PDF(Pubmed)
Abstract：
BACKGROUND: Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation.
OBJECTIVE: This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.
METHODS: We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.
RESULTS: Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users\' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.
CONCLUSIONS: This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.
BACKGROUND: PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.
OBJECTIVE: This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.
METHODS: We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.
RESULTS: Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users\' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.
CONCLUSIONS: This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.
BACKGROUND: PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.
摘要：
背景：在线论坛广泛用于心理健康同伴支持。然而,它们的安全性和有效性的证据是混合的。进一步的研究侧重于阐明论坛使用产生积极和消极影响的背景，以便为实施创新提供信息。
目的：本研究旨在开发一种现实主义程序理论来解释在线心理健康同伴支持论坛对用户的影响。
方法：我们对2019年至2023年之间发表的文献进行了现实主义综合，并对论坛工作人员进行了18位利益相关者访谈。
结果：对102个证据来源和18个访谈的综合产生了一个包含22个上下文-机制-结果配置的总体程序理论。研究结果表明，用户对心理安全的看法和论坛内容的个人相关性是持续参与的基础。提供便利获取信息和建议的安全和活跃的论坛可以改善心理健康自我效能。在欢迎和非评判性社区的背景下，用户可能会受益于与同龄人一起探索个人困难的机会，体验减少了心理健康体验的孤立和正常化，并相互鼓励。程序理论强调了主持人在创造便利的在线空间中的重要作用，刺激社区参与，并限制对令人痛苦的内容的访问。对于举办心理健康论坛的组织来说，一个关键挑战在于平衡论坛的开放性和匿名性以及执行规则的必要性。例如限制用户可以讨论的内容，促进社区安全。
结论：这是在线心理健康同伴支持论坛的第一个现实主义综合。新颖的计划理论强调了成功的实施如何取决于建立增强安全性的协议和维护用户参与以促进论坛可持续性的策略。
背景：PROSPEROCRD42022352528;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=352528。
目的：本研究旨在开发一种现实主义程序理论来解释在线心理健康同伴支持论坛对用户的影响。
方法：我们对2019年至2023年之间发表的文献进行了现实主义综合，并对论坛工作人员进行了18位利益相关者访谈。
结果：对102个证据来源和18个访谈的综合产生了一个包含22个上下文-机制-结果配置的总体程序理论。研究结果表明，用户对心理安全的看法和论坛内容的个人相关性是持续参与的基础。提供便利获取信息和建议的安全和活跃的论坛可以改善心理健康自我效能。在欢迎和非评判性社区的背景下，用户可能会受益于与同龄人一起探索个人困难的机会，体验减少了心理健康体验的孤立和正常化，并相互鼓励。程序理论强调了主持人在创造便利的在线空间中的重要作用，刺激社区参与，并限制对令人痛苦的内容的访问。对于举办心理健康论坛的组织来说，一个关键挑战在于平衡论坛的开放性和匿名性以及执行规则的必要性。例如限制用户可以讨论的内容，促进社区安全。
结论：这是在线心理健康同伴支持论坛的第一个现实主义综合。新颖的计划理论强调了成功的实施如何取决于建立增强安全性的协议和维护用户参与以促进论坛可持续性的策略。
背景：PROSPEROCRD42022352528;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=352528。
