OBJECTIVES: This review sought to answer the question: what is the use, nature and impact of electronic support groups in the prevention and promotion of health? Public health units in Ontario are "to foster the creation of a supportive environment for health" (Ministry of Health of Ontario, 1997). The provision of public health programs addressing social support, peer education and peer support are mandated under the Family Health and Chronic Diseases and Injuries programs. The objective under the equal access goal is to "reduce educational, social and environmental barriers to accessing mandatory public health programs". Barriers to access such as: literacy level, language, geography, social factors, education, economic circumstance, physical ability are to be addressed. The provincial mandate also defines the Internet as one strategy to be used for "the provision of information and opportunities for skill development to facilitate the adoption of healthrelated behaviours for the prevention of chronic diseases". It is also to be used as a mechanism for community wide education campaigns for health promotion programs. (Ministry of Health of Ontario, 1997).
METHODS: A search of published and electronic literature related to on-line support groups resulted in retrieval of 39 articles. Twenty-four relevant articles were found, three of which were content analyses. The 21 remaining articles were concerned with 16 distinct studies: one study was rated as strong, two rated as moderate and 13 rated as weak.
RESULTS: There were no negative findings on any of the studies beyond "flaming" reported in two articles. In studies that investigated multi-featured systems (information, decision support tools, etc.), communication features providing social support were the most frequently used feature, demonstrating their public appeal. Participation in multi-featured Electronic Support Group, (ESGs) result in a variety of positive health outcomes. There is a typical pattern of use found in ESGs where there is heavy use at first, a dropping-off and then leveling-off period at about 3- 4 months, indicating that ESGs require time to establish themselves. ESGs were used seven days per week and 24 hours per day, suggesting that they can be a good source of help when traditional services are not available.
CONCLUSIONS: The findings indicate that social support can be successfully provided via a computer mediated communication medium to support a broad range of populations and health conditions.