The document analyzes social support exchanges across different communication formats (forums, journals, notes) on an online health community for alcoholism. The study found: 1) Forums were used primarily to exchange informational support and provide advice, while replies offered more nurturing support. 2) Journal posts implicitly requested nurturing support by documenting feelings, while replies focused on offering nurturing support. 3) Notes were used to maintain relationships through short interactions and primarily offered nurturing support by asking "how are you?". The findings suggest the type of social support varies based on the communication format and strength of relationships. Anonymity and accessibility of online communities can reduce stigma for conditions like alcoholism.

1. HELPING YOU TO HELP ME:
EXPLORING SUPPORTIVE
INTERACTION IN ONLINE
HEALTH COMMUNITY
ASIST 2010 | Pittsburgh, PA | October 24, 2010
Katherine Y. Chuang katychuang@drexel.edu
Christopher C. Yang ccy24@drexel.edu
Drexel University
Department of Information Science and Technology
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2. Online Health Social Networking
“e-patients are looking for ‘just-in-time
someone-like-me” health information”
- Boase et al, 2006; Fox & Jones, 2009
*E-patient: internet user that is looking for health information
“e-patients are looking for a
sense of community”
-Wright & Bell, 2003
41%
read patient blog,
health newsgroup,
or health website
39%
used social
networking site
12%
shared updates or
viewed updates
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Introduction

3. “Positive comments are observed between MySpace friends”
-Thelwall & Wilkinson, 2010
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Social Networking Site Features
“Friending enables users
to form and maintain
connections”
- Ahn et al, 2007 “Private and public messaging allow
for interpersonal communication”
- Thellwall & WIlkinson, 2010
“SNS users expect to gratify their social-emotional needs”
- Rau et al, 2008
Introduction

4. Motivation for Study
• What are the different levels of social support across
different CMC formats?
• Multiple CMC formats
 each has different audience and usage
• Forum for asking questions
• Journals for recording experiences
• Notes for keeping in touch
4
Introduction

5. Medhelp.org
“connects people with
the leading medical
experts and others who
have similar experiences”
“helping patients find
answers to their questions”
“helping patients actively
manage their health”
•Founded in 1994
•Oldest online community
•Pioneer of online health communities
•10 mil monthly visitors
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Introduction

6. Profile Page
•Forum: Public Q&A
•Journals: Diary Style
•Notes: Profile Posts
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Notes
Forum
Journal
Introduction

7. The Study
Research
Question
• What are the different levels of social
support across different CMC formats?
Objective
• Study the patterns of social support exchanges of
3 CMC formats:
• Forums, Journals, Notes
Approach
• Descriptive Content Analysis
• Coding: social support types for each message
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Introduction

8. Social Support Types
Information: expressions that can
directly help the situation
Advice suggests actions to deal with
situation
Fact reassesses the situation and
presents facts.
Personal
experience
stories about person’s
experiences or incidents as a
way of presenting information.
Opinion a view or judgment formed about
something, not necessarily based
on fact or knowledge
Referral refers the recipient to a resource
Nurturant: expressions that focus
on comfort of recipient
Esteem
positive comments intended to
praise support seekers abilities or
to alleviate their feelings of guilt.
Network
messages to help support seeker
from feeling alone.
Emotional
providing understanding of
situation, express sorrow, provide
with hope and confidence.
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Methods: Coding

9. Medhelp Alcoholism Community
Forums (n = 493)
• [FP] 81 posts
• [FC] 412 comments
Journals (n = 423)
• [JP] 88 posts
• [JC] 335 comments
Notes (n = 1180)
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Methods: Data

10. Support Offered
84.9%
82.1%
73.9%
67.0%
16.0%
57.5%
51.9%
92.0%
85.2%
82.7%
(n=1180) Notes
(n=335) JC
(n=88) JP
(n=412) FC
(n=81) FP
Informational Nurturant
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Informational > Nurturant
Informational < Nurturant
Divided btwn
Posts &
Comments
Results

11. Support Requested
1.4%
4.2%
36.4%
6.3%
44.4%
20.0%
8.4%
13.6%
15.5%
72.8%
(n=1180) Notes
(n=335) JC
(n=88) JP
(n=412) FC
(n=81) FP
Informational Nurturant
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Informational > Nurturant
Divided btwn
posts &
comments
Informational > Nurturant
Results

12. Key Findings
Forums
• Used for exchanging information
• Replies are more likely to request
information but offer nurturant support.
Journals
• Used by journal keeper to document
information and feelings
• Posts implicitly request nurturant support.
• Replies offer nurturant support.
Notes
• Used for keeping in touch, offering
nurturant support
• Seeks information, mostly of the form
“how are you?”
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Results

13. Part 2: Information Support in Forum
0.0%
12.4%
0.5%
1.9%
1.7%
4.9%
48.1%
1.2%
27.2%
16.0%
Fact
Personal
Opinion
Advice
Referral
Requested
FP (n = 81) FC (n=412)
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4.9%
64.8%
18.7%
32.5%
13.6%
0.0%
74.1%
33.3%
0.0%
0.0%
Fact
Personal
Opinion
Advice
Referral
Offered
FP (n = 81) FC (n = 412)
Results

14. Key Findings
Forums
• Used for exchanging information
• Replies are more likely to request
information but offer nurturant support.
Journals
• Used by journal keeper to document
information and feelings
• Posts implicitly request nurturant support.
• Replies offer nurturant support.
Notes
• Used for keeping in touch, offering
nurturant support
• Seeks information, mostly of the form
“how are you?”
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Results
Information
Nurturant

15. Public vs. Personal Space
Public Space = less intimate
Discussion Forum
Private Space = more intimate
Journals & Notes
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Discussion

16. Support Seeking Strategy
• Disclose personal experience (info) to get support
• Must be able to describe their problem
• Gain a sympathetic ear
• increases experience of intimacy
• Self-therapy
• Specific person instead of group
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Discussion

17. Maintaining Relationships
• Periodic, short interactions to keep in touch
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Discussion

18. Insights
• Supportive interactions will vary depending on space and
strength of relationship
• Forum = informational support > emotional support.
• Journal & notes = emotional support > informational support.
• Implications For Alcoholics:
• Anonymity + Accessibility = Less Stigma
• Peer communication can play a role in facilitating new health
habits, i.e, quitting smoking (Ancker et al, 2009).
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Discussion

19. Limitations
• Data limited to those publicly available
• Further work
• Intercoder Reliability
• Social Network Analysis (positional analysis)
• Compare to generic SNS (i.e. Facebook)
• Order of support exchanges
• i.e. is support offered as result of a specific request?
• Other variables
• i.e. gender, culture, intimacy, audience, age, and stigma
• Stage of information seeking process or phase of overcoming
alcoholism
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Discussion

20. THANK YOU!
Katherine Y. Chuang katychuang@drexel.edu
Christopher C. Yang ccy24@drexel.edu
http://www.slideshare.net/katychuang/helping-you-to-help-me
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