Please read the attachment ‘Virtual Togetherness,’ which is what you will use to help ask the questions. For question #3, please use the

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Research on adolescent parenthood has found one of the most critical predictors of offspring’s well-being is social support; however, scholars have also found that expectant adolescents sometimes experience a lack of support from their face-to-face networks. Very little research has examined how adolescent parents might make up for this discrepancy by utilizing mediated social networks; therefore, this study aims to fill a gap in the literature by examining how adolescent parents and expectant adolescents utilize online networks for support. One hundred and fifty messages from two online forums of adolescent pregnancy Web sites were content analyzed to examine the type of social support solicited by individual members. Additionally, 150 pairs of messages were examined to determine whether other community members provided the type of support solicited in the original posts. Guided by the optimal matching model, findings revealed informational and emotional support were sought most frequently across the two forums, with few users soliciting esteem, network, and tangible support. A further examination of the responses provided to support seekers revealed these online communities’ members most frequently matched the type of support initially solicited, followed by situations where they provided more support than asked for. Out of all five support types, those original posts that solicited informational or tangible support were most likely to have responses that provided the support type that was requested and even though posters did not necessarily ask for it, community members often provided emotional and esteem support in their responses.

Contents

Introduction Literature review Method Results Discussion Conclusion

CouldIbepregnant?Astudyofonlineadolescent pregnancyforumsforsocialsupport byErynN.Bostwick,DanniLiao,andSunKyongLee

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Introduction

Researchers have examined online social support exchange in various environments, including discussion boards (Vayreda and Antaki, 2009) and social network sites such as Facebook (Schrag and Schmidt-Tieszen, 2014). One of the most commonly studied areas of online social support involves health-related forums. Researchers have examined the online social support exchange process in forums dedicated to topics such as individuals with disabilities (Braithwaite, et al., 1999), Amyotrophic Lateral Sclerosis (ALS; Loane and D’Alessandro, 2013), and depression (Keating, 2013).

Although the aforementioned studies have helped to dispel some myths concerning the inability of online networks to provide effective support compared to face-to-face networks, some contexts of online social support are still understudied. One of those contexts is adolescent pregnancy/parenting. Adolescent parents face a variety of stressors that make online social support a viable option for them, such as a potential lack of support from their face-to-face interpersonal networks, particularly friendship networks (Bunting and McAuley, 2004; Sherman and Greenfield, 2013). It is especially important for scholars to better understand this context because receiving social support is so integral to the success of adolescent parents and their children (Kim, et al., 2014). More knowledge of the support options available to adolescent mothers and which of those options are the most effective in particular situations could help mitigate negative outcomes associated with adolescent parenting.

In order to explore online social support exchange within the context of adolescent pregnancy/parenting, the current research utilized content analysis to investigate the following: (a) various types of support exchanged on adolescent pregnancy/parenting online forums; (b) the relationships between the type of support solicited and type of support provided by forum (or online community) members; and, (c) whether the replies given by members matched the social support solicited. This study contributes to previous research by addressing two gaps in the literature. First, the population of expectant adolescents and adolescent parents has been understudied in the social support literature, particularly in an online context. For example, Nolan, et al. (2017) did an extensive search of the literature to examine what previous scholars had found concerning the use of online social networks by adolescent mothers. The authors only found one study (i.e., Sherman and Greenfield, 2013) that examined the naturally occurring use of online networks by pregnant adolescents and/or adolescent parents. However, Sherman and Greenfield (2013) only examined posts made by forum users and did not consider how the responses users received compared to their original posts. Therefore, this study extends Sherman and Greenfield’s initial research by examining the interactive process of social support exchange communication (not just how individuals seek support). Second, this study answers a call by Vayreda and Antaki (2009) for more research that examines how the types of support provided in online forums compare to the support users solicit.

The information provided by this study is significant because it allows scholars to better understand the role online social networks play in the support exchange process of adolescent parents. Given the importance of social support to the success of adolescent parents and to the outcomes of children of adolescent parents (Furstenberg and Hughes, 1995; Pinzon and Jones, 2012), the more scholars understand about the support provided in online networks, the better practitioners will be able to help those adolescent parents who may lack support in their face-to- face networks.

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Literature review

Social support and adolescent pregnancy/motherhood

Social support, communicated via messages and actions that help people feel cared for, is particularly important in the context of adolescent pregnancy/motherhood (Furstenberg and Hughes, 1995). A social support network provides adolescent mothers with a system of individuals they can turn to in times of need, which has a variety of positive outcomes for their physical and mental health (Smith, et al., 1994). Although the number of children born to adolescent parents has declined in the past 30 years, adolescent parenting is still considered a social problem in many regions of the United States (SmithBattle and Leonard, 2012). This is likely because research has suggested children born to adolescent parents tend to have poorer life experiences than those with older parents. For example, previous research has linked adolescent parenting to poor behavioral, cognitive, and social outcomes for children (Clemmens, 2001; Kim, et al., 2014; Pinzon and Jones, 2012). Because of this research, scholars have continued to study what kind of life experiences might help to mitigate the negative outcomes children born to adolescent parents experience, and why some children have better outcomes than others. Many of the factors they have discovered were associated with social support the mother received.

For instance, Pinzon and Jones (2012) found early childhood care, provided by the infant’s family of origin, and support that helped the adolescent finish school were related to more positive outcomes for children of adolescent parents. Furthermore, Kim, et al. (2014) found adolescent mothers who reported receiving more support were less likely to experience postpartum depression. Furstenberg and Hughes (1995) suggested support from one’s family members was associated with a higher likelihood of completing school, avoiding trouble, and having more positive life outcomes for the children of adolescent parents. This research suggests familial social support plays a crucial role in the outcomes associated with adolescent parenthood.

Although support from one’s family should theoretically benefit the adolescent parent, empirical research has provided mixed results. For example, Bunting and McAuley (2004) suggested while support provided by family members could be beneficial for adolescent mothers, sometimes this support could also be a source of conflict. Adolescent parents are in a unique position in that they play the role of both child and parent. Because of this, there are times in which their own parents might provide social support that comes across as encroaching upon their independent-adult status (Bunting and McAuley, 2004). For example, longitudinal interview research revealed one adolescent mother complained about social support from her mother, suggesting that her mother’s involvement hindered her growth as a parent (SmithBattle and Leonard, 2012).

Overall, research suggests the way social support is enacted plays an important role in the outcomes of both children of adolescent parents and adolescent parents themselves. Since access to helpful social support within the family unit seems to vary, it is possible those adolescent parents that do not receive much support from their family seek support elsewhere. Some research has suggested friendship networks might be better equipped to support adolescent

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parents in a positive way (Bunting and McAuley, 2004; Nolan, et al., 2015). However, adolescent mothers tend to feel disconnected from their peer groups once they have a child (Sherman and Greenfield, 2013). Therefore, given the mixed effects of support provided by family members and potential disconnection from one’s peers, one of the resources adolescent parents might turn to in order to develop a support network could be the Internet.

Why online social support?

Online support groups help people build weak-tie networks (Wright and Bell, 2003; Wright, et al., 2013). Granovetter (1973) claimed individuals have networks that consist of both strong and weak ties. Strong ties are individuals one has known for a long time, feels intimate with, and has intense emotional connection or exchanges reciprocal amount of resources (Wright and Miller, 2010). Weak ties constitute those with whom individuals are not necessarily close (Granovetter, 1973), but may provide novel information and perspectives.

Individuals who experience difficult situations may choose weak-tie networks over strong-tie networks because of the experiential similarity of community members, more objective feedback, and greater security and comfort (Wright and Miller, 2010; Wright, et al., 2010). For example, research suggests online support contexts make it possible for individuals to seek support from others who have gone through similar experiences (Tanis, 2008; Walther and Boyd, 2002). Therefore weak-tie networks establish a platform for individuals with similar experience to convey empathy, which facilitates the provision of emotional support (Wright and Bell, 2003).

Due to these features, online networks, such as online forums focused on adolescent pregnancy and parenting, might offer a useful alternative that allows adolescent parents to feel more connected to others who understand their situation (Dunham, et al., 1998). Research by Schotanus-Dijkstra, et al. (2014) suggests online support groups can be especially helpful for individuals with a lack of face-to-face support options. Additionally, Nolan, et al. (2015) found adolescent mothers felt more socially connected when they utilized online networks. Finally, adolescent pregnancy is oftentimes stigmatized (Wiemann, et al., 2005). Previous research suggested online support networks might be particularly useful to those who were stigmatized because it provided them with a safe space to connect with similar others who were less likely to judge them, as well as an opportunity to feel empowered (Rains, et al., 2015; Sherman and Greenfield, 2013). For example, according to a report by the Centers for Disease Control and Prevention, states with the highest rates of adolescent pregnancy are located in the South and Midwest of the United States (Matthews and Hamilton, 2019). The Pew Research Center (2014) suggests many of the states with the highest rates of adolescent pregnancy also tend to be politically conservative, and have many residents that practice the Christian faith (Pew Research Center, 2019). Given that unwed pregnancy is discouraged among Christians, it is possible those individuals who grow up in religious and politically conservative areas, but become pregnant and/or have children as adolescents, may struggle to find support systems in their immediate personal environment.

Types of support necessary for adolescent parents/expectant adolescents

One way scholars have examined social support is to classify social support into five large categories; informational support incorporates providing advice, referrals, and details about situations. Emotional support includes providing empathy and physical contact. Tangible support

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refers to providing practical help. Providing compliments is the main feature of esteem support, and offering access to other sources is conceptualized as network support (Cutrona and Suhr, 1992).

According to Cutrona and Russell’s (1990) optimal matching model, in order to determine the type of social support that is most beneficial to the individual in need of support, one needs to consider the controllability of the stressor. Stressors are controllable to the extent that the individual is able to do something to prevent and/or diminish the stress caused by the situation in question. Those stressors that are controllable are best managed with support that is action- facilitating, or supportive acts that seek to eliminate the stressor or decrease its severity (Cutrona and Suhr, 1992). In the context of Cutrona and Russell’s (1990) typology, both informational and tangible support qualify as action-facilitating support (Cutrona and Suhr, 1992). Stressors that are uncontrollable, however, are best managed with nurturing types of support, or supportive acts that diminish the severity of negative emotions such as grief or guilt. In the context of the Cutrona and Suhr (1992) typology, emotional and network support are considered to be nurturing types of support. The final type of support, esteem support, is said to be helpful for handling both controllable and uncontrollable stressors (Cutrona and Suhr, 1992).

Adolescent pregnancy and being an adolescent parent present an interesting scenario to apply Cutrona and Russell’s (1990) model because some aspects of the stress associated with being an adolescent parent/an expectant adolescent are controllable, but others are not. For example, research suggests expectant adolescents worry frequently about what to expect during pregnancy and delivery (de Anda, et al., 1992). Based on Cutrona and Suhr’s (1992) definition of controllability, this particular type of stress should be considered controllable because questions about pregnancy and delivery can be answered by reading relevant books, talking to their doctor or case worker, attending parenting classes, and/or by asking others who have gone through pregnancy and delivery about their experiences. In addition, Cutrona and Russell (1990) treated transition to parenthood as a controllable event.

However, de Anta, et al. (1992) also found that expectant adolescents frequently worried about being expected to act like an adult, but treated like a child by others; thus, their own identity and abilities. Additionally, Bierman and Streett (1982) believe adolescent pregnancy creates an identity crisis for girls because they are not yet fully developed adults, but are treated as such by society and are judged by adult standards. Relatedly, the stigma placed on adolescent parents and expectant adolescents by society and potentially even close others could be a source of stress and concern (SmithBattle and Leonard, 2012). These identity-related issues are all based on the judgments of others, which are largely out of the adolescent’s control and there might not be anything the adolescent can do to change the way others in society view them. Therefore, stress related to other people’s perceptions of an adolescent parent seems to be uncontrollable vis-à-vis Cutrona and Suhr’s (1992) definition.

With this in mind, it is possible that the stress associated with adolescent pregnancy and adolescent parenting is both controllable and uncontrollable, and that all five types of Cutrona and Russell’s (1990) support are potentially relevant to adolescent parents/expectant adolescents. Although all five types of support may be relevant in general, the nature of online support communities can make certain types of support more useful in an online context than others. This possibility will be described in more detail below.

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Solicitation of types of social support online

A variety of research has utilized Cutrona and Russell’s (1990) typology to examine the most prevalent types of support individuals tend to elicit within certain online contexts. Rains, et al.’s (2015) meta-analysis revealed that among these five types of social support, informational and emotional support were most frequently exchanged in health-related online communities, whereas tangible support was least evident compared to other types of support, indicating that online communities primarily served the function of advising and comforting (Rains, et al., 2015).

Although Rains, et al.’s (2015) meta-analysis included numerous studies that examined the topic of health-related online social support, a search for literature concerning online social support for expectant adolescents and adolescent mothers yielded few results. Most of the articles were focused on online interventions for adolescent parents, not naturally occurring support networks (e.g., Dunham, et al., 1998; Kauppi and Garg, 2009). However, Sherman and Greenfield (2013) did examine online social support and adolescent parenting in a naturally occurring online context. They analyzed four online forums focused on adolescent pregnancy and/or parenting. Their results showed although most posts were community oriented, the bulk of them did reveal messages related to emotional, informational, and tangible support.

Although Sherman and Greenfield’s (2013) study provided a glimpse into the world of naturally occurring online support groups for adolescent parents and/or adolescents who are expecting, there are still a variety of questions to be answered. For example, their study examined only three types of support: emotional, informational, and instrumental, but other types of support, particularly esteem support, are likely relevant to adolescent parents. Given that adolescent parenthood is stigmatized and adolescent parents report feeling like others treat them differently and look down upon them (SmithBattle and Leonard, 2012), it is possible adolescent parents reach out to their online support networks for a boost in self-esteem and to help them recover from the identity-related damage caused by stigmatization. More importantly, Cutrona and Suhr (1992) suggest esteem support is helpful for individuals experiencing both controllable and uncontrollable stressors, and adolescent pregnancy/adolescent parenthood is indeed associated with both controllable and uncontrollable stressors; thus, esteem support is likely important in the context of adolescent parenthood. Since Sherman and Greenfield (2013) limited the scope of their study to only three types of support, we do not yet know if adolescent parents/expectant adolescents utilize their online networks for seeking esteem support as well.

Additionally, Cutrona and Russell’s (1990) optimal matching model suggests tangible support is useful for those who experience controllable stressors, while network support is important for those experiencing uncontrollable stressors. Although adolescent parents and expectant adolescents likely experience stressors that are both controllable and uncontrollable, individuals may not turn to online support networks for tangible and network support because online networks tend to be geographically varied and may not easily provide the type of resources necessary for these two types of support. In an effort to have a more holistic understanding of the online social support exchange process for adolescent parents/expectant adolescents, the present study proposed the following research question:

RQ1: How frequently do members of adolescent pregnancy/adolescent parenting online support groups solicit a)

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informational; b) emotional; c) tangible; d) esteem; and, e) network support in their forum posts?

In addition to studying support solicited by individuals, it is also important to understand the type of support that is actually offered in online support communities. Importantly, previous research found that users tended to utilize online forums specifically so the type of support they sought could be matched by the support they received (Robinson and Turner, 2003; Walther and Boyd, 2002). However, just because posters solicited a particular type of support that matches the type of support they need does not mean a match is always provided. Vayreda and Antaki (2009) examined whether individuals’ posts in an online forum for bipolar disorder received responses that matched their desired support type. Their research showed many times when a member made a post announcing their bipolar disorder it was often met with unsolicited advice, indicating a mismatch and ineffective communication between what the posters wanted and what the responders provided.

Therefore, in order to know whether online support forums offer a viable alternative for adolescent parents/expectant adolescent mothers and interactive communication environment, researchers need to examine whether the support offered in these forums is actually helpful (i.e., whether the type of support offered matches the type of support solicited). To the authors’ knowledge, no previous research has examined the match between support solicited and support offered on online teen pregnancy/parenting Web sites; therefore, the second research question was proposed:

RQ2: How frequently are the types of support solicited by users of adolescent pregnancy/adolescent parenting forums matched by others’ responses to their posts?

Method

Forum selection

The population of interest for this study was posts made within online forums dedicated to pregnant adolescents and/or adolescent parents. In order to sample the forums for this study, the first author conducted a Google search using the search terms “teen pregnancy forum” and “adolescent pregnancy forum.” This method is similar to that used by Sherman and Greenfield (2013). Additionally, since Google searches produce results that are listed based on popularity and relevance, the authors took into consideration only those boards in the top ten Web sites produced by the search. These two decisions were made because forums provided on the first page of a Google search would be most likely to be utilized by adolescents when searching for a forum to use. Out of those sites identified using the above criteria, the first author chose two for analysis. These two sites were chosen based on multiple factors, including: a) they were accessible by the general public, which meant one did not have to be a member of the forum in order to view posts; b) the posts were organized chronologically, which allowed random selection of posts for analysis, and assured the researchers they chose posts off of each site that

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occurred during a specific time period; and, c) the Web sites had a relatively equal amount of posts during the time period in question, which ensured differences in terms of frequency of user posts on each site would not cause a problem in any analyses. The importance of chronological order of the posts is discussed in more detail in the procedures section.

Forum one was a sub-community of a more general pregnancy Web site. This forum had 22,697 posts as of mid-October 2016. The Web site itself contained only forum posts and responses, with no other community features. The second forum was a community strictly dedicated to adolescent parenting, with a focus on adolescent motherhood and a smaller community for adolescent fatherhood. The site had 22,154 posts as of mid-October 2016. This second Web site contained many sections, including a dedicated forum for Q&A, as well as a space to post personal stories, and links to local pregnancy support services.

Procedures

Prior to engaging in any sort of data collection, the authors obtained the Institutional Review Board’s exemption for research because we were studying publicly accessible documents that do not require registration. After choosing the Web sites for the study, the authors randomly sampled threads in order to answer the two research questions. The goal of the first research question was to examine what types of support members of online forums associated with adolescent pregnancy solicited in their posts; in order to answer this research question, the authors randomly sampled 150 posts made between 2015 and 2016 from each of the two sites. This timeline was chosen because the authors were interested in the most recent trends in social support messages at the time of data collection. Additionally, to determine the number of posts that should be analyzed, the authors conducted an a priori power analysis using G*Power. According to the analysis, in order to detect medium effects with alpha at .05 and 95 percent power, 145 threads should have been analyzed. Since 145 posts were the minimum, the authors decided to add five additional posts per site, resulting in the total of 150 per site. These posts were then coded based on the typology provided by Cutrona and Suhr (1992) as seeking a) informational; b) tangible; c) emotional; d) esteem; and/or, e) network support. The authors recognized that one individual post might contain requests for multiple types of support; thus, each message was coded as having each type of support either present or not present. For example, the authors examined every post requesting informational support (present or not present), then re-examined each post for requests of emotional support (present or not present) and so on and so forth for each of the five types of support.

Before actually engaging in the coding process, it was important to establish inter-coder reliability; therefore, once the individual posts were collected, 20 percent of the posts were randomly selected and the coding was performed as described above. This first 20 percent served as coder training. After the training was complete and all authors felt comfortable with the codebook, they then randomly selected another 20 percent of data that each author coded separately and calculated inter-coder reliability by utilizing Krippendorf’s (2011) alpha. All reliabilities for different types of support were 1.00, so the authors split up the remaining data and coded separately.

Procedures for the second research question were similar, except the authors randomly selected 150 posts from the previous three years. This change was made because it was necessary to obtain a more diverse sample of posts for this particular question. After engaging in analysis for

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the first research question and briefly examining the results, we noticed the forums seemed to contain more posts in previous years, with only a few posts per month within the last year. Therefore, we realized a longer time period might offer more insight into how the forums were utilized during a high traffic time. Coding procedures were similar to those used for RQ1, but instead of coding only the type(s) of support solicited in the initial posts, the authors also coded the type of support offered in first response to each post. The first response was chosen for analysis because in some instances only one response was given to support-seeking posts. Additionally, in many situations the first response would be the first message the original poster sees, making it the first possible instance of receiving support. These first messages could be particularly influential to those posters who were seeking time-sensitive advice.

Once both the original post and the first response were coded for the type(s) of support they contained (i.e., informational, emotional, tangible, esteem, and/or network), the authors then examined whether the response a) contained no

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