title: Evaluation of support groups for women with breast cancer: importance of the navigator role.
abstract: BACKGROUND
  At least some forms of breast cancer are increasingly being viewed as a chronic illness, where an emphasis is placed on meeting the various ongoing needs of people living with cancer, their families and other members of their social support networks. This commentary outlines some approaches to the evaluation of cancer-related support groups, with a particular emphasis on those designed to provide long-distance support, via the internet, for women with breast cancer.
  
  
  CONCLUSIONS
  The literature on evaluations of community-based cancer support groups indicates that they offer a number of benefits, and that it is more reasonable to expect an impact of such interventions on psychosocial functioning and/or health-related quality of life than on survival. The literature on both face-to-face and online social support groups suggests that they offer many advantages, although evaluation of the latter delivery mechanism presents some ethical issues that need to be addressed. Many popular online support groups are peer-moderated, rather than professionally-moderated. In an evaluation of online support groups, different models of the role of the "navigator" need to be taken into account. Some conceptual models are outlined for the evaluation of the "navigator role" in meeting the informational, decisional and educational needs of women with breast cancer. The Breast-Cancer Mailing List, an example of an unmoderated internet-based peer-support group, is considered within the context of a Shared or Tacit Model of the navigator role.
  
  
  CONCLUSIONS
  Application of the concept of a "navigator role" to support groups in general, and to unmoderated online ones in particular, has received little or no attention in the research literature. The navigator role should be taken into account in research on this increasingly important aspect of cancer communication.
authors.affiliation: Department of Medical Biophysics and Joint Centre for Bioethics, University of Toronto, and Ontario Cancer Institute, University Health Network, Toronto, Ontario, M5G 2M9, Canada. till@uhnres.utoronto.ca
authors.forename: James E
authors.initials: JE
authors.lastname: Till
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D020407:Internet; D011788:Quality of Life; D012657:Self-Help Groups; D012944:Social Support