Successful Moderation in Online Patient Communities: Inductive Case Study.
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ABSTRACT:
SUBMITTER: Skousen T
PROVIDER: S-EPMC7109609 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
Publications
Successful Moderation in Online Patient Communities: Inductive Case Study.
Skousen Tanner T Safadi Hani H Young Colleen C Karahanna Elena E Safadi Sami S Chebib Fouad F
Journal of medical Internet research 20200317 3
<h4>Background</h4>Online patient communities are becoming more prevalent as a resource to help patients take control of their health. However, online patient communities experience challenges that require active moderation.<h4>Objective</h4>This study aimed to identify the challenges of sustaining a thriving online patient community and the moderation practices employed to address the challenges and manage the online patient community successfully.<h4>Methods</h4>An inductive case study of Mayo ...[more]
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Project description:BackgroundIn China, the utilization of medical resources is tense, and most hospitals are highly congested because of the large population and uneven distribution of medical resources. Online health communities (OHCs) play an important role in alleviating hospital congestions, thereby improving the utilization of medical resources and relieving medical resource shortages. OHCs have positive effects on physician-patient relationships and health outcomes. Moreover, as one of the main ways for patients to seek health-related information in OHCs, physician-patient communication may affect patient compliance in various ways. In consideration of the inevitable development of OHCs, although they have several shortcomings, identifying how physician-patient communication can impact patient compliance is important to improve patients' health outcomes through OHCs.ObjectiveThis study aimed to investigate the impact of physician-patient communication on patient compliance in OHCs through the mediation of the perceived quality of internet health information, decision-making preference, and physician-patient concordance, using an empirical study based on the self-determination theory.MethodsA research model was established, including 1 independent variable (physician-patient communication), 3 mediators (perceived quality of internet health information, decision-making preference, and physician-patient concordance), 1 dependent variable (patient compliance), and 4 control variables (age, gender, living area, and education level). Furthermore, a Web-based survey involving 423 valid responses was conducted in China to collect data, and structural equation modeling and partial least squares were adopted to analyze data and test the hypotheses.ResultsThe questionnaire response rate was 79.2% (487/615) and the validity rate was 86.9% (423/487); reliability and validity are acceptable. The communication between physicians and patients in OHCs positively affects patient compliance through the mediation of the perceived quality of internet health information, decision-making preference, and physician-patient concordance. Moreover, physician-patient communication exhibits similar impacts on the perceived quality of internet health information, decision-making preference, and physician-patient concordance. Patients' decision-making preference shows the weakest impact on patient compliance compared with the other 2 mediators. Ultimately, all 3 mediators play a partially mediating role between physician-patient communication and patient compliance.ConclusionsWe conclude that physician-patient communication in OHCs exhibits a positive impact on patient compliance; thus, patient compliance can be improved by guiding physician-patient communication in OHCs. Furthermore, our findings suggest that physicians can share high-quality health information with patients, discuss benefits, risks, and costs of treatment options with patients, encourage patients to express their attitudes and participate in health-related decision making, and strengthen the emotional connection with patients in OHCs, thereby decreasing patients' misunderstanding of information and increasing concordance between physicians and patients. OHCs are required to not only strengthen the management of their published health information quality but also understand users' actual attitudes toward information quality and then try to reduce the gap between the perceived and actual quality of information.
| S-EPMC6535977 | biostudies-literature
Project description:BackgroundeHealth literacy is significantly associated with patients' online information behavior, physician-patient relationship, patient adherence, and health outcomes. As an important product of the internet, online health communities (OHCs) can help redistribute idle medical resources, increase medical resource utilization, and improve patient adherence. However, studies on eHealth literacy in OHCs are limited. Therefore, this study examined patients' eHealth literacy regarding health information-seeking behavior and physician-patient communication in OHCs.ObjectiveThis study aimed to investigate the association between eHealth literacy in OHCs and patient adherence by employing social cognitive theory.MethodsThis was an empirical study, in which a research model consisting of 1 independent variable (patients' eHealth literacy), 3 mediators (physician-patient communication in OHCs, patient health information-seeking behavior in OHCs, and patients' perceived quality of health information in OHCs), 1 dependent variable (patient adherence), and 4 control variables (age, gender, living area, and education level) was established to examine the associations. Multi-item scales were used to measure variables. An anonymous online survey involving 560 participants was conducted through Chinese OHCs in July 2018 to collect data. Partial least squares and structural equation modeling were adopted to analyze data and test hypotheses.ResultsThe survey response rate was 79.6% (446/560). The reliability, convergent validity, and discriminant validity were acceptable. Age, gender, living area, and education level were positively associated with patient adherence, and gender was positively associated with physician-patient communication and patients' perceived quality of internet health information in OHCs. Patients' eHealth literacy was positively associated with patient adherence through the mediations of physician-patient communication, internet health information-seeking behavior, and perceived quality of internet health information in OHCs.ConclusionsResults indicate that physician-patient communication, internet health information-seeking behavior, and the perceived quality of internet health information are significantly associated with improving patient adherence via a guiding of eHealth literacy in OHCs. These findings suggest that physicians can understand and guide their patients' eHealth literacy to improve treatment efficiency; OHCs' operators should this strengthen the management of information quality, develop user-friendly features, and minimize the gap between the actual and perceived information quality.
| S-EPMC8477298 | biostudies-literature
Project description:BackgroundThe use of online resources has changed how people manage health care processes. Patients seek information about health conditions, guidance in treatment, and support from peers online, complementary to traditional health care trajectories. Online communities have the potential to contribute to the quality of care by increasing patient empowerment; however, there is a gap in research regarding in what way online communities contribute to patient empowerment.ObjectiveWe synthesized research regarding how online communities contribute to patient empowerment to address the research question "In what ways can participation in online communities support patient empowerment?" by studying how patient empowerment is operationalized in different studies. The definition of patient empowerment used in this paper is enablement for people to develop mastery over actions and control over decisions that influence their lives. The mastery is both through processes and outcomes of the development.MethodsA systematic review was conducted by searching in the following databases: Scopus, ACM Digital Library, EBSCO (CINAHL and MEDLINE), PubMed, and Web of Science. In total, there were 1187 papers after excluding duplicates, and through selection processes using an analytical framework with definitions of patient empowerment and related concepts, 33 peer-reviewed papers were included.ResultsFindings indicated that online communities support patient empowerment both as a process and as outcomes of these processes. Additionally, it was seen as a complement to traditional health care and encouragement for health care professionals to have a more positive attitude toward patients' usage. There was a mix between deductive (19/33, 58%), inductive (11/33, 33%), and a mixed approach (3/33, 9%) of studying patient empowerment in various forms. The online communities in most papers (21/33, 64%) were well-established and represented patients' initiatives.ConclusionsThere is a need to include professionals' perspectives regarding how health care can embrace patient empowerment through online communities. This systematic review's main contribution is the proposal of a new framework and conceptualization of how patient empowerment in online communities can be understood from different hierarchical levels.
| S-EPMC7902187 | biostudies-literature
Project description:BackgroundThe proliferation of health misinformation on social media is a growing public health concern. Online communities for mental health (OCMHs) are also considered an outlet for exposure to misinformation. This study explored the impact of the self-reported volume of exposure to mental health misinformation in misinformation agreement and the moderating effects of depression literacy and type of OCMHs participation (expert vs. peer-led).MethodsParticipants (n = 403) were recruited in Italian-speaking OCMHs on Facebook. We conducted regression analyses using PROCESS macro (moderated moderation, Model 3). Measures included: the Depression Literacy Questionnaire (Griffiths et al., 2004), the self-reported misinformation exposure in the OCMHs (3 items), and misinformation agreement with the exposure items (3 items). Whether participants were members of expert or peer-led OCMHs was also investigated.ResultsThe final model explained the 12% variance in the agreement. There was a positive and significant relationship between misinformation exposure and misinformation agreement (β = 0.3221, p < .001), a significant two-way interaction between misinformation exposure and depression literacy (β = - 0.2179, p = .0014 ), and between self-reported misinformation exposure and type of OCMH (β = - 0.2322, p = .0254), such that at higher levels of depression literacy and in case of participation to expert-led OCMHs, the relationship misinformation exposure-misinformation agreement was weaker. Finally, a three-way interaction was found (β = 0.2497, p = .0144) that showed that depression literacy moderated the positive relationship between misinformation exposure and misinformation agreement such that the more misinformation participants were exposed to, the more they agreed with it unless they had higher levels of depression literacy; this, however, occurred only if they participated in peer-led groups.ConclusionsResults provide evidence that the more members reported being exposed to mental health misinformation, the more they tended to agree with it, however this was only visible when participants had lower depression literacy and were participating in peer-led OCMHs. Results of this study suggest that both internal factors (i.e., high depression literacy) and external factors (the type of online community individuals were participating in) can buffer the negative effects of misinformation exposure. It also suggests that increasing depression literacy and expert community moderation could curb the negative consequences of misinformation exposure related to mental health. Results will guide interventions to mitigate the effects of misinformation in OCMHs, including encouraging health professionals in their administration and implementing health education programs.
| S-EPMC10436646 | biostudies-literature
Project description:Online communities have become a tool for researchers to understand and help individuals with depression. According to their operation mode in terms of management, communities can be divided into management depression communities (MDCs) and lacking-management depression communities (LDCs). This study aimed to investigate the characteristics and impact of LDCs in comparison with MDCs. All postings from the previous year were collected from the LDC and MDC. Keywords were extracted and coded to identify the themes, and a text classifier was built to identify the type of emotions and social support expressed in the postings. Community members were then clustered to explore their different participation patterns. We found that in the LDC, the expression of negative emotions was the most popular theme, there was a lack of information about the treatment of depression and a lack of social support providers, the level of engagement of providers was low, and support seekers did not receive attention. These results reveal the need for community management and can be used to develop more effective measures to support members of online depression communities.
| S-EPMC7400076 | biostudies-literature
Project description:BACKGROUND:An online health community (OHC) is a novel sharing channel through which doctors share professional health care knowledge with patients. While doctors have the authority to protect their patients' privacy in OHCs, we have limited information on how doctors' privacy protection choices affect their professional health care knowledge sharing with patients. OBJECTIVE:We examined the relationship between privacy protection and professional health care knowledge sharing in OHCs. Specifically, we examined the effects of privacy protection settings in an OHC on doctors' interactive professional health care knowledge sharing and searching professional health care knowledge sharing (two dimensions of professional health care knowledge sharing). Moreover, we explored how such effects differ across different levels of disease stigma. METHODS:We collected the monthly panel data of 19,456 doctors from Good Doctor, one of the largest OHCs in China, from January 2008 to April 2016. A natural experimental empirical study with difference-in-difference analysis was conducted to test our hypotheses. The time fixed effect and the individual fixed effect were both considered to better identify the effects of a privacy protection setting on professional health care knowledge sharing. Additionally, a cross-sectional analysis was performed for a robust check. RESULTS:The results indicate that the privacy protection setting has a significant positive effect on interactive professional health care knowledge sharing (β=.123, P<.001). However, the privacy protection setting has a significant negative effect on searching professional health care knowledge sharing (β=-.225, P=.05). Moreover, we found that high disease stigma positively impacts the effect of privacy protection on interactive professional health care knowledge sharing (coefficients are in the same valence) and negatively impacts the effects of privacy protection on searching professional health care knowledge sharing (coefficients are in the reverse valence). CONCLUSIONS:Privacy protection has a bilateral effect on professional health care knowledge sharing (ie, a positive effect on interactive professional health care knowledge sharing and a negative effect on searching professional health care knowledge sharing). Such bilateral switches of professional health care knowledge sharing call for a balanced state in conjunction with practical implications. This research also identifies a moderate effect of disease stigma on privacy protection settings and professional health care knowledge sharing.
| S-EPMC7273234 | biostudies-literature
Project description:BackgroundTrust is widely recognized as a crucial factor in successful physician-patient communication and patient engagement in treatment. However, with the rise of eHealth technologies, such as online patient portals, the role of trust and the factors that influence it need to be reconsidered. In this study, we aim to identify the factors that contribute to trust in an eHealth service and we aim to identify the consequences of trust in an eHealth service in terms of use.MethodsThe Patient Trust Assessment Tool was provided to new outpatients of a rehabilitation center in the Netherlands, that were expected to use the center's online patient portal. Via this tool, we assessed five trust-related factors. This data was supplemented by questions about demographics (age, gender, rehabilitation treatment) and data about use (number of sessions, total time spent in sessions), derived from data logs. Data was analyzed via Partial Least Squares Structural Equation Modelling.ResultsIn total, 93 patients participated in the study. Out of these participants, 61 used the portal at least once. The measurement model was considered good. Trust in the organization was found to affect trust in the care team (β = .63), trust in the care team affected trust in the treatment (β = .60). Both, trust in the care team and trust in the treatment influenced trust in the technology (β = .42 and .30, respectively). Trust in the technology affected the holistic concept trust in the service (β = .78). This holistic trust in the service finally, did not affect use.ConclusionsThis study shows that the formation of this trust is not unidimensional, but consists of different, separate factors (trust in the care organization, trust in the care team and trust in the treatment). Trust transfer does take place from offline to online health services. However, trust in the service does not directly affect the use of the eHealth technology.
| S-EPMC8199797 | biostudies-literature
Project description:Bacterial community composition and its functional potential in Ulcerative colitis patients: A case study
| PRJEB64262 | ENA
Project description:BackgroundPheochromocytoma is a rare tumour producing catecholamines and has been more frequently reported than expected in patients with a Fontan physiology.Case summaryThe patient was a 39-year-old woman born with a univentricular atrioventricular connection and pulmonary valve stenosis. A Fontan operation was performed when she was 22 years old. At the age of 38, she was diagnosed with pheochromocytoma. The most serious problem was the increased occurrence of supraventricular arrhythmias, which easily caused heart failure. We decided to perform a laparoscopic resection. Postoperative recovery was good. There were no findings of malignancy and all postoperative catecholamine levels normalized. She was discharged home on the 14th day after the surgery, walking unaided.DiscussionDiagnosis and treatment by tumour resection in the early phase are crucial in patients who undergo the Fontan procedure. However, patients after Fontan surgery have a very low cardiac reserve. Thus, the decision to perform a surgical treatment is a very difficult one to take. In this case, fenestration had been naturally closed. As fenestration provides a consistent source of systemic ventricular preload, we performed transcatheter fenestration dilatation to improve heart failure management before surgical pheochromocytoma removal. Although laparoscopic surgery is generally considered to be less invasive, pneumoperitoneum may interfere with venous return in Fontan physiology patients. There is also a risk of thrombosis via fenestration. Here, we reported the case of a successful laparoscopic pheochromocytoma resection in an adult Fontan patient.
| S-EPMC9648512 | biostudies-literature
Project description:Many researchers and practitioners use online health communities (OHCs) to influence health behavior and provide patients with social support. One of the biggest challenges in this approach, however, is the rate of attrition. OHCs face similar problems as other social media platforms where user migration happens unless tailored content and appropriate socialization is supported. To provide tailored support for each OHC user, we developed personas in OHCs illustrating users' needs and requirements in OHC use. To develop OHC personas, we first interviewed 16 OHC users and administrators to qualitatively understand varying user needs in OHC. Based on their responses, we developed an online survey to systematically investigate OHC personas. We received 184 survey responses from OHC users, which informed their values and their OHC use patterns. We performed open coding analysis with the interview data and cluster analysis with the survey data and consolidated the analyses of the two datasets. Four personas emerged-Caretakers, Opportunists, Scientists, and Adventurers. The results inform users' interaction behavior and attitude patterns with OHCs. We discuss implications for how these personas inform OHCs in delivering personalized informational and emotional support.
| S-EPMC5268468 | biostudies-literature