title: Comparing Crowdsourcing and Friendsourcing: A Social Media-Based Feasibility Study to Support Alzheimer Disease Caregivers.
abstract: BACKGROUND
  In the United States, over 15 million informal caregivers provide unpaid care to people with Alzheimer disease (AD). Compared with others in their age group, AD caregivers have higher rates of stress, and medical and psychiatric illnesses. Psychosocial interventions improve the health of caregivers. However, constraints of time, distance, and availability inhibit the use of these services. Newer online technologies, such as social media, online groups, friendsourcing, and crowdsourcing, present alternative methods of delivering support. However, limited work has been done in this area with caregivers.
  
  
  OBJECTIVE
  The primary aims of this study were to determine (1) the feasibility of innovating peer support group work delivered through social media with friendsourcing, (2) whether the intervention provides an acceptable method for AD caregivers to obtain support, and (3) whether caregiver outcomes were affected by the intervention. A Facebook app provided support to AD caregivers through collecting friendsourced answers to caregiver questions from participants' social networks. The study's secondary aim was to descriptively compare friendsourced answers versus crowdsourced answers.
  
  
  METHODS
  We recruited AD caregivers online to participate in a 6-week-long asynchronous, online, closed group on Facebook, where caregivers received support through moderator prompts, group member interactions, and friendsourced answers to caregiver questions. We surveyed and interviewed participants before and after the online group to assess their needs, views on technology, and experience with the intervention. Caregiver questions were pushed automatically to the participants' Facebook News Feed, allowing participants' Facebook friends to see and post answers to the caregiver questions (Friendsourced answers). Of these caregiver questions, 2 were pushed to crowdsource workers through the Amazon Mechanical Turk platform. We descriptively compared characteristics of these crowdsourced answers with the friendsourced answers.
  
  
  RESULTS
  In total, 6 AD caregivers completed the initial online survey and semistructured telephone interview. Of these, 4 AD caregivers agreed to participate in the online Facebook closed group activity portion of the study. Friendsourcing and crowdsourcing answers to caregiver questions had similar rates of acceptability as rated by content experts: 90% (27/30) and 100% (45/45), respectively. Rates of emotional support and informational support for both groups of answers appeared to trend with the type of support emphasized in the caregiver question (emotional vs informational support question). Friendsourced answers included more shared experiences (20/30, 67%) than did crowdsourced answers (4/45, 9%).
  
  
  CONCLUSIONS
  We found an asynchronous, online, closed group on Facebook to be generally acceptable as a means to deliver support to caregivers of people with AD. This pilot is too small to make judgments on effectiveness; however, results trended toward an improvement in caregivers' self-efficacy, sense of support, and perceived stress, but these results were not statistically significant. Both friendsourced and crowdsourced answers may be an acceptable way to provide informational and emotional support to caregivers of people with AD.
authors.affiliation: Indiana University Center for Aging Research, Indianapolis, IN, United States.|Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States.|Regenstrief Institute, Indianapolis, IN, United States.|Indiana Alzheimer Disease Center, Indianapolis, IN, United States.
authors.forename: Daniel Robert
authors.identifier: http://orcid.org/0000-0002-7415-5748
authors.initials: DR
authors.lastname: Bateman
authors.affiliation: Indiana University Center for Aging Research, Indianapolis, IN, United States.|Regenstrief Institute, Indianapolis, IN, United States.|Department of Human-Centered Computing, School of Informatics and Computing, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States.
authors.forename: Erin
authors.identifier: http://orcid.org/0000-0002-8197-5197
authors.initials: E
authors.lastname: Brady
authors.affiliation: Indiana University Center for Aging Research, Indianapolis, IN, United States.|Regenstrief Institute, Indianapolis, IN, United States.|School of Social Work, Indiana University, Indianapolis, IN, United States.
authors.forename: David
authors.identifier: http://orcid.org/0000-0002-7841-7047
authors.initials: D
authors.lastname: Wilkerson
authors.affiliation: Indiana University Center for Aging Research, Indianapolis, IN, United States.|Regenstrief Institute, Indianapolis, IN, United States.|School of Social Work, Indiana University, Indianapolis, IN, United States.
authors.forename: Eun-Hye
authors.identifier: http://orcid.org/0000-0002-1094-1205
authors.initials: EH
authors.lastname: Yi
authors.affiliation: Department of Human-Centered Computing, School of Informatics and Computing, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States.
authors.forename: Yamini
authors.identifier: http://orcid.org/0000-0002-9483-3040
authors.initials: Y
authors.lastname: Karanam
authors.affiliation: Indiana University Center for Aging Research, Indianapolis, IN, United States.|Regenstrief Institute, Indianapolis, IN, United States.|Indiana Alzheimer Disease Center, Indianapolis, IN, United States.|Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.
authors.forename: Christopher M
authors.identifier: http://orcid.org/0000-0002-4617-6672
authors.initials: CM
authors.lastname: Callahan
keywords: Alzheimer disease; Alzheimer disease and related dementias; caregivers; crowdsourcing; emotional support; friendsourcing; informational support; mobile health; online support; social media