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Continuous knowledge contribution behaviors (CKCB) are critical for the healthy development of online medical communities (OMCs). However, it is unclear that if and how contributors' prior actions and the responses they received from the community influence the nature of their future contributions. Drawing upon the Information Systems Continuance theory and Service Feedback theory, the purpose of the study is to examine the impact of knowledge contribution performance (KCP) on doctors' CKCB. Evaluation of social motivation, financial incentive and the moderating influence of expertise level (EL) provided further insight into the pathways that motivate various forms of CKCB.

In order to better understand the CKCB of physicians in OMCs, the authors divided it into two categories: A_CKCB (active CKCB) and P_CKCB (passive CKCB). Information Systems Continuance theory and Service Feedback theory are adapted and integrated with empirical findings from previous research on OMCs to develop a model of CKCB. This study used ordinary least squares (OLS) regression to test hypotheses in the preexisting research model based on data collected from a Chinese OMC platform.

The results show that KCP helps develop several facets of CKCB. According to the findings, doctors' CKCB improved dramatically after receiving feedback from A_CKCB and P_CKCB, but feedback from peers did not promote CKCB. This study found that financial rewards only have a significant positive effect on P_CKCB, and that the level of expertise has a negative effect on the effect. The findings also demonstrated that doctors' level of expertise moderates the relationship between fA_CKCB (a comprehensive evaluation of doctors' A_CKCB) and A_CKCB.

Future studies should look at the role of self-efficacy as a mediator and attitudes as a moderator in the link between KCP and various forms of CKCB. This will help authors figure out how important KCP is for physicians' CKCB. And future research should use more than one way to gather data to prove the above roles.

This study makes a significant contribution to understanding the association between CKCB and KCP by highlighting the significance of distinguishing between the various forms of CKCB and their underlying causes.

This research has advanced both the theory and practice of OMCs' user management by illuminating the central role of KCP in this context.

Free knowledge sharing in the online health community has been widely documented. However, whether free knowledge sharing can help physicians accumulate popularity and further the accumulated popularity can help physicians attract patients remain unclear. To unveil these gaps, this study aims to examine how physicians' popularity are affected by their free knowledge sharing, how the relationship between free knowledge sharing and popularity is moderated by professional capital, and how the popularity finally impacts patients' attraction.

The authors collect a panel dataset from Hepatitis B within an online health community platform with 10,888 observations from April 2020 to August 2020. The authors develop a model that integrates free knowledge sharing, popularity, professional capital, and patients' attraction. The hierarchical regression model is used to for examining the impact of free knowledge sharing on physicians' popularity and further investigating the impact of popularity on patients' attraction.

The authors find that the quantity of articles acted as the heuristic cue and the quality of articles acted as the systematic cue have positive effect on physicians' popularity, and this effect is strengthened by physicians' professional capital. Furthermore, physicians' popularity positively influences their patients' attraction.

This study reveals the aggregation of physicians' popularity and patients' attraction within online health communities and provides practical implications for managers in online health communities.

Knowledge sharing in online health communities (OHCs) disrupts consumers' health information-seeking behavior patterns such as seeking health information and consulting. Based on social exchange theory, this study explores how the two dimensions of experts' free knowledge sharing (general and specific) affect customer transactional and nontransactional engagement behavior and how the quality of experts' free knowledge sharing moderates the above relationships.

We adopted negative binomial regression models using homepage data of 2,982 experts crawled from Haodf.com using Python.

The results show that experts' free general knowledge sharing and free specific knowledge sharing positively facilitate both transactional and nontransactional engagement of consumers. The results also demonstrate that experts' efforts in knowledge-sharing quality weaken the positive effect of their knowledge-sharing quantity on customer engagement.

This study provides new insights into the importance of experts' free knowledge sharing in OHCs. This study also revealed a “trade-off” between experts' knowledge-sharing quality and quantity. These findings could help OHCs managers optimize knowledge-sharing recommendation mechanisms to encourage experts to share more health knowledge voluntarily and improve the efficiency of healthcare information dissemination to promote customer engagement.

While spontaneous and voluntary knowledge contribution in online communities promotes value co-creation, dysfunctional knowledge behaviors hamper the effectiveness and development of such communities. The study conceptualizes physicians' proactive knowledge sharing and knowledge withholding behaviors in physician-driven online health communities (OHCs) and integrates the theories of role identity as well as communal and exchange relationships to understand the root causes and motivations behind these two types of knowledge behaviors.

The authors collected survey data from 166 users from one of the largest physician-driven OHCs in China and applied the covariance-based structural equation modeling approach to test the hypotheses.

The findings suggest that (1) physicians' professional role identity had a positive indirect effect on proactive knowledge sharing behaviors through communal motivation, and work pressure weakened this indirect effect; and (2) professional role identity had a negative indirect impact on knowledge withholding behaviors through exchange motivation.

This study extends proactive knowledge sharing and knowledge withholding behaviors from the organizational management domain to the online environment, exploring the underlying causes and motivations behind both behaviors in the unique context of physician-driven OHCs. The findings offer practical suggestions for the effective management of OHC platforms, as well as policy implications that respond to the workforce shortage of healthcare providers, a crisis that is unfolding globally.

The purpose of this research paper is to explore the determinants of patients' service choices between telephone consultation and text consultation in online health communities (OHCs).

This study utilized an empirical model based on the elaboration likelihood model and examined the effect of information, regarding service quality (the central route) and service price (the peripheral route), using online health consultation data from one of the largest OHCs in China.

The logistic regression results indicated that both physician- and patient-generated information can influence the patients' service choices; service price signals will lead patients to cheaper options. However, individual motivations, disease risk and consulting experience change a patients' information processing regarding central and peripheral cues.

Previous researchers have investigated the mechanism of patient behavior in OHCs; however, the researchers have not focused on the patients' choices regarding the multiple health services provided in OHCs. The findings of this study have theoretical and practical implications for future researchers, OHC designers and physicians.

The success of online health communities (OHCs) depends on maintaining long-term relationships with physicians and preventing churn. Even so, the reasons for physician churn are poorly understood. In this study, an empirical model was proposed from a social influence perspective to explore the effects of online social influence and offline social influence on physician churn, as well as the moderating effect of their online returns.

The empirical data of 4,145 physicians from a Chinese OHC, and probit regression models were employed to verify the proposed theoretical model.

The results suggest that physicians' churn intention is influenced by online and offline social influences, and the offline social influence is more powerful. Physicians' reputational and economic returns could weaken the effect of online social influence on churn intention. However, physicians' economic returns could strengthen the effect of offline social influence on churn intention.

This research study is the first attempt to explore physician churn and divides the social influence into online and offline social influences according to the source of social relationship. The findings contribute to the literature on e-Health, user churn and social influence and provide management implications for OHC managers.

Given the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.

Drawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.

The results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.

This study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.

This study aims to demonstrate the evaluation of an incentive scheme to encourage pregnant people to set a quit-smoking date.

The paper outlines a collaborative approach, working with pregnant people, clinicians, tobacco dependency practitioners and academics to gain insights into their perspectives and experiences. Quantitative and qualitative data were analysed.

The incentive scheme and appropriate support from clinicians have been shown to encourage pregnant people to set a quit date. The tobacco dependency practitioners helped remove barriers, such as the perception of the stigmatisation of smoking when pregnant. The practitioners also helped pregnant people make informed decisions to support successful behaviour change. The impact of the scheme resulted in improved infant health indicators. The scheme’s evaluation also supported establishing stakeholder knowledge exchange and learning processes.

This is a single-site study among a relatively small group of people designed to achieve a specific evaluation objective. Caution in generalising to wider settings should be exercised.

This study highlights the efficacy of an incentive scheme, complemented with support from clinicians, and the significance of knowledge exchange and collaboration between stakeholders in health care with significance in similar settings.

The paper details the incentive scheme input, actions, output, outcomes and impact involving a wider range of stakeholders, including the emotional consequences for participants, clinicians and academics.

Online health question-and-answer (Q&A) forums have developed a new business model whereby listeners (peer patients) can pay to read health information derived from consultations between askers (focal patients) and answerers (physicians). However, research exploring the mechanism behind peer patients' purchase decisions and the specific nature of the information driving these decisions has remained limited. This study aims to develop a theoretical model for understanding how peer patients make such decisions based on limited information, i.e. the first question displayed in each focal patient-physician interaction record, considering argument quality (interrogative form and information details) and source credibility (patient experience of focal patients), including the contingent role of urgency.

The model was tested by text mining 1,960 consultation records from a popular Chinese online health Q&A forum on the Yilu App. These records involved interactions between focal patients and physicians and were purchased by 447,718 peer patients seeking health-related information until this research.

Patient experience embedded in focal patients' questions plays a significant role in inducing peer patients to purchase previous consultation records featuring exchanges between focal patients and physicians; in particular, increasingly detailed information is associated with a reduced probability of making a purchase. When focal patients demonstrate a high level of urgency, the effect of information details is weakened, while the interrogative form is strengthened.

The originality of this study lies in its exploration of the monetization mechanism forming the trilateral relationship between askers (focal patients), answerers (physicians) and listeners (peer patients) in the business model “paying to view others' answers” in the online health Q&A forum and the moderating role of urgency in explaining the mechanism of how first questions influence peer patients' purchasing behavior.

Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the experiences of language minority patients with health-care encounters when an interpreter was needed but not present.

Semistructured, in-depth interviews were conducted with 13 language minority patients with limited Danish proficiency. All interviews were conducted with interpreters in the participants’ native language. Data were analyzed using an inductive thematic approach.

Most participants experienced communication difficulties and difficulties participating actively in their own health care. The experience of unresolved language barriers led to a high degree of uncertainty and left the participants with unanswered health concerns. Participants expressed a reluctance to seek health care, which consequently limited the utilization of health care services.

Although the findings only represent a small sample of patients, the results still reveal major challenges that minority-language patients encounter when seeking health care. Future studies should explore, if the intention of the law is met through the user fees.

Despite having the same entitlements as native Danish-speaking patients, minority-language patients experienced difficulties accessing and using health care services due to the user fee and unresolved language barriers. The study elucidates patient perspectives and points to important ways of improving the quality of health care.

To the best of the authors’ knowledge, no investigation into the communicative consequences of the introduction of the user fee for interpreting services exists. Thus, this study seeks to address that gap.