ELECTRONIC SELF-HELP AND SUPPORT GROUPS

Objectives. The authors examined the impact of a voice bulletin board on the following: (1) participation in, self-help efforts, (2) express ion of emotional support, (3) development of solidarity within the gro up, (4) utilization of health-care services, and (5) health status of subjects. Methods. Subjects were 53 pregnant women who abused drugs. A quasi-experimental design with matched control group and observations before and after intervention were carried out. Clients in the contro l group were asked to participate in biweekly face-to-face meetings. C lients in the experimental group participated in the voice bulletin bo ard. Experimental subjects had previous experience with computer servi ces. Subjects reported their level of drug use, health status, and uti lization of health services. They also reported on their symptoms, att itudes toward use of physician services, loneliness, willingness to di sclose information in groups, and sense of solidarity with their group . The content of the communication among the experimental group was re corded and the utterances were classified as to the type of communicat ion. Exit interviews were done 4 months after baseline interviews were conducted. Clients were paid to complete the baseline and the exit qu estionnaires, and 94% completed the exit questionnaires. The dependent variables were utilization or health status at exit; the eo-variate w as utilization or health status at baseline; and the independent varia ble was the group in which the subject participated. RESULTS. Clients were eight times more likely to participate in the voice bulletin boar d than in the face-to-face meeting (alpha < 0.01). The majority of the comments left on the bulletin board (54.6%) were for emotional suppor t ob: each other; no ''flaming'' or overt disagreements occurred. The more clients participated in the voice bulletin board, the more they f elt a sense of solidarity with each other (alpha < 0.001), Members of the experimental group reported significantly lower rates of visiting outpatient clinics than members of the control group (alpha < 0.05), L ower utilization did not lead to poor health status or more drug use: There were no statistically significant differences in the health stat us and drug use between the experimental and the control groups, Concl usions. Voice bulletin boards may be an effective method of providing support to mothers who have a history of drug use. Use of these servic es may lead to lower cost without worsening patients' health.