How do the discussion forums of online alcohol support groups affect users’ understanding of problem drinking?

Background: Problem drinking remains a significant problem in British society and internationally (World Health Organisation, 2018a), with hospital admissions continuing to rise in the UK. Meanwhile, much has been written about the importance of ordinary (non-medical) people’s beliefs about an illness or problem (their ‘representation’ of it). Research has shown how these beliefs can strongly affect what people decide to do about an issue, and therefore its health and social outcomes. It is, therefore, important to understand lay beliefs and where these come from, in order to work well with them. Objectives: This research explores the representations of users of six alcohol online support groups (AOSGs), looking at whether, and how, the discussion forums of these groups have influenced them. It focuses only on non-12-step groups, i.e., those which do not follow the 12-step programme for recovery of Alcoholics Anonymous (AA). The thesis explores the information behaviours used in the forums which contribute to creating the impacts. Methods: The research is a cross-sectional, multi-method qualitative study, consisting of thematic analysis of 1500 texts from three purposively chosen non-12-step AOSGs, followed by semi-structured interviews with 22 users of five such groups. The study uses Leventhal and colleagues Common Sense Theory of Illness Representations (1984) to analyse user beliefs. Results: The findings showed that these discussion forums did impact upon user representations. They allowed users a space where they could be free to develop their own individual model of problem drinking, in contrast to AA. Secondly, they could impact on specific aspects of beliefs in a variety of ways. Thirdly, they had a powerful holistic effect on users’ overall views of problem drinking and themselves-as-drinker, through helping them to find others like themselves, so reducing self-stigma. A new model of the role of information behaviours in the development of representations within these discussion forums is presented