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Online health communities (OHCs) have been recognized as emerging platforms on the Internet used for health purposes. Despite its emergence, developing a successful OHC is still a challenge. Prior studies identified that value co-creation behavior (VCB) of members is an essential factor for sustaining OHCs; however, little is known about how members’ behavior drives to co-create value? Therefore, this study aims to discover the inclusive mechanism for members’ VCB in OHCs.

The authors develop the study model and hypothesis based on the service-dominant logic of value co-creation theory and social support (SS) literature. The survey data of 608 active OHCs users in China were analyzed using partial least squares structural equation modeling (PLS-SEM).

The results revealed that SS positively affects members’ VCBs. Ethical aspects; Trust and ethical interaction (EI) partially mediate their relationships. In addition, community members’ current health status (CHS) negatively moderates the relationships between SS and VCB. From the findings, it becomes evident that only SS is not enough; developing an ethical environment in OHCs, i.e. trust and ethically rich interactions among members, significantly helps OHCs to promote co-creation. Also, the negative moderation of CHS findings provides novel insights when cramming health conditions.

Exploring the complex mechanism of co-creation in OHC, the authors illustrate the potential of service-dominant logic to create new theoretical insight for healthcare and provide the framework of co-creation with ethics for the first time. This will extend the application of ethics in healthcare services and offer a robust platform from which the understanding of drivers of members’ VCB can be advanced in the OHC context.

Since the success of online communities depend on physicians' participation, understanding factors that influence community participation and content contribution are critical for online health communities (OHCs). Drawing on the self-determination theory (SDT), an empirical model was proposed to explore the effects of social returns and economic returns on physicians' community participation, private content contribution and public content contribution, and the moderating effect of their online seniority. This paper aims to address these issues.

Empirical data of 4,343 physicians were collected from a Chinese OHC, and ordinary least squares (OLS) and negative binomial regression models were employed to verify the proposed theoretical model.

The authors’ results indicate that both social and economic returns have a positive effect on physicians' community participation and private content contribution, and their online seniority strengthens the positive effects of economic returns on community participation and private content contribution.

The authors’ research extends physicians' community participation by dividing content contribution into private and public, and enhances our understanding of the determinants of physicians' participation in OHCs by exploring the effects of social and economic returns, as well as the moderating effect of online seniority. Their findings contribute to the literature on e-Health and user participation, and provide management implications for OHC managers.

The peer review history for this article is available at https://publons.com/publon/10.1108/OIR-11-2021-0615/

The purpose of this paper is to understand the effect of platform characteristics (i.e. media richness and interactivity) on individual perception (i.e. outcome expectations) and consequent behavioral response (i.e. user participation in online health communities (OHCs)) based on the stimulus-organism-response (S-O-R) model.

This study developed a research model to test the proposed hypotheses, and the proposed model was tested using partial least squares structural equation modeling (PLS-SEM) for which data were collected from 321 users with OHC experience using an online survey.

The empirical results show the following: (1) the three dimensions of media richness significantly affect the three outcome expectations, except that richness of expression has no significant effect on the outcome expectation of health self-management competence. (2) Human-to-human interaction significantly affects the three outcome expectations. Moreover, compared with human-to-human interaction, human-to-system interaction has a stronger impact on the outcome expectation of health self-management competence. (3) The three outcome expectations have a significant influence on user participation in OHCs.

This study extends the understanding about how platform characteristics (i.e. media richness and interactivity) motivate user participation in the context of OHCs. Drawing on the S-O-R model, this study reveals the underlying mechanisms by which media richness and interactivity are associated with outcome expectations and by which outcome expectations is associated with user participation in OHCs. This study enriches the literature on media richness, interactivity, outcome expectations and user participation in OHCs, providing insights for developers and administrators of OHCs.

Online health communities (OHCs) have become increasingly popular sources of health information in recent years. However, little is known about the factors that affect the relationship commitment and continuous knowledge sharing intention among OHC members. Thus, this study aims to integrate social exchange and commitment-trust theories to establish a theoretical model to fill the gap.

A research model that integrates social exchange theory and commitment-trust theory is developed. Quantitative data from 519 valid questionnaires are collected via an offline survey. Statistical product and service solutions 20.0 and analysis of a moment structures 20.0 software are used to test the hypotheses.

Relationship commitment directly influences continuous knowledge sharing intention, partially mediates the relationship between social support and continuous knowledge sharing intention, and fully mediates the relationship between perceived health risks and continuous knowledge sharing intention. Informational and emotional supports are identified as benefit factors that positively affect relationship commitment and perceived health risks are regarded as cost factors that negatively influence relationship commitment. Informational and emotional supports of OHC members produce different effects on relationship commitment when members obtain social support from different sources. Moreover, trust moderates the influences of informational support and perceived health risks on relationship commitment.

The findings provide additional insights that can augment the knowledge management literature by indicating how people are driven to share knowledge continuously in the context of OHCs. This study empirically clarifies the relationships of benefits (i.e. social support) and costs (i.e. perceived health risks) to continuous knowledge sharing intention by demonstrating the significant mediating effect of relationship commitment. In addition, the findings of this study highlight the importance of the social support source in OHCs and provide additional insights into commitment–trust theory by integrating the moderating effect of trust on the relationships between relationship commitment and its antecedents.

The purpose of this study is to investigate how community attachment to an OHC reduces the OHC users' emotional distress and therefore improves their emotional well-being.

A survey study was conducted in one of the largest online health communities (OHC) for people with diabetes.

OHC participants are likely to experience reduced emotional distress when they have developed an attachment to the community. This attachment is, in turn, positively associated with the normative expectations of reciprocity and the affective feeling of gratitude. However, some commonly used behavioral measures of community participation, such as visit frequency and membership tenure, have little to do with either community attachment or reduced emotional distress.

The research highlights the pivotal role of community attachment in appraising the much-debated benefits of OHCs. However, the cross-sectional survey study has its limitations in terms of establishing causality.

OHC managers need to look beyond some of the commonly used metrics, such as monthly visits and number of new postings, and focus on fostering a sense of attachment among existing users in order to fulfill the OHC's potential of emotional support. Our study implies that design features facilitating reciprocation and gratitude expression among users can lead to a strong emotional bond.

This is one of the first studies on the antecedents of community attachment and the relationship between community attachment and emotional distress in the context of OHC.

Online health communities (OHCs) are attracting more and more healthy consumers, including patients, their families, caregivers and the general public. This paper aims to explore the themes and characteristics of patient-generated content (PGC) in Chinese OHCs.

Baidu Tieba for hypertension was selected as the research site. Online ethnography (netnography) approach was utilized to explore the PGC and health communication in the online hypertension community. The final database included 300 randomly sampled threads and their 3,187 reply posts and was further analyzed from three perspectives: health information needs, attitudes and psychological reactions to hypertension and social support exchange.

The members' health information needs were mainly concentrated on five aspects: causes, symptoms, measuring instrument, tests and diagnosis and treatment. Their attitudes and psychological reactions to hypertension varied with the context, for example, disease stage, health condition. Within the health communication, three types of social support – information support, emotional support and network support – were generated, transmitted and exchanged among members.

OHCs are able to serve as important source of health information and tool for health education. The implications and suggestions for health promotion of individuals, health information services optimization of OHCs and national health strategy plans were also discussed.

This is the first netnography study in information field on Chinese online hypertension community. This study provides a new perspective to explore the needs, attitudes and social support behaviors of Chinese hypertension population and also enables the Chinese experience of using OHCs to reduce health disparities to come to the world.

This study aims to develop a better understanding of how online health community (OHC) members with different health literacy (HL) levels benefit from their participation, through the analysis and comparison of their resource integration (RI) processes. It investigates through a RI lens how the vulnerability of community members – captured as their level of HL – affects the benefits they derive from participation.

Quantitative and qualitative methods were used to investigate the effects of healthcare service users’ vulnerability. Data were collected about their profiles and levels of HL. Furthermore, 15 in-depth interviews were conducted.

The study demonstrates how low levels of HL act as a barrier to the integration of available online health resources. Participation in OHCs appears less beneficial for vulnerable users. Three types of benefits were identified at the individual level, namely, psychological quality-of-life, physical quality-of-life and learning. Benefits identified at the community level were: content generation and participation in the development of the community.

This study has implications for the understanding of how service users’ activities affect their own outcomes and how the vulnerability of users could be anticipated and considered in the design of the community.

This article aims to explore the factors influencing patients' distrust toward doctors in online health community.

This study leveraged the distrust construct model and socio-technical systems theory to establish a research model. The authors used the survey method to validate the research model by developing and distributing questionnaires to online health community users. 518 valid responses were collected.

The data analysis results showed that patients' distrusting beliefs were significantly related to their distrust toward doctors in online health communities. Meanwhile, social factors included perceived egoism and lack of expertise; whereas technical factors included no structural assurance, and lack of third-party recognition.

This study not only provides a solid and comprehensive theoretical understanding of patient distrust toward doctors in online health communities but also could serve as the basis to relieve the distrust between patients and doctors in online health communities, or even in the offline environment.

Effectively engaging patients is critical for the sustainable development of online health communities (OHCs). Although physicians’ general knowledge-sharing, which is free to the public, represents essential resources of OHCs that have been shown to promote patient engagement, little is known about whether such knowledge-sharing can backfire when superfluous knowledge-sharing is perceived as overwhelming and anxiety-provoking. Thus, this study aims to gain a comprehensive understanding of the role of general knowledge-sharing in OHCs by exploring the spillover effects of the depth and breadth of general knowledge-sharing on patient engagement.

The research model is established based on a knowledge-based view and the literature on knowledge-sharing in OHCs. Then the authors test the research model and associated hypotheses with objective data from a leading OHC.

Although counterintuitive, the findings revealed an inverted U-shape relationship between general knowledge-sharing (depth and breadth of knowledge-sharing) and patient engagement that is positively associated with physicians’ number of patients. Specifically, the positive effects of depth and breadth of general knowledge-sharing increase and then decrease as the quantity of general knowledge-sharing grows. In addition, physicians’ offline and online professional status negatively moderated these curvilinear relationships.

This study further enriches the literature on knowledge-sharing and the operations of OHCs from a novel perspective while also offering significant specific implications for OHCs practitioners.

Online health communities (OHCs) can be complementary to healthcare systems to improve the health behaviors of older adults with chronic diseases. This study aims to examine the impacts of habit and social support receipt on older adults' continued participation in OHCs. Particularly, the authors discussed the influences of social support received in two ways: social support received by initiating threads (direct social support receipt) and social support received by being exposed to the threads initiated by others (indirect social support receipt).

Based on the dual-process model (i.e. conscious process and unconscious process), the authors developed the research model. Data from one of the biggest online diabetes communities in Europe were collected. Besides, we used the support vector machine algorithm for social support classification and used the Cox proportion hazards model for model validation.

Older adults' continued participation is influenced by habit and indirect informational support. Habit moderates the relationship between direct informational support receipt and older adults' continued participation. Furthermore, direct and indirect emotional support receipt are both not associated with older adults' continued participation, regardless of their habit strength.

This is the first study investigating older adults' continued participation in OHCs based on the dual-process model. The findings of this study reveal that older adults' continued participation is determined by both the habit and specific conscious evaluation of benefits based on the social support receipt.