Use Of Online Health Communities Research Articles

The Effect of Offline Medical Resource Distribution on Online Physician-Patient Interaction: Empirical Study With Online and Offline Data

The relationship between online health communities (OHCs) and offline medical care is unclear because both provide physician-patient interaction services and channels. Taking advantage of information and communication technology, patients have been using OHCs widely. However, some physical medical resources (such as hospital beds and medical devices) cannot be replicated by information and communication technologies. Therefore, it is worth studying how offline medical resources affect physician-patient interactions in OHCs and how OHCs help to solve resource scarcity and the uneven distribution of traditional medical treatment. This study aimed to support the notion that physician-patient consultations in OHCs are influenced by the objective distribution of offline health care capital (accessibility and availability) and to provide suggestions for the allocation of medical resources in practice through the judicious use of offline and online channels. The empirical data in this study were collected from both online and offline channels. The offline data include 9 years (2006-2014) of medical resource statistics of 31 provincial administrative regions in mainland China. Moreover, data regarding the geolocation-based physician-patient interaction network in the OHC were also collected. The online data come from one of China's largest OHCs. We obtained 92,492 telephone consultation records of 6006 physicians using an automatic web crawler program. Social network analysis was used to visualize the descriptive statistics of the offline geolocation-based physician-patient interaction network in the OHC. A regression model with a squared variable was applied to analyze online and offline empirical data to further test our hypothesis. Two types of robustness tests were used to increase the reliability of the test results of the initial model. The results of our social network analysis show that there is a uniform geographic distribution of patients who use OHCs, whereas the physician relies more on geographic advantage (eg, a higher medical resource capability). Moreover, the empirical results of the regression model support the notion that physician-patient telephone consultations are positively influenced by physicians' online contributions (βcontribution=.210; P<.001) and capital availability (βbed=.935; P=.07), and, interestingly, spatial accessibility has an inverted U-shaped effect (βdistance=.199; P<.001 and βdistance2=-.00449; P=.008). The results indicate that the use of OHCs, although constrained by offline medical resources, provides a channel for offline resources to flow from areas with high availability to those with low availability. This study explores the relationship between online and offline channels by investigating online physician-patient interactions and offline medical resources. In particular, this study analyzes the impact of offline channels on online channels and verifies the possibility of OHC capital use shifting from a high-availability area to a low-availability area. In addition, it provides a theoretical and practical basis for understanding the interaction of online and offline channels of medical care.

African American Women's Willingness to Participate in Online Health Communities During COVID-19.

Introduction: The use of online health communities (OHCs) for health information, disease self-management, and social support increased during the COVID-19 pandemic. However, there are limited data on the willingness of African American women (AAW) to participate in OHCs. Materials and Methods: A sample of 985 AAW completed an online survey. Multinomial logistic regression examined associations between three age groups (18-29, 30-50, and 51+ years) and 10 motivators and 10 barriers to participating in OHCs. Women 51+ years were the referent group. Results: Women 51+ years were more likely to have been diagnosed with obesity and hypertension than the other groups (p < 0.01), but less likely to be diagnosed with a mental health condition than the other groups (p < 0.01). The top 2 motivators were to learn about a disease/condition (70%) and to prevent a disease/condition (64%). There were no significant differences with these variables. However, compared with women 18-29 years of age, women 51+ years were more likely to be motivated to manage an illness (p < 0.001), and more likely than the other groups to be motivated to support others (p = 0.011). The top 2 barriers were being too busy (53%) and privacy concerns (45%). Compared with women in the two other groups, women 51+ years were more concerned about privacy (p < 0.001). Discussion: AAW expressed a willingness to participate in OHCs. Willingness to participate in OHCs will vary by the topic and disease/condition and the age group. Conclusions: Opportunities exist to recruit AAW in age-specific OHCs.

How COVID-19 Affects the Willingness of the Elderly to Continue to Use the Online Health Community

In response to the COVID-19 outbreak, the governments of different countries adopted, such as locking down cities and restricting travel and social contact. Online health communities (OHCs) with specialized physicians have become an important way for the elderly to access health information and social support, which has expanded their use since the outbreak. This paper examines the factors influencing elderly people’s behavior in terms of the continuous use of OHCs from a social support perspective, to understand the impact of public health emergencies. Research collected data from March to April 2019, February 2020, and August 2021, in China. A total of 189 samples were collected and analyzed by using SmartPLS. The results show that (1) social support to the elderly during different stages has different influences on their sense of community and (2) the influence of the sense of community on the intention to continuously use OHCs also seems to change over time. The results of this study provide important implications for research and practice related to both OHCs and COVID-19.

Lived experiences and unique psychosocial impacts following bariatric surgery in a publicly funded Australian tertiary hospital: a qualitative study

ABSTRACT Objective Gain an understanding of the lived experiences and unique psychosocial impactsfollowing bariatric surgery. Methods Qualitative study design, consisting of semi-structured interviews. Based on thematic analysis principles, transcripts were inductively coded. Results Fifteen participants were included; predominantly female (n = 9, 60%) and underwent Roux-en-Y gastric bypass (n =12, 80%), with a mean age of 57 years. Five themes were generated including ‘Key Motivators to Undergo Bariatric Surgery’, “Positive Changes”, “Facing the Challenges”, “Tackling Social Relationships”, and “Skills to Move Forward”. There were common health-related motivators to undergo surgery, yet psychosocial motivators were not reported. Patients reported positive changes post-operatively; though not exclusively. Challenges included being surprised by the rapid weight loss, a delayed identification of their new body, and new body image concerns. Participants reported using different sources of support for the different types of support needs and were required to navigate negative confrontations and perceived stigma. Skills to move forward included implementing strategies and behaviour change techniques along with adjusting their lifestyle, routine, and mindset. Conclusion Experiences and psychosocial challenges post-operatively are multifaceted. Tailoring services to address these challenges in both pre- and post-operative healthcare settings is recommended. KEY POINTS What is already known about this topic: Long-term psychological and dietary support is important to help individuals navigate the challenges and maintain positive changes achieved after bariatric surgery. Lived experiences of bariatric surgery are characterised by normality, control, and ambivalence. To date, no qualitative study has been conducted in Australia to report the lived experience and unique psychosocial impacts following bariatric surgery. What this topic adds: Health-related motivators to undergo bariatric surgery were common; however, there were no reports of psychosocial motivators to undergo surgery (i.e., improved body image). Patients electing bariatric surgery may not be fully prepared for the psychosocial challenges rapid weight loss presents. Different sources of support were utilized by patients for different types of social support, with the prominent use of Online Health Communities.

Patients' Perspective About the Cost of Diabetes Management: An Analysis of Online Health Communities.

ObjectiveTo understand the perspectives of persons’ living with diabetes about the increasing cost of diabetes management through an analysis of online health communities (OHCs) and the impact of persons’ participation in OHCs on their capacity and treatment burden.Patients and MethodsA qualitative study of 556 blog posts submitted between January 1, 2007 and December 31, 2017 to 4 diabetes social networking sites was conducted between March 2018 and July 2019. All posts were coded inductively using thematic analysis procedures. Eton’s Burden of Treatment Framework and Boehmer’s Theory of Patient Capacity directed triangulation of themes with existing theory.ResultsThree themes were identified: (1) cost barriers to care: participants describe individual and systemic cost barriers that inhibit prescribed therapy goals; (2) impact of financial cost on health: participants describe the financial effects of care on their physical and emotional health; and (3) saving strategies to overcome cost impact: participants discuss practical strategies that help them achieve therapy goals. Finally, we also identify that the use of OHCs serves to increase persons’ capacity with the potential to decrease treatment burden, ultimately improving mental and physical health.ConclusionHigh cost for diabetes care generated barriers that negatively affected physical health and emotional states. Participant-shared experiences in OHCs increased participants’ capacity to manage the burden. Potential solutions include cost-based shared decision-making tools and advocacy for policy change.

The new normal: parental use of online health communities in the NICU.

The aim of this study was to identify if and why NICU families use online health communities (OHCs) and to assess how participation in these virtual spaces impacts relationships between parents and their child's medical team. Surveys were administered to eligible persons. Quantitative analysis was conducted using standard statistical methods. Publicly accessible posts from the platform Reddit were aggregated and analyzed for recurring themes. In all, 58.3% (n = 141) of NICU parents surveyed endorsed OHC use, primarily for the purpose of connecting with other NICU families and alleviating distress regarding their child's health. Risks of OHCs as discussed in previous studies including health information privacy and medical misinformation were similarly identified. However, parents did not report a harmful association between OHC use and their relationship with their child's providers, with only 2.8, 4.3, and 2.8% of participants reporting an overall negative effect of OHC use on communication, trust, and confidence, respectively. OHCs are a commonly used resource that help NICU families build communities and reduce anxiety. These data suggest that OHCs do not inherently pose a threat to the parent-provider relationship and should be validated by the medical team as a valuable potential resource, while acknowledging the legitimate risks that exist. Use of OHCs is increasingly common among NICU parents; however, it has been met with concern by many medical professionals. Existing literature has not yet explored the effect on dynamics in the NICU. Overall, our data show that OHCs have become a vital resource for families looking to build community among NICU parents and reduce anxiety. Though risks do exist around patient privacy and access to medical misinformation, fears regarding the impact of OHC use on parent-provider relationships may be largely unfounded. By using data to demonstrate how OHCs benefit the NICU parent experience, we hope to reframe OHC use and allow physicians to validate engagement and therefore mitigate legitimate concerns.

Analyses of posts written in online eating disorder and depression/anxiety moderated communities: Emotional and informational communication before and during the COVID-19 outbreak

IntroductionModerated online health communities (OHCs) are digital platforms that provide a means for patients with similar medical conditions to communicate with each other under the supervision of healthcare professionals. AimsTo examine the impact of the COVID-19 outbreak on content and type of posts published in two moderated OHCs – eating disorders and depression/anxiety – by comparing categorizations of posts written before vs. after the lockdown, and about vs. not about the pandemic. MethodsPosts were retrieved from Camoni, the first Israeli medical social network (January-June 2017, March-May 2020). A total of 1475 posts were analyzed. Of them, 802 posts were written before and 680 were written during the first lockdown. Posts were divided into two main categories: informational and emotional, and into fourteen subcategories. ResultsBefore the pandemic, the eating disorders OHC was characterized as primarily emotional (emotional: 66.7%, informational: 45.4%) and the depression/anxiety OHC as primarily informational (emotional: 49.8%, informational: 65.8%) (χ2 = 31.6, p < 0.001). During the lockdown, there was a transition in the eating disorders community, from primarily emotional to primarily informational communication (emotional: 46.1%, informational: 71.7%) (χ2 = 30.3, p < 0.001). In both OHCs, only about one in six posts written during the lockdown was related to the pandemic. There were only minimal differences in subcategorization of posts written before vs. after the outbreak (e.g., searching for medical information was more common during the pandemic: χ2 = 40.9, p < 0.001), as well as about vs. not about the pandemic (e.g., sharing negative emotions was more common when writing about the pandemic: χ2 = 4.1, p = 0.43). ConclusionDuring the first lockdown, people with eating disorders have increased their use of OHCs as sources of informational (as opposed to emotional) support, but the overall impact of the pandemic on the content of posts written in the examined OHCs was minimal, suggesting that OHCs have not changed their function as a valuable means of providing emotional and informational support for people with mental difficulties.

Cognitive mechanisms underlying interaction and contribution in online health communities: the perspectives of doctors and patients

PurposeActive interaction and knowledge contribution are vital yet challenging elements of the sustainable development of online health communities (OHCs). To investigate the cognitive mechanisms underlying these behaviours in doctors' and patients' use of OHCs, this study develops a theoretical model to examine the relationships among cognitive modes, patterns of interaction, perceived usefulness, and contribution behaviour and the impact of user identity on these relationships.Design/methodology/approachTo test the research hypotheses, structural equation modelling and multiple-group analysis were used to analyse survey data from 207 doctors and 213 patients.FindingsThe results indicate that dual processes and perceived usefulness are the key cognitive antecedents of interaction and knowledge contribution, respectively. However, the correlation of the rational mode and instrumental interaction is significantly stronger in the doctors' group than in the patients' group, while a stronger correlation between the experiential mode and instrumental interaction is observed in the patients' group.Practical implicationsThese findings support the development of information and system strategies to support the operation of dual processes underlying doctors' and patients' instrumental and affective interactions, facilitate evaluation and sense-making of interaction activities, and motivate knowledge contribution.Originality/valueThis study uncovers the invariance and variability in the relationships between salient cognitive activities and behavioural responses in doctors' and patients' use of OHCs and the impact of user identity on variability.

Factors affecting online health community participation behavior in patients with thyroid cancer.

Globally, cancer patients obtain much of their disease information online. Online health communities allow patients to share questions and information about diseases. However, there have been few studies on the factors affecting online health community participation behavior in cancer patients. Online social networking is associated with mental health problems, and patients with thyroid cancer experience high levels of distress, anxiety and depression. The purpose of this study was to investigate factors associated with use of online health communities by patients with thyroid cancer to understand the characteristics of patients participating in such online communities. A questionnaire survey was completed by 114 thyroid cancer patients admitted for surgery at a general hospital in Seoul, Korea. General characteristics, clinical characteristics, attitude toward cancer, distress, and anxiety and depression scores of patients who joined an online health community (user group) and patients who did not (non-user group) were compared. The factors affecting online health community participation were education (p = 0.049), tumor size (p = 0.010), attitude toward cancer (p = 0.022), and anxiety and depression (p = 0.021). The average score of satisfaction with the online health community was 4.25 of 5. The user group had larger tumors, a high awareness of the risk of thyroid cancer, and high levels of anxiety and depression. Patients who actively used the online health community have relatively larger cancer size and had higher levels of mental stress. As such patients are often very anxious and depend heavily on the gathered information, the quality of this information is important. Healthcare professionals need to develop appropriate interventions for patients participating in the online health community.

Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review.

BackgroundPatient participation in the health care domain has surged dramatically through the availability of digital health platforms and online health communities (OHCs). Such patient-driven service innovation has both potential and challenges for health care organizations. Over the last 5 years, articles have surfaced that focus on value cocreation in health care services and the importance of engaging patients and other actors in service delivery. However, a theoretical understanding of how to use OHCs for this purpose is still underdeveloped within the health care service ecosystem.ObjectiveThis paper aimed to introduce a theoretical discussion for better understanding of the potential of OHCs for health care organizations, in particular, for patient empowerment.MethodsThis literature review study involved a comprehensive search using 12 electronic databases (EMBASE, PsycINFO, Web of Science, Scopus, ScienceDirect, Medical Literature Analysis and Retrieval System Online, PubMed, Elton B Stephens Co [academic], Cumulative Index of Nursing and Allied Health Literature, Accelerated Information Sharing for Law Enforcement, Association for Computing Machinery, and Google Scholar) from 2013 to 2019. A total of 1388 studies were identified from the database search. After removing duplicates and applying inclusion criteria, we thematically analyzed 56 articles using the Braun and Clarke thematic analysis approach.ResultsWe identified a list of 5 salient themes: communication extension, improved health literacy for patients and health care organizations, communication transparency with patients, informational and social support for patients, and patient empowerment in self-management. The most frequent theme was communication extension, which covers 39% (22/56) of the literature. This theme reported that an extension of communication between patients, caregivers, and physicians and organizations led to new opportunities to create value with minimal time and cost restrictions. Improved health literacy and communication transparency with patients were the second and third most frequent themes, respectively, covering 26% (15/56) and 25% (14/56) of the literature, respectively. The frequency of these themes indicated that the use of OHCs to generate new knowledge from patients’ interactions helped health care organizations to customize treatment plans and establish transparent and effective communication between health care organizations and patients. Furthermore, of the 56 studies, 13 (23%) and 10 (17%) studies contended the opportunity of using OHCs in terms of informational and emotional support and empowering patients in their self-management of diseases.ConclusionsThis review enables better understanding of the current state of the art of the online value cocreation and its potential for health care organizations. This study found that the opportunities for health care organizations through enhancement of patient participation and their cocreation of value in digital health platforms have been rapidly increasing. The identified gaps and opportunities in this study would identify avenues for future directions in modernized and more effective value-oriented health care informatics research.

Patient Continued Use of Online Health Care Communities: Web Mining of Patient-Doctor Communication.

BackgroundIn practice, online health communities have passed the adoption stage and reached the diffusion phase of development. In this phase, patients equipped with knowledge regarding the issues involved in health care are capable of switching between different communities to maximize their online health community activities. Online health communities employ doctors to answer patient questions, and high quality online health communities are more likely to be acknowledged by patients. Therefore, the factors that motivate patients to maintain ongoing relationships with online health communities must be addressed. However, this has received limited scholarly attention.ObjectiveThe purpose of this study was to identify the factors that drive patients to continue their use of online health communities where doctor-patient communication occurs. This was achieved by integrating the information system success model with online health community features.MethodsA Web spider was used to download and extract data from one of the most authoritative Chinese online health communities in which communication occurs between doctors and patients. The time span analyzed in this study was from January 2017 to March 2017. A sample of 469 valid anonymous patients with 9667 posts was obtained (the equivalent of 469 respondents in survey research). A combination of Web mining and structural equation modeling was then conducted to test the research hypotheses.ResultsThe results show that the research framework for integrating the information system success model and online health community features contributes to our understanding of the factors that drive patients' relationships with online health communities. The primary findings are as follows: (1) perceived usefulness is found to be significantly determined by three exogenous variables (ie, social support, information quality, and service quality; R2=0.88). These variables explain 87.6% of the variance in perceived usefulness of online health communities; (2) similarly, patient satisfaction was found to be significantly determined by the three variables listed above (R2=0.69). These variables explain 69.3% of the variance seen in patient satisfaction; (3) continuance use (dependent variable) is significantly influenced by perceived usefulness and patient satisfaction (R2=0.93). That is, the combined effects of perceived usefulness and patient satisfaction explain 93.4% of the variance seen in continuance use; and (4) unexpectedly, individual literacy had no influence on perceived usefulness and satisfaction of patients using online health communities.ConclusionsFirst, this study contributes to the existing literature on the continuance use of online health communities using an empirical approach. Second, an appropriate metric was developed to assess constructs related to the proposed research model. Additionally, a Web spider enabled us to acquire objective data relatively easily and frequently, thereby overcoming a major limitation of survey techniques.

Do online communities change power processes in healthcare? Using case studies to examine the use of online health communities by patients with Parkinson's disease

ObjectiveCommunication technologies, such as personal online health communities, are increasingly considered as a tool to realise patient empowerment. However, little is known about the actual use of online health communities....

A Multirelational Social Network Analysis of an Online Health Community for Smoking Cessation.

BackgroundOnline health communities (OHCs) provide a convenient and commonly used way for people to connect around shared health experiences, exchange information, and receive social support. Users often interact with peers via multiple communication methods, forming a multirelational social network. Use of OHCs is common among smokers, but to date, there have been no studies on users’ online interactions via different means of online communications and how such interactions are related to smoking cessation. Such information can be retrieved in multirelational social networks and could be useful in the design and management of OHCs.ObjectiveTo examine the social network structure of an OHC for smoking cessation using a multirelational approach, and to explore links between subnetwork position (ie, centrality) and smoking abstinence.MethodsWe used NetworkX to construct 4 subnetworks based on users’ interactions via blogs, group discussions, message boards, and private messages. We illustrated topological properties of each subnetwork, including its degree distribution, density, and connectedness, and compared similarities among these subnetworks by correlating node centrality and measuring edge overlap. We also investigated coevolution dynamics of this multirelational network by analyzing tie formation sequences across subnetworks. In a subset of users who participated in a randomized, smoking cessation treatment trial, we conducted user profiling based on users’ centralities in the 4 subnetworks and identified user groups using clustering techniques. We further examined 30-day smoking abstinence at 3 months postenrollment in relation to users’ centralities in the 4 subnetworks.ResultsThe 4 subnetworks have different topological characteristics, with message board having the most nodes (36,536) and group discussion having the highest network density (4.35×10−3). Blog and message board subnetworks had the most similar structures with an in-degree correlation of .45, out-degree correlation of .55, and Jaccard coefficient of .23 for edge overlap. A new tie in the group discussion subnetwork had the lowest probability of triggering subsequent ties among the same two users in other subnetworks: 6.33% (54,142/855,893) for 2-tie sequences and 2.13% (18,207/855,893) for 3-tie sequences. Users’ centralities varied across the 4 subnetworks. Among a subset of users enrolled in a randomized trial, those with higher centralities across subnetworks generally had higher abstinence rates, although high centrality in the group discussion subnetwork was not associated with higher abstinence rates.ConclusionsA multirelational approach revealed insights that could not be obtained by analyzing the aggregated network alone, such as the ineffectiveness of group discussions in triggering social ties of other types, the advantage of blogs, message boards, and private messages in leading to subsequent social ties of other types, and the weak connection between one’s centrality in the group discussion subnetwork and smoking abstinence. These insights have implications for the design and management of online social networks for smoking cessation.

Understanding the sustained use of online health communities from a self‐determination perspective

Sustained use of an information source is sometimes important for achieving an individual's long‐term goals, such as learning and self‐development. It is even more important for users of online health communities because health benefits usually come with sustained use. However, little is known about what retains a user. We interviewed 21 participants who had been using online diabetes communities in a sustained manner. Guided by self‐determination theory, which posits that behaviors are sustained when they can satisfy basic human needs for autonomy, competence, and relatedness, we identified mechanisms that help satisfy these needs, and thus sustain users in online health communities. Autonomy‐supportive mechanisms include being respected and supported as a unique individual, feeling free in making choices, and receiving meaningful rationales about others' decisions. Competence‐cultivating mechanisms include seeking information, providing information, and exchanging information with others to construct knowledge. Mechanisms that cultivate relatedness include seeing similarities between oneself and peers, receiving responses from others, providing emotional support, and forming small underground groups for closer interactions. The results suggest that, like emotions, information and small group interactions also play a key role in retaining users. System design and community management strategies are discussed based on these mechanisms.

Perceived healthcare provider reactions to patient and caregiver use of online health communities

ObjectiveMany Internet users seek health information through online health communities (OHCs) and other social media. Yet few studies assess how individuals use peer-generated health information, and many healthcare providers (HCPs) believe OHCs interfere with patient–provider relationships. This study explored how individuals use OHC content in clinical discussions and how HCPs react to it. MethodsWe conducted in-person and virtual focus groups with patients/caregivers who visited OHCs (n=89). A trained moderator asked about reasons for membership, sharing OHC content with providers, HCP reactions, and preferred roles for HCPs. Two researchers independently coded verbatim transcripts (NVivo 9.2) and conducted thematic response analysis. ResultsParticipants described OHCs as supplementing information from HCPs, whom they perceived as too busy for detailed discussions. Almost all participants shared OHC content with HCPs, although only half cited OHCs as the source. Most HCPs reacted negatively to OHC content, making participants feel disempowered. Despite these reactions, participants continued to use OHCs, and most desired HCP feedback on the accuracy of OHC content. ConclusionsIndividuals do not use OHCs to circumvent HCPs but instead to gather more in-depth information. Practice implicationsHCPs should discuss OHC content with patients to help them avoid misinformation and make more informed decisions.

A qualitative investigation of factors enabling sustained use of online health communities

The duration of consumers’ use of an online health community directly impacts their health outcomes. However, little is known about factors enabling sustained use. Using survey methods, this study found that referral from trusted others, useful content, and large, diverse, and supportive community environment is associated with continuous use of online health communities. Implications for designing web-based health communities and interventions were discussed.

Using Online Health Communities to Deliver Patient-Centered Care to People With Chronic Conditions

BackgroundOur health care system faces major threats as the number of people with multiple chronic conditions rises dramatically.ObjectiveTo study the use of Online Health Communities (OHCs) as a tool to facilitate high-quality and affordable health care for future generations.MethodsOHCs are Internet-based platforms that unite either a group of patients, a group of professionals, or a mixture of both. Members interact using modern communication technologies such as blogs, chats, forums, and wikis. We illustrate the use of OHCs for ParkinsonNet, a professional network for Parkinson disease whose participants—both patients and professionals—use various types of OHCs to deliver patient-centered care.ResultsWe discuss several potential applications in clinical practice. First, due to rapid advances in medical knowledge, many health professionals lack sufficient expertise to address the complex health care needs of chronic patients. OHCs can be used to share experiences, exchange knowledge, and increase disease-specific expertise. Second, current health care delivery is fragmented, as many patients acquire relationships with multiple professionals and institutions. OHCs can bridge geographical distances and enable interdisciplinary collaboration across institutions and traditional echelons. Third, chronic patients lack adequate tools to self-manage their disease. OHCs can be used to actively engage and empower patients in their health care process and to tailor care to their individual needs. Personal health communities of individual patients offer unique opportunities to store all medical information in one central place, while allowing transparent communication across all members of each patient’s health care team.ConclusionsOHCs are a powerful tool to address some of the challenges chronic care faces today. OHCs help to facilitate communication among professionals and patients and support coordination of care across traditional echelons, which does not happen spontaneously in busy practice.

Building Trusting Relationships in Online Health Communities

This study investigates consumers' use of online health communities (OHCs) for healthcare from a relationship building perspective based on the commitment-trust theory of relationships. The study proposes that perspective taking, empathic concern, self-efficacy, and network density affect the development of both cognitive and affective trust, which together determine OHC members' membership continuance intention (MCI) and knowledge contribution. Data collected from eight existing OHCs (N=255) were utilized to test the hypothesized model. Results show that perspective taking and self-efficacy can increase cognitive trust and affective trust, respectively. Network density contributes to cognitive and affective trust. Both cognitive trust and affective trust influence MCI, while only affective trust impacts members' knowledge contribution behaviors.

REVALORIZING FEMININE WAYS OF KNOWING

Two robust fields of study – one exploring the impacts of ICTs on medical expertise and the other examining women's online communication – have infrequently been analyzed together. Mothers are heavy Internet users, especially seeking health information, but there is little study on their use of online health communities. Using qualitative research methods, this article explores seven years of mothers’ interactions in one online health community and argues that the mothers create a space in which they produce knowledge and use their communicative acts to rethink expertise and epistemological validity so that the ways of knowing most often associated with women – subjective, experiential, and concrete – are accorded validity and value beside traditional epistemologies that prize objectivity and empiricism.