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Cited by 90Cancer survivorship and careHealth Literacy and Information AccessibilityWomen's cancer prevention and management

Online support groups for women with breast cancer

Open access
McCaughan, Eilis, Parahoo, Kader, Hueter, Irene, Northouse, Laurel, Bradbury, Ian·2017·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd011652.pub2PMC PMC6464660
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Abstract

BACKGROUND: Survival rates for women with a diagnosis of breast cancer continue to improve. However, some women may experience physical, psychological and emotional effects post diagnosis, throughout treatment and beyond. Support groups can provide opportunities for people to share their experiences and learn from others. As the number of online support groups increases, more and more women with breast cancer will likely access them. OBJECTIVES: To assess effects of online support groups on the emotional distress, uncertainty, anxiety, depression and quality of life (QoL) of women with breast cancer. SEARCH METHODS: We searched for trials in the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4), MEDLINE, Embase and PsycINFO on 2 May 2016, and we handsearched journals and reference lists. We also searched the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) search portal and clinicaltrials.gov on 2 May 2016. SELECTION CRITERIA: We included randomised controlled trials (RCTs) assessing effects of online support groups on women with a diagnosis of breast cancer and women who have completed breast cancer treatment. We included studies comparing online support groups with a usual care group, and studies comparing two or more types of online support groups (without a usual care group). DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias. We presented outcome data using mean differences (MDs) and standardised mean differences (SMDs) along with 95% confidence intervals (CIs), and we used the fixed-effect model when appropriate. We assessed the quality of the body of evidence using the GRADE approach. MAIN RESULTS: We included six studies (492 women) that assessed online support groups for women with breast cancer. Online support groups in these six trials lasted from six to 30 weeks. Women participated in these groups between 1.5 and 2.5 hours per week, and investigators conducted all studies in the USA. Participants were predominantly white and well educated and were moderate to high earners. Four studies compared an online support group versus a control group, and the other two compared a 'moderated' versus a 'peer-led' online support group, and a 'standard' versus an 'enhanced' online support group, respectively.None of the included studies measured 'emotional distress' or uncertainty. One study (78 women) for which data for analysis were missing reported no positive effects of online support on 'distress' and 'cancer-specific distress' versus support provided by a control group. Two studies measured anxiety: One study (72 women) found no difference in anxiety at the end of the intervention between the online support group and the control group (MD -0.40, 95% CI -6.42 to 5.62; low-quality evidence), and the second study (184 women) reported a reduction in anxiety levels at the end of the intervention when comparing the 'standard' support group (run by participants without prompting from health professionals) versus an 'enhanced' online support group (in which participants were specifically asked by the researcher to respond to one another's need for support).Five studies (414 women) measured depression. Three studies compared depression in the online support group with depression in the control group. Pooled data from two studies (120 women) showed a small to moderate reduction in depression in the online support group compared with control groups at the end of the intervention (SMD -0.37, 95% CI -0.75 to 0.00; very low-quality evidence). The third study, a pilot study (30 women), provided no data for analysis but reported no difference in depression between participants in support and control groups at the end of the intervention. Of the remaining two studies that measured depression, one study (60 women) provided no extractable data for comparison but reported no difference in depressive symptoms between a 'moderated' and a 'peer-led' support group; the other study (184 women) reported greater reduction in depression in the 'standard' support group than in the 'enhanced' online support group.Three studies measured quality of life. One pilot study (30 women) provided limited data for analysis but reported no change in quality of life at the end of the intervention. Only two studies (140 women) provided data for pooling and showed no positive effects on quality of life at four months post intervention compared with controls (SMD -0.11, 95% CI -0.47 to 0.24; very low-quality evidence). At 12 months post intervention, one study (78 women) reported that the intervention group did not attain better quality of life scores than the control group (MD -10.89, 95% CI -20.41 to -1.37; low-quality evidence).We found no data for subgroup analyses on stage of disease, treatment modality and types and doses of interventions. No studies measured adverse effects. AUTHO

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  • Coping strategies promoted by basic ACT processes have been seen as predictors of better psychosocial outcomes in people with cancer.

    “Las estrategias de afrontamiento promovidas por los procesos básicos de ACT se han visto como predictores de mejores resultados psicosociales en personas con cáncer (46,64) .”

    From AVANZACT: protocolo e intervención psicoterapéutica en cáncer avanzado basados en Terapia de Aceptación y Compromiso. (2025) · cites this paper as [46]

    In “How the intervention might work” (page not provided), the review says that coping with difficulties can foster control and empowerment. In “Background—Description of the condition” (page not provided), it reports that psychological factors predicted later quality of life in people with breast cancer. Neither passage identifies coping strategies promoted by ACT processes as predictors of better psychosocial outcomes, so the specific attribution is unsupported. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • ACT-based interventions in advanced cancer have been implemented fundamentally in person, with some exceptions in telephone and online format.

    “Lo mismo ocurre con la modalidad online, ya que las intervenciones basadas en ACT en cáncer avanzado se han implementado fundamentalmente de manera presencial (46,49) , con algunas excepciones en formato telefónico (70,71) y online (69) .”

    From AVANZACT: protocolo e intervención psicoterapéutica en cáncer avanzado basados en Terapia de Aceptación y Compromiso. (2025) · cites this paper as [46]

    The Participants section reports an online support-group study involving women with metastatic breast cancer, supporting the cited online-format exception. The review does not identify that intervention as ACT-based, so it does not support that qualification. No page number is available in our copy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 1

  1. International Agency for Research on Cancer 2013 International Agency for Research on Cancer. Latest world cancer statistics. Press release number 223. https://www.iarc.fr/ en/media-centre/pr/2013/pdfs/pr223_E.pdf 2013 (accessed on 26 February 2017).

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Authors
McCaughan, E., Parahoo, K., Hueter, I., Northouse, L., & Bradbury, I.
Affiliations
  • Ulster University; Institute of Nursing and Health Research; Coleraine UK BT52 1SA
  • University of Ulster (GB)
  • Columbia University (US)
  • University of Michigan (US)
  • Frontier Science Scotland; Kincraig Scotland UK
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2017-03-10
Volume
2017
Issue
3
Pages
CD011652-CD011652
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd011652.pub2
PMC
PMC6464660
OpenAlex
W1535209921
Cited by
90
References
44
Citations by year
2026: 5 · 2025: 16 · 2024: 6 · 2023: 5 · 2022: 16 · 2021: 10 · 2020: 7 · 2019: 11 · 2018: 6 · 2017: 3 · 2016: 1 · 2015: 4
FWCI
0.77
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion, public-domain)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Ulster University Research Portal (Ulster University) (publishedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords
online support groups, breast cancer, breast cancer patients, emotional distress, anxiety, depression, quality of life, peer-led support, cancer-specific distress, uncertainty, survivorship, psychological well-being, social support, breast cancer recurrence, breast cancer screening
MeSH terms
Anxiety, Breast Neoplasms, Depression, Female, Humans, Peer Group, Quality of Life, Self-Help Groups, Time Factors, Randomized Controlled Trials as Topic, Consumer Health Information

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