Helping you to help me: Exploring Supportive
Interaction in Online Health Community
Katherine Y. Chuang
College of Information Science and Technology,
3141 Chestnut Street, Philadelphia, PA 19104
Christopher C. Yang
College of Information Science and Technology,
3141 Chestnut Street, Philadelphia, PA 19104
People are able to express support for each other through
online support groups by communicating their feelings and
exchanging personalized information. In the domain of
health information, this ability enables patients to connect
with each other to build their own sense of community
filled with healthy, supportive relationships. This paper
reports a comparison of levels of social support types
(informational, nurturant, and instrumental) that were
identified among interactions across three different types of
computer-mediated communication tools (forum, journals,
and notes) from an online alcoholism support community.
Findings show that people use each communication tool for
different purposes, which can be associated with each
tool’s inherent design characteristics. Forums were used for
exchanging information, whereas journals and notes were
used for exchanging nurturant support. We suggest that this
difference may be explained by the perceived levels of
social support for each communication tool. These results
can prove useful to health professionals in the development
of social support systems for their patients that encourage
health behavior change.
Social networking, social support, healthcare
People go online for many reasons, with common activities
on the Internet being informational and communicative or
social (Tufekci, 2008). The Internet allows people to seek
help from their social networks, such as to gather
information and to find support as they face important
decisions (Boase et al., 2006). In 2006, the Pew Internet &
American Life Research Center found that over seven
million Americans searched for online health information,
many of which seek help from their social networks to care
for someone with a major illness or medical condition.
With respect to online health behavior (Boase et al., 2006):
81% asked for health information from their core ties,
and 46% from at least one of their significant ties.
17 million Americans said that the Internet played
important role in helping with at least one major life
decision in past 2 yrs regarding a medical condition or
28% said that the Internet helped them connect to
people when seeking for help in decision making, and
30% said that the Internet allowed them to compare
A more recent study published last year showed that, e-
patients are more likely to access user-generated or “just-
in-time someone-like-me” health information(Fox & Jones,
41% of e-patients have read someone else's
commentary or experience about health or medical
issues on an online news group, website, or blog.
39% used a social networking site (i.e. MySpace,
12% shared updates about themselves or viewed
updates about others
Surveys conducted in 2002, 2004, 2006, 2007, and 2008
consistently found that between 75-83% of internet users
looked online for health information (Fox & Jones, 2009).
By 2009, 60% said they or an acquaintance was helped by
following medical advice or health information found on
the internet. This number increased since 2006 when 31%
reported being aware of helpful outcomes (Fox & Jones,
Patients using online communities as support groups
benefit from sharing experiences, discussing information,
and exchanging social support through CMC. Social
support can improve an individual’s ability to cope with
stress and also increase access to information (Cohen,
2004; McCormack, 2010). Sharing personal experiences
may involve personal information. Information types can
vary from treatment options, links to other websites, or
book recommendations. Exchanging emotional support is
important for building a supportive environment. Peer
communication such as establishing social norms or role
models and sharing feelings can also play a role in
facilitating new health habits, such as quitting smoking
(Ancker et al, 2009).
Studying the behavior of users as they connect with others
about their health concerns will give insight into better
understanding of their information and emotional needs.
For instance, many users join online support groups for a
ASIST 2010, October 22–27, 2010, Pittsburgh, PA, USA.
sense of community with those who share similar
experiences (Wright & Bell, 2003). Social network sites
(SNS) enables users with common interests to find each
other and build connections (Ahn et al, 2007), while
offering a spectrum of communication spaces for
individuals to communicate and provide an opportunity for
the exchange of social support between users. The
objective of this research is to identify the types of social
support in an online healthcare social networking site
across three different text-based communication tools;
discussion forums, personal journals, and notes. People use
these tools for different purposes in order to seek support.
This study will present empirical data as evidence that
people exchange different types of social support online
using different tools.
The Internet opens a door for users to a social environment
where users can communicate with each other and build a
sense of belonging to a community (Hoybye et al, 2005). In
particular, SNS provide users the capability to represent
themselves with an online presence that contains shareable
personal info, such as birthday, hobbies, preferences,
photographs, writings, etc (boyd & Ellison, 2007).
Convenient features allow users to form and maintain
online network “friends”, where if one user invites another
user to be friend and if accepted, a relationship is
established on the website. However, this friendship does
not distinguish the strength of ties. The friend feature is
convenient tool to exchange messages and stay in touch.
(Ahn et al, 2007) Friends can communicate through SNS in
several ways, including private and public messaging
systems (Thelwall & Wilkinson, 2010). We are interested
in studying some of the community features that allow
users to engage with each other.
Computer-mediated communication (CMC) is one of the
ways in which individuals can exchange information and
build intimacy in their relationships. Communicating
online, especially through use of an SNS, provides benefits
at varying levels. It encourages “disparate individuals” to
connect, communicate, and take action (Ellison et al, 2009)
especially because identity information from online profiles
can assist in developing common ground and facilitate
Expressing emotion can be important in the daily
management of relationships, for instance positive
comments between friends are often observed on general
SNS websites such as MySpace between friends (Thelwall
& Wilkinson, 2010). Unlike in other online communities,
SNS users tend to expect to gratify their social-emotional
needs rather than informational needs (Rau et al, 2008).
The “appropriate perception and communication of
emotion is important for maintaining human relationships
and friendships, not just intimate relationships” (Thelwall
& Wilkinson, 2010). It has been observed that close friends
are sources of emotional support that can help women cope
in difficult times or to improve mental health (Gilbert &
Karahalios, 2009; Schaefer et al, 1990; Thelwall et al,
2010). People with strong ties often communicate thru
many channels (Gilbert & Karahalios, 2009;
Haythornthwaite, 2002). We suspect that communication
channels can reveal different types of relationships based
upon type of social support identified.
MedHelp Support Communities
The MedHelp website provides open forums for both peer
support communities and ‘ask a doctor’ expert
communities. Each community includes several tools
through which users can interact with each other, such as
discussion forums, journals, and notes. The forum for each
support community is unmoderated where any MedHelp
user is able to post questions and respond to them with
comments. Journals allow users to record thoughts and
feelings. Notes are a way for users to keep in touch with
each other on MedHelp.
While the communication on each of these CMC tools
might be displayed publicly depending on privacy level
settings (public, friends, private), the interactions on each
may differ based on expected audience and the purpose of
communication. Attributes for each communication tool are
listed in Table 1. When posting to forum and journals,
ticker data (Figure 4) can be added. All forum content
created by users will be publicly accessible. Journals and
notes features can be set to one of three options:
‘Everyone’, ‘Only my friends’, ‘Only Me’. New posts to
the forum can be viewed on the forum page, which is also
known as the support community page. Updates to public
journals (new posts or new comments) are listed on the
support community page under ‘recent activity’ box. There
is also a section that lists community members with links to
their profile pages.
Each profile page, displays sections regarding the user’s
activity in forums, on their public journal, or any public
notes. If the setting for journal and notes are set to ‘only my
friends’ then only users who are ‘friended’ may view these
content. If setting is set to ‘only me, only the user can see
their own content when logged in. The content in each of
these tools is organized chronologically.
CMC Access Tags Other features
Forum Public Yes Select topic,
Add to watch list,
Only my friends
Yes Show Ticker,
Only my friends
Add as friend
Table 1. Comparison of CMC Attributes
The communication tools offered by MedHelp support
communities include forum, journals, and notes. Each has
specific formats for posting content. Users can post
questions or polls to the forum. They are required to fill out
a title, select a topic, describe their question, and are free to
add tags (figure 1). Posting to journals can include title,
entry, tags, photos, with selected privacy options (figure 2).
Posting notes on a user’s profile includes type of note and
the content in the note (figure 3). If the user is not a friend,
there is an option to befriend the user. The screen shots are
Figure 1. Posting Forum Question
Figure 2. Posting Journal Post
Figure 3. Posting Note
Figure 4. Ticker Data
The research question we explore in this study is, “What
are the different levels of support across different
communication channels?” We study the patterns of
interactions among the three communication tools that
allow users to engage with each other in order to answer
All public data from the MedHelp alcoholism community
(forums, journals, notes) were downloaded via a web
crawler on September 9, 2009 and saved as text files. Data
spanned several years and it was too large a dataset for
manageable preliminary study, so we limited analysis to
three months. Three samples were selected for analysis:
messages from (1) the alcoholism community forum, (2)
the personal journals of users belonging to alcoholism
forum, and (3) the profile notes of users belonging to
alcoholism forum. Each sample contains user generated
content between a three month period of June 9, 2009 and
September 9, 2009. Messages contained the sender’s user
name, the timestamp for the message, and the content itself.
Related studies used qualitative content analysis to
categorize online patient community messages of
discussion boards using approximately 300 messages
(Eichhorn, 2008; Winzelberg, 1997). A qualitative
approach was used here to classify support types because as
Gilbert and Karahalios (2009) mention, emotional support
is hard to quantify and there are currently no accurate
methods to automatically classify natural language text for
emotional content (Gilbert & Karahalios, 2009).
Additionally, people engaged in interactions usually
exchange more than one type of support that would require
careful reading to distinguish them. After identifying social
support in the interactions, the results were reported with
descriptive quantitative analysis.
Social support definitions were developed inductively from
reviewing examples from related literature and also from
matching them with the data (Bambina, 2007; Cutrona &
Suhr, 1992; McKenna et al, 2002; Winzelberg, 1997).
First, we conducted a literature search to find related
studies that identified social support types in online health
communities (Chuang & Yang, 2010). Concepts and their
definitions were drawn out and organized into the three
categories (information, nurturant, instrumental). Next,
these definitions were tested on a small sample (one month
of forum posts). Afterwards, samples were coded with the
support types. There are primarily two types of support
found in the data – informational support and nurturant
support. A third type, instrumental support, is more
typically found in face-to-face support groups and not
found in the data.
Informational Support is information relating to treatment
or coping with alcoholism or withdrawal symptoms, such
as clarifying the problem or making suggestions (Bambina,
2007; Eichhorn, 2008; McCormack, 2010; Radin, 2001;
Winzelberg, 1997; Wright & Bell, 2003). There are five
types of information identified in the data.
Advice: offers ideas and suggests actions; provides detailed
information, facts, or news about the situation; or skills
needed to deal with situation.
Offered: “Campral works better...ask u r doc about it!”
Requested: “are you suppose to like wean off the alcohol like
you do drugs?”
Fact: reassesses the situation and presents facts.
Offered: “Drinking too much alcohol daily can be a high risk
to your health, you might fall into alcohol addiction.”
Requested: “is there a medicine to take to stop the craving for
Personal experience: stories about person’s experiences or
incidents as a way of presenting information.
Offered: “I have been going though something like that with
an addict using in our bathroom and….”
Requested: “can I ask you why you took an unreliable test?”
Opinion: a view or judgment formed about something, not
necessarily based on fact or knowledge. This is different
from advice because it does not provide a suggestion for
action, but rather thoughts on a situation.
Offered: “From what have you posted, it seems that you are in
the stage where you have been looking to drink everyday and it
is a clear sign of alcohol addiction.”
Requested: “Am I going crazy?”
Referral: refers the recipient to some other source of help.
Offered: “Im gonna send you a link that might help.”
Requested: “Have you tried contacting a local AA???”
Nurturant Support is expressions that show signs of
listening, expressing sympathy, or expressing the
importance of relationship (Bambina, 2007; Eichhorn,
2008; McCormack, 2010; Radin, 2001; Winzelberg, 1997;
Wright & Bell, 2003). There are three types of nurturant
Esteem: positive comments intended to praise support
seekers abilities or to alleviate their feelings of guilt.
Offered: “Congratulations on your sobriety!”
Requested: “What you had to say was so good to hear. Needs
to be heard”
Network: messages to help support seeker from feeling
Offered: “Just reach out and I will be there ok?”
Requested: “.u r needed in this forum!please stay in touch!!!”
Emotional: providing understanding of situation, express
sorrow, provide with hope and confidence.
Offered: “You're going through a rough time....” or “Hang in
Requested: “please pray for me”
Instrumental Support is provision of material or financial
aid, or services (Cutrona & Suhr, 1992; Eichhorn, 2008).
There are no examples available of this type of support
from the samples. An example is offering to drive someone
to Alcoholics Anonymous meeting.
Three months of data (June 9, 2009 – Sept 9, 2009) were
examined using qualitative content analysis to identify the
different types of support. Each message that was created in
this time period was coded with multiple types of support.
The three sample sizes were (n=493, n=423, and n=1180)
for forums, journals, and notes respectively and
summarized in Table 2. The forum and journal samples are
subdivided into posts and comments. There were 81 forum
posts (FP), 412 forum comments (FC), 88 journal posts
(JP), and 335 journal comments (JC). A majority of FP
were created by an author seeking information for him or
herself, 14 by caretakers, and 11 that were unidentified.
Journals have one author but anyone who can read the JP is
allowed to comment. Friends and same community
members are more likely to notice new posts. There were
collectively 1180 notes from 74 profiles.
Sample Forums Journals Notes
Size N = 493 N = 423 N=1180
Posts FP = 81 JP = 88
Comments FC = 412 JC = 335
Table 2. Summary of samples
Nurturant and informational were the only occurring
themes, with no observation of instrumental support. Most
messages had more than one support type (i.e.
informational and nurturant); however each message was
coded only once per support type. The results are presented
first by support offered then by support received.
There were greater levels of informational support offered
in the forum posts (FP) and forum comments (FC) than
nurturant support. Journal posts (JP) also typically offered
informational support. On the other hand, notes and journal
comments (JC) were more likely to offer nurturant support.
Figure 4. Support offered
82.7% of FP offered informational support, which is much
more than 16% that offered nurturant support. This shows
that users who create forum posts are more likely to offer
85.2% of FC offered informational support, whereas 66.9%
offered nurturant support. This shows that users replying to
forum posts are more likely to offer information than
When FP and FC results are added together, 84.7%
messages offer information whereas 58.6% offers nurturant
support. This shows that in general forums are a source of
92.0% of JP offered informational support, which is much
more than 73.8% that offered nurturant support. This shows
that users who keep journals are more likely to be
51.2% of JC offered informational support, whereas 82.0%
offered nurturant support. This shows that users replying to
journal posts are much more likely to offer nurturant
When JP and JC results are added together, 53.1%
messages offer information whereas 80.3% offers nurturant
support. This shows that overall, journals are a source of
57.5% of notes offered informational support, whereas
84.9% offered nurturant support. This shows that users
posting notes on friends’ profiles are much more likely to
express nurturant support.
Forum messages and notes were more likely to request for
information than nurturant support. In contrast to the forum
sample, journal posts were more likely to request nurturant
Figure 5. Support Requested
72.8% of FP requested informational support, which is
much more than 44.4% that requested nurturant support.
This shows that users who create forum posts are more
likely to request information.
Summary Informational Nurturant
Forum Used for exchanging
- Posts are more likely to offer and request
- Replies are more likely to offer and
Hardly used for nurturant support
Journals Used by journal keeper to
document information and
feelings and for supportive
- Posts contain information, possibly to
- Replies seek information, probably to
clarify type of emotional support to offer.
- Posts implicitly request nurturant
- Replies offer nurturant support.
Notes Used for keeping in touch - Seeks information, mostly of the form
“how are you?”
- Many messages contain
expressions of nurturant support.
Table 3. Summary of Results
15.5% of FC requested informational support, whereas
6.3% requested nurturant support. This shows that users
replying to forum posts are more likely to request
information, probably to clarify information being
requested in the posts.
When FP and FC results are added together, 24.9%
messages request information whereas 15.0% sought
nurturant support. This shows that overall; forums are
perceived as a source of informational support.
13.6% of JP requested informational support, which is
much less than 36.3% that sought nurturant support. This
shows that users who keep journals are more likely to be
seeking nurturant support.
8.35% of JC requested informational support, whereas
0.29% requested nurturant support. This shows that users
replying to journal posts are much more likely looking for
more information, maybe to clarify what kind of nurturant
support to give.
When JP and JC results are added together, 10.6%
messages offer information whereas 14.6% offers nurturant
support. This shows that overall journals are a source of
20.0% of notes requested informational support, whereas
1.4% requested nurturant support. This shows that users
posting notes on friends’ profiles are much more likely to
seek specific information about their friend, most likely to
In comparing these three samples, it is clear that forums are
used for both providing and seeking information support
more than nurturant support. A summary is shown in Table
3. This difference is explored more in the following
Information Support in Forum
The bias of using the forum as an information resource
brings to question the type of information being exchanged.
Among the five informational support types, FP tends to
exhibit only personal experiences or opinions. FC, on the
other hand, exhibits all types, with mostly personal
experiences and advice as leading forms of information.
Figure 6. Information support offered
FP messages sought personal experiences, advice, and
referrals more often than other types. However, while FC
also seeks personal experience, it happens considerably
less. Perhaps the forum users are disclosing personal
experiences as a strategy for seeking support.
Figure 7. Information support requested
Posts include a mixture of offering opinions and personal
experiences, with requests for all types of information. In
this sample users do not create posts that offer information
referral, advice, or facts. Perhaps there is a sense of
uncertainty that brings them to the forum to post questions.
Forum comments have almost the opposite effect where
users offer all types of information support but mainly
request some personal experience. People replying to forum
posts are not seeking as much support as those who create
threads. The order in which information types are sought
for personal experience, advice, and referral match with
those offered. Surprisingly, users offer more opinion than
facts, especially when the reverse is requested. There are a
FP (n = 81) FC (n = 412)
FP (n = 81) FC (n=412)
number of possible reasons for these patterns, and they are
discussed in the next section.
Examining CMC interactions of non-expert participants,
namely the people suffering from alcohol addiction and
their caregivers allowed us to identify various types of
social support in the three samples (online forum, journals,
and notes) of the MedHelp Alcoholism support community.
Interactions show that each tool serves a different purpose.
It is valuable to study these online interactions because “the
internet has become a prime venue for social interaction”
for people “sharing aspects of their daily lives” (McKenna
et al, 2002). We speculated that the characteristics of each
communication medium will have impact on supportive
interactions and our results show this is especially evident
in forums, which are used as for exchanging information
support. People are drawn to these support communities
for information and also to form supportive relationships.
Communication is important in the relationship building
process, for instance keeping in touch by using emotional
Our results support previous findings that users participate
in online health support communities to find peers with
similar experiences and to seek social support. For
example, they might want to obtain an alternate source of
information than what is provided by their physician, to
seek personalized information, or to seek out others with
understanding of the situation that are able to provide more
compassion (Wright & Bell, 2003). Finding other patients
is important because by listening to others’ stories one can
discover insights about “what it really feels like and what to
expect next, in a way that only someone with personal
experience can” (Wright & Bell, 2003). It was especially
evident in the forum sample, where users are exchanging
informational support with each other. Additionally,
participation in these communities usually consists of
posting positive comments or sharing experiences and
worries (McCormack, 2010). This was especially evident in
the journal comments where users offer more esteem
Participation is active in this MedHelp support community,
because people in online support groups “go in search of
people who will listen to them and who will address
everyday issues and fears that healthcare providers may
either not realize or have time to address” (Wright & Bell,
2003), because they have difficulty finding this type of
support in person. In our study, users who create forum
posts are more likely to request information and offer
information. However, while they offer opinions and
personal experiences, they tend to request personal
experiences and advice. Perhaps a substantial part of
supportive communication is in hearing multiple opinions.
It is possible that these forum users are disclosing personal
experiences as a strategy for seeking support from a
spectrum of perspectives. It is important that users are able
to exchange support, especially because social support is
known to produce positive benefits for health outcomes, as
well as assisting in the creation of new relationships among
friends. The perceived benefits can make a patient reduce
stress associated with their health condition (Bambina,
2007; McCormack, 2010; Wright & Bell, 2003).
The particularly high amount of information support
exchanged in the forums may be a support seeking strategy.
In order for users to seek help, they need to be able to
describe their problem (Eichhorn, 2008). In order for users
to be helped and engage in supportive interactions, they
need to be willing to open up and describe their problem. In
fact, a side effect of writing ones’ problem is the ability for
self-reflection and more clarity one’s situation (Wright &
There may be some differences in these online supportive
interactions when compared to face-to-face interactions,
such as those that occur at Alcoholic Anonymous meetings.
Firstly, CMC interaction provides some anonymity as
opposed to face-to-face, which “allows a person to discuss
fears, ask factual questions and discuss common experience
to reduce isolation” (Wright & Bell, 2003) and also “to
help each other cope with shared problems (McCormack,
2010). Although social interaction through CMC resembles
face-to-face interactions, the greater anonymity can
produce greater intimacy and closeness because it gets past
the traditional “gates” such as stigma, which cause ridicule
and rejection (McKenna et al, 2002). People often engage
in greater self disclosure with strangers because they worry
less about repeated interactions with all other friends,
however, relationships may still develop closeness and
intimacy faster over internet than those which began off-
line (McKenna et al, 2002). While users tend to attract
others who are similar and share opinions and interests,
sometimes physical “gates” such as stuttering, stigma,
visible shyness, social anxiety, and physical attraction
inhibit relationship formation during face-to-face
interactions (McKenna et al, 2002). CMC can increase the
number of potential supporters a person may receive
because it helps the person overcome geographic and time
constraints and also stigma (McKenna et al, 2002; Wright
& Bell, 2003). The Internet is a potentially powerful tool in
motivating and assisting problematic drinkers due to its
anonymity and accessibility, where participants may not
feel the same stigma associated with participation in face to
face intervention (Humphreys, 2001).
Our results show that the CMC format has impact on
supportive interactions (i.e. exchanging information vs.
nurturant support), for instance, the users from this study
are likely to explicitly request emotional support from those
they are already connected to. In particular, forum users
typically exchange informational support, which may be
accounted for the fact that users may feel weaker
connection to those members. It may be a tool for finding
answers, and not to therapeutically discuss their feelings.
On the other hand, because more nurturant support was
observed in the other two samples, this study supports
previous findings that people are more likely to express
emotions with those whom they feel are close ties (Gilbert
& Karahalios, 2009; Singla & Richardson, 2008).
Differences in social support variation across the three
samples may also be due to relationship closeness. Online
communities allow people to form and strengthen
relationships, but to form relationships; users must first find
a shared goal and a reason to initiate contact. This is
possible in the forum where users can pose questions to
anyone in the community. Journals and notes are designed
so that friends are more likely to keep ‘in the loop’ with
each other. This helps people form relationships as they are
able to interact regularly (McKenna et al., 2002). The more
time they spend talking with each other, the stronger this
relationship is and more likely they are to share interests
(i.e. quitting alcohol addiction) than a random pair of users
(Singla & Richardson, 2008). Wright (1999) found that the
more time people spend in an online group, the larger their
online social network and the higher the satisfaction with
the received support.
It is valuable to study the interactions within each
communication channel, since information tends to flow
through the connections within a social network (Singla &
Richardson, 2008) and because communication is a key
component of social support to manage psychosocial
stressors (Wright & Bell, 2003). In particular, studying the
nurturant support will give us insight into the level of
intimacy that characterizes these relationships. Emotional
support is more intimate kind of support (Bambina, 2007)
as it requires “a relationship with a greater amount of trust
and interaction to be requested or provided.” (p.142). In
addition, self-disclosure and partner disclosure increases
people’s experience of intimacy in interactions (McKenna
et al, 2002). Intimacy is the greatest predictor of tie
strength between two individuals in a social network,
which is built upon a process of forming trust through
communication (Gilbert & Karahalios, 2009; McKenna et
al, 2002; Radin, 2001). Thelwall et al. (2010) suggest that
SNS members should be sensitive to the emotion conveyed
by friends and try to reciprocate to show support for each
other (Thelwall et al, 2010). In this study, we see users
exhibiting nurturant support (especially in journal
comments and in notes), which probably demonstrates a
more intimate nature provided by those tools. Furthermore,
users may be more comfortable in requesting that type of
support when using those tools through which they feel
there is a closer tie. Forums are not seen as an intimate
arena but rather as a tool for finding people to ask questions
and fish for social support.
Notes are an interesting feature for SNS, because they can
help with maintaining relationships through periodic, short
interactions such as notes brief communications between
friends, and are essential component of the popularity of
SNS (Kim & Yun, 2007). Users remind each other of their
presence in notes to maintain their relationship. For
instance users in this community who post notes on friends’
profiles are more likely to be expressing nurturant support.
In addition, users replying to FP are more likely to offer
information than emotional support but request
information, probably to clarify information being
requested in the posts. MySpace profile wall posts are
found to be relatively rapid but rarely used for prolonged
exchanges, because they primarily fulfill two purposes:
making initial contact and keeping in touch (Thelwall &
Wilkinson, 2010). The notes sample in this study showed
that users left short messages for each other. On the other
hand, users in this MedHelp alcoholism community who
keep journals are more likely to be documenting
information with long posts while implicitly seeking
nurturant support. Users replying to journal posts are much
more likely to be seeking specific information such as
updates or clarifying what was said, but mostly to offer
Our results support previous findings about the availability
of informational and emotional support in online support
groups among patients and caregivers; however there are
still some limitations to this work. Because not all users are
active in these neither groups nor are all relationships are
created equal (Gilbert & Karahalios, 2009), it would be
useful for further research to differentiate the different
positions people hold in a support network. In addition,
some other variables may influence the supportive
communication in such groups, namely gender, culture,
intimacy, audience, age, and stigma attached to illness.
These could also be studied in future work. It would also be
interesting to study the order of support exchanges, for
instance whether support is offered preceding requests, or
The work has provided empirical evidence that compares
different communication tools with each other as users
exchange support. We started by identifying and classifying
the various support types in different CMC using
qualitative content analysis. Findings show that forum users
were more likely to seek and provide informational support
than emotional support. This deviates from findings from
journal and notes, which shows higher levels of emotional
support than informational support. Based on patterns
found among the samples in this study, people do use each
communication tool for a different purpose. The user
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