This review investigated the effect of participation in a computer-mediated support group on perceptions of social support, depression, quality of life and self-efficacy. The authors concluded that participation in a computer-mediated support group can result in positive health outcomes for group members. Due to possible inappropriate pooling of studies and lack of validity assessment, these conclusions may not be reliable.

To investigate the effect of participation in a computer-mediated support group on perceptions of social support, depression, quality of life and self-efficacy.

MEDLINE, EBSCO, ERIC, PsycINFO, ProQuest, PsycExtra (grey literature) and the Association of Computing Machinery were searched (search dates not reported). Search terms were reported. References of literature reviews of computer-mediated support group research were also searched.

Studies of computer-mediated support groups (as defined by the authors) that reported means and standard deviations for at least one of the variables of interest prior to the intervention were eligible for inclusion. The authors defined a computer-mediated support group as: a group that focused on a health condition; that involved computer-mediated interaction between members; that included an education-related component; that had closed membership; and that had a fixed start and completion point.

The majority of included studies were of non-student adults (who had a variety of health conditions) and evaluated the outcomes of interest using a variety of scales and other measures. Asynchronous and/or synchronous communication channels were used. Study duration ranged from four to 52 weeks, where reported.

The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.

The authors did not state that they assessed validity. Attrition rates were reported.

Effects sizes were calculated for each study.

The authors did not state how many reviewers performed the data extraction.

The weighted mean effect (r) and corresponding 95% confidence intervals (CIs) were calculated for each variable using a random-effects meta-analysis. Moderator variables (group size, nature of available communication channels, members frequency of contact with group, and duration of computer-mediated support group) were tested using a modified form of weighted least squares regression.

Twenty-eight studies were included in the review (n=4,081 participants; range 32 to 580). The mean attrition rate was 22%.

Participation in a computer-mediated support group was associated with improved social support (r=0.16, 95% CI: 0.01 to 0.31; n=866 participants), less depression (r=-0.23, 95% CI -0.31 to -0.16; n=1,030 participants), greater quality of life (r=0.14, 95% CI 0.07 to 0.21; n=954 participants) and improved self-efficacy to manage their health condition (r=0.15, 95% CI 0.05 to 0.25, discrepancy between table and text; n=534 participants).

Participation in a computer-mediated support group could result in positive health outcomes for group members.

The research question was supported by inclusion criteria for intervention and outcomes and broad criteria for participants. The authors did not state whether language restrictions were applied, so was unclear whether language bias was present. Unpublished studies were sought, although publication bias was not assessed. The authors did not describe the review process, so it was not known whether there were measures in place to reduce reviewer error and bias.

Study validity was not assessed, so the reliability of these studies was unknown. Also, the study designs included were not clear. The reporting between tables and text was also inconsistent for one outcome. Heterogeneity between studies was not assessed, and a wide range of clinical conditions and outcome measures were included, so it was unclear whether meta-analysis was appropriate.

Due to possible inappropriate pooling of studies and lack of validity assessment, the authors' conclusions may not be reliable.

Practice: The authors stated that practitioners developing a computer-mediated support group intervention should consider (and pre-test) the duration, size and communication channels available in the intervention.

Research: The authors did not state any implications for further research.

Not stated.

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.