Pediatric Nursing, 30(5), 381–401.
Binford Hopf, R. B., Le Grange, D., Moessner, M., & Bauer, S. (2013). Internet-based chat support groups for parents in family-based treatment for adolescent eating disorders: a pilot study. European Eating Disorders Review, 21(3), 215–223. doi:10.1002/erv.2196.
Boman, K., Lindahl, A., & Bjork, O. (2003). Disease-related distress in parents of children with cancer at various stages after the time of diagnosis. Acta Oncologica, 42(2), 137–146.
Buchanan, E. A., & Zimmer, M. (2012). Internet research ethics. Stanford Encyclopedia of Philosophy, Winter 2012. Retrieved from http://plato.stanford.edu/archives/win2012/entries/ethics-internet-research/.
Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode, R., Buysse, D., Choi, S., Cook, K., Devellis, R., DeWalt, D., Fries, J. F., Gershon, R., Hahn, E. A., Lai, J. S., Pilkonis, P., Revicki, D., Rose, M., Weinfurt, K., & Hays, R. (2010). The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. Journal of Clinical Epidemiology, 63(11), 1179–1194. doi:10.1016/j.jclinepi.2010.04.011.
Chiou, H. H., & Hsieh, L. P. (2008). Parenting stress in parents of children with epilepsy and asthma. Journal of Child Neurology, 23(3), 301–306. doi:10.1177/0883073807308712.
Clifford, T., & Minnes, P. (2013). Logging on: evaluating an online support group for parents of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(7), 1662–1675. doi:10.1007/s10803-012-1714-6.
Crisp, D., Griffiths, K., Mackinnon, A., Bennett, K., & Chritensen, H. (2014). An online intervention for reducing depressive symptoms: secondary benefits for self-esteem, empowerment, and quality of life. Psychiatry Research, 216(1), 60–66.
Griffiths, K. M., Mackinnon, A. J., Crisp, D. A., Christensen, H., Bennett, K., & Farrer, L. (2012). The effectiveness of an online support group for members of the community with depression: a randomised controlled trial. PloS One, 7(12), e53244. doi:10.1371/journal.pone.0053244.
Grootenhuis, M. A., & Last, B. F. (1997). Adjustment and coping by parents of children with cancer: a review of the literature. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 5(6), 466–484.
Hinton, L., Kurinczuk, J. J., & Ziebland, S. (2010). Infertility; isolation and the internet: a qualitative interview study. Patient Education and Counseling, 81(3), 436–441. doi:10.1016/j.pec.2010.09.023.
Hoekstra-Weebers, J. E., Jaspers, J. P., Kamps, W. A., & Klip, E. C. (1999). Risk factors for psychological maladjustment of parents of children with cancer. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1526–1535. doi:10.1097/00004583-199912000-00014.
Hoybye, M. T., Dalton, S. O., Deltour, I., Bidstrup, P. E., Frederiksen, K., & Johansen, C. (2010). Effect of internet peer-support groups on psychosocial adjustment to cancer: a randomised study. British Journal of Cancer, 102(9), 1348–1354. doi:10.1038/sj.bjc.6605646.
Iseri, P. K., Ozten, E., & Aker, A. T. (2006). Posttraumatic stress disorder and major depressive disorder is common in parents of children with epilepsy. Epilepsy & Behavior, 8(1), 250–255. doi:10.1016/j.yebeh.2005.10.003.
Jerant, A., Kravitz, R., Moore-Hill, M., & Franks, P. (2008). Depressive symptoms moderated the effect of chronic illness self-management training on self-efficacy. Medical Care, 46, 523–531.
Kim, A., Gillespie, A., Dombi, E., Goodwin, A., Goodspeed, W., Fox, E., Balis, F. M., & Widemann, B. C. (2009). Characteristics of children enrolled in treatment trials for NF1-related plexiform neurofibromas. Neurology, 73(16), 1273–1279. doi:10.1212/WNL.0b013e3181bd1326.
Klassen, A. F., Gulati, S., Granek, L., Rosenberg-Yunger, Z. R., Watt, L., Sung, L., Klaassen, R., Dix, D., & Shaw, N. T. (2011). Understanding the health impact of caregiving: a qualitative study of immigrant parents and single parents of children with cancer. Quality of Life Research. doi:10.1007/s11136-011-0072-8.
Kratz, L., Uding, N., Trahms, C. M., Villareale, N., & Kieckhefer, G. M. (2009). Managing childhood chronic illness: parent perspectives and implications for parent-provider relationships. Families, Systems & Health, 27(4), 303–313. doi:10.1037/a0018114.
Kreutzer, J. S., Rapport, L. J., Marwitz, J. H., Harrison-Felix, C., Hart, T., Glenn, M., & Hammond, F. (2009). Caregivers' well-being after traumatic brain injury: a multicenter prospective investigation. Archives of Physical Medicine and Rehabilitation, 90(6), 939–946. doi:10.1016/j.apmr.2009.01.010.
Letourneau, N., Stewart, M., Masuda, J. R., Anderson, S., Cicutto, L., McGhan, S., & Watt, S. (2012). Impact of online support for youth with asthma and allergies: pilot study. Journal of Pediatric Nursing, 27(1), 65–73. doi:10.1016/j.pedn.2010.07.007.
Lorig, K., Stewart, A., Ritter, P., Gonzalez, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks, CA: Sage Publications.
Madden, M., Lenhart, A., Cortesi, S., Gasser, U., Duggan, M., Smith, A., & Beaton, M. (2013). Teens, social media, and privacy. Pew Research Center: Internet, Science & Tech. Retrieved from pewinternet.org website.
Malik, S. H., & Coulson, N. S. (2008). Computer-mediated infertility support groups: an exploratory study of online experiences. Patient Education and Counseling, 73(1), 105–113. doi:10.1016/j.pec.2008.05.024.
Martin, S., Wolters, P. L., Baldwin, A., Roderick, M. C., Toledo-Tamula, M. A., Gillespie, A., & Widemann, B. (2014). Attitudes about internet support groups among adolescents and young adults with neurofibromatosis type 1 and their parents. Journal of Genetic Counseling, 23(5), 796–804. doi:10.1007/s10897-014-9688-5.
Mo, P. K. H., & Coulson, N. S. (2010). Empowering processes in online support groups among people living with HIV/AIDS: a comparative analysis of 'lurkers' and 'posters'. Computers in Human Behavior, 26, 1183–1193.
Olino, T. M., Yu, L., McMakin, D. L., Forbes, E. E., Seeley, J. R., Lewinsohn, P. M., & Pilkonis, P. A. (2013). Comparisons across depression assessment instruments in adolescence and young adulthood: an item response theory study using two linking methods. Journal of Abnormal Child Psychology, 41(8), 1267–1277. doi:10.1007/s10802-013-9756-6.
Patino-Fernandez, A. M., Pai, A. L., Alderfer, M., Hwang, W. T., Reilly, A., & Kazak, A. E. (2008). Acute stress in parents of children newly diagnosed with cancer. Pediatric Blood & Cancer, 50(2), 289–292. doi:10.1002/pbc.21262.
Pilkonis, P. A., Choi, S. W., Reise, S. P., Stover, A. M., Riley, W. T., Cella, D., & Group, Promis Cooperative (2011). Item banks for measuring emotional distress from the patient-reported outcomes measurement information system (PROMIS(R)): depression, anxiety, and anger. Assessment, 18(3), 263–283. doi:10.1177/1073191111411667.
Pilkonis, P. A., Yu, L., Dodds, N. E., Johnston, K. L., Maihoefer, C. C., & Lawrence, S. M. (2014). Validation of the depression item bank from the patient-reported outcomes measurement information system (PROMIS) in a three-month observational study. Journal of Psychiatric Research, 56, 112–119. doi:10.1016/j.jpsychires.2014.05.010.
Raghavendra, P., Newman, L., Grace, E., & Wood, D. (2013). 'I could never do that before': effectiveness of a tailored internet support intervention to increase the social participation of youth with disabilities. Child: Care, Health and Development, 39(4), 552–561. doi:10.1111/cch.12048.
Rearick, E. M., Sullivan-Bolyai, S., Bova, C., & Knafl, K. A. (2011). Parents of children newly diagnosed with type 1 diabetes: experiences with social support and family management. The Diabetes Educator, 37(4), 508–518. doi:10.1177/0145721711412979.
Reiter-Purtill, J., Schorry, E. K., Lovell, A. M., Vannatta, K., Gerhardt, C. A., & Noll, R. B. (2008). Parental distress, family functioning, and social support in families with and without a child with neurofibromatosis 1. Journal of Pediatric Psychology, 33(4), 422–434. doi:10.1093/jpepsy/jsm077.
Rieley, M. B., Stevenson, D. A., Viskochil, D. H., Tinkle, B. T., Martin, L. J., & Schorry, E. K. (2011). Variable expression of neurofibromatosis 1 in monozygotic twins. American Journal of Medical Genetics. Part A, 155A(3), 478–485. doi:10.1002/ajmg.a.33851.
Rodriguez, A., & King, N. (2009). The lived experience of parenting a child with a life-limiting condition: a focus on the mental health realm. Palliative & Supportive Care, 7(1), 7–12. doi:10.1017/S1478951509000030.
Shaw, J. (2000). Health care in the information age. Manag Care, 9(11 Suppl), 13–16; quiz 12, 23–15.
Stone, A. A., Broderick, J. E., Junghaenel, D. U., Schneider, S., & Schwartz, J. E. (2015). PROMIS fatigue, pain intensity, pain interference, pain behavior, physical function, depression, anxiety, and anger scales demonstrate ecological validity. Journal of Clinical Epidemiology. doi:10.1016/j.jclinepi.2015.08.029.
Swallow, V. M., Knafl, K. A., Santacroce, S., Campbell, M., Hall, A. G., Smith, T., & Carolan, I. (2014). An interactive health communication application for supporting parents managing childhood long-term conditions: outcomes of a randomized controlled feasibility trial. JMIR Research Protocols, 3(4), e69.
Szabo, A., Mezei, G., Kovari, E., & Cserhati, E. (2010). Depressive symptoms amongst asthmatic children's caregivers. Pediatric Allergy and Immunology, 21(4 Pt 2), e667–e673. doi:10.1111/j.1399-3038.2009.00896.x.
Tonsgard, J. H. (2006). Clinical manifestations and management of neurofibromatosis type 1. Seminars in Pediatric Neurology, 13, 2–7.
van Uden-Kraan, C. F., Drossaert, C. H., Taal, E., Seydel, E. R., & van de Laar, M. A. (2008). Self-reported differences in empowerment between lurkers and posters in online patient support groups. Journal of Medical Internet Research, 10(2), e18. doi:10.2196/jmir.992.
Vayena, E., Mastroianni, A., & Kahn, J. (2013). Caught in the web: informed consent for online health research. Sci Trans Med, 5(173), 173–176.
Wolkenstein, P., Rodriguez, D., Ferkal, S., Gravier, H., Buret, V., Algans, N., Simeoni, M. C., & Bastuji-Garin, S. (2009). Impact of neurofibromatosis 1 upon quality of life in childhood: a cross-sectional study of 79 cases. The British Journal of Dermatology, 160(4), 844–848. doi:10.1111/j.1365-2133.2008.08949.x.
Wolters, P. L., Burns, K. M., Martin, S., Baldwin, A., Dombi, E., Toledo-Tamula, M. A., Dudley, W. N., Gillespie, A., & Widemann, B. C. (2015). Pain interference in youth with neurofibromatosis type 1 and plexiform neurofibromas and relation to disease severity, social-emotional functioning, and quality of life. American Journal of Medical Genetics. Part A. doi:10.1002/ajmg.a.37123.
Wood, L. J., Sherman, E. M., Hamiwka, L. D., Blackman, M. A., & Wirrell, E. C. (2008). Maternal depression: the cost of caring for a child with intractable epilepsy. Pediatric Neurology, 39(6), 418–422. doi:10.1016/j.pediatrneurol.2008.08.007.
Acknowledgments
The authors appreciate the participation of the parents who took part in this study. We also thank the Children’s Tumor Foundation for providing the online infrastructure for the internet support group. This research was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute. In addition, this project was funded in whole or in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
S. Martin, M.C. Roderick, R. Lockridge, M.A. Toledo-Tamula, A. Baldwin, P. Knight, P. Wolters declare that they have no conflict of interest.
Human Studies and Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Animal Studies
No animal studies were carried out by the authors for this article.
Rights and permissions
About this article
Cite this article
Martin, S., Roderick, M.C., Lockridge, R. et al. Feasibility and Preliminary Efficacy of an Internet Support Group for Parents of a Child with Neurofibromatosis Type 1: a Pilot Study. J Genet Counsel 26, 576–585 (2017). https://doi.org/10.1007/s10897-016-0031-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10897-016-0031-1