UC Irvine

Childhood cancer survivors (CCS) face a lifetime of significantly elevated risks for chronic and life-threatening illnesses. The unknown challenges of survivorship contribute to elevated levels of emotional distress for parents of CCS. With few clinical supportive resources available, parents of CCS are more frequently turning to online social media for peer support. Because social media have become increasingly important to parents, they represent a critical context in which parents access and share CCS-related support. To date, little research exists on the supportive use of social media among parents of CCS. Thus, an explanatory sequential mixed- methods design was used to (1) examine the relation between social media use of parents (age >18) of young CCS (age <13; >1 year out of treatment), parent social media peer relationships— operationalized as a composite measure, online social integration (OSI)—and parent emotional distress; (2) describe the parent transition into survivorship and identify potential points for social media interventions in that transition; and (3) identify and describe the experiences of seeking, joining, and interacting in cancer-related social media platforms. Quantitative results showed that social media use was positively associated with OSI (rs = 0.29; p<0.01), and also positively associated with parent depression when controlling for OSI (β = .28, p < 0.01). However, bootstrapping mediation analyses provided evidence that OSI competitively mediates the relationship between social media and depression among parents (c = -.12, 95% CI -0.03, -0.21) in such a way that it offsets the potentially deleterious relationships between social media use and depression. Qualitative findings first showed that parents experienced the transition off cancer treatment as uniquely distressing and ideal for supportive interventions because it represents a disruption of the hard-won safety represented by regular clinical relationships. Second, parents shared a common process of supportive social media use that culminated in sharing informational, emotional, appraisal, and experiential support with experientially similar parents on disease-specific Facebook groups. The findings from this research provide a foundation for developing and evaluating targeted, low-cost, and exportable social media interventions that improve survivorship outcomes for parents and children affected by cancer.