We spoke with Dr. Susan Fussell, the Principal Investigator on the project entitled Creation and Evaluation of a Discourse Coding System to Assess the Benefits of Online Discussion on Mental and Physical Health at Carnegie Mellon University.

Q: What is unique and/or innovative about your study?
Our study focuses on developing metrics that will allow us to compare different types of online support. Although others have studied specific online support services for specific conditions, they have rarely tried to develop measures that would be applicable across a wide range of support technologies and health conditions. In addition, our study attempts to demonstrate the validity of our metrics by linking them to changes in mental and physical health over time.

Q: How is your project progressing so far?
It is progressing very well. We devised a system for coding online discourse in a mental health support chatroom and used it to track changes in the content of visitors’ messages as a function of how many visits they had paid to the chatroom. We recently had a preliminary report on our techniques accepted for presentation at the CHI Conference on Human Computer Interaction to be held in Vienna in April. We’re now making some changes to our discourse analysis tool that will allow us to differentiate between cases in which people use negatively-toned emotion terms to refer to their own conditions versus to provide empathy with others’ emotional states. We’re also coding the discourse using a mental health questionnaire, in order to establish the validity of our automated content coding system.

Q: What prompted you to explore this research?
This project is a combination of my long-standing research interests in face-to-face and computer-mediated communication and my own volunteer work in an online support chatroom. During my time volunteering, I observed that those participating in the chatroom were receiving benefit from talking to others with similar problems; at the same time, I had visited other chatrooms that appeared to be much less beneficial. Because there are so many options today for online support, I became convinced that we needed metrics that would allow us to measure the benefits and costs of different technologies and sites. Such metrics would provide professionals and end-users with guidelines for determining what sites are worth visiting, and provide site developers with insights into how to create a venue of maximal benefit for their visitors.

Q: How would a typical end-user utilize the final product/results of your research?
The results will help end users understand how online support can benefit them or their friends/family and help them make reasoned selections among available online support options. I anticipate the benefits will spread as other investigators use our metrics and tools to evaluate a wide range of online support groups for a wide range of mental and physical conditions.

Q: What are the greatest challenges in eHealth and more specifically, your project?
There are many great challenges in eHealth but one of the most fascinating to me is how we can adapt our technologies for use in third-world countries, where there is such a great need for medical assistance, but such different views on illness and technology. Even in our chatroom studies, we have seen large cross-cultural differences in perceptions of mental illness. In countries in which mental disorders are viewed negatively by friends and family, online support may be especially valuable.

Perhaps the greatest challenge in our own project is understanding how interpersonal dynamics affect the value of online support. Unlike other technologies that can be used by single individuals, a chatroom’s benefit is a function not only of the technology but also of the other visitors and their contributions to the interaction. To some extent these issues can be studied by examining each site’s policies about who can participate and what can be discussed. But on top of that, the value of the room is shaped by how many other visitors are present, the quality of their support, and other aspects of interpersonal interaction. Understanding how to capture these dimensions of online support in our metrics is especially challenging.

Q: In what ways would you like to see eHealth evolve?
I would like to see better tools for people to find and interact with physicians and other medical professionals via video and other advanced technologies, so that those in remote areas can receive better treatment than they do today. In the mid-90s, I was a professor at a university in rural central Mississippi. I was struck by the near complete lack of physicians in the area. Most specialists visited one day a month from the closest cities. The Internet gives us much potential to provide service to those in isolated areas, both here and abroad.

I would also like to see specific outreach efforts to sufferers of rare conditions. These people often have little or no peer support for their illnesses in their everyday life, and may live in areas with no specialists for their condition.

Q: How do you stay informed of advances and innovations in eHealth?
All sorts of ways. I read proceedings of AMIA, visit online e-health research sites, and talk to other researchers. Because Human-Computer Interaction is my home discipline, I often work backwards: I keep track of new HCI technologies developed in non-health fields and try to think about how they might be extended to the e-health domain.

Thanks to Susan for sharing her perspectives on eHealth!

Stay tuned, our April edition will feature Dr. Elmer Bernstam at the University of Texas Health Science Center.