The Role of Seed Users in Nurturing an Online Health Community for Smoking Cessation Among People With HIV/AIDS

BACKGROUND

To nurture a new online community for health behavior change, a fruitful strategy is to recruit "seed users" to create content and encourage participation.

PURPOSE

This study evaluated the impact of support from seed users in an online community for smoking cessation among people living with HIV/AIDS and explored the linguistic characteristics of their interactions.

METHODS

These secondary analyses examined data from a randomized trial of a smoking cessation intervention for HIV+ smokers delivered via an online health community (OHC). The analytic sample comprised n = 188 participants randomized to the intervention arm who participated in the community. Independent variables were OHC interactions categorized by participant interlocutor type (study participant, seed user) and interaction type (active, passive). The primary outcome was biochemically verified 7-day abstinence from cigarettes measured 3 months post-randomization; 30-day abstinence was examined for robustness.

RESULTS

Logistic regression models showed that participants' interactions with seed users were a positive predictor of abstinence but interactions with other study participants were not. Specifically, the odds of abstinence increased as the number of posts received from seed users increased. Exploratory linguistic analyses revealed that seed users wrote longer comments which included more frequent use of "we" and "you" pronouns and that study participants users used more first-person singular pronouns ("I").

CONCLUSIONS

Seeding a community at its inception and nurturing its growth through seed users may be a scalable way to foster behavior change among OHC members. These findings have implications for the design and management of an OHC capable of promoting smoking cessation.

The impact of gamification on the patient's engagement in the online health community

Purpose

Gamification has been widely implemented to improve user engagement in the online health community (OHC). While its effect on the physicians' engagement has recently been documented, whether and how gamification influences the patients' engagement in the OHC remains an untapped research area. The purpose of this study is to fill this dearth by encompassing the gamification strategy of Haodf.com, which awards the “Annual Physician” badges to the physicians, to analyze how this gamification approach motivates patients’ engagement in the OHC.

Design/methodology/approach

Real-world data are leveraged from the OHC. The Tobit model is employed for modeling the gamification-patient's engagement nexus in an OHC. Robust findings are obtained by incorporating different measures of a dependent variable, a set of control variables about the physician's characteristics and hospital's features, and alternative estimation techniques.

Findings

The results reveal that a patient's engagement in the OHC in the form of appointments and review-posting behavior is enhanced by the gamification strategy. Besides, the positive influence of gamification on the patient's engagement is further strengthened by the physician's professional capital. It is basically obtained that the gamification is an efficacious tool to accelerate not only the physicians' engagement but also of the patients in the OHC platform.

Originality/value

The study provides both theoretical and empirical discussion to enrich the understanding on how OHCs enhance patients' engagement by developing gamification techniques. The findings guide the practitioners of OHC to better understand the implications of their gamification design to optimize user engagement.

Examining online health community users’ sharing behaviour: A social influence perspective

Online health communities (OHC) provide a platform for users to exchange health-related information and seek emotional support. However, users often lack the intention to share their knowledge, which may lead to the failure of OHC. Drawing on the social influence theory, this research examined OHC users’ sharing behaviour. The results indicated that users’ sharing intention is influenced by three social influence factors, which include subjective norm, social identity and group norm. In addition, social support and privacy concern have effects on these three social influence factors. The results imply that OHC need to leverage social influence in order to facilitate users’ sharing behaviour.

Attraction, selection, and attrition in online health communities: Initial conversations and their association with subsequent activity levels

BACKGROUND

The effectiveness of online health communities (OHCs) for improving outcomes for health care consumers, health professionals, and health services has already been well investigated. However, research on determinants of OHC users' activity levels, what is associated with attrition or attraction to these communities, and the impacts of initial posts is limited.

OBJECTIVES

We sought to explore topic exchanges in OHCs and determine how users' initial posts and community reactions to them are associated with their subsequent activity levels. We also aimed to extend the theory of Attraction-Selection-Attrition for Online Communities (OCASA) to this area.

METHODS

We examined exchanges in a major Australian OHC for cancer patients, analyzing about 2500 messages posted over 2009-18. We developed a novel annotation scheme to examine new members' initial posts and the community's reactions to them.

RESULTS

The annotation scheme includes five themes: informational support provision, emotional support provision, requests for help, self-reflection & disclosures, and conversational cues. Initial conversations were associated with future activity levels in terms of active posting versus non-active engagement in the community. We found that most OHC members disclosed personal reflections to bond with the community, and many actively posted to the community solely to provide informational and emotional support to others.

CONCLUSION

Our work extends OCASA theory to bond-based contexts, presents a new annotation scheme for OHC support topics, and makes an important contribution to knowledge about the relationship between users' activity levels and their initial posts. The findings help managers and owners understand how members use OHCs and how to encourage active participation. They also suggest how to attract new members and minimize attrition among existing members.