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Background: Online health communities have given rise to a new e-service known as online medical consultations (OMCs), enabling remote interactions between physicians and patients. To address challenges, such as patient information overload and uneven distribution of physician visits, online health communities should develop OMC-oriented recommenders., Objective: We aimed to comprehensively investigate what paradigms lead to the success of OMC-oriented recommendations., Methods: A literature search was conducted through e-databases, including PubMed, ACM Digital Library, Springer, and ScienceDirect, from January 2011 to December 2023. This review included all papers directly and indirectly related to the topic of health care-related recommendations for online services., Results: The search identified 611 articles, of which 26 (4.3%) met the inclusion criteria. Despite the growing academic interest in OMC recommendations, there remains a lack of consensus among researchers on the definition of e-service-oriented recommenders. The discussion highlighted 3 key factors influencing recommender success: features, algorithms, and metrics. It advocated for moving beyond traditional e-commerce-oriented recommenders to establish an innovative theoretical framework for e-service-oriented recommenders and addresses critical technical issues regarding 2-sided personalized recommendations., Conclusions: This review underscores the essence of e-services, particularly in knowledge- and labor-intensive domains such as OMCs, where patients seek interpretable recommendations due to their lack of domain knowledge and physicians must balance their energy levels to avoid overworking. Our study's findings shed light on the importance of customizing e-service-oriented personalized recommendations to meet the distinct expectations of 2-sided users considering their cognitive abilities, decision-making perspectives, and preferences. To achieve this, a paradigm shift is essential to develop unique attributes and explore distinct content tailored for both parties involved., (©Hongxun Jiang, Ziyue Mi, Wei Xu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 30.07.2024.)

The development of online social platforms has promoted the improvement of online health communities (OHCs). However, OHCs often ignore differences in user discussions caused by the characteristics of diseases. The purpose of this research was to study differences in the topics and emotions of patients with physiological and psychological diseases by mining the text that they posted in OHCs as well as to discuss how to satisfy these differences. The data came from Baidu Post Bar, the world's biggest Chinese forum. We collected 50,230 posts from heart disease, hypertension, depression and obsessive-compulsive bars. Then, we used topic modeling and sentiment analysis techniques on these posts. The results indicate that there are significant differences in the preferences of discussion and emotion between patients with physiological and psychological diseases. First, people with physiological diseases are more likely to discuss treatment of their illness, while people with psychological diseases are more likely to discuss feelings and living conditions. Second, psychological disease patients' posts included more extreme and negative emotions than those of physiological disease patients. These results are helpful for society to provide accurate medical assistance based on disease type to different patients, perfecting the national medical service system., Competing Interests: The authors declare no conflict of interest.

Background: Launched in 2006 for patients with amyotrophic lateral sclerosis, PatientsLikeMe is an online community offering patient-reported outcomes, symptom tracking, and social features. Every member of the site can see all the data reported by every other member, view aggregated reports, identify "patients like them," and learn about treatment options in order to live better with their condition. In previous studies, members reported benefits such as improved condition knowledge, increased medication adherence, and better management of side effects. However, the site evolved in 2011 from condition-specific "vertical" communities consisting only of people with the same disease to a "generalized platform," in which every patient could connect with every other patient regardless of condition and with generic, rather than condition-specific, data tools. Some, but not all, communities received further custom tracking tools., Objective: We aimed to understand (1) whether members of PatientsLikeMe using the generalized platform still reported similar benefits and (2) assess factors associated with benefits, such as community customization, site use, and patient activation., Methods: A cross-sectional retrospective custom survey was fielded to 377,625 members between 2016 and 2017 including the Patient Activation Measure (PAM). A benefit index was developed for comparability across conditions., Results: The invitation was viewed by 26,048 members of whom 11,915 did not respond, 5091 opted out, 1591 provided partial data, and 17 were screened out. Complete responses were received from 7434 participants. Users perceived greatest benefit in understanding how their condition may affect them (4530/6770, 66.91% participants, excluding "does not apply" answers), understanding what might help them live better with their condition (4247/6750, 62.92%), which treatments were available (4143/6898, 60.06%), understanding treatment side effects (4182/6902, 60.59%), and important factors in making treatment decisions (3919/6813, 57.52%). The benefit index was 29% higher for the "most activated" patients (PAM level 4 vs PAM level 1; relative risk [RR]=1.29, P<.001), 21% higher for conditions with some community customization versus none (RR=1.21, P<.001), and 11% higher in those using the site most often versus least (RR=1.11, P<.001)., Conclusions: Members of the generalized platform reported a range of benefits related to improved knowledge and understanding of their condition and treatment management. Condition-specific customization may improve their experience still further. Future studies will explore longitudinal changes to patient activation., (©Paul Wicks, Eileen Mack Thorley, Kristina Simacek, Christopher Curran, Cathy Emmas. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.05.2018.)

Background: Electronic health (eHealth) literacy is an important skill that allows patients to navigate intelligibly through the vast, often misleading Web-based world. Although eHealth literacy has been investigated in general and specific demographic populations, it has not yet been analyzed on users of online health communities (OHCs). Evidence shows that OHCs are important Web 2.0 applications for patients for managing their health, but at the same time, warnings have been expressed regarding the quality and relevance of shared information. No studies exist that investigate levels of eHealth literacy among users of OHCs and differences in eHealth literacy between different types of users., Objective: The study aimed to investigate eHealth literacy across different types of users of OHCs based on a revised and extended eHealth literacy scale (eHEALS)., Methods: The study was based on a cross-sectional Web survey on a simple random sample of 15,000 registered users of the most popular general OHC in Slovenia. The final sample comprised 644 users of the studied OHC. An extended eHEALS (eHEALS-E) was tested with factor analytical procedures, whereas user types were identified with a hierarchical clustering algorithm. The research question was analyzed with analysis of variance (ANOVA) procedure and pairwise comparison tests., Results: Factor analysis of the revised and extended eHEALS revealed six dimensions: awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information, and being smart on the Net. The factor solution demonstrates a good fit to the data (root mean square error of approximation [RMSEA]=.059). The most developed dimension of eHEALS-E is awareness of different Internet sources (mean=3.98, standard deviation [SD]=0.61), whereas the least developed is understanding information (mean=3.11, SD=0.75). Clustering resulted in four user types: active help-seekers (48.3%, 311/644), lurkers (31.8%, 205/644), core relational users (16.9%, 109/644), and low-engaged users (3%, 19/644). Analysis of the research question showed statistically significant differences among user types across all six dimensions of eHEALS-E. Most notably, core relational users performed worse than lurkers on the validating information dimension (P=.01) and worse than active help-seekers on the being smart on the Net dimension (P=.05). Active help-seekers have the highest scores in all dimensions of the eHEALS-E, whereas low-engaged users have statistically significantly lower scores on all dimensions of the eHEALS-E in comparison with the other groups., Conclusions: Those who are looking for advice and support in OHCs by making queries are well equipped with eHealth literacy skills to filter potential misinformation and detect bad advice. However, core relational users (who produce the most content in OHCs) have less-developed skills for cross-validating the information obtained and navigating successfully through the perils of the online world. Site managers should monitor their activity to avoid the spread of misinformation that might lead to unhealthy practices., (©Gregor Petrič, Sara Atanasova, Tanja Kamin. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.10.2017.)

Background: The emerging research on nurturing the growth of online communities posits that it is in part attributed to network effects, wherein every increase in the volume of user-generated content increases the value of the community in the eyes of its potential new members. The recently introduced metric engagement capacity offers a means of quantitatively assessing the ability of online platform users to engage each other into generating content; meanwhile, the quantity engagement value is useful for quantifying communication-based platform use. If the claim that higher engagement leads to accelerated growth holds true for online health forums (OHFs), then engagement tracking should become an important tool in the arsenal of OHF managers. Indeed, it might allow for quantifying the ability of an OHF to exploit network effects, thus predicting the OHF's future success., Objective: This study aimed to empirically analyze the relationship between internal OHF use (quantified using engagement measurement), and external growth., Methods: We collected data from 7 OHFs posted between the years 1999 and 2016. Longitudinal analyses were conducted by evaluating engagement in the OHFs over time. We analyzed 2-way causality effects between the engagement value and metrics evaluating OHF growth using Granger causality tests. User activity metrics per week were correlated with engagement metrics, followed by linear regression analyses., Results: Observational data showed a 1-way causal relationship between the OHF engagement value and reach (P=.02). We detected a 2-way causal relationship between the engagement value and delurking, with further analysis indicating that the engagement value was more likely to cause delurking (P<.001 with lag 2; for the reverse hypothesis, P=.01 with lag 2). Users who engaged each other more were more likely (up to 14 times, depending on how much one user engaged another) to develop personal connections. Finally, we found that the more engaging an OHF user was in a given week, the more likely (up to 2 times, depending on their ability to engage others) they were to remain active in the OHF in the following week., Conclusions: This study supports the claim that network effects play an important role in accelerating OHF growth, opening the door to exploiting these effects in calculated ways. In such efforts, engagement metrics can be used to monitor the "health" of an OHF and to identify the users most important to its success., (©Rahul Gopalsamy, Alexander Semenov, Eduardo Pasiliao, Scott McIntosh, Alexander Nikolaev. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 29.08.2017.)

Identifying topics of discussions in online health communities (OHC) is critical to various information extraction applications, but can be difficult because topics of OHC content are usually heterogeneous and domain-dependent. In this paper, we provide a multi-class schema, an annotated dataset, and supervised classifiers based on convolutional neural network (CNN) and other models for the task of classifying discussion topics. We apply the CNN classifier to the most popular breast cancer online community, and carry out cross-sectional and longitudinal analyses to show topic distributions and topic dynamics throughout members' participation. Our experimental results suggest that CNN outperforms other classifiers in the task of topic classification and identify several patterns and trajectories. For example, although members discuss mainly disease-related topics, their interest may change through time and vary with their disease severities., (Copyright © 2017. Published by Elsevier Inc.)

Objective To examine whether and to what extent relevant and meaningful discussions of weight loss occurred in the Weight Watchers' online community, and whether and to what extent the online community is designed for fostering such discussions., Methods: A multimethod approach was used here. First, a quantitative content analysis was conducted on 320 posts from 64 threads sampled from WeightWatchers.com's message boards between December 1, 2011, and January 31, 2012. The coding categories included constructs from the health belief model, the planned behavior theory, and the theory of self-efficacy. An acceptable level of intercoder reliability was reached; frequencies, cluster analysis, and t test were reported. Second, a conventional content analysis of the posts was conducted. The posts were examined for themes and patterns within the discussion. Finally, the researchers examined the sociability features of the message boards. The qualitative review followed established procedures and was conducted independently by four researchers., Results: Mastery experience occurred in 46% of the posts. Threads focusing on physical activities contained more perceived barriers, mastery experiences, and verbal persuasion than other types of threads. Posts focusing on diet included unanswered questions about dieting practices with certain medical conditions. Posts focusing on mastery experience celebrated any small step toward success. Posts irrelevant to weight loss mostly contained events and happenings in members' lives. The sociability review revealed a lack of moderation., Conclusion: The Weight Watchers' online community included much discussion about weight loss. Findings suggest that physical activities require more encouragement than dieting. Health educators have an opportunity to interject and moderate meaningful discussions. For example, dieting with certain medical conditions, opinions on various diets, and the relationship between dieting and being healthy are opportunities to facilitate learning. Discussion posts irrelevant to weight loss help build social relationships., (© 2016 Society for Public Health Education.)

Many researchers and practitioners use online health communities (OHCs) to influence health behavior and provide patients with social support. One of the biggest challenges in this approach, however, is the rate of attrition. OHCs face similar problems as other social media platforms where user migration happens unless tailored content and appropriate socialization is supported. To provide tailored support for each OHC user, we developed personas in OHCs illustrating users' needs and requirements in OHC use. To develop OHC personas, we first interviewed 16 OHC users and administrators to qualitatively understand varying user needs in OHC. Based on their responses, we developed an online survey to systematically investigate OHC personas. We received 184 survey responses from OHC users, which informed their values and their OHC use patterns. We performed open coding analysis with the interview data and cluster analysis with the survey data and consolidated the analyses of the two datasets. Four personas emerged-Caretakers, Opportunists, Scientists, and Adventurers. The results inform users' interaction behavior and attitude patterns with OHCs. We discuss implications for how these personas inform OHCs in delivering personalized informational and emotional support., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.

Objective: Online health communities (OHCs) have become a major source of support for people with health problems. This research tries to improve our understanding of social influence and to identify influential users in OHCs. The outcome can facilitate OHC management, improve community sustainability, and eventually benefit OHC users., Methods: Through text mining and sentiment analysis of users' online interactions, the research revealed sentiment dynamics in threaded discussions. A novel metric--the number of influential responding replies--was proposed to directly measure a user's ability to affect the sentiment of others., Results: Using the dataset from a popular OHC, the research demonstrated that the proposed metric is highly effective in identifying influential users. In addition, combining the metric with other traditional measures further improves the identification of influential users., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: A previously reported study examined the treatment of primary care patients with at least moderate severity depressive or anxiety symptoms via an evidence-based computerized cognitive behavioral therapy (CCBT) program (Beating the Blues) and an online health community (OHC) that included a moderated internet support group. The 2 treatment arms proved to be equally successful at 6-month follow-up. Objective: Although highly promising, e-mental health treatment programs have encountered high rates of noninitiation, poor adherence, and discontinuation. Identifying ways to counter these tendencies is critical for their success. To further explore these issues, this study identified the primary care patient characteristics that increased the chances patients would not initiate the use of an intervention, (ie, not try it even once), initiate use, and go on to discontinue or continue to use an intervention. Methods: The study had 3 arms: one received access to CCBT (n=301); another received CCBT plus OHC (n=302), which included a moderated internet support group; and the third received usual care (n=101). Participants in the 2 active intervention arms of the study were grouped together for analyses of CCBT use (n=603) because both arms had access to CCBT, and there were no differences in outcomes between the 2 arms. Analyses of OHC use were based on 302 participants who were randomized to that arm. Results: Several baseline patient characteristics were associated with failure to initiate the use of CCBT, including having worse physical health (measured by the Short Form Health Survey Physical Components Score, P=.01), more interference from pain (by the Patient-Reported Outcomes Measurement Information System Pain Interference score, P=.048), less formal education (P=.02), and being African American or another US minority group (P=.006). Characteristics associated with failure to initiate use of the OHC were better mental health (by the Short Form Health Survey Mental Components Score, P=.04), lower use of the internet (P=.005), and less formal education (P=.001). Those who initiated the use of the CCBT program but went on to complete less of the program had less formal education (P=.01) and lower severity of anxiety symptoms (P=.03). Conclusions: This study found that several patient characteristics predicted whether a patient was likely to not initiate use or discontinue the use of CCBT or OHC. These findings have clear implications for actionable areas that can be targeted during initial and ongoing engagement activities designed to increase patient buy-in, as well as increase subsequent use and the resulting success of eHealth programs. [ABSTRACT FROM AUTHOR]

This study examines the determinants that drive the behavior of sharing health information within online health communities. Leveraging the Theory of Planned Behavior, the Technology Acceptance Model, and the "Knowledge-Attitude-Practice" theory, a comprehensive model elucidating the key elements that sway the health information-sharing behavior among users of online health communities is designed. This model is validated through Structural Equation Modeling (SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA). Findings derived from the SEM suggest that perceived ease of use, perceived usefulness, perceived trust, and perceived behavioral control exert a significant positive impact on attitudes towards health information sharing, the intention to share health information, and the actual health information-sharing behavior. The fsQCA unfolds two unique configuration path models that lead to the emergence of health information-sharing behavior: one predicated on perceived trust and sharing intention, and the other on perceived usefulness, behavioral control, and sharing attitude. This research provides invaluable insights, fostering a deeper comprehension of the dynamics involved in health information sharing within online communities, thereby directing the design of more effective health platforms to augment user engagement and enable informed health decisions. [ABSTRACT FROM AUTHOR]

Drawing on observations of a Chinese online depression community, this article explored the members' sense making of depression by analyzing their narrative accounts of depression. Four types of sense making were predominant among the depression sufferers: complaining, regret, superiority, and discovery. The complaining narrative is the members' telling about the pain caused by family (parental control or neglect), school bullying, stress from study or work, and social norms. The regret narrative is the members' reflection on their habit of perfectionism and lack of self-disclosure. The superiority narrative is the members' attribution of depression to their intelligence and morality that surpass the average people. The discovery narrative is the members' novel understanding of the self, significant others, and key events. The findings suggest that the social and psychological explanation of the causes of depression, instead of the medical model, is popular among the Chinese patients. Their stories of depression are also stories of marginalization, visions for the future, and realizing the normalization of identity as depression patients. The findings have implications for public policy around support for mental health. [ABSTRACT FROM AUTHOR]

Background: Online health communities (OHCs) provide a new channel for users to obtain more health-related information and support, playing an important role in alleviating hospital congestion and uneven medical resource distribution, especially during the COVID-19 pandemic in China. An in-depth study of users' continuous usage is of great value for the long-term development of OHCs. Objective: The purpose of this study is to explore the factors that influence users' continuous usage in online health communities based on the theory of planned behavior (TPB) and social cognitive theory (SCT). Methods: Data from 480 users with experience in online health communities were collected through a questionnaire survey, and structural equations were applied to verify the model hypotheses empirically. Results: Self-efficacy and controllability have significant effects on users' continuous intention; attitude has a significant relationship with continuous intention; social norms have a positive effect on continuous intention. Moreover, the relationship between continuous intention and behavior is positive. Self-efficacy and outcome expectations have significant positive associations with continuous usage. Finally, system quality, information quality, and social interaction ties have significant and positive relationships to continuous usage. Conclusion: To improve the level of user's continuous usage, online health service providers can improve the quality of the community by organizing the website's page layout, navigation menus, and site elements to ensure users quickly search and find what they want meanwhile try to change people's cognition gradually, in addition, decision and policymakers should provide more favorable policies to stimulate and help provider in building and managing strategic plans for sustaining a thriving online community. A supportive climate in society through public service advertisements and others for the sake of OHCs is necessary. Limitations: (1) This study collected data through a cross-sectional survey. Thus, it lacked the process of capturing the changes in participants' attitudes toward all variables. (2) The environmental factors in SCT theory need to be more comprehensive, containing online factors without offline factors. (3) The dates were obtained from China, which neglects the different cultural content. [ABSTRACT FROM AUTHOR]

Aim: To identify a serial multiple mediation effect of social support in online health communities and collective empowerment on the relationship between diabetes‐related burden (DRB) and self‐efficacy, among mothers using a continuous glucose monitoring device for children with type 1 diabetes (T1D). Design: A secondary analysis, cross‐sectional, descriptive study. Methods: Data were obtained from 198 mothers of children with T1D via a web survey, from August to September 2020. Measures used were the Collective Empowerment in the Online Health Community Scale, a modified version of the Multidimensional Scale of Perceived Social Support, Problem Areas in Diabetes Survey—Parent Revised version and a modified version of the Maternal Self‐efficacy for Diabetes Management Scale. Data were analysed using SPSS 25.0, and PROCESS MACRO for SPSS v3.5. Results: A serial multiple mediation model was used. The indirect effects of both social support in online health communities and collective empowerment were identified in the relationship between DRB and diabetes self‐efficacy (DSE). However, there was no indirect effect of social support in online health communities on these relationships. Conclusion: These findings suggest that online social support alone has a limited role in chronic disease management self‐efficacy. Collective empowerment should be a strategic component in intervention development using online health communities to strengthen DSE in mothers of children with T1D. Impact This study provides novel insights into the functional mechanism of online health communities for T1D. Peer mentor coaching by parents of children with T1D effectively helps other children's parents with its recent diagnosis. The findings recognize a need for strategies enhancing collective empowerment among parents of children with T1D. Along with peer coaching, these strategies should strengthen knowledge of resources and methods to impact social change as well as resource mobilization for collective actions. [ABSTRACT FROM AUTHOR]

Since its beginning in the 1980s, the mental health rhetoric research (MHRR) has explored the rhetorical construction of mental illness from a genre perspective. Despite a growing body of research on the rhetorical study of mental health in the West, the discourse of depression has been rarely explored in the Chinese context. This study investigates a corpus of 3217 posts in the Baidu depression community in China with an attempt to identify typical rhetorical features of the posts in the depression community as a genre. We intend, through an exploration of the exigences, social actions, and consequences of the posts, to facilitate a better understanding of the depressed population in China. We argue that the social exigences for the posts in online depression communities can be regarded as a failure of the rhetorical environment in real life and that expressing emotions, exchanging information, establishing interpersonal relationships, and communicating across spatiotemporal boundaries are the typified social actions performed by the posts in the Baidu depression community. Moreover, as a genre, the posts have successfully created an ambience of collective intimacy. Taken together, the findings shed light on the rhetorical study of depression in China. • Applying the rhetorical genre theory to explore the field of health and medicine. • Facilitating a better understanding of the depression communities in China. • Exploring the rhetoric of health and medicine (RHM) in a non-western culture. • Employing a corpus-based approach with a large data set from real-world sources. [ABSTRACT FROM AUTHOR]

Purpose: Socially supportive relationships help cancer survivors cope with their diagnosis and may improve quality of life; however, many survivors report unmet support and information needs. Online communities of survivors may address these needs, but research on their benefits have been equivocal. This cross-sectional, self-report study investigated relationships among cancer survivors' level of engagement in an online survivor community (The American Cancer Society Cancer Survivors Network®; CSN), perceptions of emotional/informational support available from online communities ("online social support"), well-being, and moderating effects of "offline social support."Methods: Participants were 1255 registered users of the CSN who completed surveys between 2013 and 2014. Three types of engagement with the CSN-social/communal, interpersonal communication, and informational/search engagement-were identified through principal components analysis. Regression analyses examined hypotheses.Results: More frequent social/communal and interpersonal communication engagement were associated with increased online social support (p < .0001), and the relationship between interpersonal communication engagement and online social support was strongest for survivors reporting lower offline social support (interaction β = - .35, p < .001). Greater online social support was associated with increased well-being, but only among survivors reporting low offline social support (interaction β = - .35, p < .0001).Conclusions: Engagement in online survivor communities may increase support perceptions that promote well-being, but benefits may accrue more to survivors reporting low offline social support.Implications For Cancer Survivors: Newly diagnosed cancer survivors, particularly those with unmet emotional/informational support needs, should be given the opportunity to communicate with other survivors through online survivor support networks. [ABSTRACT FROM AUTHOR]

Online health support forums utilize straightforward online discussion designs to create a sociotechnical space where people can seek social support from others. The advice generated in these forums exists as an archival resource for future health information seekers. The present study uses mixed methods to investigate how invisible social processes lead advice to be adapted over time by forum members. Drawing on the construct of 'reification' from the communities of practice (COP) literature, we operationalize the reification of advice (RoA) as a process by which advice is developed across multiple discussion threads, and construct an algorithmic procedure to extract posts that trace this process. We evaluate our algorithm with crowd-workers, and perform an inductive, qualitative analysis to identify different modes of advice reification. We suggest that RoA could be used as the basis of a mid-level theory that treats online support communities and bundles of advice trajectories embedded in a shifting sociotechnical context. In our closing analysis, we propose that our approach might be a first step in an algorithmic procedure for assessing advice quality, drawing on the idea that reified advice may be considered a product of the collective intelligence of an online health support community. • Online health communities refine the advice they provide to newcomers over time. • This is similar to the reification of practice in a community of practice. • We introduce an algorithm to extract advice refinement arrayed across posts. • We identify three different types of advice refinement. • These different types reflect differences in the status of each type of advice for the community. [ABSTRACT FROM AUTHOR]

Online health communities (OHCs) have become new venues for online professional-patient interactions in which patients, as OHC users, can undertake online consultations with health professional moderators. This interaction has previously been investigated mainly from the user's perspective, whilst neglecting the insights of health professional moderators. The aim of this study is to explore and compare the benefits and challenges of online professional-patient interactions for users and health professional moderators and the effects on face-to-face medical encounters. The study employed a qualitative research design, with in-depth, semi-structured interviews conducted with users ( n = 8) and health professional moderators ( n = 7) from the largest OHC in Slovenia. Data analysis utilised inductive thematic analysis and principles of grounded theory. The results of this small study demonstrate that the OHC enabled users and health professional moderators to overcome weaknesses of face-to-face medical encounters. Both users and professionals view the primary benefits of online professional-patient interaction as delivering informational and emotional support for users' health-related needs. The main challenges for users and health professional moderators stem from the limitations of computer-mediated communication (CMC). Users and health professional moderators expressed different and ambivalent attitudes toward the OHC and its effect on face-to-face medical encounters. [ABSTRACT FROM AUTHOR]

Highlights: [•] Intrapersonal and interactional psychological empowerment can develop in HROSCs. [•] Participation is not a necessary condition for intrapersonal empowerment in HROSCs. [•] Posters and lurkers have a similar degree of intrapersonal empowerment in HROSCs. [•] Posters experience higher degree of interactional empowerment than lurkers in HROSCs. [•] Intensity of posting is associated only with interactional dimension of empowerment. [Copyright &y& Elsevier]

The rapid development of Web 2.0 technologies has made it possible for online health communities to provide convenient platforms that enable doctors to provide medical services and enable patients to consult the doctors online. When patients finish medical treatment in offline hospitals, they can find the doctor for online follow-up service at the post-diagnosis step. To understand which factors can affect patients' decisions on adopting an online follow-up service, this paper drew on the Elaboration Likelihood Model as the theoretical base to study patients' decision process. We regarded the technical quality and interpersonal quality of doctors' medical service as central cues and considered electronic word-of-mouth (eWOM) as a peripheral cue. By analyzing the data from a popular online health community in China, the results show that the technical quality, interpersonal quality, and eWOM of doctors' medical services positively impacted patients' online follow-up intention. Moreover, we also found that high-privacy disease and private doctor service significantly moderate the relationship between technical quality or eWOM of doctors' medical services and patients' online follow-up intention. Our study sheds some light on profoundly understanding the decision process of patients in using online follow-up services and contributes to the research of online healthcare services. • Information processing impacts patients' intention to adopt online follow-up service. • Service quality and eWOM positively affect patients' online follow-up intention. • High-privacy diseases amplify the effect of technical quality on patients' intention. • High-privacy diseases undermine the effect of eWOM on patients' intention. • Private doctor service amplifies the effects of technical quality and eWOM. [ABSTRACT FROM AUTHOR]

Background: With the rapid development of online health communities, increasing numbers of patients and families are seeking health information on the internet.Objective: This study aimed to discuss how to fully reveal the health information needs expressed by patients with hypertension in their questions in a web-based environment and how to use the internet to help patients with hypertension receive personalized health education.Methods: This study randomly selected 1000 text records from the question data of patients with hypertension from 2008 to 2018 collected from Good Doctor Online and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning intention of each patient with hypertension based on the patient's question and used co-occurrence network analysis and the k-means clustering method to explore the features of the health information needs of patients with hypertension.Results: The classification system for the health information needs of patients with hypertension included the following nine dimensions: drugs (355 names), symptoms and signs (395 names), tests and examinations (545 names), demographic data (526 kinds), diseases (80 names), risk factors (37 names), emotions (43 kinds), lifestyles (6 kinds), and questions (49 kinds). There were several characteristics of the explored web-based health information needs of patients with hypertension. First, more than 49% of patients described features, such as drugs, symptoms and signs, tests and examinations, demographic data, and diseases. Second, patients with hypertension were most concerned about treatment (778/1000, 77.80%), followed by diagnosis (323/1000, 32.30%). Third, 65.80% (658/1000) of patients asked physicians several questions at the same time. Moreover, 28.30% (283/1000) of patients were very concerned about how to adjust the medication, and they asked other treatment-related questions at the same time, including drug side effects, whether to take the drugs, how to treat the disease, etc. Furthermore, 17.60% (176/1000) of patients consulted physicians about the causes of clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, and medications and examinations. Fourth, by k-means clustering, the questioning intentions of patients with hypertension were classified into the following seven categories: "how to adjust medication," "what to do," "how to treat," "phenomenon explanation," "test and examination," "disease diagnosis," and "disease prognosis."Conclusions: In a web-based environment, the health information needs expressed by Chinese patients with hypertension to physicians are common and distinct, that is, patients with different background features ask relatively common questions to physicians. The classification system constructed in this study can provide guidance to health information service providers for the construction of web-based health resources, as well as guidance for patient education, which could help solve the problem of information asymmetry in communication between physicians and patients. [ABSTRACT FROM AUTHOR]

Background: Substantial research demonstrates the importance of online health communities (OHCs) for patient empowerment, although the impact on the patient-physician relationship is understudied. Patient empowerment also occurs in relationship with the physician, but studies of OHCs mostly disregard this. The question also remains about the nature and consequences of this empowerment, as it might be based on the limited validity of some information in OHCs.Objective: The main purpose of this study was to examine the impact of social processes in OHCs (information exchange with users and health professional moderators, social support, finding meaning, and self-expressing) on functional and dysfunctional patient empowerment in relationship with the physician (PERP). This impact was investigated by taking into account moderating role of eHealth literacy and physician's paternalism.Method: An email list-based Web survey on a simple random sample of 25,000 registered users of the most popular general OHC in Slovenia was conducted. A total of 1572 respondents completed the survey. The analyses were conducted on a subsample of 591 regular users, who had visited a physician at least once in the past 2 years. To estimate the impact of social processes in OHC on functional and dysfunctional PERP, we performed a series of hierarchical regression analyses. To determine the moderating role of eHealth literacy and the perceived physician characteristics, interactions were included in the regression analyses.Results: The mean age of the respondents in the sample was 37.6 years (SD 10.3) and 83.3% were females. Factor analyses of the PERP revealed a five-factor structure with acceptable fit (root-mean-square error of approximation =.06). Most important results are that functional self-efficacy is positively predicted by information exchange with health professional moderators (beta=.12, P=.02), information exchange with users (beta=.12, P=.05), and giving social support (beta=.13, P=.02), but negatively predicted with receiving social support (beta=-.21, P<.001). Functional control is also predicted by information exchange with health professional moderators (beta=.16, P=.005). Dysfunctional control and competence are inhibited by information exchanges with health professionals (beta=-.12, P=.03), whereas dysfunctional self-efficacy is inhibited by self-expressing (beta=-.12, P=.05). The process of finding meaning likely leads to the development of dysfunctional competences and control if the physician is perceived to be paternalistic (beta=.14, P=.03). Under the condition of high eHealth literacy, the process of finding meaning will inhibit the development of dysfunctional competences and control (beta=-.17, P=.01).Conclusions: Social processes in OHCs do not have a uniform impact on PERP. This impact is moderated by eHealth literacy and physician paternalism. Exchanging information with health professional moderators in OHCs is the most important factor for stimulating functional PERP as well as diminishing dysfunctional PERP. Social support in OHCs plays an ambiguous role, often making patients behave in a strategic, uncooperative way toward physicians. [ABSTRACT FROM AUTHOR]