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J Med Internet Res. 2011 Dec 7;13(4):e106. doi: 10.2196/jmir.1718.

Determinants of engagement in face-to-face and online patient support groups.

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Department of Otolaryngology / Head and Neck Surgery, VU University Medical Centre, Amsterdam, Netherlands.



Although peer-to-peer contact might empower patients in various ways, studies show that only a few patients actually engage in support groups.


The objective of our study was to explore factors that facilitate or impede engagement in face-to-face and online peer support, using the theory of planned behavior (TPB).


A questionnaire was completed by 679 patients being treated for arthritis, breast cancer, or fibromyalgia at two Dutch regional hospitals.


Our results showed that only a minority of the patients engaged in organized forms of peer support. In total 10% (65/679) of the respondents had engaged in face-to-face meetings for patients in the past year. Only 4% (30/679) of the respondents had contact with peers via the Internet in the past year. Patients were more positive about face-to-face peer support than about online peer support (P < .001). In accordance with the TPB, having a more positive attitude (P < .01) and feeling more supported by people in the social environment (P < .001) increased the intention to participate in both kinds of peer support. In addition, perceived behavioral control (P = .01) influenced the intention to participate in online peer support. Nevertheless, the intention to engage in face-to-face and online peer support was only modestly predicted by the TPB variables (R(2) = .33 for face-to-face contact and R(2) = .26 for online contact).


Although Health 2.0 Internet technology has significantly increased opportunities for having contact with fellow patients, only a minority seem to be interested in organized forms of peer contact (either online or face-to-face). Patients seem somewhat more positive about face-to-face contact than about online contact.

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