Exploring the benefits and challenges of health professionals' participation in online health communities: Emergence of (dis)empowerment processes and outcomes

BACKGROUND Various online applications and service has led to the development of online health communities (OHCs), which in addition to the peer-to-peer communication offer patients and other users also interaction with health professionals. While the benefits and challenges of patients and other users' participation in OHCs have been extensively studied, a thorough examination of how health professionals as moderators (i.e., those who provide clinical expertise to patients and other users in OHCs) experience participation in OHCs is lacking. OBJECTIVE The aim of this study is to explore the main benefits and challenges of health professional moderators' participation in the OHCs. METHODS The study undertakes an exploratory qualitative study, with in-depth semi-structured interviews with health professional moderators (n=7) participating in the largest OHC in Slovenia, Med.Over.Net. The data was analysed using inductive thematic analysis approach and principles of grounded theory. RESULTS Four themes of health professional moderators' experiences were identified: (a) benefits of addressing OHC users' health-related needs, (b) challenges of addressing OHC users' health-related needs, (c) health professional moderators' benefits, and (d) health professional moderators' challenges. CONCLUSIONS This small study demonstrates that health professional participating in OHCs as moderators perceive themselves as facilitators of patients and other OHC's users empowering processes and outcomes, in which OHC's users improve their health literacy, develop skills, expand their social support, and gain other important resources necessary when dealing with health-related issues. Health professional moderator's role, however, also involves several duties, responsibilities and limitations that are often experienced as difficulties in providing patients and other users with adequate counselling and online medical service. OHCs also represent an important terrain for personal and professional empowerment of health professional moderators, although the presence of disempowering processes also needs to be noted.

[1]  M. Zimmerman Psychological empowerment: Issues and illustrations , 1995, American journal of community psychology.

[2]  C. V. van Uden-Kraan,et al.  Participation in online patient support groups endorses patients' empowerment. , 2009, Patient education and counseling.

[3]  John Suler,et al.  Fostering empowerment in online support groups , 2008, Comput. Hum. Behav..

[4]  G. Laverack Improving health outcomes through community empowerment: a review of the literature. , 2006, Journal of health, population, and nutrition.

[5]  John Suler,et al.  The Online Disinhibition Effect , 2004, Cyberpsychology Behav. Soc. Netw..

[6]  Anselm L. Strauss,et al.  Basics of qualitative research : techniques and procedures for developing grounded theory , 1998 .

[7]  Jina Huh,et al.  Weaving clinical expertise in online health communities , 2014, CHI.

[8]  W. Pratt,et al.  Managing the Personal Side of Health: How Patient Expertise Differs from the Expertise of Clinicians , 2011, Journal of medical Internet research.

[9]  A. Broom Virtually He@lthy: The Impact of Internet Use on Disease Experience and the Doctor-Patient Relationship , 2005, Qualitative health research.

[10]  Jing Zhao,et al.  Building Trusting Relationships in Online Health Communities , 2013, Cyberpsychology Behav. Soc. Netw..

[11]  N. Coulson,et al.  Are online support groups always beneficial? A qualitative exploration of the empowering and disempowering processes of participation within HIV/AIDS-related online support groups. , 2014, International journal of nursing studies.

[12]  Xiaoqian Jiang,et al.  Lessons Learned for Online Health Community Moderator Roles: A Mixed-Methods Study of Moderators Resigning From WebMD Communities , 2016, Journal of medical Internet research.

[13]  C. V. van Uden-Kraan,et al.  Self-Reported Differences in Empowerment Between Lurkers and Posters in Online Patient Support Groups , 2008, Journal of medical Internet research.

[14]  Jina Huh,et al.  Clinical Questions in Online Health Communities: The Case of "See your doctor" Threads , 2015, CSCW.

[15]  Daniel R. Fesenmaier,et al.  Assessing Motivation of Contribution in Online Communities: An Empirical Investigation of an Online Travel Community , 1998, Electron. Mark..

[16]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[17]  Kent Nakamoto,et al.  Patient behavior and the benefits of artificial intelligence: the perils of "dangerous" literacy and illusory patient empowerment. , 2013, Patient education and counseling.

[18]  Neil S. Coulson,et al.  Empowering processes in online support groups among people living with HIV/AIDS: A comparative analysis of 'lurkers' and 'posters' , 2010, Comput. Hum. Behav..

[19]  Paul Michael Di Gangi,et al.  Online health communities: An assessment of the influence of participation on patient empowerment outcomes , 2013, Inf. Technol. People.

[20]  Ann Bygholm,et al.  Narratives of empowerment and compliance: Studies of communication in online patient support groups , 2013, Int. J. Medical Informatics.

[21]  Gregor Petric,et al.  Differences in intrapersonal and interactional empowerment between lurkers and posters in health-related online support communities , 2014, Comput. Hum. Behav..

[22]  Virginia Braun,et al.  Successful Qualitative Research: A practical guide for beginners , 2013, QMiP Bulletin.

[23]  Keith Dowding,et al.  Encyclopedia of power , 2011 .

[24]  Neil S. Coulson,et al.  Nurturing health-related online support groups: Exploring the experiences of patient moderators , 2013, Comput. Hum. Behav..

[25]  G. Spreitzer PSYCHOLOGICAL EMPOWERMENT IN THE WORKPLACE: DIMENSIONS, MEASUREMENT, AND VALIDATION , 1995 .

[26]  Colleen Young,et al.  Community Management That Works: How to Build and Sustain a Thriving Online Health Community , 2012, Journal of medical Internet research.

[27]  Ray B. Jones,et al.  Online anonymous discussion between service users and health professionals to ascertain stakeholder concerns in using e-health services in mental health , 2013, Health Informatics J..

[28]  Sanjay T Menon,et al.  Toward a model of psychological health empowerment: implications for health care in multicultural communities. , 2002, Nurse education today.

[29]  Farah Ahmad,et al.  Are Physicians Ready for Patients With Internet-Based Health Information? , 2006, Journal of medical Internet research.

[30]  Yijun Li,et al.  How users adopt healthcare information: An empirical study of an online Q&A community , 2016, Int. J. Medical Informatics.

[31]  N. Coulson,et al.  Developing a model for online support group use, empowering processes and psychosocial outcomes for individuals living with HIV/AIDS , 2012, Psychology & health.

[32]  D. Nutbeam The evolving concept of health literacy. , 2008, Social science & medicine.

[33]  M. Minkler,et al.  Contributions of Community Involvement to Organizational-Level Empowerment: The Federal Healthy Start Experience , 2001, Health education & behavior : the official publication of the Society for Public Health Education.

[34]  Robert M. Anderson,et al.  Patient empowerment: myths and misconceptions. , 2010, Patient education and counseling.

[35]  David W. McDonald,et al.  Patient Moderator Interaction in Online Health Communities , 2013, AMIA.

[36]  Paul Kinnersley,et al.  Doctors'non-verbal behaviour in consultations: look at the patient before you look at the computer. , 2010, The British journal of general practice : the journal of the Royal College of General Practitioners.

[37]  A. Wilkinson,et al.  The Meaning of Empowerment: The Interdisciplinary Etymology of A New Management Concept , 2002 .

[38]  Elmer V. Bernstam,et al.  Social support in an Internet weight loss community , 2010, Int. J. Medical Informatics.

[39]  C. V. van Uden-Kraan,et al.  Patient-initiated online support groups: motives for initiation, extent of success and success factors , 2010, Journal of telemedicine and telecare.

[40]  Andraž Petrovčič,et al.  Factors of collective psychological empowerment of active users in the online health community med.over.net , 2014 .