Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 16, 2021
Date Accepted: Oct 7, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Pragmatics to Reveal Intent in Social Media Peer Interactions: A Qualitative Inquiry
ABSTRACT
Background:
Online health communities have emerged as the leading venues for behavior change and health-related information seeking. The soul and success of these digital platforms lie in their ability to foster social togetherness and a sense of community by providing personalized support. However, we have a minimal understanding of how conversational posts in these settings lead to collaborative societies and ultimately result in positive health changes through social influence.
Objective:
Our objective is to develop a content-specific and intent-sensitive methodological framework for analyzing peer interactions in online health communities.
Methods:
We employed the Speech Act Theory to understand the manifestation of expressions in communications within online health communities for tobacco cessation and diabetes self-management. A total of 3011 randomly selected set of peer interactions (n=2005 from QuitNet [QN], n=1006 from American Diabetes Association support community [ADA]) were analyzed. We conducted a thematic analysis to identify communication themes and linguistic expressions (speech acts) embedded in the dataset. We also developed an empirical user persona based on their engagement levels and behavior profiles. Further, we have examined the association between speech acts and communication themes across observed tiers of user engagement and self-reported behavior profiles.
Results:
While social support, the most prevalent theme in both communities, was expressed in several subtle manners, the expression of emotions was higher in the tobacco cessation community, and assertions were higher in the diabetes self-management community. Specific theme-speech act relationships were revealed, such as social support theme was significantly associated (p< 0.05) with nine speech acts from a total of ten speech acts (i.e., assertion, commissive, declarative, desire, directive, expressive, question, stance, and statement) within the QN community; while only four speech acts (i.e., commissive, emotion, expressive, and stance) were significantly associated (p < 0.05) with the social support theme in the ADA community. The speech acts were also significantly associated with the users’ abstinence status within the QN community and with the users’ lifestyle status within the ADA community (p< 0.05).
Conclusions:
Such an overlay of communication intent implicit in online peer interactions alongside content-specific theory-linked characterizations of social media discourse can inform the development of effective digital health technologies in the field of health promotion and behavior change. Our analysis revealed a rich gradient of expressions across a standardized thematic vocabulary, with a distinct variation in emotional and informational needs depending on the behavioral and disease management profiles within and across the communities. This signifies the need and opportunities for coupling pragmatic messaging in digital therapeutics and care management pathways for personalized support.
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