What influences user participation in an online health community? The stimulus-organism-response model perspective
| DOI | https://doi.org/10.1108/AJIM-12-2021-0383 |
| Published date | 10 August 2022 |
| Date | 10 August 2022 |
| Pages | 364-389 |
| Subject Matter | Library & information science,Information behaviour & retrieval,Information & knowledge management,Information management & governance,Information management |
| Author | Peiyu Zhou,Shuping Zhao,Yiming Ma,Changyong Liang,Junhong Zhu |
What influences user participation
in an online health community?
The stimulus-organism-response
model perspective
Peiyu Zhou, Shuping Zhao, Yiming Ma, Changyong Liang and
Junhong Zhu
Hefei University of Technology, Hefei, China
Abstract
Purpose –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 onlinehealth communities(OHCs)) based on the stimulus-organism-response(S-O-R) model.
Design/methodology/approach –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.
Findings –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.
Originality/value –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.
Keywords Online health community, Media richness, Interactivity, Outcome expectation, User participation,
The stimulus-organism-response model
Paper type Research paper
1. Introduction
The World Health Organization (WHO) proposed a global strategy on digital health, aiming to
empowerpeople and achievethe vision of healthfor all through the application of digital health
technologies (WHO, 2021). Drivenby digitalhealth technologies,online medicalcare has become
a very important medical service model. It has changed the way people obtain medical resources
and is of great significance to the public’s health self-management. According to statistics, as of
June 2021, the number of online medical users in China had reached 239 million, accounting for
23.7% of total Internet users in China (CNNIC, 2021), which shows the huge development
potential of China’s online medical market. In particular, online health communities (OHCs) have
become a valuable platform for patients to use to seek health information, share medical and
AJIM
75,2
364
The authors thank Dr. Xie for her inspiration and discussion in topic selection and demonstration.
Funding: This work was supported by the Key Program of National Natural Science Foundation of
China (grant number: 72131006), the Key Program of National Social Science Foundation of China (grant
number: 21AZD116), Anhui Provincial Natural Science Foundation (grant number: 2208085MG182),
Fundamental Research Funds for the Central Universities (grant number: JZ2021HGTB0066).
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 19 December 2021
Revised 10 February 2022
25 June 2022
Accepted 10 July 2022
Aslib Journal of Information
Management
Vol. 75 No. 2, 2023
pp. 364-389
© Emerald Publishing Limited
2050-3806
DOI 10.1108/AJIM-12-2021-0383
treatment experience knowledge with others, and manage their health, with no temporal,
geographical or spatial limitations (Mirzaei and Esmaeilzadeh, 2021). In addition to the above
contributions, OHCs contribute to both individuals and society. For individuals, OHCs assist
patients in interacting with other members without barriers, build and enhance social
relationships and enable becoming part of a community (Gopalsamy et al.,2017;Yan and Tan,
2014). For society, OHCs narrow rural-urban health disparities via improving the health
capabilities ofunderprivilegedpeople (Goh etal., 2016) and can help alleviate hospital congestion
and integrate idle medical resources, which results in many health dividends to society.
However, despite the benefits that OHCs offer, OHCs still face the problems of low user
participation and low user stickiness; therefore, it is difficult to continuously promote user
health and conduct online treatments. Van found that more than 90% of OHC users are short-
term observers who merely browse for health information without posting content or
interacting with others, and OHCs face the problem of a high user drop-out rate, which
hinders the continuous development of OHCs and also hinders users from obtaining more
high-quality health information and treatment experiences (Van Mierlo, 2014). Therefore,
how to encourage users to actively participate in OHCs and increase user stickiness is an
urgent problem to be solved (Mirzaei and Esmaeilzadeh, 2021).
Most of the previous studies on user participation in OHCs have discussed its key
antecedents, and the existing studies have mainly discussed from the following two
perspectives. The first perspective is personal-related factors. It believes that personal-related
factors such as internal motivation and external motivation (Imlawi and Gregg, 2020;Zhang,
2016;Oh, 2012), individual needsat different levels(Sharma and Khadka, 2019;Yan et al., 2016)
and personality traits (Moqbel et al., 2020) are important antecedents for user participation in
OHCs. The second perspective is social-related factors. It believes that social-related factors such
as social support (Song et al.,2018;Liu et al., 2020;Atanasova et al., 2018;Mirzaei and
Esmaeilzadeh, 2021;Wang et al.,2021), social capital (Li et al., 2021a;Zhou, 2020;Zhao et al., 2016)
and trust (Zhou, 2020;Zhao et al.,2016)ar ei mportantantecede ntsfor user particip ationin OHCs.
The previous literature provides a theoretical foundation to understand user participation
in OHCs from the perspective of personal-related factors and social-related factors. However,
few studies have considered the important perspective of platform characteristics, and fewer
studies have combined platform characteristics and individual cognitive factors to explore
the influence mechanism of user participation in OHCs. In the context of social media,
platform characteristics (such as media richness and interactivity) make it easier for users to
interpret and assimilate information (Maity et al., 2018), to interact with each other and to
manipulate the content (Xue et al., 2020). Therefore, the two platform characteristics of media
richness and interactivity can well meet users’needs for information acquisition, social
interaction and building social relationships (Chen and Chang, 2018;Shao and Pan, 2019;
Zhao and Lu, 2012;Zhang et al., 2014;Lin and Chang, 2018) and further affect user
participation in social media (such as WeChat, SinaWeibo, Facebook, etc.) (Shao and Pan,
2019;Zhao and Lu, 2012;Zhang et al., 2014;Lin and Chang, 2018). In the context of OHCs, the
OHC also provides users with rich health information resources and interaction channels, the
two platform characteristics of media richness and interactivity could be critical factors that
may have an impact on user participation in OHCs. Therefore, this paper will study the
antecedents of user participation in OHCs from the perspective of platform characteristics.
In the context of OHCs, the main needs of users include obtaining a large amount of health
information and interacting with other OHC members to establish social relationships (Yan
et al., 2016). Since high media richness and interactivity can, respectively, provide rich
information and good interpersonal interactions, this paper believes that these two important
characteristics of the OHC platform (media richness and interactivity) can, respectively, meet
the information needs and social needs of users and will have an important impact on user
participation in OHCs.
User
participation in
OHCs
365
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