Unconscious or conscious? The impacts of habit and social support receipt on older adults' continued participation in online health communities
| DOI | https://doi.org/10.1108/AJIM-08-2021-0223 |
| Published date | 19 January 2022 |
| Date | 19 January 2022 |
| Pages | 688-709 |
| Subject Matter | Library & information science,Information behaviour & retrieval,Information & knowledge management,Information management & governance,Information management |
| Author | Dan Ma,Meiyun Zuo |
Unconscious or conscious? The
impacts of habit and social support
receipt on older adults’continued
participation in online
health communities
Dan Ma and Meiyun Zuo
School of Information, Research Institute of Smart Senior Care,
Renmin University of China, Beijing, China
Abstract
Purpose –Online health communities (OHCs) can be complementary to healthcare systems to improve the
health behaviors of older adults with chronic diseases. This study aims to examine the impacts of habit and
social support receipt on older adults’continued participation in OHCs. Particularly, the authors discussed the
influences of social support received in two ways: social support received by initiating threads (direct social
support receipt) and social support received by being exposed to the threads initiated by others (indirect social
support receipt).
Design/methodology/approach –Based on the dual-process model (i.e. conscious process and unconscious
process), the authors developed the research model. Data from one of the biggest online diabetes communities
in Europe were collected. Besides, we used the support vector machine algorithm for social support
classification and used the Cox proportion hazards model for model validation.
Findings –Older adults’continued participation is influenced by habit and indirect informational support.
Habit moderates the relationship between direct informational support receipt and older adults’continued
participation. Furthermore, direct and indirect emotional support receipt are both not associated with older
adults’continued participation, regardless of their habit strength.
Originality/value –This is the first study investigating older adults’continued participation in OHCs based
on the dual-process model. The findings of this study reveal that older adults’continued participation is
determined by both the habit and specific conscious evaluation of benefits based on the social support receipt.
Keywords Online health communities, Continued participation, Older adults, Social support receipt
Paper type Research paper
1. Introduction
Population aging is one of the most significant trends in the 21st century (Kamiya et al.,2020).
According to the data of World Population Ageing 2020, there were an estimated 727 million
persons aged 65 years and above worldwide, accounting for 9.3% of the global population
(Kamiya et al., 2020). Meanwhile, the popularity of the internet makes older adults start to
embrace digital life. In 2021, the Pew Research Center pointed out that 75% of adults aged 65 and
aboveintheUSAwereonline(Anderson and Sara, 2021). Data from the community survey on
information and communications technology (ICT) usage in households and by individuals
reported that 61% of Europeans aged 65–74 used the internet in 2020 (Eurostat, 2021). The
intersection of aging and digitalization calls the researchers to understand the technology
adoption and continued use of older adults for older adults’well-being (Marston and
Musselwhite, 2021).
Aging brings a higher risk of chronic diseases such as diabetes, cancer, hypertension that
need longitudinal healthcare and require patients’self-management (Kennedy et al., 2014).
AJIM
74,4
688
The authors would like to acknowledge the partial financial support from the Fundamental Research
Funds for the Central Universities and the Research Funds of Renmin University of China (Grant No.
21XNL018) and the National Natural Science Foundation of China (Grant No. 71771210).
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/2050-3806.htm
Received 11 August 2021
Revised 25 November 2021
Accepted 2 January 2022
Aslib Journal of Information
Management
Vol. 74 No. 4, 2022
pp. 688-709
© Emerald Publishing Limited
2050-3806
DOI 10.1108/AJIM-08-2021-0223
Social support is critical for the improvement of chronic disease self-management, especially
for the improvement of diabetes self-management (Gallant, 2003). Particularly, peers with
similar health problems can offer specific disease-related advice and engage in self-
management activities (e.g. exercise) with the patients (Gallant, 2003). The development of
information technologies such as Web 2.0 provides older adults with new channels to obtain
social support (Stellefson et al., 2013). Online health communities (OHCs) that consist of
individuals with similar interests on one or multiple health issues have attracted the attention
of older adults (Stellefson et al., 2013). Social support exchange is the essential function of
OHCs (Liu et al., 2020b). OHCs allow the users to obtain social support without the constraints
of time and geographical location (Wang et al., 2021).
Continued participation is essential for users to benefit from OHCs (Li and Yan, 2020).
In general, users who have been in the OHCs for a longer time are more rational and
analytical, and can better benefit from the health information in OHCs and further improve
their health behaviors than novices (Li and Yan, 2020). Continued participation in OHCs can
also change users’health attitudes. Zhang et al. (2014) pointed out that the longer users join
the OHC, the more positive their emotion is. For older adults, they can acquire increased
health knowledge and improved self-care abilities, and engage in emotional support to
mitigate negative feelings in self-management through participating in OHCs (Litchman
et al., 2018).
Moreover, similar to other online communities, OHCs operate on the basis of users’
collected wisdom; hence, users are the important sources of resources (Young, 2013). Lasting
relationship between users and OHCs is a key to the success of OHCs (Young, 2013). Users
who continue to participate tend to have high community commitment and are willing to
contribute to the online communities (Bateman et al., 2011). Older adults are likely to be a
primary user group of OHCs as they are at high risks of chronic diseases (Stellefson et al.,
2013;Kennedy et al., 2014). Understanding the factors affecting older adults’continued
participation is benefit for their self-management and necessary for the healthy development
of OHCs.
Information technology/information systems (IT/IS) continued use model suggests that
users’perception about the usefulness of IT in facilitating the achievement of various benefits
determines users’continued use (Bhattacherjee, 2001;Zhao et al., 2013). This perception is
often derived from the outcomes of past experiences (Bhattacherjee, 2001). Specifically, the
perceived benefit may be significant for older adults because most of their IT/IS use results
from “benefit-driven”selectivity (Melenhorst et al., 2006;Lee and Coughlin, 2015). Compared
with the young group, the IT/IS use of older adults depends more on the benefits they can
obtain rather than the cost or other factors (e.g. availability) (Melenhorst et al., 2006).
Users can benefit from the OHCs through exchanging social support rather than obtaining
enjoyment or economic reward (Liu et al., 2020b). For older adults, seeking social support from
peers is the most important reason for joining the OHCs (Litchman et al., 2018;Lewis et al.,
2018). Users in OHCs can seek social support through initiating threads or being exposed to
the threads initiated by other users (Liu et al., 2020a). The social support received by these two
ways is referred to as direct social support receipt and indirect social support receipt
(Wang et al., 2017). Following the logic of the wanting–liking model (Litman, 2010), users
seeking social support via initiating threads in OHCs often depend on the wanting route and
expect to gain particular information and relief from uncertainty. It is goal-directed and a type
of purposeful social support seeking (Liu et al., 2020a). Social support received via initiating
threads is often customized to users’needs. By directly receiving social support from others,
users can not only obtain health-related information, suggestions and experiences, but also
feel encouraged, supported or cared for (Chen et al., 2019;Litchman et al., 2018).
Social support received indirectly may not be necessary for users to cope with the
problems and negative feelings in self-management (Liu et al., 2020a). However, being
Older adults’
continued
participation in
OHCs
689
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