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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.

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.

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.

Doctor–medical institution collaboration (DMIC) services are an emerging service mode in focal online health communities (OHCs). This new service mode is anticipated to affect user satisfaction and doctors' engagement behaviors. However, whether and how DMIC occurs is still ambiguous because the topic is rarely examined. To bridge this gap, this study explores doctors' participation in DMIC services and its effects on their online performance, as well as its effect on patients' evaluation of them on OHC platforms.

The authors propose hypotheses based on structural holes theory. A unique dataset obtained from one of the most popular OHCs in China is used to test the hypotheses, and difference-in-differences estimation is adopted to test the causality of the relationship.

The results demonstrate that providing DMIC services improves doctors' online consultation performance and patients' evaluations of them but has no significant effect on doctors' knowledge-sharing performance on OHC platforms. Doctors' knowledge-sharing performance and consultation performance mediate the relationship between participation in DMIC services and patients' evaluation of doctors. Regarding doctors' participation in DMIC services, its impact on doctors' consultation performance and patients' evaluation of them is weaker for doctors with higher professional titles than for doctors with lower professional titles.

The findings clarify the value creation mechanisms of online collaboration between doctors and medical institutions and thereafter facilitate doctors' participation in DMIC services and enhance the sustainable development of OHCs.

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.

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.