Online health communities (OHCs) often struggle to retain active users because they endow users with both a positive and a stigmatized social identity that respectively encourages and discourages ...their engagement. We integrate social identity theory with the concepts of social stigma, psychological capital, and digital divide to investigate this phenomenon. We collected survey data from 221 users from one large online lymphoma community in November 2017. We find that users' positive social identity had a positive influence on how they perceived the effectiveness of OHCs and this influence was stronger for the high socio-economic status (SES) group; at the same time, a stigmatized social identity had a negative influence on perceived effectiveness of OHCs and this influence was stronger for the low SES group. Moreover, users’ perceived effectiveness of OHCs had positive influences on their participation and recommendation intentions, and the influences on participation and recommendation intentions were stronger for the high and the low SES group, respectively. Our study highlights the dual influences of valenced social identities on user engagement with OHCs through their effectiveness perceptions and interprets these influences through the lens of digital divide. The findings also offer practical insights for the effective management of OHCs.
•Positive social identity increases perceived effectiveness of OHCs.•Stigmatized social identity decreases perceived effectiveness of OHCs.•Perceived effectiveness of OHCs positively impacts user engagement.•SES moderates the impacts of valanced social identities on perceived effectiveness.•SES moderates the impacts of perceived effectiveness on user engagement.
This paper contributes to the discussion on patient engagement in online health communities (OHCs) by integrating channel expansion and social exchange theories. Using survey data from 348 users of ...OHC, we examine the impacts of perceived channel richness, social support, and willingness to exchange information on OHC engagement. Results show that the perceived channel richness positively influences OHC engagement. The effect of patients’ willingness to share and seek information on engagement is moderated by health status. Finally, engagement in OHCs enhances self-care efficacy and perceived health outcomes. We propose several theoretical implications for researchers and practical contributions for OHC administrators.
•Live streaming in OHC enhances patients’ understanding about physicians.•Physicians’ faster, quality responses in live increase patient subscriptions.•More physician subscribers positively correlate ...with increased paid consultations.
Live diagnosis is an application of live streaming in online health communities, through which physicians share knowledge and interact with patients in real time. Live videos enable patients to evaluate physicians comprehensively before a paid consultation. By applying dual-process theory, we examine the relationships between physicians’ speech features, demographic characteristics, the information quality of live content in live videos and patients’ subscription and consultation behavior. Data from 992 physicians who provided live diagnoses were collected from an online health community. Results show that physicians’ speech features and live content quality are significantly associated with patients’ subscription behavior, which is further associated with their online consultation behavior. This study provides a new perspective for investigating patients’ consultation behavior in the online health community context. It enriches the application of dual-process theory, and offers implications for physicians and online health community administrators in providing better live diagnosis services.
Despite extensive research into electronic Word-of-Mouth (eWOM) in the healthcare sector, its impact on patients’ choice of online consultation in Online Health Communities (OHCs) remains largely ...unexplored. The current study aims to fill this research gap by investigating the heterogeneous effect of different eWOM characteristics on both OHCs and Social Networking Sites (SNSs) from a cross-media perspective. Drawing upon the Elaboration Likelihood Model (ELM) and cognitive cost model, a research model is proposed and hypotheses are examined employing data gathered from 8,472 physicians across two platforms. The findings indicate that both the quality and quantity of eWOM in OHCs positively affects patients’ choice of online selection, eWOM on SNSs is also positively related to patients’ choice. Additionally, eWOM on SNSs negatively moderates the relationship between eWOM quality in OHCs and patients’ choice, while eWOM on SNSs exhibits a U-shape moderating influence on the relationship between eWOM quantity in OHCs and patients’ choice.
Physicians' active engagement is a critical part of sustaining online health communities (OHCs) development. Gamification design can be leveraged to invoke physicians' gameful experience, better ...motivating their engagement in OHCs. However, it can also create inequality of economic returns among physicians, causing harm to these communities. Drawing on this operational paradox, this paper empirically examines both positive and negative effects of gamification on physicians and the contingent role of disparity in professional seniority on their engagement and inequality of economic returns, to advance knowledge of such practices. Although gamification design engages physicians and increases their income, the results indicate increased economic inequality among the physicians as a consequence. Considering physician's higher professional seniority in the same department, it weakens the positive effect of gamification design on their engagements but strengthens such effect on economic inequality. Managers are advised to carefully plan their gamification design in order to promote physician engagement in OHCs and avoid the related paradoxes.
There have been heated ongoing debates about the pros and cons of the online channel to traditional services in hospitals. We examine the digital channel’s effect on healthcare from the ...trust-transfer and medical service continuity perspectives by focusing on key indicators of performance: outpatient visits, operational efficiency, resource utilization efficiency, patient loyalty, and satisfaction and analyzing 250,344 physician–patient interactions from an online health community (OHC) and a well-known hospital in China over the period from January 2010 to December 2018 through three studies. Our work offers managerial insights on performance improvement by adopting a multi-channel strategy in the emerging era of “Internet plus healthcare.”
Health care consumers and patients are increasingly using online health communities (OHCs) to exchange social support and enhance their well-being. The success of OHCs in promoting health, however, ...depends not just on posting activity by participants, but, crucially, on whether or not responses are subsequently received. While previous studies have considered various mechanisms by which the likelihood of social support provisioning can be increased (e.g., the establishment of social capital), the impacts of linguistic signals have yet to be considered. Therefore, we consider whether or not linguistic signals in posts—including sentiment valence, linguistic style matching, readability, post length, and spelling—impact the amount of support received. Adopting an overarching theoretical framework of signaling theory, this study proposes a model that explains the signaling roles of linguistic features within OHC posts in promoting social support provision from OHC participants. The research model is empirically tested on a large dataset collected from an OHC platform covering multiple health conditions. Results show that affective linguistic signals, including negative sentiment and linguistic style matching, are effective in invoking both informational and emotional support from the community. We also find that informative linguistic signals including readability, post length, and spelling are positively associated with informational support receipt, while readability and spelling are also positively associated with emotional support receipt. Overall, this research not only enriches our current understandings of the linguistic signaling in OHCs, but also provides practical insights into improving social support exchange in OHCs.
•We investigate the impact of linguistic signals on online social support exchange.•Affective linguistic signals are effective in invoking social support exchange.•Readability, post length, and spelling promote informational support provision.•Readability and spelling positively associate with emotional support receipt.
This research examines physician-driven online health communities (OHC), a social media application in healthcare that engages both patients and physicians. Drawing on the "patient–physician ...partnership" paradigm in managing chronic disease (Bodenheimer et al. 2002), we argue that physician-driven OHC facilitates patient–physician collaborative care and self-management support, which may improve patient well-being and patient–physician relationships. We test the mutual impact between patients' and physicians' participation in physician-driven OHC and the impact of patients' and physicians' participation on patient well-being and the patient–physician relationship in the context of managing diabetes and depression. We collect data from a leading Chinese online consultation platform. To make credible causal inference, we exploit two events that separately create plausibly exogenous variations in patients' and physicians' participation. We find that physicians' participation significantly increases patients' participation for both diabetes and depression, but patients' participation only increases physicians' participation for depression. Although both patients' and physicians' participation significantly improve patient well-being and the patient–physician relationship, there are interesting nuances in these effects over time. These findings have important implications for self-managing chronic diseases and healthcare policy making.
Health consumers are increasingly participating in consumer-to-consumer (C2C) online health communities (OHCs) to receive health-related support and to provide assistance and support to others. ...However, questions remain as to how individual OHC participants are affected by the relationships they have established within an OHC and how the content exchanged between OHC participants impacts individual-level health knowledge and attitudes. To address these open questions, we develop a model that integrates participant network position (i.e., structural social capital) in an OHC, informational and emotional support exchange, and downstream individual-level health knowledge and attitudes. Based on a panel dataset collected from nine chronic disease-focused discussion boards within an OHC platform, we find that structural social capital is indeed a significant antecedent to social support exchange within an OHC and, interestingly, that social support provisioning (i.e., proactively aiding others) has a stronger effect than social support receipt on health literacy and health attitude improvement.
•OHCs enable physicians to share both general and specific health knowledge.•General knowledge-sharing is positively associated with specific knowledge-sharing through online reputation.•Patient ...involvement strengthens the effects of general knowledge-sharing on online reputation and specific knowledge-sharing.•General knowledge-sharing can be an efficient approach for physicians to recruiting patients.
Although the sharing of knowledge in online health communities (OHCs) has been explored in recent years, little research has been done to explore the relationship between general and specific knowledge-sharing. Based on the literature on knowledge-sharing in OHCs, this study developed a research model to explore how physicians’ general knowledge-sharing behaviors influence their specific knowledge-sharing activities via their online reputations and the contingent role of patient involvement in OHCs. The research model was tested using objective data from a leading OHC in China. The results show that general knowledge-sharing is positively associated with specific knowledge-sharing, and this effect is exerted through online reputation. Moreover, patient involvement strengthens the relationship between general and specific knowledge-sharing as well as the relationship between online reputation and specific knowledge-sharing. By uncovering the relationship between general and specific knowledge-sharing, the research findings extend the understanding of knowledge-sharing and patient recruiting in OHCs and provide significant practical implications for practitioners.
